RESUMO
BACKGROUND: Suboptimal prescribing and medications use is a problem for health systems globally. Systematic reviews are a comprehensive resource that can help guide evidence-informed decision-making and implementation of interventions addressing such issues; however, a barrier to the use of systematic reviews is their inaccessibility (due to both dispersion across journals and inaccessibility of content). Publicly available databases, such as Rx for Change, provide quick access to summaries of appraised systematic reviews of professional and consumer-oriented interventions to improve prescribing behaviour and appropriate medication use, and may help maximise the use of evidence to inform decisions. The present study aims to evaluate a training program to improve attitudes towards, confidence in skills, intentions to use, and use of systematic review evidence contained within Rx for Change. METHODS: Guided by the Knowledge to Action framework, a training program with content customised to local provider and consumer contexts was developed with knowledge user input. The training program consisted of a 6 minute information video, a 1 hour workshop with hands-on, interactive and didactic components, and two post-training reminders. Forty-nine people from five medicines-focused organisations in Canada and Australia attended one of six workshops. Participants were surveyed immediately pre and post and 3 months after training to evaluate their attitudes towards, confidence in skills, intentions to use, and use of Rx for Change, and attitudes towards and confidence in skills for using evidence for decision-making. Analyses for differences for each of the outcomes at three time points (pre, post and 3 months after training) was performed using a random effects model. RESULTS: Immediately post-training, there were higher respondent attitudes towards Rx for Change (mean increase = 0.54 out of 5, 95% CI, 0.18-0.83, P < 0.005); intention to use Rx for Change (0.53, 95% CI, 0.21-0.86, P < 0.005); confidence in skills for using Rx for Change (2.08, 95% CI, 1.74-2.42, P < 0.005); and confidence in skills for using evidence in policy decision-making (0.50, 95% CI, 0.22-0.77, P < .005) compared to pre-training. Confidence in skills for using both Rx for Change and evidence were maintained 3 months after training (both P < 0.005). CONCLUSIONS: Participants of this training program reported sustained improvements in their confidence in skills for using evidence in policy decision-making. This may have important implications for uptake of systematic review evidence promoting improved prescribing and medication use.
RESUMO
A headspace solid-phase microextraction (HS-SPME) combined with gas chromatography-mass spectrometry (GC/MS) method was developed to quantify lemon oil components and their degradation products in oil-in-water (O/W) emulsions prepared with sodium caseinate-heated-lactose (NaC-T + Lact) glycoconjugates as wall materials at two pH values (3.0 and 6.8). NaC-T + Lact conjugates had a significantly lower solubility at both pHs. Hydrolysis prior to glycation enhanced the solubility of glycoconjugates. Glycation with lactose did not improve the emulsion activity of NaC, while caseinate glycoconjugates showed much stronger antioxidant activity than the NaC-control sample. This might be due to the presence of melanoidins formed between the sugar and amino acid compounds as supported by the increase in browning intensity. Among the SPME-fibres tested, carboxen/polydimethylsiloxane (CAR/PDMS) provided better results in terms of sensitivity and selectivity for oil lemon components and their degradation products. Storage studies of these emulsions demonstrated that glycated NaC-T + Lact showed protection against peroxidation compared to the control. However, acidic pH conditions altered their stability over storage time. The major off-flavor components (α-terpineol and carvone) were inhibited in emulsions stabilized with glycated NaC, particularly at pH 6.8. The use of NaC-T + Lact conjugates showed improved encapsulation efficiency and stability and could be used as potential food ingredient-emulsifiers for stabilising citrus oils against oxidative degradation in food and beverage applications.
