Need For Definition Research Articles

An epidemiological study on early orthodontic treatment need among eastern Saudi Arabian children in the mixed dentition stage.

Estimation of early orthodontic treatment need among children is essential for planning orthodontic interventions in the mixed dentition stages thereby reducing the burden in a publicly funded healthcare system. The present study aimed to assess the early orthodontic treatment need among children with mixed dentition in the Eastern Saudi Arabia. A descriptive cross-sectional study was conducted among Saudi children visiting the outpatient clinics in a University dental setting, and data were collected based on Index for preventive and interceptive orthodontic need (IPION). Descriptive statistics, chi-square test and Fisher's exact test were used for data analysis with statistical significance set at p < 0.05. The category of 'no treatment need' accounted for 11.3% while 'moderate treatment need' and 'definite treatment need' categories accounted for 29.3% and 59.4% respectively. There was no statistical difference between males and females in the distribution of the three categories of treatment need (p = 0.513). This study demonstrated a very high need for early orthodontic treatment among Saudi children in the mixed dentition stage. Emphasis should be placed on increased awareness and benefits of seeking early orthodontic treatment involving preventive and interceptive procedures in the mixed dentition.

Evaluation of Dry Eye Severity and Ocular Surface Inflammation in Patients with Autoimmune Rheumatic Diseases

ABSTRACT Purpose To evaluate dry eye severity and ocular surface inflammation in autoimmune rheumatic diseases (ARDs). Methods Seventy-nine patients with ARDs were enrolled, including 26 patients with rheumatoid arthritis (RA), 33 patients with systemic lupus erythematosus (SLE), and 20 patients with primary Sjögren’s syndrome (pSS). All patients underwent ocular surface evaluations, including ocular surface symptoms, signs, conjunctival impression cytology, and tear multicytokine detection. Systemic conditions, including disease duration, disease activity, and serological parameters, were also noted. Results SLE patients had the shortest disease duration, and nearly half of them had low disease activity, while RA patients and pSS patients had a relatively long disease duration, and approximately 90% of them had moderate or high disease activity. The incidence of dry eye and the levels of the proinflammatory tear cytokines in SLE were significantly lower than those in RA and pSS. However, ocular surface squamous metaplasia was more severe in SLE and pSS than in RA. Dry eye severity in all ARD patients was shown to be independent of disease activity, while Nelson’s grades were positively correlated with disease duration in RA patients. Disease-related serological parameters were associated with tear proinflammatory cytokines in all ARD patients. Conclusions Variable degrees of dry eye and immune-mediated ocular surface inflammation persist in different ARD patients. In addition to a well-known association between dry eye and pSS, dry eye is also commonly observed in SLE and RA patients. Therefore, there is a definite need for regular ophthalmologic evaluations and topical medications in all patients with ARDs.

Evaluation of orthodontic treatment need in school children of shimla using index of orthodontic treatment need

: The objective of this survey was to assess the orthodontic treatment need in school children of Shimla aged 12-16 years using Index of orthodontic treatment need.The study included 576 children studying in Shimla, Himachal Pradesh, India who were assessed for orthodontic treatment need using IOTN and results were expressed in percentages. The difference in orthodontic treatment need for males and female and the orthodontist and subjects perception of orthodontic treatment need was calculated by χ² test. Pearson’s correlation assessed the correlation between the Dental Health Component and Aesthetic Component of IOTN. 10.7% (62) of the children had definite need for orthodontic treatment (AC) while 31.9% (184) had definite need for orthodontic treatment (DHC) with statistically insignificant difference between male and female. The difference between orthodontist perception of treatment need and that of subject was statistically significant. A strong and positive correlation between DHC and AC of IOTN was found which was statistically significant.31.9% (184) and 10.8% (62) of the schoolchildren had definite need for orthodontic treatment according to the dental health component and aesthetic component of index of orthodontic treatment need respectively. 49.7% (286) of the subjects had knowledge about orthodontic treatment. 45.8% (264) of the subjects expressed desire to undergo orthodontic treatment. Orthodontist was more critical in aesthetic evaluation as compared to the schoolchildren.

Vaginal Stenosis After Gender-affirming Vaginoplasty: A Systematic Review

To review the literature and report the incidence of vaginal stenosis (VS) after vaginoplasty and compare the incidence rates by surgical technique and follow-up duration. We performed a systematic literature review according to PRISMA guidelines. Original research on primary vaginoplasty was included. Exclusion criteria included non-English studies, mixed cohorts without subgroup analysis, revision vaginoplasty, and papers without stenosis rates. The search was ran in Pubmed, Embase, Scopus, and Cochrane on September 9, 2022. Stenosis rates were compared with descriptive statistics using SPSS. Fifty-nine studies with a cumulative 7338 subjects were included. The overall incidence of VS was 5.83% (range 0%-34.2%). Combining VS with introital stenosis (IS) and contracture results in a cumulative incidence of 9.68%. The rate of VS in the penile inversion vaginoplasty subgroup (PIV) was 5.70%, compared to 0.20% in primary intestinal vaginoplasty. The rate of IS in the PIV group was 3.13% and 4.7% in the intestinal vaginoplasty subgroup. The overall rate of VS was 5.83%, which is lower than previously documented. This may be related to the inclusion of more recent studies and analysis limited to primary vaginoplasty. The similar rate of IS in PIV and intestinal vaginoplasty subgroups may be secondary to multiple suture lines and the need for dilation through this anastomosis. Our research demonstrates a need for a standardized definition of VS.

Rethinking the boundaries of cause-related marketing: Addressing the need for a new definition

Rethinking the boundaries of cause-related marketing: Addressing the need for a new definition

Towards a patient-centred definition for atopic dermatitis flare: a qualitative study of adults with atopic dermatitis.

The term 'flare' is used across multiple diseases, including atopic dermatitis (AD), to describe increased disease activity. While several definitions of an AD flare have been proposed, no single definition of AD flare is widely accepted and it is unclear what the term 'AD flare' means from the patient perspective. To understand AD flares from the adult patient perspective and to explore how adults with AD define an AD flare. Participants were adults with AD recruited from the National Eczema Association Ambassadors programme, a volunteer patient-engagement programme. They participated in online focus groups to discuss how they describe AD flares from their perspective, how they define its start and stop, and how they relate to existing definitions of flare. Using a grounded theory approach, transcripts were analysed and coded using an iterative process to identify concepts to support a patient-centred conceptual framework of 'flare'. Six 90-min focus groups of 3-8 participants each were conducted with 29 US adults (≥ 18 years of age) with AD who had at least one self-reported AD flare in the past year. When participants were presented with examples of previously published definitions of AD flare, participants found them problematic and unrelatable. Specifically, they felt that flare is hard to quantify or put on a numerical scale, definitions cannot solely be about skin symptoms and clinical verbiage does not resonate with patients' lived experiences. Concepts identified by patients as important to a definition of flare were changes from patient's baseline/patient's normal, mental/emotional/social consequences, physical changes in skin, attention needed/all-consuming focus, itch-scratch-burn cycle and control/loss of control/quality of life. Figuring out the trigger that initiated a flare was an underlying concept of the experience of flare but was not considered a contributor to the definition. The results highlight the complexity and diversity of AD flare experiences from the adult patient perspective. Previously published definitions of AD flares did not resonate with patients, suggesting a need for a patient-centred flare definition to support care conversations and AD management.

A systematic review of literature examining the application of a social model of health and wellbeing.

Following years of sustained pressure on the UK health service, there is recognition amongst health professionals and stakeholders that current models of healthcare are likely to be inadequate going forward. Therefore, a fundamental review of existing social models of healthcare is needed to ascertain current thinking in this area, and whether there is a need to change perspective on current thinking. Through a systematic research review, this paper seeks to address how previous literature has conceptualized a social model of healthcare and, how implementation of the models has been evaluated. Analysis and data were extracted from 222 publications and explored the country of origin, methodological approach, and the health and social care contexts which they were set. The publications predominantly drawn from the USA, UK, Australia, Canada and Europe identified five themes namely: the lack of a clear and unified definition of a social model of health and wellbeing; the need to understand context; the need for cultural change; improved integration and collaboration towards a holistic and person-centred approach; measuring and evaluating the performance of a social model of health. The review identified a need for a clear definition of a social model of health and wellbeing. Furthermore, consideration is needed on how a model integrates with current models and whether it will act as a descriptive framework or, will be developed into an operational model. The review highlights the importance of engagement with users and partner organizations in the co-creation of a model of healthcare.

Fresh Parent's Own Milk for Preterm Infants: Barriers and Future Opportunities.

While direct at-the-breast feeding is biologically optimal, Neonatal Intensive Care Unit (NICU) admission due to infant immaturity or illness often necessitates the expression and storage of parent's milk. The provision of freshly expressed (never stored) parent's own milk to preterm infants is not widely prioritized, and this article provides an exploration of NICU practices and their implications for feeding premature or ill infants with parent's own milk. In this article, we discuss the potential biological benefits of fresh parent's own milk, highlighting its dynamic components and the changes incurred during storage. Research suggests that fresh milk may offer health advantages over stored milk. The authors advocate for further research, emphasizing the need for standardized definitions. Research is needed on the biological impact of fresh milk, both short- and long-term, as well as defining and understanding healthcare economics when using fresh milk.

Defining digital nursing.

The use of technology in health care, including nursing, is growing, owing in part to the COVID-19 pandemic and in response to national policy. To investigate nurses' perceptions of digital nursing (DN). Community and primary care nurses from across Wales were recruited (n=249) through a survey comprising open and closed questions. This was supplemented with semistructured interviews (n=25). Thematic analysis was used to analyse qualitative data. Nurses had a broad range of perspectives on what DN meant, with four main themes being identified: access; impact on care; technology; and digital future. The positive impacts of DN on ways of working and patient outcomes were supported by answers to closed survey questions. Many nurses understand the value of digital tools within nursing and are clear about their benefits for patients, nurses and multiprofessional teams. However, there is a need for a clear definition and increased awareness of DN.

Invasive device-associated skin complications and mechanical dysfunctions in paediatric healthcare: A systematic review and meta-analysis.

This study aimed to estimate the proportion and rate of skin complications and mechanical dysfunction associated with indwelling invasive devices in paediatric healthcare. This systematic review is reported in accordance with Cochrane standards for randomized controlled trials and the Meta-analysis of Observation Studies in Epidemiology for cohort studies. MEDLINE, CINAHL, Embase, Web of Science, Scopus, Cochrane CENTRAL, clinical trial registries, and unpublished study databases were searched. Cohort studies and trials published from January 2011 to June 2022, including (1) indwelling invasive devices, (2) paediatric participants admitted to a hospital, (3) reporting post-insertion device-associated skin complication and/or mechanical dysfunction, and (4) published in English, were included. Device-associated skin complication and mechanical dysfunction (infiltration, leakage, occlusion/blockage, dislodgement/malposition, breakage and others). Pooled proportion and incidence rate per 1000 device days are reported. This review synthesized 114 studies (30,782 devices; 1,635,649 device-days). Skin complications were reported in 40 studies, but none exclusively reported individual device-related pressure injuries. Mechanical dysfunctions were well-reported for central venous access devices, peripheral intravenous catheters, nasogastric/gastric tubes and peritoneal dialysis catheters but less for arterial catheters, extracorporeal membrane oxygenation and ventricular assist devices. This systematic review highlights the need for standardized definitions and reporting methods to better surveil and benchmark device-related complications, particularly for understudied device types. Device-related pressure injuries were not reported in any of the included studies, and all devices except for vascular access devices require standardized reporting of complications. Despite the widespread use of invasive devices, comprehensive data on their prevalence, utility, and associated paediatric complications is limited. This review identified prevalent skin complications, occlusions and dislodgments in children with devices, underscoring the need for standardized reporting to enhance surveillance and understanding of paediatric device-related complications. MOOSE (Meta-analyses Of Observational Studies in Epidemiology) Checklist. No Patient or Public Contribution.

Defining a Lewy Body: Running Up the Hill of Shifting Definitions and Evolving Concepts.

Lewy bodies (LBs) are pathological hallmarks of Parkinson's disease and dementia with Lewy bodies, characterized by the accumulation of α-synuclein (αSyn) protein in the brain. While LBs were first described a century ago, their formation and morphogenesis mechanisms remain incompletely understood. Here, we present a historical overview of LB definitions and highlight the importance of semantic clarity and precise definitions when describing brain inclusions. Recent breakthroughs in imaging revealed shared features within LB subsets and the enrichment of membrane-bound organelles in these structures, challenging the conventional LB formation model. We discuss the involvement of emerging concepts of liquid-liquid phase separation, where biomolecules demix from a solution to form dense condensates, as a potential LB formation mechanism. Finally, we emphasize the need for the operational definitions of LBs based on morphological characteristics and detection protocols, particularly in studies investigating LB formation mechanisms. A better understanding of LB organization and ultrastructure can contribute to the development of targeted therapeutic strategies for synucleinopathies.

The Scope of Precision Medicine in Management of Type 2 Diabetic Patients with Hypertension

There is an exponential increase in prevalence of diabetes and hypertension worldwide and more so in India, and despite of numerous state and national awareness programs and evidence-based approach in management of these diseases, the burden of mortality and morbidity, instead of decreasing, has been rapidly climbing upwards. Hence, there is definite need of precision medicine approach, even though the pathway would be challenging, can provide more precise treatment to an individual based on his/her genetic, phenotypic, and metabolic make up.

Subtle variation in sepsis-III definitions markedly influences predictive performance within and across methods

Early detection of sepsis is key to ensure timely clinical intervention. Since very few end-to-end pipelines are publicly available, fair comparisons between methodologies are difficult if not impossible. Progress is further limited by discrepancies in the reconstruction of sepsis onset time. This retrospective cohort study highlights the variation in performance of predictive models under three subtly different interpretations of sepsis onset from the sepsis-III definition and compares this against inter-model differences. The models are chosen to cover tree-based, deep learning, and survival analysis methods. Using the MIMIC-III database, between 867 and 2178 intensive care unit admissions with sepsis were identified, depending on the onset definition. We show that model performance can be more sensitive to differences in the definition of sepsis onset than to the model itself. Given a fixed sepsis definition, the best performing method had a gain of 1–5% in the area under the receiver operating characteristic (AUROC). However, the choice of onset time can cause a greater effect, with variation of 0–6% in AUROC. We illustrate that misleading conclusions can be drawn if models are compared without consideration of the sepsis definition used which emphasizes the need for a standardized definition for sepsis onset.

Presbyphagia: A Conceptual Analysis of Contemporary Proposals and Their Influences on Clinical Diagnosis.

Swallowing is an essential process to maintain homeostasis in the human body. With aging, changes occur in both central and peripheral structures, giving rise to presbyphagia, involving morphological and functional alterations in swallowing. However, there is a lack of consensus on the definition of presbyphagia and its relationship with dysphagia. The primary objective of this research is to analyze the proposed definitions for the term "presbyphagia" in specialized literature and, secondarily, to assess how these definitions can influence the diagnosis of oropharyngeal dysphagia (OD). A systematic review was conducted to analyze the proposed definitions of presbyphagia and their impact on dysphagia diagnosis. Three main approaches to the definitions of presbyphagia were identified: (1) presbyphagia as an alteration in the swallowing process in healthy older adults, (2) presbyphagia as a swallowing disorder compensated by the physiological potential of healthy older adults, and (3) presbyphagia as a synonym for dysphagia. This study addresses the need for a clear definition of presbyphagia in older adults. It is concluded that presbyphagia should be understood as the etiology of OD rather than a compensated disorder or a synonym. This has significant implications for the diagnosis and treatment of swallowing disorders in the aging population. Given the ongoing nature of scientific discussion in this field, further research is required.

The need for a consensual definition of mental health.

The need for a consensual definition of mental health.

Structuring Interdigitated Back Contact Solar Cells Using the Enhanced Oxidation Characteristics Under Laser‐Doped Back Surface Field Regions

Interdigitated back contact (IBC) architecture can yield among the highest silicon wafer‐based solar cell conversion efficiencies. Since both polarities are realized on the rear side, there is a definite need for a patterning step. Some of the common patterning techniques involve photolithography, inkjet patterning, and laser ablation. This work introduces a novel patterning technique for structuring the rear side of IBC solar cells using the enhanced oxidation characteristics under the locally laser‐doped n++ back surface field (BSF) regions with high‐phosphorous surface concentrations. Phosphosilicate glass layers deposited via POCl3 diffusion serve as a precursor layer for the formation of local heavily laser‐doped n++ BSF regions. The laser‐doped n++ BSF regions exhibit a 2.6‐fold increase in oxide thickness compared to the nonlaser‐doped n+ BSF regions after undergoing high‐temperature wet thermal oxidation. The utilization of oxide thickness selectivity under laser‐doped and nonlaser‐doped regions serves two purposes in the context of the IBC solar cell, first patterning rear side and second acting as a masking layer for the subsequent boron diffusion. Proof‐of‐concept solar cells are fabricated using this novel patterning technique with a mean conversion efficiency of 20.41%.

Definition of Needs and Requirements for an Accessible Cabin on Regional Aviation

Definition of Needs and Requirements for an Accessible Cabin on Regional Aviation

Strengthening Workplace Learning in Medical and Health Profession Education: Medical Educators’ Perspective

Abstract The profession of medicine is a challenging one considering the pace with which medical knowledge continues to expand on a daily basis. The purpose of the current review was to explore the significance of workplace learning from the perspective of different stakeholders. An extensive search of all materials related to the topic was carried out on the PubMed and Google Scholar search engines, and a total of 26 articles were selected based on their suitability with the current review objectives. Keywords used in the search include workplace learning and medical education in the title alone only. The workplace offers an opportunity for medical students to apply their acquired knowledge and participate in the process of patient care. Workplace learning gives a platform for medical students to not only participate in patient care but also gradually move forward on the path to becoming an effective member of the health workforce. We must realize that it is not only the students who derive benefits from workplace learning but also the teachers who can optimize their teaching and facilitation skills. To conclude, acknowledging the scope and merits attributed to workplace learning for different stakeholders, there is a definitive need to strengthen the overall process. Medical teachers have a crucial role to play in the strengthening and reinforcement of workplace learning in different contexts, and thus, they should be supported in their task to eventually improve the quality of medical doctors that we are producing.

PROBLEMS OF THE EFFECTIVENESS OF REGULATORY LEGAL ACTS IN THE HEALTHCARE SYSTEM FOR MAINTAINING THE QUALITY OF ACTIVE LONGEVITY IN THE REPUBLIC OF KAZAKHSTAN

The article analyzes the institute of active longevity in the Republic of Kazakhstan, which has been called “antiaging” in science from the point of view of legal regulation of basic socio-economic direc-tions. This covers, first of all, the health care system, social security, social services, etc. The article exam-ines the socio-legal policy of the state on issues of ensuring a fruitful human life expectancy. The authors draw attention to the priority, from their point of view, directions of state policy in the field of regulation of healthy lifestyle issues and ensuring human life expectancy. Special attention is paid to the lack of le-gal regulation of the conceptual category of active longevity and its definitions in Kazakhstan. Attention is drawn to the fact that today in Kazakhstan there is no full-fledged, multidimensional legal framework, in addition, there is a clear need for a clear definition of the object of regulation in the sphere of these legal relations and the differentiation of hierarchy, that is, the levels of regulatory legal regulation. The article notes the need to conduct special research on increasing human life expectancy. The lack of or-ganizational and legislative measures create the main difficulties in the practical implementation of the achievements of medical science in the practical life of the country. The scientific achievements avail-able to medicine to prolong human life and maintain its quality are based primarily on the fight against diseases caused by aging, rather than on intervention in the aging process itself. The author emphasizes the latest achievements of scientists that genetically a person has a complex program to counteract ag-ing. And without a theoretical understanding of the aging process and the identification of technologies to overcome the limit of human life expectancy, the whole complex of biomedical sciences, from the point of view of practice, may not be so effective without direct interaction with other branches of sci-ence and, above all, right-wing science.

Potential for Energy Recovery from Boundary-Layer Ingesting Actuator Disk Propulsion

The theoretical benefits of highly integrated propulsion systems are highlighted herein by assessing the potential for energy recovery utilization using actuator disk propulsion. Decomposing aerodynamic forces into thrust and drag for closely integrated bodies, particularly those employing boundary-layer ingestion, becomes challenging. In this work, a mechanical energy-based approach was taken using the power balance method. This allowed the performance to be analyzed through the mechanical flow power in the fluid domain, disregarding the need for any explicit definition of thrust and drag. Through this, the benefit of boundary-layer ingestion was observed from a wake energy perspective as a decrease in the downstream mechanical energy deposition and associated viscous dissipation. From a propulsion perspective, the reduction in power demand necessary to produce propulsive force indicated the possibility of power savings by utilizing the energy contained within the ingested boundary-layer flow.