Evidence-based Assessment Research Articles

Evidence-Based Pain Assessment in Nonverbal Palliative Care Patients

BackgroundCentral to palliative care is the early assessment and treatment of pain, whether physical, psychosocial, or spiritual. Nonverbal palliative care patients are at risk for inadequate pain assessment leading to prolonged suffering. AimsThe purpose of this project was to implement and evaluate an evidence-based pain assessment tool for nonverbal palliative care patients. DesignThe Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Healthcare and the Implementation Strategies for Evidence-Based Practice Guide provided the guiding frameworks. SettingsOn a six-bed adult inpatient Palliative Care Unit (PCU). Participants/SubjectsNonverbal palliative care patients. MethodsEvidence supported use of the Multidimensional Objective Pain Assessment Tool (MOPAT) for nonverbal patients receiving palliative care. During an eight-week pilot, nurses recorded pain assessments on a paper form and trended pain scores over a 24-hour period. Evaluation included knowledge, attitudes, and behaviors pre- and post-pilot and was subsequently used in a Precision Implementation Approach to promote adoption. ResultsNurses’ attitudes toward palliative care pain assessment improved in all items on the evaluation tools. Pain was assessed using MOPAT for 74% of nonverbal palliative care patients and 88% of patients had linked pain interventions to MOPAT scores. ConclusionsMOPAT is the only valid evidence-based pain assessment tool for nonverbal patients receiving palliative care. This project led to successful adoption of the MOPAT within the PCU.

Enhancing Research Quality: Emphasizing the Scientific Method, Design Guidelines, and Evidence-Based Assessment

Research quality forms the backbone of research across the disciplines of Science, Technology, Engineering, and Mathematics (STEM), providing a systematic approach to inquiry, experimentation, and discovery. In the fields of Information Technology (IT) and Computer Science, the application of research quality is particularly crucial for ensuring the rigor, validity, and reproducibility of research findings. This paper explores the importance of research quality in STEM research, with a focus on IT and Computer Science, where the rapid pace of technological advancement demands precise and reliable methodologies. The study examines how research quality facilitates hypothesis testing, data analysis, and theory development, enabling researchers to address complex problems, innovate responsibly, and contribute to the advancement of knowledge. By highlighting key examples from IT and Computer Science research, the paper underscores the essential role of the research quality in driving progress, ensuring ethical standards, and fostering interdisciplinary collaboration in the pursuit of scientific excellence

Engagement of the Resilience Evaluation Instrument for Pasar Blumbang Wirokerten Tourism Village Yogyakarta Against Disaster Risk

Wirokerten village has advantages in the field of cultural tourism and Micro, Small Medium Enterprise (MSME) potential place called Pasar Blumbang. Despite all the advantages, this area also a threat of disaster. Therefore, this research aims to assess village resilience against risky disaster to measure the level of community resilience in facing disasters. Research methods using evidence-based independent assessments by villages and Focus Group Discussions (FGD) to agree on assessments assisted by facilitators or village assistants. The result of assessment shows that the percentage shows an increase in residents’ awareness of potential disasters in the Wirokerten Village area. These results become the basis for decision-making about actions to increase disaster resilience and monitor its progress. This workshop is expected to increase the resilience of Wirokerten Village and surrounding communities to natural disasters.

Cultural Competence in Ophthalmic Dispensing Education: A Qualitative Study.

Understanding and acknowledging cultural diversity in healthcare is essential in providing culturally competent care. Higher education institutions are critical to providing students with the necessary knowledge, attitudes, and skills to respond to cultural diversity in various contexts. Cultural competence teaching in ophthalmic dispensing education has emerged as an essential concept that needs to be included in the curriculum. This study explored ophthalmic dispensing lecturers' understandings, experiences, and attitudes in teaching cultural competence. This study used a qualitative approach within an interpretivist paradigm by conducting semi-structured interviews with lecturers (n = 7) in the ophthalmic dispensing program. Braun and Clarke's framework for thematic analysis was utilized. The research was conducted at an ophthalmic dispensing department at a South African university. The analysis of the semi-structured interviews indicated three main themes of importance regarding factors influencing cultural competence education in the ophthalmic dispensing curriculum: the interplay between experiences and understandings of cultural competence, cross-cultural exposure and teaching practices, and inclusion of cultural competence into the curriculum. The participants recognized that cultural competence was not explicitly included in the curriculum. Including culture in education was rather unsystematic and, in most cases, unplanned. Further training of lecturers on cultural competence skills and evidence-based teaching and assessment strategies are required to assist in developing curricula that include cultural competence.

Development of a novel primate welfare assessment tool for research macaques.

Primates are important species for biomedical research and ensuring their good welfare is critical for research translatability and ethical responsibility. Systematic animal welfare assessments can support continuous programme improvements and build institutional awareness of areas requiring more attention. A multi-facility, collaborative project aimed to develop and implement a novel primate welfare assessment tool (PWAT) for use with research macaques. PWAT development involved: establishing an internal focus group of primate subject matter experts, identifying animal welfare categories and descriptors based on literature review, developing a preliminary tool, beta-testing the tool to ensure practicality and final consensus on descriptors, finalising the tool in a database with semi-automated data analysis, and delivering the tool to 13 sites across four countries. The tool uses input- and outcome-based measures from six categories: physical, behavioural, training, environmental, procedural, and culture of care. The final tool has 133 descriptors weighted based upon welfare impact, and is split into three forms for ease of use (room level, site level, and personnel interviews). The PWAT was trialled across facilities in March and September 2022 for benchmarking current macaque behavioural management programmes. The tool successfully distinguished strengths and challenges at the facility level and across sites. Following this benchmarking, the tool is being applied semi-annually to assess and monitor progress in behavioural management programmes. The development process of the PWAT demonstrates that evidence-based assessment tools can be developed through collaboration and consensus building, which are important for uptake and applicability, and ultimately for promoting global improvements in research macaque welfare.

Prevalence and Risk Factors of Allergic Rhinitis; A systematic Review

Allergic rhinitis (AR), an immunoglobulin E-induced nasal infection, significantly impacts nasal mucosa function and quality of life. Its incidence has risen globally, showing variations across income categories. This systematic study aimed to determine the prevalence and risk factors of AR. Data were sourced from PubMed/Medline, Scopus, and Embase, following PRISMA guidelines. English-language articles (2010–2023) discussing AR prevalence and risk factors were included. A total of 15 articles were reviewed, with surveys and national database analyses being predominant (n=15). The search initially yielded 95 studies, of which 15 met inclusion criteria. Enhanced knowledge of prevalence and risk factors is crucial for future treatment improvements. The prevalence of AR has surged, necessitating evidence-based assessments of risk factors. For adults, risk factors include smoking, asthma, family history of AR, drug and food allergies, pollen allergy history, antibiotic use, occupational dust exposure, home renovation, and middle school education. In children, passive smoking, asthma, family history of AR, allergies, eczema, pet ownership, seafood consumption, male gender, and breastfeeding were identified as risk factors. The study highlights AR prevalence\'s correlation with allergic diseases, familial allergy history, and environmental factors. Comprehending these associations is pivotal for enhancing adherence to preventive management plans.

Distribution, seroprevalence and risk factors for bovine brucellosis in Brazil: Official data, systematic review and meta-analysis

Bovine brucellosis is an endemic disease in Brazil, and evidence-based assessments of the available literature on its seroprevalence and risk factors are limited. The aim of this study was to systematically review and summarize studies related to seroprevalence and risk factors of bovine brucellosis in the entire Brazil, in addition to comparing published data with the most recent official reports. Articles available in scientific databases and published between October 2006 and October 2021 were evaluated. Forty-five publications were included in the meta-analysis on the seroprevalence of brucellosis and 29 publications in the review on risk factors. The largest number of publications was found for the State of Mato Grosso do Sul (n=4), and the highest and lowest seroprevalences were observed in Acre (11%; 95% CI: 8.0–14.0%) and in the Federal District (0.4%; 95% CI: 0.2–0.7%). The main risk factors were the purchase of animals for breeding, vaccination, the number of heifers (female ≥2 years), the presence of calving paddocks and the occurrence of abortions. The need for new official studies has been suggested to determine the true prevalence of bovine brucellosis in Brazil, supported by the National Program for the Control and Eradication of Animal Brucellosis and Tuberculosis.

DRIVING CHANGE: EXAMINING MANAGERIAL ABILITIES AND SOCIOECONOMIC IMPACT IN WOMEN'S SELF-HELP GROUP ENTREPRENEURSHIP-A REVIEW

Purpose: Women entrepreneurs act as change agents and accelerators for the prosperity and economic growth of emerging and developing countries. Many womens self-help groups opened the path for the creation of self-employment and the reduction of poverty by engaging in entrepreneurial activities. The purpose of the research paper is to examine how womens self-help groups are empowered through entrepreneurial endeavors, focusing mainly on their managerial abilities and socioeconomic impact. Approach/Design/methodology: The descriptive technique is used in this study to explain the existing condition and offer a reason. Secondary sources, such as journals, papers, books, and other relevant resources, are used to perform a complete evidence-based assessment of the managerial abilities of self-help group women entrepreneurs. Findings/result: Despite the many obstacles they encountered, women entrepreneurs were able to advance socially, economically, entrepreneurial, and technologically due to entrepreneurship education, training, and supporting legislative frameworks. To improve the managerial abilities of women entrepreneurs in self-help groups, motivational programs, risk management, financial management, and awareness program should be offered. Originality /value: Fewer studies have been done on the managerial skills of women self-help group entrepreneurs, even though many studies have been done on the empowerment of women through their entrepreneurial activities. This research article emphasizes and highlights the managerial skills of women self-help group entrepreneurs and contributes to the literature on the various conventional and nonconventional managerial skills adopted by women entrepreneurs of self-help groups. Type of paper/paper type: Review KEYWORDS: Women entrepreneurs, self-help groups, empowerment, managerial abilities, socioeconomic impact

Pengembangan Instrumen Deteksi Kemunduran Bio, Psiko, Sosio, Spiritual pada Pasien Lanjut Usia

This research aims to develop an instrument that detects bio, psycho, social, and spiritual decline in elderly hospital patients by using theoretical concepts in nursing care. The research method uses cross-sectional, with validity and reliability tests using the Product Moment correlation test. The research results show that the bio, psycho, social, and spiritual deterioration detection instrument consists of 26 questions with high validity and reliability. This instrument has been based on various concepts that focus on the individual's bio, psychological, social, and spiritual needs. In conclusion, this instrument is easy to use and is an evidence-based nursing assessment tool.
 Keywords: Bio-Psycho-Socio-Spiritual Decline; Elderly Patients

A CHECKLIST-BASED INTERVENTION TO SUPPORT FAMILY CAREGIVERS IN PRIMARY CARE

Abstract Family caregivers commonly accompany older adults to their routine medical visits, but caregivers’ own needs and concerns are not systematically identified or addressed in clinical practice. Collaborative Healthcare Encounters with Caregivers (CHEC) is a checklist-based intervention that uses a prioritization approach to help caregivers efficiently identify and communicate their most salient concerns to primary care providers. This presentation will report findings from a pilot randomized controlled trial of N=37 patient-caregiver dyads who were randomized to CHEC (N=21) or usual care (n=16). The goals of the pilot trial were to evaluate CHEC’s impact on medical visit duration and communication (using time-stamped audio-recordings and a structured coding system) and caregivers’ perceptions of CHEC’s utility (using questionnaires and interviews). Total visit duration was comparable across treatment groups (CHEC: 29.3 minutes vs. UC: 32.8 minutes; p=0.55), but a greater proportion of the visit time was spent addressing caregivers’ concerns among CHEC group participants, as compared to usual care participants (25% vs. 6%; p<.001). In post-visit interviews, caregivers commented that CHEC was useful in helping them to prepare for the visit by thinking about their questions in advance and prompting providers to acknowledge their concerns. Findings from this study explicitly address the RAISE Act’s recommendation for integrating evidence-based caregiver assessment instruments into clinical care delivery (Outcome 2.2) and indicate CHEC’s potential as an efficient, clinically feasible intervention that can support greater inclusion of caregivers in primary care discussions.

Materials and Applications of 3D Printing Technology in Dentistry: An Overview.

This narrative review aims to provide an overview of the mechanisms of 3D printing, the dental materials relevant to each mechanism, and the possible applications of these materials within different areas of dentistry. Subtopics within 3D printing technology in dentistry were identified and divided among five reviewers. Electronic searches of the Medline (PubMed) database were performed with the following search keywords: 3D printing, digital light processing, stereolithography, digital dentistry, dental materials, and a combination of the keywords. For this review, only studies or review papers investigating 3D printing technology for dental or medical applications were included. Due to the nature of this review, no formal evidence-based quality assessment was performed, and the search was limited to the English language without further restrictions. A total of 64 articles were included. The significant applications, applied materials, limitations, and future directions of 3D printing technology were reviewed. Subtopics include the chronological evolution of 3D printing technology, the mechanisms of 3D printing technologies along with different printable materials with unique biomechanical properties, and the wide range of applications for 3D printing in dentistry. This review article gives an overview of the history and evolution of 3D printing technology, as well as its associated advantages and disadvantages. Current 3D printing technologies include stereolithography, digital light processing, fused deposition modeling, selective laser sintering/melting, photopolymer jetting, powder binder, and 3D laser bioprinting. The main categories of 3D printing materials are polymers, metals, and ceramics. Despite limitations in printing accuracy and quality, 3D printing technology is now able to offer us a wide variety of potential applications in different fields of dentistry, including prosthodontics, implantology, oral and maxillofacial, orthodontics, endodontics, and periodontics. Understanding the existing spectrum of 3D printing applications in dentistry will serve to further expand its use in the dental field. Three-dimensional printing technology has brought about a paradigm shift in the delivery of clinical care in medicine and dentistry. The clinical use of 3D printing has created versatile applications which streamline our digital workflow. Technological advancements have also paved the way for the integration of new dental materials into dentistry.

Towards evidence-based human resource development for South African local government

Background: The effective management of human resources is crucial for the sustainability of municipalities. However, as evidenced by poor service delivery, municipalities are not measuring human resource development. There is no known assessment tool or system to measure the performance of human resource development in South African municipalities.Aim: This study investigated the human resource development challenges experienced in municipalities and recommends, among other things, an evidence-based assessment tool that will improve human resource development implementation.Setting: Participants included line managers, human resource development professionals, employees, and councillors from randomly sampled local, district and metropolitan municipalities in South Africa.Method: An exploratory sequential mixed-methods design was used. Quantitative data were collected using questionnaires from 111 respondents. Qualitative data were collected from respondents given an opportunity to elaborate on their responses to statements in the questionnaire.Results: The results of the study show that municipalities are not effectively implementing human resource development, which compromises service delivery and municipal performance. They also suggest that municipalities are not effectively implementing the adopted Integrated Municipal Framework for Human Resource Development.Conclusion: The study concludes that there is an urgent need for local government to prioritise the management of human resource development. An evidence-based assessment tool will ensure that human resource development governance gaps are addressed in municipalities.Contribution: This study adds to the debate on the management of human resource development in South African local government by providing a context-specific analysis of implementing and managing human resource development and by recommending improvement strategies.

A systematic methodology to assess the identity of plants in historical texts: A case study based on the Byzantine pharmacy text John the Physician's Therapeutics

Ethnopharmacological relevanceIn recent decades, the study of historical texts has attracted research interest, particularly in ethnopharmacology. All studies of the materia medica cited in ancient and medieval texts share a concern, however, as to the reliability of modern identifications of these substances. Previous studies of European or Mediterranean texts relied mostly on authoritative dictionaries or glossaries providing botanical identities for the historical plant names in question. Several identities they suggest, however, are questionable and real possibility of error exists. Aim of the studyThis study aims to develop and document a novel and interdisciplinary methodology providing more objective assessment of the identity of the plants (and minerals) described in these resources. Materials and methodsWe developed an iterative experimental approach, using the 13th century Byzantine recipe text John the Physician's Therapeutics in its Commentary version (JC) as a case study. The methodology has six stages and relies on comparative analyses including statistical evaluation of botanical descriptions and information about medicinal uses drawn from both historical and modern sources. Stages 1–4 create the dataset, stage 5 derives the primary outcomes to be reviewed by experts in stage 6. ResultsUsing Disocorides’ De Materia Medica (DMM) (1st century CE) as the culturally related reference text for the botanical descriptions of the plants cited in JC, allowed us to link the 194 plants used medicinally in JC with 252 plants cited in DMM. Our test sample for subsequent analyses consisted of the 50 JC plant names (corresponding to 61 DMM plants) for which DMM holds rich morphological information, and the 130 candidate species which have been suggested in the literature as potential botanical identities of those 50 JC plant names. Statistical evaluation of the comparative analyses revealed that in the majority of the cases, our method detected the candidate species having a higher likelihood of being the correct attribution from among the pool of suggested candidates. Final assessment and revision provided a list of the challenges associated with applying our methodology more widely and recommendations on how to address these issues. ConclusionsWe offer this multidisciplinary approach to more evidence-based assessment of the identity of plants in historical texts providing a measure of confidence for each suggested identity. Despite the experimental nature of our methodology and its limitations, its application allowed us to draw conclusions about the validity of suggested candidate plants as well as to distinguish between alternative candidates of the same historical plant name. Fully documenting the methodology facilitates its application to historical texts of any kind of cultural or linguistic background.

The impact of whole of patient nursing assessment frameworks on hospital inpatients: A scoping literature review.

A comprehensive patient assessment is essential for safe patient care. Patient assessment frameworks for nurses are generally restricted to patients who already have altered vital signs and are at risk of deterioration, or to specific risks or body systems such as falls, pressure injury and the Glasgow Coma Score. Comprehensive and structured evidence-based nursing assessment frameworks that consider the whole patient and extend beyond vital signs, specific risks and single systems are not routinely used in inpatient settings but are important to establish early risks for patient deterioration. The aim of this review was to identify nursing assessment tools or frameworks used to holistically assess hospitalized patients and to identify the impact of these tools on patient and health service outcomes. A scoping literature review was conducted. Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest Dissertations and Thesis, Embase and Scopus were databases used in the search. The initial search was conducted in August 2021 and repeated in November 2022. No date parameters were set. The Participants, Concept, Context (PCC) framework was used to guide the development of the research question and consolidate inclusion and exclusion criteria. The PRISMA-ScR Checklist Item was followed to ensure a methodologically sound checklist was used. Ten primary research studies evaluating six nursing assessment frameworks were included. Of the five nursing assessment frameworks, none were explicitly designed for general ward nursing, but rather the emergency department or specific patient cohorts, such as oncology. Four studies reported on reliability and/or validity; two reported on patient outcomes and four on staff satisfaction. Evidence-based nursing patient assessment frameworks for use in general inpatient wards are lacking. Existing assessment tools are largely designed for specific patient cohorts, specific body systems or the already deteriorating patient. A framework to enable a structured approach to patient assessment in this environment is needed for patient safety, consistency in assessment, nursing staff enablement and confidence to escalate care. Routine systematic nursing assessment could also aid timely patient escalation. What problem did the study address? This study addresses the lack of evidence-based nursing assessment frameworks for use in hospitalized patients. The impact of this is that it highlights the need for an evidence-based, whole of patient assessment framework for use by nurses for patients admitted to a ward environment. What were the main findings? This review identified limited comprehensive, patient assessment frameworks for use in general ward inpatient areas. Those identified were not validated for this patient cohort and are aimed at patients already deteriorating. Where and on whom will the research have an impact? This review has the potential to impact future research and patient care. It highlights that most research is focussed on processes to detect and escalate care for the already deteriorating patient. There is a need for an evidence-based routine nursing assessment framework for patients admitted to a ward environment to promote positive patient outcomes and prevent deterioration. This review contributes to existing knowledge of nursing patient assessment frameworks, yet it also highlights several gaps. Currently, there are no known, validated, holistic, structured nursing patient assessment frameworks for use in general ward inpatient settings. However, areas that do use such assessment frameworks (e.g. the emergency department) have shown positive patient outcomes and staff usability. Hospitalized ward patients would benefit from routine, structured nursing assessments targeting positive patient outcomes prior to the onset of deterioration.

The risk assessment of imminent inpatient aggression: A cross-cultural validation study of the dynamic appraisal of situational aggression in Estonia.

The reason for this study was void of a data-driven imminent risk assessment instrument for aggression in psychiatry clinics in Estonia. The predictive accuracy of the observer-rated Dynamic Assessment of Situational Aggression (DASA) has been repeatedly demonstrated. However, the research gap remains regarding a deeper conceptual understanding of the underlying latent structure of the DASA. Comprehensively evaluate the psychometric properties of the Estonian DASA version for cross-cultural clinical use. We used a prospective repeated measure design and collected 6097 risk evaluations from 381 adult inpatients, 151 of whom committed 1013 aggressive incidents during the study. The Estonian DASA version has acceptable inter-rater reliability (Kendall's τ = 0.74) and is a useful instrument with excellent predictive validity (AUC = 0.86) for identifying potentially aggressive inpatients. In our sample, the DASA has a bi-factorial structure which explains 83% of the total variance. The adapted DASA has acceptable validity and reliability indices for measuring imminent aggression risk in adult inpatient units. Evidence-based risk assessment of aggression in psychiatric clinics enhances recognition of the signs of potentially aggressive behaviour in order to apply preventive actions and reduce aggression, thereby improving the quality of the care provided.

Predictability of Dental Distalization with Clear Aligners: A Systematic Review.

The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic tooth movement. "Orthodontics, aligners" and "distalization" were the search terms used on the Scopus, Web of Science and Pubmed databases with the Boolean operator "AND". The results of the last ten years of research were 146 studies; of these, 19 publications were included for this review. The distalization movement is possible with invisible masks alone, but the risk of losing anchorage in the anterior sectors is very probable. The stability of the results and the reduction of unwanted effects can be guaranteed by the use of skeletal anchoring devices and interproximal enamel reduction (IPR), with which compensations are obtained to reduce the initial overjet. Temporary anchorage devices (TADs) can be used to manage posterior anchorage after distalization of maxillary molars with aligners. This hybrid approach has demonstrated the greatest orthodontic success. TADs are useful aids to provide direct and indirect skeletal anchorage. The opposite effect must be considered when planning dental distalization, especially of the molars, in patients with large overjet, and corrective measures or the use of auxiliaries may be necessary to prevent midcourse corrections. This systematic review provides a critical evidence-based assessment of the predictability of dental distalization with CAs, an ever-evolving orthodontic technique.

Interdisciplinary Team - How to Make It Work?

The philosophy of interdisciplinary teams in infertility centers is a fundamental aspect of the reproductive medicine Centre’s approach to patient care. It aims to delve into the core principles and beliefs that underpin the philosophy of interdisciplinary teams in Union Hospital’s infertility center, shedding light on the critical role they play in optimizing treatment outcomes and patient satisfaction. The art of interdisciplinary teams’ centers on the recognition that infertility is a complex and multi-faceted issue that requires a comprehensive approach involving professionals from diverse disciplines. At our Centre, the foundation of this philosophy lies in the belief that by combining the expertise and perspectives of specialists in reproductive endocrinology, embryology, andrology, genetics, psychology, and nursing, patients can receive the highest standard of holistic care. The primary goal of the interdisciplinary team is to provide individualized care that is tailored to each patient’s unique needs and circumstances. This involves a synergistic collaboration among team members to ensure a thorough evaluation of the patient’s reproductive health, addressing not only the physical aspects but also the emotional and psychological aspects of their infertility journey. By integrating a range of perspectives, the team aims to provide comprehensive, evidence-based assessments and treatment plans. Furthermore, we emphasize the importance of continuous communication and coordination among team members. Regular team meetings and case discussions allow for the exchange of ideas, insights, and knowledge, ultimately leading to more informed decision making and improved treatment outcomes. The interdisciplinary team ethos also fosters a supportive and compassionate environment, where patients feel heard, valued, and understood throughout their treatment journey. Interdisciplinary team infertility centre also embraces the utilization of cutting-edge technologies and diagnostic tools. By integrating advancements in reproductive medicine, such as genetic testing and personalized treatment protocols, the team can offer patients the most effective and innovative options available. In conclusion, the philosophy of interdisciplinary teams in infertility centers is rooted in the belief that by bringing together professionals from diverse disciplines, patients can receive tailored, comprehensive care that addresses the entirety of their infertility journey. It emphasizes collaboration, communication, and the utilization of advanced technologies, ultimately leading to enhanced treatment outcomes, patient satisfaction, and overall reproductive well-being.

PP27 The Private Healthcare Responses Against COVID-19 Emergencies In Brazil

IntroductionThe Corona Virus Disease 2019 (COVID-19) pandemic is the biggest public health crisis of all time. Private health care plays a major role in health globally. We conducted a study to document the engagement of a Brazilian private health care organization to influence decisions to private and public health emergencies of COVID-19.MethodsThis retrospective study evaluated the outputs of the health technology assessment (HTA) group of Unimed-BH, a private Health Maintenance Organization (HMO) with 1.5 million participants in Belo Horizonte, Minas Gerais state. The study evaluated the impacts on the overview of health local decisions in the municipality and the national supplementary health agency (ANS) during the period from March 2020 to December 2022.ResultsDuring the pandemic, Unimed-BH made all its sanitary decisions based on scientific research, such as the use of masks and appropriate medications. Even though some medicines, such as regdanvimab, were authorized for emergency use by the Brazilian Health Regulatory Agency (ANVISA), Unimed-BH did not recommend their use due to uncertain evidence, and months later, ANVISA withdrew the registration.Unimed-BH also conducted a systematic review of ivermectin for COVID-19 treatment, which showed no effect, and therefore did not recommend its use. Additionally, Unimed-BH provided weekly updates on COVID-19 data, including suspected and confirmed cases, hospitalizations, and deaths in their customer portfolio. The organization also actively supported the decisions made by ANS and municipal managers using evidence and statistics on the pandemic. The Unimed-BH HTA group produced a total of 167 reports from March 2020 to December 2022.ConclusionsBelo Horizonte had the lowest in-hospital mortality rates with COVID-19 in Brazil. Unimed-BH’s HTA reports provided evidence-based assessments for decision-making, proposed partnership with policymakers, fomented information transparency, and strict follow-up on pandemic numbers, which may have contributed to the lower fatality rate in our city. These findings underscore the importance of private healthcare organizations in responding to COVID-19 emergencies, and their potential to support evidence-based decision-making and minimize the impact of the pandemic.

Recent Advances in 3D Printing of Polymers for Application in Prosthodontics.

Contemporary mass media frequently depict 3D printing as a technology with widespread utilization in the creation of dental prosthetics. This paper endeavors to provide an evidence-based assessment of the current scope of 3D printing's integration within dental laboratories and practices. Its primary objective is to offer a systematic evaluation of the existing applications of 3D-printing technology within the realm of dental prosthetic restorations. Furthermore, this article delves into potential prospects, while also critically examining the sustained relevance of conventional dental laboratory services and manufacturing procedures. The central focus of this article is to expound upon the extent to which 3D printing is presently harnessed for crafting dental prosthetic appliances. By presenting verifiable data and factual insights, this article aspires to elucidate the actual implementation of 3D printing in prosthetic dentistry and its seamless integration into dental practices. The aim of this narrative review is twofold: firstly, to provide an informed and unbiased evaluation of the role that 3D printing currently plays within dental laboratories and practices; and secondly, to instigate contemplation on the transformative potential of this technology, both in terms of its contemporary impact and its future implications, while maintaining a balanced consideration of traditional dental approaches.

Social Network Analysis as a Tool in the Care and Wellbeing of Zoo Animals: A Case Study of a Family Group of Black Lemurs (Eulemur macaco).

Social network analysis (SNA) is an increasingly utilised technique in the literature examining the social structures and organisation of animals and understanding the bonds between groups and individuals. Using a case study as an illustration, the applications of SNA are explored, including the identification of dominance hierarchies and detection of sources of social pressure, with a particular focus on the applications of SNA to holistic assessments of animal welfare alongside other methods. Based on the examination of social dynamics in a family group of four black lemurs (Eulemur macaco), a primate whose social organisation is characterised by patterns of female dominance, it is demonstrated that SNA can be used to examine the affiliative and agonistic interactions between individuals living in human care. SNA showed species-typical forms of female dominance that were largely directed towards the two males, characterised by the initiation of aggressive interactions and male submission. More intricate relationships and consistent social roles across networks were revealed through the examination of SNA. It is concluded that SNA has wide-ranging benefits in the assessment of effects of environmental changes, such as informing social management decisions, developing enrichment and intervention programs, and guiding overall improvements to the housing and care of individual animals. SNA, as part of an animal welfare toolbox, could, therefore, be a pivotal technique for modern animal welfare assessment that considers individual animals and their social lives. By sharing a case study of the technique in use, it is hoped that animal collections may adopt similar modern and evidence-based assessment methods.