Evidence-based Methodology Research Articles

Consensus on targeted drug therapy for spondyloarthritis.

Spondyloarthritis (SpA) is a group of chronic inflammatory diseases that predominantly involve the spine and/or peripheral joints. The clinical manifestations of SpA are highly heterogenous and complicated with various comorbidities. SpA is a disabling disease and adversely affects the quality of life of patients. Many new medications that target cytokines or pathways specific for the pathogenesis of SpA have been developed and they are becoming increasingly important in the treatment of SpA. However, identifying the target patient population and standardizing the usage of these drugs are critical issues in the clinical application of these "targeted therapeutic drugs". Under the leadership of National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), managed by Peking Union Medical College Hospital, the "Consensus on targeted drug therapy for spondyloarthritis" has been developed in collaboration with the Rheumatology and Immunology Physicians Committee, Chinese Medical Doctors Association, Rheumatology and Immunology Professional Committee, Chinese Association of Rehabilitation Medicine, and Chinese Research Hospital Association Rheumatology and Immunology Professional Committee. This consensus has been developed with evidence-based methodology and has followed the international standard for consensus development.

Creating a Community Advisory Board

ABSTRACT: Health leaders in an academic setting sought to engage with community members to gain insight into their health information needs. Using evidence-based practice methodology, they established a community advisory board that represents and articulates patients' perspectives, which are then incorporated into educational efforts to assist the public in using evidence to make health decisions.

Copy-Pasting in Patients' Electronic Medical Records (EMRs): Use Judiciously and With Caution.

An electronic medical record (EMR) is an electronic, comprehensive, and up-to-date compilation of a patient's medical history and information stored in a secure digital format. It provides real-time access to patient data, enabling healthcare providers to make informed decisions quickly and accurately. EMR systems streamline a patient's healthcare journey and enable shared care across the medical practice. By providing a comprehensive view of a patient's medical history, EMRs can be invaluable tools for physicians and healthcare providers, allowing them to collaborate more effectively and provide better care. Additionally, EMRs can help reduce paperwork, improve accuracy, and increase efficiency, ultimately leading to improved patient outcomes. The true potential of EMR systems can be realized when they are used in conjunction with evidence-based medicine methodologies, quality improvement initiatives, and team-based care. This combination of technologies and practices can revolutionize healthcare delivery, improving patient outcomes, greater efficiency, and cost savings. "Copy-pasting" is an essential feature of EMR systems, with physicians relying on it for up to 35.7% of their workflow. By leveraging the copy-pasting feature of their EMR system, physicians can ensure that their data capture is accurate and timely, leading to better patient care. Copy-pasting can be a valuable tool for physicians, saving time and allowing them to focus on practical clinical issues. However, it is essential to note that while most clinicians copy-paste, 25% of them believe it can lead to a high frequency of medical errors, with the potential for a significant number of errors being attributed to this practice. Therefore, physicians must exercise caution when copy-pasting and take the necessary steps to ensure accuracy and reduce the risk of errors. Copy-pasting can cause severe adverse patient events by introducing new inaccuracies, rapidly spreading inaccurate or outdated information, leading to discordant notes, and creating long notes that mask essential clinical information. Despite these risks, copy-pasting has become widely used in EMRs. Additionally, copy-pasting can reduce the time spent on documentation, allowing healthcare providers to focus more on patient care. Inappropriate copy-pasting can have serious consequences, such as compromising data integrity, endangering patient safety, increasing costs, and even leading to fraudulent malpractice claims. In conclusion, copy-pasting can be helpful for healthcare professionals, but it must be used cautiously. Proper education and safeguards should be implemented to ensure accuracy and up-to-date patient data. Additionally, healthcare professionals should be aware of the legal implications of copy-pasting, as it may be considered a form of medical malpractice. With the proper precautions, copy-pasting can be a safe and efficient way to save time and reduce errors in patient records.

Consensus on targeted drug therapy for spondyloarthritis

Spondyloarthritis (SpA) is a group of chronic inflammatory conditions that predominantly involve the spine and/or peripheral joints. The clinical manifestations of SpA are diverse and disabling, with SpA adversely affecting the quality of life of patients. Many new medications that target cytokines or pathways specific for the pathogenesis of SpA have been developed and these are becoming increasingly important in the treatment of SpA. However, establishing how to identify the target patient population and standardizing the usage of these drugs are critical issues in the clinical application of these "targeted therapies".Under the leadership of National Clinical Research Center for Dermatologic and Immunologic Diseases (Peking Union Medical College Hospital), the"Consensus on targeted drug therapy for spondyloarthritis" has been developed collaborating with the Rheumatology and Immunology Physicians Committee, Chinese Medical Doctors Association, Rheumatology and Immunology Professional Committee, Chinese Association of Rehabilitation Medicine, Chinese Research Hospital Association Rheumatology and Immunology Professional Committee. This consensus was developed with evidence-based methodology and followed the international standard for consensus development.

Epizootic Risk of Contagious Animal Pathology in Agro-Industrial Complex of the Northwestern Region of Russia

Introduction. Urbanisation of territories creates a critical risk related to contagious animal diseases. The agro-industrial complex (AIC) of the Northwestern region is an important component of the food security system of the Russian Federation. The research is aimed at studying and defining the degree of epizootic risk of contagious animal diseases in the region, determining the degree of epizootic threat thereof at the population and interpopulation levels.Materials and methods. For conducting the study the comprehensive epizootological approach (analysis) was used, along with the methods of evidence-based epizootology, epizootological diagnostics, methods of modern prognostics and statistical methods of quality control.Results. Functioning of infectious parasitic systems have been studied under specific conditions of place and time, using digitalisation achievements and statistical quality control. The epizootological categories have been proposed and applied for the three-dimensional measurement of the epizootic manifestation of contagious diseases using the corresponding units for their mathematical measurement (indicator of ill-being, epizootic index, incidence and prevalence, pathogenicity spectrum, frequency, recurrence, seasonal epizootic growth and year-round disease incidence). All the above allows carrying out the epizootic supervision over the formation and functioning of separate nosological units in animal populations under specific conditions of place and time. Using the comprehensive epizootological approach and the evidence-based epizootological methodology, the degree of epizootic risk of contagious animal (bird) diseases in the agro-industrial complex of the Northwestern region was studied in relation to the various economic and technological levels of animal husbandry and the degree of territory urbanisation.Discussion and conclusions. It has been found that in the agro-industrial complex of the metropolis suburban area of the Northwestern region, there have formed and periodically appear 45 animal diseases, predominantly of infectious etiology (62.2 %). The different degree of diseases epizootic risk was revealed: from its absence, in case of 4 nosological units, up to high and very high degree, in case of 15 nosological units (33.3 % of the total number). Therefore, the purpose of the present work was to study the degree of the risk of infectious diseases potential occurrence in populations of production animals in various areas of the Northwestern region and to identify the cause-andeffect indicators underlying the differences.

Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023)

The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.

Success Factors for Quality and Safety of Intensive Care Unit Transitional Care – Listening to the Sharp End

Purpose: The purpose of this paper was to present success factors for increasing quality and safety of intensive care unit (ICU) transitional care as described by co-workers at the sharp end using the core values of total quality management (TQM) as a theoretical lens. Methodology/Approach: The study had a qualitative design, with data from nine interdisciplinary focus group discussions, including co-workers from the intensive care and general wards. Data were sorted into TQM core values and analysed using qualitative content analysis. Findings: Quality and safety in transfer processes requires a holistic view, avoiding silos, shared arenas for collaboration, and evidence-based methodologies and tools for safe transfers. Research Limitation/Implication: A limitation of this study is that it only portrays the challenges encountered by two hospitals during the process of transitional care in the ICU. Originality/Value of paper: By using TQM core values as a theoretical lens, we could present a usable, holistic picture of success factors and how to improve the transfer process.

Co-creating an intervention to promote physical activity in adolescents with intellectual disabilities: lessons learned within the Move it, Move ID!-project

BackgroundCo-creation is a method to develop acceptable, contextually appropriate and potentially more effective interventions. Adolescents with intellectual disabilities (ID) seldomly participate in research and program development due to the assumption that they lack the capacity to understand and discuss the related topics.ObjectiveThis study describes reflections on a co-creation process with adolescents with ID from the point of view of the researchers in developing an intervention to increase physical activity. It was the aim to highlight elements that must be considered when implementing co-creation and consequently formulate important lessons learned.MethodsTwenty-three adolescents (14–22 y) with mild to moderate ID participated in six co-creation sessions at their school. The objectives and working methods in each session are described. Inductive thematic analysis was conducted on the researchers' reflection forms, which were completed after each session.ResultsSeven main themes could be distinguished from the data: experiences related to assistance (i.e., teacher presence) during sessions, the importance of building rapport, co-decision making power, the impact of different group dynamics, the relevance of adapted questioning, the influence of co-creative working methods and required characteristics of a co-creation researcher.ConclusionSeven lessons learned were formulated when preparing and conducting co-creation with adolescents with ID. Innovative, concrete (non-abstract) and creative working methods are highly needed. Describing the entire process transparently could be a first step to turn co-creative research into an evidence-based methodology.

Smartphone apps for point-of-care information summaries: systematic assessment of the quality and content

BackgroundClinicians need easy access to evidence-based information to inform their clinical practice. Point-of-care information summaries are increasingly available in the form of smartphone apps. However, the quality of information from...

A National Implementation Project to Prevent Healthcare-Associated Infections in Intensive Care Units: A Collaborative Initiative Using the Breakthrough Series Model.

Although there are simple and low-cost measures to prevent healthcare-associated infections (HAIs), they remain a major public health problem. Quality issues and a lack of knowledge about HAI control among healthcare professionals may contribute to this scenario. In this study, our aim is to present the implementation of a project to prevent HAIs in intensive care units (ICUs) using the quality improvement (QI) collaborative model Breakthrough Series (BTS). A QI report was conducted to assess the results of a national project in Brazil between January 2018 and February 2020. A 1-year preintervention analysis was conducted to determine the incidence density baseline of the 3 main HAIs: central line-associated bloodstream infections (CLABSIs), ventilation-associated pneumonia (VAP), and catheter-associated urinary tract infections (CA-UTIs). The BTS methodology was applied during the intervention period to coach and empower healthcare professionals providing evidence-based, structured, systematic, and auditable methodologies and QI tools to improve patients' care outcomes. A total of 116 ICUs were included in this study. The 3 HAIs showed a significant decrease of 43.5%, 52.1%, and 65.8% for CLABSI, VAP, and CA-UTI, respectively. A total of 5140 infections were prevented. Adherence to bundles inversely correlated with the HAI incidence densities: CLABSI insertion and maintenance bundle (R = -0.50, P = .010 and R = -0.85, P < .001, respectively), VAP prevention bundle (R = -0.69, P < .001), and CA-UTI insertion and maintenance bundle (R = -0.82, P < .001 and R = -0.54, P = .004, respectively). Descriptive data from the evaluation of this project show that the BTS methodology is a feasible and promising approach to preventing HAIs in critical care settings.

Implementation of a Student-Teacher-Based Blended Curriculum for the Training of Medical Students for Nasopharyngeal Swab and Intramuscular Injection: Mixed Methods Pre-Post and Satisfaction Surveys.

The COVID-19 pandemic caused a major disruption in the health care sector with increased workload and the need for new staff to assist with screening and vaccination tasks. Within this context, teaching medical students to perform intramuscular injections and nasal swabs could help address workforce needs. Although several recent studies discuss medical students' role and integration in clinical activities during the pandemic, knowledge gaps exist concerning their role and potential benefit in designing and leading teaching activities during this period. The aim of our study was to prospectively assess the impact in terms of confidence, cognitive knowledge, and perceived satisfaction of a student-teacher-designed educational activity consisting of nasopharyngeal swabs and intramuscular injections for the training of second-year medical students in the Faculty of Medicine, University of Geneva, Switzerland. This was a mixed methods pre-post surveys and satisfaction survey study. Activities were designed using evidence-based teaching methodologies based on the SMART (specific, measurable, achievable, realistic, and timely) criteria. All second-year medical students who did not participate in the activity's old format were recruited unless they explicitly stated that they wanted to opt out. Pre-post activity surveys were designed to assess perception of confidence and cognitive knowledge. An additional survey was designed to assess satisfaction in the mentioned activities. Instructional design was blended with a presession e-learning activity and a 2-hour practice session with simulators. Between December 13, 2021, and January 25, 2022, a total of 108 second-year medical students were recruited; 82 (75.9%) students participated in the preactivity survey and 73 (67.6%) in the postactivity survey. Students' confidence in performing intramuscular injections and nasal swabs significantly increased on a 5-point Likert scale for both procedures-from 3.31 (SD 1.23) and 3.59 (SD 1.13) before the activity to 4.45 (SD 0.62) and 4.32 (SD 0.76) after the activity (P<.001), respectively. Perceptions of cognitive knowledge acquisition also significantly increased for both activities. For the nasopharyngeal swab, knowledge acquisition concerning indications increased from 2.7 (SD 1.24) to 4.15 (SD 0.83), and for the intramuscular injection, knowledge acquisition concerning indications increased from 2.64 (SD 1.1) to 4.34 (SD 0.65) (P<.001). Knowledge of contraindications for both activities increased from 2.43 (SD 1.1) to 3.71 (SD 1.12) and from 2.49 (SD 1.13) to 4.19 (SD 0.63), respectively (P<.001). High satisfaction rates were reported for both activities. Student-teacher-based blended activities for training novice medical students in commonly performed procedural skills seem effective for increasing their confidence and cognitive knowledge and should be further integrated within a medical school curriculum. Blended learning instructional design increases students' satisfaction about clinical competency activities. Future research should elucidate the impact of student-teacher-designed and student-teacher-led educational activities.

Comment on the Need to Fill a Gap in the Assessment of Neurological Status Before Elective Surgery.

Comment on the Need to Fill a Gap in the Assessment of Neurological Status Before Elective Surgery.

Les applications numériques en santé mentale : état des lieux, enjeux et perspectives

ObjectivesNew, digital-based technologies promise a revolution in the field of medicine. Mental health is experiencing the emergence of numerous innovations such as digital phenotyping, the use of AI in diagnostics, and digital therapies. Digital technology can improve psychiatry by creating new treatment strategies that are available to a larger number of people. It will enable the development of new therapeutic modalities: mobile applications (Apps) will contribute to psycho-education, diagnosis, identification of and monitoring of symptoms in a personalized way, to therapy (psychotherapeutic interventions, coping strategies), to prevention in at-risk subjects and finally to medical decision support. Finally, digital technology can allow us to exploit new data collection methods and thus improve our scientific research in order to analyze, detect, predict and even prevent symptoms. However, many reviews or meta-analyses stress the recurrent lack of scientific evidence for a large majority of the proposed tools and that there is often a significant gap between the designers’ statements and their real therapeutic potential. In addition, some of these proposed tools are said to be emerging because they present new ideas or improve the service provided. Others are said to be “disruptive”, a term that defines technologies that result in a breakthrough by creating new methods or processes that replace those previously used. Finally, those that need to be developed further are described as “immature”, which is frequently the case in mental health. These different points contribute to the distrust observed among mental health professionals with regard to new technologies. But above all, various studies have shown that rejection was not necessarily due to theoretical positions, but rather to a lack of knowledge and information regarding digital technology. The integration of new technologies in the cultural organization of providing psychiatric care is therefore a real challenge. It is not a question of replacing caregivers, but rather of increasing their efficiency. This imposes a reflection on the definition and evaluation of these tools, but also on the level of training necessary for their use. The evaluation of these tools is in essence multiple, since it involves different actors, each with their own frame of reference. Health professionals refer to an evidence-based methodology, based in most cases on studies that respect standards set by the scientific community and evaluated by peers. Developers refer to processes with design standards, development processes and norms to be respected. Finally, users rely mainly on so-called external resources, which can be expert or non-expert opinions (comments on websites, tutorials from influencers, videos of opinions or comparisons). The evolution and complexity of the technologies used therefore require adapted and above all integrative evaluation models. In this article, we will first review the current challenges of using digital tools in mental health and specify the doctrines of the different authorities involved at the national level in their development. Secondly, we will formulate a definition of these different digital tools. Thirdly, after having specified the elements on which the concept of the digital medical device is based, which will allow us to propose scientifically proven tools, we will offer current and future criteria for their evaluation, based in particular on the notion of acceptability. The overall objective is therefore to provide users with the necessary reference points for the constitution of a theoretical framework for the optimal use of digital technology in psychiatry.

DTMethod: A New Evidence-Based Design Thinking Methodology for Effective Teamwork

Design thinking (DT) emerged as a popular method of problem solving and idea generation in creative teams. However, despite the rapid increase in interest in DT as a practical tool, evidence for its effectiveness is rather scarce. Furthermore, neither the theory underlying the methods used in DT nor the definition of DT is coherent. As such, we have decided to introduce a new approach to DT by designing an evidence-based methodology and testing its efficacy among teams working on a specific task. In this article, we present the design thinking method (DTMethod), developed by an interdisciplinary team of practitioners and academics. We also present empirical evidence on the effectiveness of the DTMethod in the teamwork setting. In our study of 39 teams, we found that by using the DTMethod teams achieved more favorable results in terms of utility and meeting set requirements but not in terms of cost or time efficiency. We also found that individuals working according to the DTMethod reported experiencing less positive emotional states but were, overall, more satisfied with the experience and rated teamwork more favorably in terms of cohesiveness and team effort.

The Triple Aim Quality Improvement Gold Standard Illustrated as Extremely Premature Infant Care.

The Triple Aim is widely regarded as the quality improvement gold standard that enhances population health, lowers costs, and betters individual care. There have been no large-scale, sustained demonstrations of such improvement in healthcare. Illustrating the Triple Aim using relevant extremely premature infant outcomes might highlight interwoven proficiency and efficiency complexities that impede sustained value progress. Ten long-term collaborating neonatal intensive care units (NICU) in the Vermont Oxford Network calculated the Triple Aim in 230/7 to 276/7-week infants using three surrogate measures: (1) population health/x-axis-eight major morbidity rates as a composite, risk-adjusted metric; (2) cost/y-axis-total hospital length of stay; and (3) individual care/z-axis-mortality, then illustrated this relationship as a sphere within a three-dimensional cube. Three thousand seven hundred six infants born between January 1, 2014 and December 31, 2019, with mean (standard deviation) gestational age of 25.7 (1.4) weeks and birth weight of 803 (208) grams were analyzed. Triple Aim three-axis cube positions varied inconsistently comparing NICUs. Each NICUs' sphere illustrated mixed x- and z-axis movement (clinical proficiency), and y-axis movement (cost efficiency). No NICU demonstrated the theoretically ideal Triple Aim improvement in all three axes. Backward movement in at least one axis occurred in eight NICUs. The whole-group Triple Aim sphere moved forward along the x-axis (better morbidities metric), but moved backward in the y-axis length of stay and z-axis mortality measurements. Illustrating the Triple Aim gold standard as extreme prematurity outcomes reveals complexities inherent to simultaneous attempts at improving interwoven quality and cost outcomes. Lack of progress using relevant Triple Aim parameters from our well-established collaboration highlights the difficulties prioritizing competing outcomes, variable potentially-better-practice applications amongst NICUs, unmeasured biologic interactions, and obscured cultural-environmental contexts that all likely affect care. Triple Aim excellence, if even remotely possible, will necessitate scalable, evidence-based methodologies, pragmatism regarding inevitable trade-offs, and wise constrained-resource decisions. · The Triple Aim gold standard is elusive. There is no demonstration of sustained, large-scale success in healthcare and our quality improvement network has previously published benchmark extreme prematuritymorbidity improvements.. · Extreme prematurity outcomes illustrated as the Triple Aim show uneven results in relevant surrogate parameters and Triple Aim achievement, if even possible, will necessitate evidence-based methodologies that are scalable.. · Pragmatism, inevitable trade-offs, and wise constrained-resource decisions are required for Triple Aim success..

Development of Adverse Outcome Pathways relevant for the identification of substances having endocrine disruptors properties

This report is the outcome of an EFSA procurement (NP/EFSA/PREV/2020/01) which aims at contributing to the development of adverse outcome pathways (AOPs) to be integrated in a network addressing uterine adenocarcinoma in mammals. The outcome is intended to support the identification of substances with endocrine disruptor mode of action. For this specific purpose, an evidence-based approach methodology was adopted. Available evidence was systematically mapped from the literature to identify Molecular Initiating Events (MIEs) and Key Events (KEs) linked to adverse outcome (AO) “uterine endometrioid adenocarcinoma” independently from prototypical stressors, by means of: 1. a priori defined search strategies initially addressing the AO and biologically plausible MIEs, 2. application of machine learning technique (Topic modelling) that automatically analyzes text data to identify biologically plausible KERs, 3. systematic literature review and critical appraisal of prioritized evidence, taking into account human, in vivo and in vitro studies. Estradiol and tamoxifen, two recognized human risk factors for endometrioid adenocarcinoma, were used as tool chemical compounds to empirically support the response and temporal concordance of the identified key event relationships (KERs). All evidence has been then integrated by means of the AOP conceptual network. An evidence-based AOP starting from activation of uterine estrogen receptor-alfa leading to endometrial adenocarcinoma via epigenetic modulation was postulated.

Development of adverse outcome pathways relevant for the identification of substances having endocrine disruption properties Uterine adenocarcinoma as adverse outcome.

Development of adverse outcome pathways (AOPs) for uterine adenocarcinoma can provide a practical tool to implement the EFSA-ECHA Guidance (2018) for the identification of endocrine disruptors in the context of Regulations (EU) No 528/2012 and (EC) No 1107/2009. AOPs can give indications about the strength of the relationship between an adverse outcome (intended as a human health outcome) and chemicals (pesticides but not only) affecting the pathways. In this scientific opinion, the PPR Panelexplored the development of AOPs for uterine adenocarcinoma. An evidence-based approach methodology was applied, and literature reviews were produced using a structured framework assuring transparency, objectivity, and comprehensiveness. Several AOPs were developed; these converged to a common critical node, that is increased estradiol availability in the uterus followed by estrogen receptor activation in the endometrium; therefore, a putative AOP network was considered. An uncertainty analysis and a probabilistic quantification of the weight of evidence have been carried out via expert knowledge elicitation for each set of MIEs/KEs/KERs included in individual AOPs. The collected data on the AOP network were evaluated qualitatively, whereas a quantitative uncertainty analysis for weight of the AOP network certainty has not been performed. Recommendations are provided, including exploring further the uncertainties identified in the AOPs and putative AOP network; further methodological developments for quantifying the certainty of the KERs and of the overall AOPs and AOP network; and investigating of NAMs applications in the context of some of the MIEs/KEs currently part of the putative AOP network developed.

Understanding mentoring relationships between mentees, peer and senior mentors

BackgroundMentoring relationships play a critical but poorly understood role in mentoring’s overall success. To overcome these knowledge gaps, a study of mentee experiences in the Palliative Medicine Initiative, a structured research-based mentoring program, is proposed. The program’s clearly described mentoring approach, competency-based mentoring stages and curated mentoring environment ensure a consistent mentoring experience. It provides a unique platform to study mentoring relationships longitudinally and its implications on professional identity formation.MethodologyThe Tool Design Systematic Evidence-Based Approach methodology is used to map and employ current understanding. A review of recent reviews on mentoring processes, mentoring’s effects, professional identity formation and professional identity formation assessment tools lay the foundation for the design of semi-structured interviews and mentoring diaries to evaluate the characteristics of successful mentoring relationships and mentoring’s impact on professional identity formation. The data accrued from these tools were evaluated using this methodology whilst changes in professional identity formation were assessed using the Ring Theory of Personhood.ResultsThe semi-structured interviews revealed four themes: stakeholders, mentoring stages, mentoring relationships and professional identity formation whilst the mentoring diaries revealed two: mentoring processes and mentoring relationships. Two final domains emerged – mentoring relationships and professional identity formation.ConclusionsThe Palliative Medicine Initiative’s structured stage-based mentoring approach, trained stakeholders, curated environment, assessment-directed and personalized mentoring support reveal seven developmental stages of mentoring relationships. These culminate in changes to the values, beliefs and principles that shape how mentees see, feel and act as professionals. These findings suggest that mentoring programs may help to further develop and fine-tune their professional identity formation.

Clinical Practice Guidelines for Oral Frailty

The associations between lowered oral health status and frailty in elderly have been previously reported in many studies. Despite the increasing number of elderly populations in Korean society, there have been no attempt to develop clinical practice guideline and diagnostic criteria for oral frailty. Hence, this study reviewed the previous cohort studies and systematic reviews about oral frailty and proposed 15 recommendations as an oral frailty guideline for Korean elderly on the basis of the evidence-based methodology. This clinical practice guideline will provide overall guidance on the identification, diagnosis, and management of oral frailty in pri-mary dental care setting and finally help to achieve healthy aging in elderly.

Improving Location Decisions For Charity Retailers: Applying Operations Research and Customer Discovery

This study provides a novel methodology at the nexus of Customer Discovery and business analytics for critical location decisions charity retailers with circular supply chains face. It integrates spatial network analysis with Customer Discovery and multicriteria decision-making. Traditional analyses are primarily based on customer location but for donated goods applying Customer Discovery and expert judgment and systematic analysis of data prevails. This integration provides an agile approach to producing optimal alternative locations, which can be applied to Habitat for Humanity ReStore, and Goodwill Industries, and similar organizations globally. This cross-disciplinary approach is practical and cost-effective and can increase efficiency, decrease risks, and strengthen organizational buy-in. It categorizes the drivers affecting location decisions and combines the current business model search techniques and an overall analytical framework to create the Expert Knowledge and Evidence-Based Location Methodology (EKELM).