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In a context of rapid technological innovation and expensive new products, the paper calls for the generation of real-world data to inform decision-making and an international discussion on the affordability of new medicines, particularly for low- and middle-income countries. Without these, the challenges of health judicialization will continue to grow. [ABSTRACT FROM AUTHOR]

• PEDro is a free global resource to support evidence-based physical therapy • PEDro indexes trials, reviews, and guidelines of physical therapy interventions • PEDro web-site, newsletter, videos, and social media are available in Portuguese • Trials are pre-appraised with the PEDro scale (Portuguese version available) • Keep up to date in 15 areas of practice with PEDro's 'Evidence in your inbox' The Physiotherapy Evidence Database (PEDro) is a free, preeminent, global resource to support evidence-based physical therapy. PEDro provides rapid access to randomized controlled trials, systematic reviews, and clinical practice guidelines evaluating physical therapy interventions. This paper describes the PEDro scale, PEDro contents, who uses PEDro, searching, browsing the latest content, and developing skills in evidence-based physical therapy. Strategies specifically developed to break down barriers for Portuguese-speaking physical therapists are emphasized. All trials indexed in PEDro are assessed for methodological quality using the 10-point PEDro scale. These ratings are used to rank search results. In August 2019 PEDro indexed 44,309 articles: 34,619 trials, 9004 reviews, and 686 guidelines. The number of trials is predicted to double by 2025. PEDro users come from 214 countries. Physical therapists in Brazil are the largest users (23% of all searches). Physical therapists are encouraged to use the PEDro advanced search page to find answers for their clinical questions. PEDro's 'Evidence in your inbox' allows physical therapists to browse the latest content. To assist users develop skills in evidence-based physical therapy, PEDro includes tutorials and a series of 'how to' videos. PEDro web-site is fully available in Portuguese and English. PEDro facilitates the use of high-quality clinical research by physical therapy clinicians, educators, students, and researchers. In 2019 PEDro celebrated its twentieth anniversary. Some enhancements to mark this milestone include launching a new database called DiTA (Diagnostic Test Accuracy) that focuses on the accuracy of diagnostic tests used by physical therapists. [ABSTRACT FROM AUTHOR]

This paper describes the development of statistical classifiers to help diagnose meningococcal meningitis, i.e. the most sever, infectious and deadliest type of this disease. The goal is to find a mechanism able to determine whether a patient has this type of meningitis from a set of symptoms that can be directly observed in the earliest stages of this pathology. Currently, in Brazil, a country that is heavily affected by meningitis, all suspected cases require immediate hospitalization and the beginning of a treatment with invasive tests and medicines. This procedure, therefore, entails expensive treatments unaffordable in less developed regions. For this purpose, we have gathered together a dataset of 22,602 records of suspected meningitis cases from the Brazilian state of Bahia. Seven classification techniques have been applied from input data of nine symptoms and other information about the patient such as age, sex and the area they live in, and a 10 cross-fold validation has been performed. Results show that the techniques applied are suitable for diagnosing the meningococcal meningitis. Several indexes, such as precision, recall or ROC area, have been computed to show the accuracy of the models. All of them provide good results, but the best corresponds to the J48 classifier with a precision of 0.942 and a ROC area over 0.95. These results indicate that our model can indeed help lead to a non-invasive and early diagnosis of this pathology. This is especially useful in less developed areas, where the epidemiologic risk is usually high and medical expenses, sometimes, unaffordable. [ABSTRACT FROM AUTHOR]

This article explores the mobilization of power by health workers during policy implementation, showing how in a context of discretion and resource scarcity they can reproduce inequalities in access to health services. The argument innovates theoretically by supplementing the 'street-level bureaucracy' literature, which emphasizes frontline worker discretion, with a conceptualization of power as domination encompassing the shaping of behavior, the constitution of subjects and the reproduction of inequality. Empirically, the article focuses on Brazilian community health workers (agentes comunitários de saúde , CHWs). CHWs are a neglected but highly important segment of the health workforce that traditionally functions as a link between the health system and disadvantaged groups. The article examines how Brazilian CHWs act as street-level bureaucrats mobilizing power in their interactions with users. They operate within a severely under-resourced public health system, the Sistema Único de Saúde , which places constraints upon their action and forces them to make allocation decisions with little training and support. The article highlights the ways in which inequalities in access to health services are reproduced (inadvertently or not) through the practices, discursive styles and classifications of CHWs. Methodologically, the paper is based on ethnography with 24 CHWs and interviews with 77 other CHWs in Brazil. • Develops a novel framework for analysing health worker discretion and power. • Supplements the street-level bureaucracy approach with the concept of domination. • Explores the mobilization of power by Brazilian community health workers. • Shows how policy implementation can reproduce inequality in access to healthcare. [ABSTRACT FROM AUTHOR]