Search

Issue Addressed Methods Results Conclusion So What? Intersectoral action is integral in promoting population health and health equity. In South Australia, public health partnership authorities (PHPAs) are one mechanism to promote intersectoral collaboration for addressing complex public health issues. This case study examined contemporary evidence on the critical elements of successful partnerships, explored the role of formalisation in success, and examined how identified critical elements were operationalised over time in an existing PHPA.In the first phase, a scoping review was conducted. The second phase was a retrospective longitudinal case study of a government‐academic PHPA agreement, involving partnership document review and key informant interviews. Data triangulation and iterative thematic analysis were performed.The critical elements of successful partnership, triangulated through multiple data sources, are mutuality, governance, communication, resources, leadership, and interactions and relationships. These elements have a high degree of interdependence. Trust supports and is reinforced by these elements, particularly during times of change or crisis. Formalisation of a partnership supports success in many ways but is insufficient on its own.Operating in dynamic environments, a partnership requires dedicated time and effort to be successful. Attention to the strength and interconnectedness of the critical elements over the course of a partnership is crucial.This case study describes how the elements of successful partnership can be applied to progress beyond transactional relationships towards authentic collaboration and overcome cross‐border and cross‐boundary public health challenges to promote population health and well‐being. [ABSTRACT FROM AUTHOR]

Background: Palliative care is seldom integrated in healthcare in fragile, conflict affected and vulnerable settings with significant refugee populations. Aim: This study aimed to evaluate the integration of palliative care into a fragile, conflict affected and vulnerable community in Northern Uganda. Design: Consecutive Rapid Participatory Appraisals were conducted to evaluate the integration of palliative care in Adjumani District. The first established a baseline and the second, 4 years later, evaluated progress. Data collection included documentary review, key informant interviews and direct observation. Setting/participants: A rural district in Uganda with equal numbers of refugees and host populations living side-by-side. 104 key informants were interviewed, and practice observed in 11 health facilities. Results: At baseline, palliative care was not routinely integrated in the health system. Barriers included health system challenges, cultural beliefs, understanding and trust, mental health issues, gaps in palliative care provision, the role of the community and beliefs about illness impacted care with the village health teams being a trusted part of the health system. Following integration activities including training, mentorship and community sensitisation, the repeat rapid appraisal after 4 years showed a significant increase in palliative care delivery. New themes identified included increased provision of palliative care, the impact of training and community engagement and ownership of palliative care. Conclusion: Community engagement and participation, training interventions and referral pathways enabled the integration of palliative care. Rapid Participatory Appraisal provides a useful framework to evaluate activities aimed at integration of palliative care in a community. [ABSTRACT FROM AUTHOR]

This study proposes the GOOSE algorithm as a novel metaheuristic algorithm based on the goose's behavior during rest and foraging. The goose stands on one leg and keeps his balance to guard and protect other individuals in the flock. The GOOSE algorithm is benchmarked on 19 well-known benchmark test functions, and the results are verified by a comparative study with genetic algorithm (GA), particle swarm optimization (PSO), dragonfly algorithm (DA), and fitness dependent optimizer (FDO). In addition, the proposed algorithm is tested on 10 modern benchmark functions, and the gained results are compared with three recent algorithms, such as the dragonfly algorithm, whale optimization algorithm (WOA), and salp swarm algorithm (SSA). Moreover, the GOOSE algorithm is tested on 5 classical benchmark functions, and the obtained results are evaluated with six algorithms, such as fitness dependent optimizer (FDO), FOX optimizer, butterfly optimization algorithm (BOA), whale optimization algorithm, dragonfly algorithm, and chimp optimization algorithm (ChOA). The achieved findings attest to the proposed algorithm's superior performance compared to the other algorithms that were utilized in the current study. The technique is then used to optimize Welded beam design and Economic Load Dispatch Problems, Pressure vessel Design Problems, and the Pathological IgG Fraction in the Nervous System, four renowned real-world challenges. The outcomes of the engineering case studies illustrate how well the suggested approach can optimize issues that arise in the real-world. [ABSTRACT FROM AUTHOR]

Copyright of Prävention und Gesundheitsförderung is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Advance Care Planning (ACP) enables patients and relatives to define and share values, goals and preferences for future medical treatment and care. The IMplementing Pediatric Advance Care Planning Toolkit (IMPACT), developed in the Netherlands, is a method for conducting ACP in pediatric palliative care. Healthcare professionals who were trained to use IMPACT, indicated their need for ongoing support to practice ACP communication skills optimally over time. Therefore, we developed a team-based learning program aimed at teaching participants how to transfer knowledge on ACP, continue practicing ACP communication skills and reflect on ACP conversations within their own team context. The aim of this study was to evaluate the program’s transfer of knowledge as well as the professionals’ experience and team reflection on ACP. Methods A one-day IMPACT train-the-trainer course was developed and a selection of healthcare professionals (facilitators) from pediatric palliative care teams (PPCTs) from all seven Dutch university hospitals and the specialized Center for Pediatric Oncology were invited to participate. Hereafter, facilitators were asked to transfer their course-acquired knowledge to their team members (learners) by organizing two coaching-on-the-job sessions. A mixed-methods design, combining questionnaires and field notes, was used to evaluate the level of knowledge transfer and team reflection achieved. Results Eighteen healthcare professionals in the role of facilitator participated in the train-the-trainer course. In seven PPCTs one (n = 3) or two (n = 4) coaching-on-the-job session(s) took place, attended by 29 and 17 learners, respectively. In the questionnaires, 11 facilitators indicated that they had to some extent transferred acquired knowledge to their team members as intended. Sixteen out of 21 learners who participated in at least one coaching-on-the-job session, reported (somewhat) increased self-confidence for conducting ACP conversations. The reported main strength of the program was practicing with/learning from colleagues whereas dealing with workload and variation in existing ACP skills within PPCTs need more attention. Conclusions The newly developed team-based learning program resulted in intended transfer of knowledge and methodical reflection on ACP in coaching-on-the-job sessions in most participating PPCTs. Planning coaching-on-the-job sessions regarding ACP in pediatric palliative care with multiple healthcare professionals is challenging and needs more emphasis in the training.

Background: Assessing the learning environment provides an overview of the current educational status and aids in identifying areas of concern. This study aimed to understand the students’ perceptions of the educational environment at the Paramedical Faculty of Ilam University of Medical Sciences in 2021.Methods: This cross-sectional research was conducted at Ilam University of Medical Sciences, where 300 paramedical students were recruited by census. The Dundee Ready Education Environment Measure (DREEM) was used as the data collection tool. An independent t-test and one-way analysis of variance were used to investigate the relationships between demographic variables and each dimension of the questionnaire. Data analysis was performed using SPSS-26 software.Results: The sample studied included 166 female and 134 male students with an average age of 24.68±7.837 years. The mean and SD of the perception of the educational environment were 112.34 (24.63). There was a significant relationship between marital status, education level, age, and academic semester with students’ understanding of the educational environment (P≤0.05). Twenty percent of the items in the questionnaire indicated a “problematic” situation, while the rest were in a “need of attention” status.Conclusion: The results of this study showed that paramedical students have a positive perception of the educational environment. The lowest mean and SD of the dimensions of the questionnaire were observed in students’ understanding of learning and social self-perception. The other dimensions were in a more satisfactory condition.

Introduction: The methodological preparation of academic directive of the Main Integrative Discipline Integral Stomatology is essential to achieve an educational process with quality, when contributing the integral formation of the graduate. Objective: To design an instrument for the evaluation of the methodological preparation of the academic directive of the Main Integrative Discipline Integral Stomatology. Methods: A descriptive, traverse, observational study was carried out in the Stomatology Faculty, University of Medical Sciences of Santiago from Cuba, from January to May 2023. For the design of the instrument dimensions and indicators were selected according to pedagogic, methodological investigative and managerial approaches; the proposal underwent consideration of a group of experts that completed the inclusion requirements and evaluated it through a Likert scale with three alternatives: very good agreement, in agreement and in disagreement. Theoretical: analysis-synthesis, induction-deduction; empiric: documental revision, and statistical: percentage like summary measure methods were used. Results: The instrument proposed had three dimensions and 18 indicators; 61,1 % of the experts was very of agreement with the proposal. Conclusions: The instrument designed to evaluate the methodological preparation of the academic directive of the Main Integrative Discipline Integral Stomatology is useful, novel, of easy application, that obtained an evaluation of very good agreement in more than half of the experts. [ABSTRACT FROM AUTHOR]

Water resources carrying capacity refers to the ability of the water resources ecosystem to continuously carry the coordination relationship between human society and economy in the normal development process of a country or a region. Its self-sustaining ability, self-regulation and self-development potential often hinder sustainable development in water shortage areas. Research on water resources' carrying capacity is a meaningful way to support regional water resources security and realize harmonious development of society, economy, and ecological environment. Correct assessment of water carrying capacity and response to government policies will contribute to improved water use and sustainable economic and social development. This study first sorts out the relevant questionnaires of water resources carrying capacity level evaluation, proposes the evaluation indicators of water resources carrying capacity level, collects and standardizes the required data, and calculates the weight of each evaluation index by entropy weight method. Then, it calculates the comprehensive evaluation value of China's water resources carrying capacity from 2012 to 2022 in the TOPSIS model. The results show that the total afforestation area, total investment in environmental pollution control, and total industrial wastewater discharge are the third most important factors in improving the carrying capacity of water resources. From 2003 to 2010, China's water resources carrying capacity improved year by year. From 2011 to 2021, China's water resources carrying capacity remained stable year by year. The continuous adjustment of China's industrial structure and strengthening environmental pollution control are inevitable measures to improve the carrying capacity of China's water resources. This study provides a scientific basis for exploring the changing trend of China's water resources carrying capacity and formulating reasonable optimal allocation of water resources. It also has great significance for promoting China's water resources' carrying capacity and sustainable development of the social economy and ecological environment. [ABSTRACT FROM AUTHOR]

Youth experiencing or at risk of experiencing homelessness need tailored prevention programming to prevent unplanned pregnancy and sexually transmitted infections. This study evaluated the efficacy of a small-group, future-oriented positive youth development (PYD) intervention to reduce sexual risk behaviors. Youth aged 14–19 (n = 483) experiencing or at risk of experiencing homelessness were recruited at youth-serving agencies and in alternative schools. Each cohort enrolled was randomized either to a 10-session, 5-week group future-oriented intervention to support them in adopting health-promoting behaviors such as using contraception, including condom use (n = 244) or to a no-treatment condition where they received usual services/schooling (n = 239). We assessed at baseline and 3-month and 9-month follow-up (1) vaginal intercourse without consistent contraception use, (2) vaginal and anal intercourse without consistent condom use, and (3) sexual risk behaviors, including current (last 3 months) effective contraception use by females who did not report current use at baseline. There was no significant difference between treatment and control conditions for most outcomes. However, among females not currently using contraception at baseline, 34% in the treatment condition compared to 12.9% in the control condition reported using contraception in the 3 months before the 9-month survey, a statistically significant difference. This sexual risk reduction intervention, grounded in PYD theory and tailored to address the needs of marginalized groups of youth, demonstrated efficacy at increasing contraceptive uptake among females. The need for PYD interventions that can be delivered in a variety of nontraditional school and service settings are discussed. [ABSTRACT FROM AUTHOR]

Background: Patient and public involvement and engagement (PPIE) in the design of trials is important, as participant experience critically impacts delivery. The Edmond J Safra Accelerating Clinical Trials in PD (EJS ACT-PD) initiative is a UK consortium designing a platform trial for disease modifying therapies in PD. Objective: The integration of PPIE in all aspects of trial design and its evaluation throughout the project. Methods: PwP and care partners were recruited to a PPIE working group (WG) via UK Parkinson's charities, investigator patient groups and participants of a Delphi study on trial design. They are supported by charity representatives, trial delivery experts, researchers and core project team members. PPIE is fully embedded within the consortium's five other WGs and steering group. The group's terms of reference, processes for effective working and PPIE evaluation were co-developed with PPIE contributors. Results: 11 PwP and 4 care partners have supported the PPIE WG and contributed to the development of processes for effective working. A mixed methods research-in-action study is ongoing to evaluate PPIE within the consortium. This includes the Patient Engagement in Research Scale -a quantitative PPIE quality measure; semi-structured interviews -identifying areas for improvement and overall impressions of involvement; process fidelity- recording adherence; project documentation review – identifying impact of PPIE on project outputs. Conclusions: We provide a practical example of PPIE in complex projects. Evaluating feasibility, experiences and impact of PPIE involvement in EJS ACT-PD will inform similar programs on effective strategies. This will help enable future patient-centered research. [ABSTRACT FROM AUTHOR]

Research over many years indicates that individuals with problematic alcohol or drug use or gambling disorders can cause considerable burden on family members. And yet, affected family members (AFMs) are largely neglected in research, health and social care policy and provision. To address the needs of AFMs of people struggling with a substance use or gambling disorder, the 5-Step Method was developed. The goal of this study is to evaluate the routinely delivered 5-Step Method in the Netherlands using measures at baseline (N = 145), and end-of-treatment (N = 102). In addition, a subsample at three-month post intervention (N = 70) was included. The intervention was delivered via video-conferencing to half (47.6%) of the participants. Participants reported significantly lower rates of Total Family Burden after completing the 5-Step Method, when comparing measurements at baseline and end-of-treatment (d = 0.56), and measurements at baseline and three-month post intervention (d = 0.85). In addition, participants following the intervention via video-conferencing (N = 69) performed equally well or better compared to participants following the intervention face-to-face (N = 76). Following the 5-Step Method for AFMs results in lower Total Family Burden. In accordance with the Stress-Strain-Information-Coping-Support (SSICS) model, the effectiveness of the intervention could be improved by finding new ways of increasing support for AFMs. [ABSTRACT FROM AUTHOR]

Building Information Modeling (BIM) is a powerful process for creating and managing data throughout the life cycle of a building. Traditionally, measuring the well-being of building occupants has been addressed solely through objective physical variables such as temperature or relative air humidity. However, recent studies indicate that the built environment influences subjective aspects of human well-being. This article presents a scoping review to find information related to the use of BIM in the assessment of the mental and emotional state of inhabitants. A scoping review has been undertaken following the PRISMA-ScR guidelines by searching in Scopus, ACM, IEEE Xplore and PsycINFO databases. Fourteen articles meeting the inclusion criteria were found after the screening process, all of them published in the last decade, twelve in the last five years. Two ways of using BIM have been identified in relation to the subject matter of this review: (i) for visualization and monitoring of occupant well-being and (ii) for showing building design alternatives to future occupants. The included papers show that BIM has potential for assessing the mental and emotional state of building occupants. However, the results of these studies are still limited and much research in this area remains pending. [ABSTRACT FROM AUTHOR]

Copyright of Argentinian Journal of Respiratory & Physical Therapy (AJRPT) is the property of Asociacion Civil Cientifica de Difusion y Promocion de la Kinesiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT Objective: To evaluate the intra and inter observer agreement of the Sauvegrain, Greulich and Pyle methods. Material and methods: This is an observational, retrospective and cross-sectional study ethically approved by opinion 6,192,391. 100 radiographic images of the elbow and 100 of the left wrist and hand were collected from children whose images were selected by a researcher who did not carry out the evaluations. The Sauvegrain, Greulich and Pyle methods were used to determine bone age. We provided a detailed explanation of each method and the evaluators received a file with the study images. After three weeks, the exams were randomized and the radiograms were reevaluated. Of the 100 patients in group A, 61 (61%) were boys and 39 (39%) were girls. In group B, 67 (67%) were boys and 33 (33%) were girls. Four statistical analyzes were used: correlation; intraclass correlation; analysis using the Bland-Altman graph; differences between groups. Results: Intra and interobserver agreement between groups was considered excellent. Conclusions: Despite the excellent agreement, group A presented a significantly better value than B. Biological ages show a greater difference compared to chronological ages in group A. In group B, skeletal and chronological ages do not show statistical difference according to the accuracy test. Level of Evidence III, Cross-Sectional Observational Study.

BACKGROUND AND OBJECTIVES: Digital and analogue algometry have been widely employed in clinical studies, but a recent investigation observed a systematic error between devices, which may hinder comparison of data from different studies. The objective of this study was to evaluate the reproducibility and reliability of analogue and digital algometers. METHODS: This was an observational transversal study involving 40 healthy adults. They had preserved cognitive capacity and no chronic or acute pain. Participants were submitted to pressure pain threshold (PPT) assessment by two different algometers, 15 minutes apart: a digital device (Wagner Pain Test FPX) and an analogue one (Wagner Force Dial). Data collection involved 2 evaluators and occurred once a week. The muscles evaluated were teres major, upper trapezius, elevator scapulae, supraspinatus, infraspinatus, pectoralis, middle gluteus, paraspinal and deltoid. RESULTS: Reliability between the measurements taken by the same evaluator (intra-rater reliability) or with the same device (inter-rater reliability) on different days was analyzed using the Intraclass Correlation Coefficient (ICC). When comparing the intra-rater reliability (evaluator 1, weeks 1 and 3), good or excellent reproducibility was observed in most of the sites, with both analogue and digital algometers, with statistical significance. The inter-device reliability (digital and analogue algometers) showed a significant and excellent correlation (r > 0.75) in all evaluated sites for both evaluators. The analysis of inter-rater reliability (2 different evaluators) for the digital algometer revealed good or excellent significant correlation in almost all sites, except for the left pectoralis major. For the analogue algometer, all evaluated sites exhibited good or excellent correlation with statistical significance. CONCLUSION: The data highlight that digital and analogue algometry have good intra-rater reliability (reproducibility), inter-device reliability and inter-rater reliability in a sample of healthy young individuals.

Objective: To demonstrate the feasibility and efficacy of a new video-observation training method (intensive visual simulation) to improve upper limb function. Design: Small sample, randomized, evaluator-blind, monocentric study. Patients: Seventeen early subacute ischaemic stroke patients with complete hemiplegia were randomly assigned to the therapeutic group (n = 8) or control group (CG, n = 9). Methods: Thirty sessions of intensive visual simulation combined with corrected visual feedback (therapeutic group) or uncorrected visual feedback (control group) were performed over 6 weeks on top of a standard rehabilitation programme. Main outcome measure: 400-point hand assessment test (400p-HA). Secondary outcome measures: Box and Blocks (B&B), Purdue Pegboard test, Minnesota. Results: The 400p-HA test improved significantly from T0 to 6 months for both groups, with a significant difference between groups at 3 months (MW-UT p = 0.046) and 4 months (MW-UT p = 0.046) in favour of the therapeutic group. One-phase exponential modelling of 400p-HA showed a greater plateau for the therapeutic group (F test p = 0.0021). There was also faster recovery of the ability to perform the B&B tests for the therapeutic group (log-rank test p = 0.03). Conclusion: This study demonstrated the feasibility and potential efficacy of an intensive visual simulation training programme to improve upper limb function in subacute stroke patients. A larger study is needed to confirm these results.

Background The training ability of community preceptors is an important factor related to the quality of standardized training for general practitioners (GPs) . In recent years, training programs for community GP preceptors have been conducted in several regions of China, but no research evaluated the implementation of these programs using a comprehensive approach so far. Objective To explore the current situation and obstacles to the implementation of training program of Graded-Supervised Ambulatory Training by the Second Affiliated Hospital of Zhejiang University School of Medicine, and provide theoretical references and strategic support for the development of problem-oriented countermeasures. Methods From October 2021 to January 2022, the implementation status of Graded-Supervised Ambulatory Training program by the Second Affiliated Hospital of Zhejiang University School of Medicine was systematically evaluated based on CIPP model from four aspects of context, input, process and product, using multiple research methods such as content analysis, expert panels, in-depth interviews, expert rating, and surveys. Results The results of policy document analysis and literature review indicated that community preceptor's training is strongly supported by national health policies, and has been widely implemented in China. The training system developed by the Second Affiliated Hospital of Zhejiang University School of Medicine basically covers the content and process of community preceptor training programme, while the assessment and incentive system developed by the community lacks of detailed instructions. From May 2021 to January 2022, ten community preceptors completed 57 times of ambulatory training, each attending four to seven times. The average score of ability of ambulatory training increased from (78.6±5.7) in the first round to (87.8±4.5) in the seventh round. The satisfaction rates of "site and equipment of training" "training forms" "content of training" and "effect of training" were over 90% among community preceptors and GP residents, yet the satisfaction rate of "proper incentives" among community preceptors was only 20%. Participants reported that the main barriers at present were "imperfect incentive system" "difficulties in recruiting appropriate patients" and "inapplicable training content" . Conclusion In the initial stage, the Graded-Supervised Ambulatory Training programme has achieved desired results in many aspects, but there is still room for improvement. In the next stage of training, countermeasures should be formulated based on the actual situation of the community practice base to continuously improve the quality of training.

Objectives: Prognostic and diagnostic models must work in their intended clinical setting, proven via "external evaluation", preferably by authors uninvolved with model development. By systematic review, we determined the proportion of models published in high-impact radiological journals that are evaluated subsequently. Methods: We hand-searched three radiological journals for multivariable diagnostic/prognostic models 2013–2015 inclusive, developed using regression. We assessed completeness of data presentation to allow subsequent external evaluation. We then searched literature to August 2022 to identify external evaluations of these index models. Results: We identified 98 index studies (73 prognostic; 25 diagnostic) describing 145 models. Only 15 (15%) index studies presented an evaluation (two external). No model was updated. Only 20 (20%) studies presented a model equation. Just 7 (15%) studies developing Cox models presented a risk table, and just 4 (9%) presented the baseline hazard. Two (4%) studies developing non-Cox models presented the intercept. Just 20 (20%) articles presented a Kaplan–Meier curve of the final model. The 98 index studies attracted 4224 citations (including 559 self-citations), median 28 per study. We identified just six (6%) subsequent external evaluations of an index model, five of which were external evaluations by researchers uninvolved with model development, and from a different institution. Conclusions: Very few prognostic or diagnostic models published in radiological literature are evaluated externally, suggesting wasted research effort and resources. Authors' published models should present data sufficient to allow external evaluation by others. To achieve clinical utility, researchers should concentrate on model evaluation and updating rather than continual redevelopment. Clinical relevance statement: The large majority of prognostic and diagnostic models published in high-impact radiological journals are never evaluated. It would be more efficient for researchers to evaluate existing models rather than practice continual redevelopment. Key Points: • Systematic review of highly cited radiological literature identified few diagnostic or prognostic models that were evaluated subsequently by researchers uninvolved with the original model. • Published radiological models frequently omit important information necessary for others to perform an external evaluation: Only 20% of studies presented a model equation or nomogram. • A large proportion of research citing published models focuses on redevelopment and ignores evaluation and updating, which would be a more efficient use of research resources. [ABSTRACT FROM AUTHOR]

BACKGROUND: When establishing Physical Employment Standards, validity is dependent on the correct identification and characterisation of critical job tasks. OBJECTIVE: To develop and validate a standardised protocol for the identification, characterisation, and documentation of critical physical job tasks in military occupational specialities in the Swedish Armed Forces (SwAF), and propose a definition of critical physical job tasks for use in the SwAF. METHODS: A protocol was drafted with three content domains, including a preliminary definition. Protocol content validity was iteratively assessed in two consecutive stages where ten subject experts rated relevance and simplicity. A consensus panel revised the protocol after each stage. Content validity index (CVI) was calculated as item-CVI (I-CVI) per each feature and as scale average (S-CVI/Ave) per content domain. Acceptable content validity thresholds were 0.78 and 0.90, respectively. RESULTS: The validated protocol consisted of 35 items with an I-CVI≥0.90 and≥0.80 for relevance and simplicity, respectively. The S-CVI/Ave was 0.97 for relevance and 0.98 for simplicity. The protocol was language reviewed, reorganised for easy use, and approved by the consensus panel. The final protocol includes: background and aim of the protocol, the accepted generic and critical physical job task definitions, protocol instructions, subject expert-qualifications, job task source and characteristics. CONCLUSION: A standardised protocol for identification and characterisation of critical job tasks in SwAF military occupational specialties was developed. The protocol content was rated relevant and simple by experts and will be of importance in future work establishing physical requirements in the SwAF. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was the multicentric assessment of the virtual prosthetic case planning environment (VCPE), which relocates patient planning into the virtual space in dental education. Materials and Methods: The VCPE is separated into two rooms: a virtual entry area where the user can choose between 10 different prosthetic case plans of ascending complexity, and a virtual patient case planning room. In spring term 2022, the use of virtual case planning was voluntarily assessed in four different German dental schools (DSs) from the perspective of both lecturers and students. The assessment was performed afterwards using a questionnaire. Data were analysed using Kolmogorov–Smirnov test, exploratory data analysis, Fisher–Freeman–Halton test, and exact Fisher test. Reliability was assessed with Cronbach Alpha test (α < 0.05). Results: A total of 59 lecturers and 63 students were included. There were 38.5% male, 60.7% female, and 0.8% diverse participants. The mean age of the lecturers was 36.2 ± 9.0 years and of the students 24.3 ± 3.0 years. The VCPE was assessed as good, yet the evaluations between either the DSs or between the lecturers and students were significantly different. Conclusions: Even though for some assessment criteria significantly different results between the four DS were observed, the majority of participants evaluated the VCPE positively and recommended them for teaching. The virtual reality as a teaching method for teaching prosthetic case planning for the further preparation of the students for the later professional life can be considered as helpful. [ABSTRACT FROM AUTHOR]

Background: Stroke as a cause of disability in adulthood causes an increasing demand for therapy and care services, including telecare and teletherapy. Objectives: Aim of the study is to analyse the acceptance of telepresence robotics and digital therapy applications. Methods: Longitudinal study with a before and after survey of patients, relatives and care and therapy staff. Results: Acceptance of the technology analysed is high in all three groups. Although acceptance among patients declined in parts of the cases in the second survey after having used telerobotics, all in all approval ratings remained high. With regard to patients no significant correlation was found between the general technology acceptance and the acceptance of use of telerobotics. Conclusion: Accepted new telecare and teletherapies can be offered with the help of telepresence robotics. This requires knowledge of and experience with the technology. [ABSTRACT FROM AUTHOR]

Objective: to analyze the criteria for selecting experts in studies evaluating the validity of educational technologies in nursing. Methods: an integrative review was carried out in five databases. Full publications from the last five years in Portuguese, English, and Spanish were included. The analysis was carried out by two independent researchers, with the help of a third reviewer. Results: 29 studies were included. The majority chose to adopt criteria drawn up by the authors themselves (n = 18; 62.1%); followed by using other methodological references (n = 7; 24.1%); and the original Fehring or with adaptations (n=4; 13.8%). The criteria analyzed referred to the domains of academic training, professional performance/experience, and productions. Conclusion: most of the studies did not cite a reference to determine the criteria for selecting experts, nor did they establish a minimum score for selecting experts. Contributions to practice: the need for standardization in the selection of experts and the development of new, comprehensive, and up-to-date criteria such as the one proposed is essential to guide researchers and health professionals in the selection of experts for the evaluation of educational technologies in the field of nursing.

In the context of large-scale rural construction in China, scientific and effective cognition and evaluation of the visual quality of public space in traditional villages is very important for improving the spatial quality of traditional villages. This study builds a cognitive and evaluation mechanism about the visual quality of public space in traditional villages by focusing on eye tracking techniques in ergonomic analysis, combining the results of subjective questionnaires and empirical judgments about the spatial perception of traditional villages. Lixiang Village in Nanjing is selected as a case to explore a scientific analysis of the visual quality of public spaces in traditional villages by using eye tracking technology to collect the subjects’ observation of different types of public spaces in the village and combining the results of the subjective questionnaire. The results of the study showed that the correlations between subjects’ subjective ratings and eye movement data are not as strong, but only moderate for some of these indicators. Moreover, buildings and structures are the most important factors in shaping the richness of public space. Finally, relevant design suggestions and strategies are proposed: in traditional village public spaces, the visual quality of structures and surrounding enclosing buildings should be focused on enhancing, while the focus should be on optimizing the orientation of paths, and also on shaping the unique visual impression of each public space.

This study explored changes in pain-related parameters, occupational function, occupational balance, lifestyle factors, and self-perceived health status in adults with chronic high-impact pain participating in an occupational therapy lifestyle intervention.

Introduction: Conversational agents, powered by artificial intelligence (AI) and natural language processing (NLP), are gaining traction in healthcare for various purposes. This study aimed to assess the potential of ChatGPT, a large language model, for generating health-related communication. Methods: ChatGPT was prompted with identical queries related to healthcare challenges, digital hospital benefits, and principles for organizing a digital hospital. The prompts were presented in January 2023 and 2024, and the resulting outputs were compared. Results: ChatGPT's outputs demonstrated a significant increase in complexity and detail between 2023 and 2024. The 2023 content catered to a general audience, offering clear and concise explanations suitable for raising awareness. In contrast, the 2024 outputs delved deeper into the topics, presenting multifaceted solutions and a broader global perspective. Notably, the 2024 outputs incorporated more technical language, potentially limiting accessibility for a lay audience. Both the 2023 and 2024 versions could benefit from including data to support the claims presented. This study suggests that ChatGPT exhibits promise for generating healthcare content. The observed increase in complexity over time aligns with advancements in AI language models. However, considerations like data inclusion, audience adaptation, and the use of clear language remain crucial. Conclusion: This research contributes to the growing body of knowledge on large language models in healthcare communication. The findings highlight the potential of ChatGPT for content creation while emphasizing the importance of human oversight and tailoring content for the target audience. Future research can explore these aspects in greater detail to optimize the use of AI in healthcare communication strategies. [ABSTRACT FROM AUTHOR]

This study explored changes in pain-related parameters, occupational function, occupational balance, lifestyle factors, and self-perceived health status in adults with chronic high-impact pain participating in an occupational therapy lifestyle intervention. This one-group longitudinal feasibility study was performed in three continuous feasibility rounds. The occupational therapists-led intervention targeted meaningful occupations, regular physical activity, and a healthy diet. The intervention contained individual and group sessions and was added to the standard multidisciplinary chronic pain treatment. Outpatients (n=40, 85 % females, 46.6 ± 10.9 years old) participated in the study between April 2019 and December 2021. The analysis includes data for 31 participants. Analysis of pre-post changes assessed after each feasibility round were performed for the outcomes: pain intensity, pain sensitivity and pain modulation (pressure pain threshold and tolerance, temporal summation of pain and conditioned pain modulation), pain self-efficacy, pain catastrophizing, motor and process skills, occupational balance, daily wake-time movement, daily walking steps, body mass index, waist circumference, blood pressure, and self-perceived health status. Improvements in motor skills (assessment of motor and process skills score=0.20 (1.37; 1.57), 95 % CI 0.01; 0.38) and temporal summation of pain (−1.19 (2.86; −1.67), 95 % CI −2.16; −0.22), but a decrease in pain tolerance (−7.110 (54.42; 47.32), 95 % CI −13.99; −0.22) were observed. Correlation analysis suggested moderate-to-very strong statistically significant relationships in several outcomes related to pain, health, pain coping, occupational balance, occupational functioning, body anthropometrics, and pain sensitivity. This study suggested that the lifestyle intervention would benefit motor skills while effects on other outcomes were unclear in adults with chronic pain. To confirm the findings, a randomized trial evaluating effectiveness is needed. Ethical committee number: SJ-307 Reg. Clinicaltrials.gov: NCT03903900 [ABSTRACT FROM AUTHOR]

Background: In orthopedics, the use of patient decision aids (ptDAs) is limited. With a mixed-method process evaluation, we investigated patient factors associated with accepting versus declining the use of the ptDA, patients' reasons for declining the ptDA, and clinicians' perceived barriers and facilitators for its use. Methods: Patients with an indication for joint replacement surgery (N = 153) completed questionnaires measuring demographics, physical functioning, quality of life (EQ-5D-3L), and a visual analog scale (VAS) pain score at 1 time point. Subsequently, their clinician offered them the relevant ptDA. Using a retrospective design, we compared patients who used the ptDA (59%) with patients who declined (41%) on all these measures as well as the chosen treatment. If the use of the ptDA was declined, patients' reasons were recorded by their clinician and analysed (n = 46). To evaluate the experiences of clinicians (n = 5), semistructured interviews were conducted and thematically analyzed. Clinicians who did not use the ptDA substantially (<10 times) were also interviewed (n = 3). Results: Compared with patients who used the ptDA, patients who declined use had higher VAS pain scores (7.2 v. 6.2, P <.001), reported significantly worse quality of life (on 4 of 6 EQ-5D-3L subscales), and were less likely to receive nonsurgical treatment (4% v. 28%, P <.001). Of the patients who declined to use the ptDA, 46% said they had enough information and felt ready to make a decision without the ptDA. The interviews revealed that clinicians considered the ptDAs most useful for newly diagnosed patients who had not received previous treatment. Conclusion: These results suggest that the uptake of a ptDA may be improved if it is introduced in the early disease stages of hip and knee osteoarthritis. Highlights: Patients who declined the use of a patient decision aid (ptDA) for hip and knee osteoarthritis reported more pain and worse quality of life. Most patients who declined to use a ptDA felt sufficiently well informed to make a treatment decision. Patients who declined the ptDA were more likely to have received prior treatment in primary care. Clinicians found the ptDA to be a helpful addition to the consultation, particularly for newly diagnosed patients. [ABSTRACT FROM AUTHOR]

This study explores the impact of using auditory media in school curricula on the braille-related skills of students who are blind at a Sudanese school. Three sets of braille-related skills (6-dot braille writing, Arabic alphabet writing, and Arabic text reading) were used to evaluate and compare the students' ability to read braille versus listening to text via audio media. The purpose of testing full cells of braille writing was to determine writing speed while that of testing braille writing of the Arabic alphabet was to examine students' accuracy and proficiency in writing. Arabic text reading was tested to determine braille-reading speed. The three braille-related skills were evaluated for a total of 34 students in two groups (Group 1: grades 3 and 4; Group 2: grades 5–8), but the listening speed test was only administered to the second group. T-tests were used to compare the results for the braille-related tests with those for the listening speed test to determine whether braille-related skills were affected by the use of auditory media when accessing school curricula in the early grades of elementary school. The statistical results indicated there were significant differences between the two groups in 6-dot writing and Arabic text reading, whereas there was no significant difference in Arabic alphabet writing. As mastery of braille is an integrated process that requires instruction towards the parallel development of all braille-related skills, the ratio of instructional time devoted to listening compared to that devoted to braille may require adjustment. [ABSTRACT FROM AUTHOR]

Background/Aim. The shortcomings of the orthopanto-mography (OPG) method and radiographic misinterpretations may lead to poor treatment planning and complications during or after the third molar extraction. The aim of this study was to determine the validity and reliability of OPG findings concerning post-extraction wisdom tooth root morphology, as well as whether the degree of clinical expertise affects assessment accuracy. Methods. The cross-sectional study included 200 patients who were referred for third molar extraction. Preoperative OPGs were evaluated by the examiners, who were classified by their level of experience into three groups: students, residents, and professors. True root morphologies were recorded after the extraction, and the accuracy of the assessment was evaluated using various statistical tests. Results. The majority of assessments were accurate for the lower and upper third molars with a single root. The professor group was the most accurate when compared to the assessments made by the students and residents (p = 0.0015). Weighted Cohen's kappa (kw) values for intra-respondent accuracy gradually increased from the student to professor group (0.06, 0.28, 0.34, respectively). The highest discrepancy in inter-respondent accuracy was determined between the student and professor groups (poor; Kw = 0.25584). Conclusion. In this study, the results that confirm the reliability of the OPG scan for the detection of accurate third molars root morphology have not been achieved. The level of clinical experience affects diagnostic accuracy, but complex clinical cases should be evaluated using different methods. [ABSTRACT FROM AUTHOR]

Analytical and therapeutic innovations led to a continuous but variable extension of newborn screening (NBS) programmes worldwide. Every extension requires a careful evaluation of feasibility, diagnostic (process) quality and possible health benefits to balance benefits and limitations. The aim of this study was to evaluate the suitability of 18 candidate diseases for inclusion in NBS programmes. Utilising tandem mass spectrometry as well as establishing specific diagnostic pathways with second‐tier analyses, three German NBS centres designed and conducted an evaluation study for 18 candidate diseases, all of them inherited metabolic diseases. In total, 1 777 264 NBS samples were analysed. Overall, 441 positive NBS results were reported resulting in 68 confirmed diagnoses, 373 false‐positive cases and an estimated cumulative prevalence of approximately 1 in 26 000 newborns. The positive predictive value ranged from 0.07 (carnitine transporter defect) to 0.67 (HMG‐CoA lyase deficiency). Three individuals were missed and 14 individuals (21%) developed symptoms before the positive NBS results were reported. The majority of tested candidate diseases were found to be suitable for inclusion in NBS programmes, while multiple acyl‐CoA dehydrogenase deficiency, isolated methylmalonic acidurias, propionic acidemia and malonyl‐CoA decarboxylase deficiency showed some and carnitine transporter defect significant limitations. Evaluation studies are an important tool to assess the potential benefits and limitations of expanding NBS programmes to new diseases. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To identify the factors associated with the omission of nursing care and patient safety climate. Method: A cross-sectional study developed at a university hospital in the Brazilian Center-West, between September and December 2022. The MISSCARE-Brazil and the Safety Attitudes Questionnaire were applied to a convenience sample of 164 nursing professionals. Results: The most omitted care was walking three times a day or as prescribed (66.5%). The overall score of the Safety Attitudes Questionnaire was 63,8 (SD: 12,6). The level of satisfaction (p

Summary: Background: Bloodstream infections (BSI) pose a significant threat due to high mortality rates and the challenges posed by antimicrobial resistance (AMR). In 2019, an estimated 4.95 million deaths were linked to bacterial AMR. The highest impact was seen in resource-limited settings (RLS). For diagnosis of BSI, performant continuously-monitoring blood culture systems (CMBCS) have been optimized. However, in RLS, the implementation of CMBCS is hindered by budget constraints and unsuitable environmental conditions. Manufacturers from growing economies are currently producing affordable in vitro diagnostics, which could fill the gap in capacity, but so far these are not established outside their domestic markets. Methods: This study evaluated the performance, usability, and interchangeability of Chinese CMBCS in a laboratory setting using simulated blood cultures with a panel of 20 BSI-associated strains. Four systems were selected for the assessment: Autobio BC60, Mindray TDR60, Scenker Labstar50, and DL-biotech DL-60. Findings: Overall, all evaluated CMBCS demonstrated good performance with high yield (96.7–100%) and specificity (97.5–100%), comparable to the reference system (bioMérieux 3D). In addition, when used as “manual” blood cultures in a conventional incubator with visual growth detection, performance was also satisfactory: yield was between 90 and 100% and specificity was 100% for all BCBs. Both the CMBCS and the BCBs were easy to use and lot-to-lot variability in BCBs was minimal. The interchangeability testing indicated that the BCBs from different brands (all except Scenker) were compatible with the various automates, further highlighting the potential for a harmonized “universal BCB.'' Interpretation: Based on this in vitro study, we recommend the use of these systems in settings with challenging environments and limited resources. The Autobio system performed best for automatic detection and DL-Biotech BCBs for manual cultures respectively (combination of performance, price, usability). The appropriateness for use in RLS should still be confirmed in a field study. Funding: The study was funded by FIND.

Yali Liu,1,&ast; Zhihong Qi,2,&ast; Meirong Bai,1,&ast; Jianle Kang,1 Jinxin Xu,1 Huochun Yi3 1Department of Thoracic Surgery, Zhongshan Hospital Xiamen University, Xiamen, Fujian, 361012, People’s Republic of China; 2Department of Urologic Surgery, Zhongshan Hospital Xiamen University, Xiamen, Fujian, 361012, People’s Republic of China; 3Clinical Laboratory, Zhongshan Hospital Xiamen University, Xiamen, Fujian, 361012, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jinxin Xu, Department of Thoracic Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, No. 201 Hubin South Road, Siming District, Xiamen, People’s Republic of China, Email 2297203944@qq.com Huochun Yi, Centre of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, No. 201 Hubin South Road, Siming District, Xiamen, People’s Republic of China, Email yhc1818@xmu.edu.cnObjective: This study aims to investigate the independent prognostic factors of patients with coronavirus disease 2019 (COVID-19) and thereafter construct a related prognostic model.Methods: The subjects were screened following the COVID-19 diagnostic criteria. The independent prognostic factors were selected based on the indicators, including medical history, clinical manifestation, laboratory tests, imaging examination and clinical prognosis. Subsequently, we constructed a nomogram model to predict short-term prognosis.Results: Clinical information was obtained from 393 COVID-19 patients admitted to Zhongshan Hospital at Xiamen University between December 2022 and January 2023. The independent risk factors determined by Cox multivariate regression analysis included gender (OR: 0.355, 95% CI: 0.16~0.745), age (OR: 3.938, 95% CI: 1.221~15.9), pectoral muscle index (PMI, OR: 4.985, 95% CI: 2.336~11.443), pneumonia severity score (PSS, OR: 6.486, 95% CI: 2.082~21.416) and lactate dehydrogenase (LDH, OR: 3.857, 95% CI: 1.571~10.266). A short-term prognostic nomogram was developed based on the five independent risk factors above. The area under the receiver operating characteristic (ROC) curve (AUC) of the nomogram model was 0.857. The calibration curve confirmed the outcomes of the prognostic model, which exhibited excellent consistency with the actual results.Conclusion: In summary, gender, age, pectoral muscle index, pneumonia severity score, and lactate dehydrogenase are all independent risk factors for COVID-19 mortality. Thus, the nomogram based on the above indicators can predict the risk of mortality in COVID-19 patients. This may have the potential of being clinical application in prognostic evaluation of COVID-19.Keywords: COVID-19, risk factors, nomogram, prognoses, evaluation study

This report describes the experience and lessons learnt from designing and implementing a combined quantitative and qualitative method to assess barriers to accessing health services. This approach was developed to study barriers to access in five dimensions: availability; geographical, financial, and organizational accessibility; acceptability; contact; and effective coverage. The study design was used in six countries in the World Health Organization Region of the Americas. The findings highlight the importance of having a well defined analysis framework and the benefits of adopting a mixed-methods approach. Using existing data and contextualizing findings according to specific population groups and geographical areas were essential for relevance and utilization of the study outcomes. The findings demonstrate the feasibility of using mixed methods to understand the complexity of access problems faced by different subpopulations. By involving decision-makers from the beginning and allowing flexibility for sustained discussions, the analysis and findings had an impact. The engagement of health authorities and key stakeholders facilitated the use of the findings for collaborative identification of policy options to eliminate access barriers. Lessons learnt from the study emphasized the need for active participation of decision-makers, flexibility in the process, and sustained opportunities for discussion to ensure impact. Giving consideration to local priorities and adapting the methods accordingly were important for the relevance and use of the findings. Future efforts could consider incorporating mixed methods into national and local monitoring and evaluation systems.

ObjectivesThis systematic literature review and meta-analysis aimed to determine the effect of body position on the measurement of pelvic floor muscle (PFM) contractility and to analyze the influential factors.Data sourcesFive databases (PubMed, Web of Science, EMBASE, Cochrane Library and Scopus) were searched for relevant studies published up to 12nd October 2023.Study selection or eligibility criteriaIncluded cross-sectional studies had to involve the assessment of pelvic floor muscle function in at least two positions.Study appraisal and synthesis methodsWe calculated standardized mean difference (SMD) with 95% confidence intervals (CI) to ascertain the potential effect of body position on outcomes.ResultsIn total, we included 11 cross-sectional studies to ascertain the potential effect of body position on outcomes. There was no statistical difference in the results of maximum voluntary contraction (MVC) of the pelvic floor muscles when assessed in between supine and standing positions (SMD −0.22; 95% CI −0.72 to 0.28; p = 0.38). The results of the meta-analysis showed significantly larger values of resting voluntary contractions (RVC) measured in the standing position compared to the supine position (SMD −1.76; 95% CI −2.55 to −0.97; p

HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic disabling disease. However, there is a lack of an adequate and specific health measurement instrument validated and with good performance to assess their degree of physical disability. This led us to carry out this study and to evaluate the performance of Fiocruz's National Institute of Infectious Diseases (IDS) disability scale, a specific instrument for HAM/TSP. Ninety-two HAM/TSP patients participated in the study. One researcher applied the IDS, IPEC scale, Disability Status Scale (DSS), Expanded DSS (EDSS), Osame scale, Beck Depression Inventory, and the WHOQOL-BREF questionnaire. In parallel, blindly, and separately, other researchers applied the IDS. An inter-rater reliability analysis of the IDS, correlation analysis with the other scales, and depression and quality of life questionnaires were performed. The applicability of the IDS was also evaluated. The IDS showed high reliability in all scores. The inter-rater reliability test for the total IDS score was 0.94 (0.82-0.98) on its four dimensions. The scale adequately indicated the different degrees of disability, presenting a distribution similar to normal. There was a high correlation with the other scales (Spearman coefficients > 0.80, p < 0.001). The scale had good acceptance among users and a short application time. IDS for HAM/TSP was reliable, consistent, easy, and fast to use. It can be used for both prospective evaluations and clinical trials. The present study supports the IDS as a valid instrument to measure disability in patients with HAM/TSP compared to previously used scales. [ABSTRACT FROM AUTHOR]

Background Stroke is among the three leading causes of disability around the world, and it results in immediate difficulty in mobility and gait. There is a lack of instruments to evaluate what daily life is like for these individuals using their lower limbs in real-life environments (outside of the clinical environment). Objective To perform the translation and cultural adaptation to Brazilian Portuguese of the Lower-Extremity Motor Activity Log (LE-MAL) and test its measurement properties in chronic poststroke individuals. Methods The LE-MAL was translated into Brazilian Portuguese and adapted to the Brazilian culture. The comprehension and relevance of the final version were analyzed by a committee of specialists. The reliability, validity, and responsiveness of the LE-MAL/Brazil to detect changes after lower extremity constraint-induced movement therapy (LE-CIMT) and an intensive conventional therapy were tested. Results The LE-MAL/Brazil showed excellent inter- and intrarater reliability, with an intraclass correlation coefficient and Cronbach alpha > 0.70, as well as standard error of measurement and smallest detectable change 0.50.

Plain Language Summary Cesarean section rates in Brazil are among the highest in the world, particularly in private hospitals. In 2015, a quality improvement project was implemented in private hospitals aiming to reduce the cesarean section (CS) rates (the Adequate Childbirth Project—PPA). In the 2017–2018 period, the Healthy Birth Study (HBS) was proposed to assess the effect of the PPA project in CS rates, as well as use of obstetric interventions, adoption of good practices during labor and birth care and outcomes for both women and their babies. This article presents the comparison of 4873 births analyzed in the HBS, 2589 who were exposed to the PPA project and 2284 who received standard care. The analysis aim was to compare CS rates at the same time to assess if women who were part of the PPA intervention were less likely to have a negative event for themselves or their babies. A group of 15 measures of safety of obstetric care and negative outcomes for women and their babies was compared. Women who were exposed to the PPA intervention had a lower chance of CS, late preterm and early term deliveries. At the same time, the PPA group did not have worse outcomes for women or babies. In terms of safety care, the PPA intervention was associated with both positive and negative effects. For instance, women exposed to the PPA group had a higher chance of not receiving antibiotics to prevent infections when they needed, when compared to standard care.

Purpose: Few studies have evaluated real-world performance of radiological AI-tools in clinical practice. Over one-year, we prospectively evaluated the use of AI software to support the detection of intracranial large vessel occlusions (LVO) on CT angiography (CTA). Method: Quantitative measures (user log-in attempts, AI standalone performance) and qualitative data (user surveys) were reviewed by a key-user group at three timepoints. A total of 491 CTA studies of 460 patients were included for analysis. Results: The overall accuracy of the AI-tool for LVO detection and localization was 87.6%, sensitivity 69.1% and specificity 91.2%. Out of 81 LVOs, 31 of 34 (91%) M1 occlusions were detected correctly, 19 of 38 (50%) M2 occlusions, and 6 of 9 (67%) ICA occlusions. The product was considered user-friendly. The diagnostic confidence of the users for LVO detection remained the same over the year. The last measured net promotor score was −56%. The use of the AI-tool fluctuated over the year with a declining trend. Conclusions: Our pragmatic approach of evaluating the AI-tool used in clinical practice, helped us to monitor the usage, to estimate the perceived added value by the users of the AI-tool, and to make an informed decision about the continuation of the use of the AI-tool.

In May 2018, the Scottish Government introduced a minimum unit price (MUP) for alcohol of £0.50 (1 UK unit = 8 g ethanol) to reduce alcohol consumption, particularly among people drinking at harmful levels. This study aimed to evaluate MUP's impact on the prevalence of harmful drinking among adults in Scotland. This was a controlled interrupted monthly time series analysis of repeat cross-sectional data collected via 1-week drinking diaries from adult drinkers in Scotland (N = 38,674) and Northern England (N = 71,687) between January 2009 and February 2020. The primary outcome was the proportion of drinkers consuming at harmful levels (>50 [men] or >35 [women] units in diary week). The secondary outcomes included the proportion of drinkers consuming at hazardous (≥14–50 [men] or ≥14–35 [women] units) and moderate (<14 units) levels and measures of beverage preferences and drinking patterns. Analyses also examined the prevalence of harmful drinking in key subgroups. There was no significant change in the proportion of drinkers consuming at harmful levels (β = +0.6 percentage points; 95% confidence interval [CI] = −1.1, +2.3) or moderate levels (β = +1.4 percentage points; 95% confidence interval = −1.1, +3.8) after the introduction of MUP. The proportion consuming at hazardous levels fell significantly by 3.5 percentage points (95% CI = −5.4, −1.7). There were no significant changes in other secondary outcomes or in the subgroup analyses after correction for multiple testing. Introducing MUP in Scotland was not associated with reductions in the proportion of drinkers consuming at harmful levels but did reduce the prevalence of hazardous drinking. This adds to previous evidence that MUP reduced overall alcohol consumption in Scotland and consumption among those drinking above moderate levels. [ABSTRACT FROM AUTHOR]