Percentage of patients shifting to another treatment modality: An experience-guided decision

ABSTRACT Objective: This study aimed to assess the frequency with which orthodontic patients decided to shift to another type of orthodontic appliance, among conventional metal brackets, ceramic brackets, lingual brackets and clear aligner, based on their personal experiences of pain, ulcers, bad breath, hygiene issues and social difficulties. Material and Methods: This study comprises of patients seeking orthodontic treatment. The sample (n = 500; age group = 19-25 years) was divided equally into four groups based on the treatment modality: conventional metal brackets, ceramic brackets, lingual brackets and clear aligner. Patients rated the questionnaire using a visual analogue scale, to assess variables (such as pain, ulcer etc) that impact various treatment modalities. Subsequently, patients from all groups provided feedback regarding their treatment experiences, and expressed their preference for an alternative modality. Intergroup comparison among the four groups was done using one-way analysis of variance with Tukey's HSD post-hoc test (p ≤ 0.05). Results: Patients who received lingual brackets reported higher levels of pain and ulceration, as compared to those who received clear aligners. All four groups showed statistically significant differences for ulcers during treatment (p ≤ 0.05). Of the 125 patients who received conventional metal brackets, 28% expressed a preference for clear aligner therapy, while 20% preferred ceramic brackets. In the lingual group, 56% of 125 patients preferred clear aligner therapy, and 8% preferred ceramic brackets to complete their treatment. In the ceramic group, 83% did not want to switch, whereas 17% desired to switch to clear aligner, while in aligner group no patient desired to switch. Conclusions: A higher percentage of patients from lingual brackets group chose to shift to clear aligners, followed by conventional metal brackets group and by ceramic brackets group, in this descending order. The clear aligner group demonstrated fewer issues than the other treatment modalities.

RESUMO Objetivo: Este estudo teve como objetivo avaliar a frequência com que pacientes ortodônticos decidiram mudar para outro tipo de aparelho ortodôntico, entre braquetes convencionais de metal, braquetes cerâmicos, braquetes linguais e alinhadores transparentes, com base em suas experiências pessoais de dor, aftas, mau hálito, problemas de higiene e dificuldades sociais. Material e Métodos: Esse estudo foi composto por pacientes que procuram tratamento ortodôntico. A amostra (n = 500; faixa etária = 19-25 anos) foi dividida igualmente em quatro grupos, com base na modalidade de tratamento: braquetes metálicos convencionais, braquetes cerâmicos, braquetes linguais e alinhadores transparentes. Os pacientes responderam a um questionário, usando uma escala visual analógica, para avaliar variáveis como dor e aftas, que impactam diferentes modalidades de tratamento. Posteriormente, os pacientes de todos os grupos forneceram feedback sobre suas experiências de tratamento e expressaram sua preferência por uma modalidade alternativa. A comparação intergrupos entre os quatro grupos foi feita usando análise de variância unidirecional com teste post-hoc HSD de Tukey (p ≤ 0,05). Resultados: Os pacientes que usaram braquetes linguais relataram níveis mais elevados de dor e aftas, em comparação com aqueles que usaram alinhadores transparentes. Todos os quatro grupos apresentaram diferenças estatisticamente significativas para aftas durante o tratamento (p ≤ 0,05). Dos 125 pacientes que usaram braquetes metálicos convencionais, 28% expressaram preferência pelo tratamento com alinhadores transparentes, enquanto 20% preferiram braquetes cerâmicos. No grupo com braquetes linguais, 56% dos 125 pacientes preferiram o tratamento com alinhadores transparentes e 8% preferiram braquetes cerâmicos para completar o tratamento. No grupo com braquetes cerâmicos, 83% não queriam trocar de tratamento, enquanto 17% desejavam mudar para os alinhadores transparentes; enquanto no grupo de alinhadores nenhum paciente desejou mudar. Conclusões: Uma porcentagem maior de pacientes do grupo com braquetes linguais optou pela mudança para alinhadores transparentes, seguido pelo grupo com braquetes metálicos convencionais e pelo grupo com braquetes cerâmicos, em ordem decrescente. O grupo de alinhadores transparentes demonstrou menos problemas do que as outras modalidades de tratamento.

Knowledge about COVID-19 in the General Population of Mexico

An analytical observational study was conducted to investigate the association between knowledge of COVID-19 in the general population of Mexico and sociodemographic variables of interest. A total of 758 adults between 18 and 74 years old (M = 37.3 SD = 12.6), of which 88.9% had higher education and 33.2% were health care workers, participated in an online questionnaire assessing disease knowledge and the COVID-5 item Fear Scale, which was adapted by the research team. The proportion of individuals with high knowledge about COVID-19 was found to be 41.0%. Participants with higher education and healthcare professionals demonstrated higher knowledge scores in comparison to those with primary and secondary education, as well as non-healthcare professionals (PR=1.25, 95%CI 1.05-1.48). In conclusion, that people with higher education and healthcare workers exhibited better knowledge scores regarding the disease, while high knowledge about COVID-19 was only associated with being a health professional.

Se realizó un estudio observacional analítico con el objetivo de explorar la asociación entre el conocimiento que tiene la población general de México sobre COVID-19 y las variables sociodemográficas de interés. Un total de 758 adultos entre 18 y 74 años (M=37,3 DE=12,6), 88,9% con educación superior y 33,2% trabajadores de la salud, diligenciaron un cuestionario en línea sobre conocimientos la enfermedad y la Escala de Temor a COVID-5, adaptada por el equipo de investigación. La proporción de conocimientos altos sobre COVID-19 fue del 41,0%. Las personas con educación superior y los profesionales de la salud presentaron puntajes de conocimientos altos en comparación con los que tenían primaria y secundaria y con los que no pertenecían al gremio de la salud RP = 1,25 IC 95% (1,05 - 1,48). Se concluye que las personas con escolaridad superior y los profesionales de la salud tienen mejores puntajes de conocimientos sobre la enfermedad, mientras que el conocimiento alto sobre COVID-19 solo se asoció con ser profesional de la salud.

Foi realizado um estudo observacional analítico com o objetivo de explorar a associação entre o conhecimento que tem a população geral de México sobre COVID-19 e as variáveis sociodemográficas de interesse. Um total de 758 adultos entre 18 e 74 anos (M=37,3 DE=12,6), 88,9% com ensino superior e 33,2% trabalhadores da saúde, responderam um questionário on-line sobre conhecimentos a doença e a Escala de Temor a COVID-5, adaptada pela equipe de pesquisa. A proporção de conhecimentos altos sobre COVID-19 foi do 41,0%. As pessoas com educação superior e os profissionais da saúde apresentaram pontuação de conhecimentos altos em comparação com os que tinham ensino básico e ensino médio e com os que não pertenciam aos profissionais da saúde RP = 1,25 IC 95% (1,05 - 1,48). Concluise que as pessoas com educação superior e os profissionais da saúde têm melhor pontuação de conhecimentos sobre a doença, enquanto que o conhecimento alto sobre COVID-19 só se associou com ser professional da saúde.

Desordens informativas: análise de pronunciamentos de Jair Bolsonaro contra a vacinação de covid-19 / Information disorders: analysis of statements by Jair Bolsonaro against covid-19 vaccination / Trastornos de la información: análisis de las declaraciones de Jair Bolsonaro contra la vacunación contra la covid-19

Baseando-se nos conceitos de "desordens informativas" propostos por Claire Wardle e Hossein Derakhshan, este trabalho propõe-se a observar o fenômeno de hesitação vacinal e a opinião pública em relação à vacina CoronaVac contra a covid-19, a partir da análise de falas públicas do presidente Jair Bolsonaro sobre esse imunizante produzido pelo Instituto Butantan em parceria com a biofarmacêutica chinesa Sinovac. As falas em questão foram proferidas no período de julho de 2020 a janeiro de 2021. Através de uma pesquisa de abordagem qualitativa, com finalidades exploratórias e descritivas, o trabalho analisou o conteúdo de dez pronunciamentos do então presidente sobre as vacinas no contexto do primeiro ano da pandemia de covid-19 no Brasil e observou desordens informativas dos seguintes tipos: má informação (17,6%), informação incorreta (47,1%) e desinformação (35,3%) em todas as falas. As desordens informativas propagadas contribuíram para os sentimentos de desconfiança e as posturas coletivas de hesitação vacinal relacionadas à covid-19, principalmente em relação à CoronaVac

Using the concepts of "informational disorder" proposed by Claire Wardle and Hossein Derakhshan, this paper observes the phenomenon of vaccine hesitancy and the public opinion towards the CoronaVac vaccine against covid-19, from the analysis of public speeches by President Jair Bolsonaro about this immunizer produced by Instituto Butantan in partnership with the Chinese biopharmaceutical company Sinovac. The speeches in question were delivered in the period from July 2020 to January 2021. Through a qualitative approach research, with exploratory and descriptive purposes, the work analyzed the content of ten pronouncements of the president about vaccines in the context of the first year of the covid-19 pandemic in Brazil and observed informational disorders of the following types: bad information (17.6%), incorrect information (47.1%) and misinformation (35.3%) in all speeches. The propagated informational disorders contributed to feelings of distrust and collective postures of vaccine hesitancy related to covid-19, especially in relation to CoronaVac

Utilizando los conceptos de "desórdenes informativos" propuestos por Claire Wardle y Hossein Derakhshan, este trabajo observa el fenómeno de la vacilación a la vacunación y la opinión pública hacia la vacuna CoronaVac contra el covid-19, a partir del análisis de los discursos públicos del presidente Jair Bolsonaro sobre este inmunizante producido por el Instituto Butantan en asociación con la biofarmacéutica china Sinovac. Los discursos en cuestión se pronunciaron en el periodo comprendido entre julio de 2020 y enero de 2021. A través de una investigación de abordaje cualitativo, con fines exploratorios y descriptivos, el trabajo analizó el contenido de diez pronunciamientos del presidente sobre vacunas en el contexto del primer año de la pandemia de covid-19 en Brasil y observó trastornos informativos de los siguientes tipos: mala información (17,6%), información incorrecta (47,1%) y desinformación (35,3%) en todos los discursos. Los trastornos informativos propagados contribuyeron a los sentimientos de desconfianza y a las posturas colectivas de indecisión vacunal relacionadas con el covid-19, especialmente en relación con CoronaVac

Conocimientos sobre el aborto inducido y opiniones sobre el uso del misoprostol en Aguascalientes / Knowledge about induced abortion and opinions about the use of misoprostol in Aguascalientes

Resumen Antecedentes: El misoprostol es un medicamento de fácil acceso con el que se puede tener un aborto seguro. Objetivo: Explorar los conocimientos sobre la situación legal del aborto en el Estado de Aguascalientes, en donde el aborto está penalizado, así como los conocimientos y opiniones sobre el misoprostol. Método: Se aplicó un cuestionario en línea a 208 adultos. Resultados: La mayoría de las participantes no conocía la situación legal del aborto ni del Estado de Aguascalientes ni del país. Cerca de la mitad conocía el misoprostol, y sus principales fuentes de información fueron Internet y redes sociales. Aproximadamente la mitad de estos participantes no supo qué complicaciones puede ocasionar que requieran atención médica. Conclusión: El conocimiento sobre la situación legal del aborto y sobre el uso del misoprostol como método abortivo es limitado. Existe consciencia de la importancia de la supervisión médica cuando se usa, aunque esta se dificulta debido a la ilegalidad del aborto en Aguascalientes.

Abstract Background: Misoprostol is an easily accessible medication with which to have a safe abortion. Objective: To explore knowledge about the legal situation of abortion in the state of Aguascalientes, where abortion is criminalized, as well as knowledge and opinions about misoprostol. Method: An online questionnaire was administered to 208 adults. Results: Most of the participants did not know the legal situation of abortion neither in the state of Aguascalientes nor in the country. Almost half of them knew about misoprostol, and their main sources of information were the Internet and social networks. About half of these participants did not know which are the complications that misoprostol may cause that require medical attention. Conclusion: Knowledge about the legal situation of abortion and about the use of misoprostol as an abortion method is limited. There is awareness of the importance of medical supervision when misoprostol is used, but obtaining this supervision is difficult due to the illegality of abortion in Aguascalientes.

The impact of patients with generalized anxiety disorder in the Brazilian Private Healthcare System: a claim database study with expert's perspective / O impacto de pacientes com transtorno de ansiedade generalizada no Sistema Único de Saúde: um estudo de base de sinistros com a perspectiva de especialistas

This study describes the healthcare resource use and costs associated with anxiety assessing claim database outcomes and expert opinion from the perspective of the Brazilian Private Healthcare System. A retrospective analysis of the Orizon database was conducted, containing claims data of anxiety patients reported in Private Healthcare Systems (2015-2017) according to the ICD-10 code (F40 or F41 and their subtypes). Further, a 3-hour online meeting brought together five anxiety and Health Insurance Companies experts to discuss their perspectives. The total cost of the 18,069 patients identified in the database was BRL 490 million: related to medical appointments (2%), exams (16%), emergency room (5%), and others (77%). The mean number of appointments was 5.1 in a 4-year period, performed by 61% of the patients. Approximately 2,595 visits were made to psychiatrists by 923 patients, and 95% underwent at least one examination (100.6 examinations per patient, on average). The identification of anxiety patients and their corresponding burden is challenging to estimate. The higher impact is related to the frequency of healthcare use before the diagnosis than the treatment itself. These outcomes may help plan and implement adequate healthcare programs for patients with anxiety.

Este estudo descreve o uso de recursos de saúde e os custos relacionados à ansiedade associando resultados de uma base de dados administrativa e opinião de especialistas na perspectiva do Sistema Privado de Saúde Brasileiro. Foi realizada uma análise retrospectiva da base de dados da Orizon de pacientes com ansiedade em atendimento hospitalizar ou ambulatorial no Sistema Privado de Saúde (2015 - 2017) com o código CID-10 (F40 ou F41 e os seus subtipos), adicionalmente promovemos uma reunião online de 3 horas com cinco especialistas em ansiedade e em seguros de saúde para discutir as suas perspectivas. O custo total dos 18.069 pacientes identificados no banco de dados foi de R$ 490 milhões, relacionados a consultas médicas (2%), exames (16%), pronto-socorro (5%) e outros (77%). A média de consultas foi de 5,1 em um período de 4 anos, realizadas por 61% dos pacientes. Aproximadamente 2.595 visitas foram feitas a psiquiatras por 923 pacientes, e 95% realizaram pelo menos um exame (média de 100,6 exames por paciente. É desafiador identificar e estimar o impacto da doença no Sistema Privado de Saúde Brasileiro. O impacto maior está relacionado à frequência de uso de serviços de saúde antes do diagnóstico, em comparação com o próprio tratamento. Esses resultados podem ajudar a planejar e implementar programas de saúde adequados para pacientes com ansiedade.

The impact of depression in the Brazilian private healthcare system: patient journey and economic burden study associating claim database and expert's opinion approach / O impacto da depressão no sistema de saúde privado brasileiro: estudo da jornada do paciente e da carga econômica associando banco de dados de sinistros e abordagem de opinião de especialistas

Objective: The study aimed to describe the profile and economic burden of patients with depression from the perspective of the Brazilian Private Healthcare System (PHS). Methods: A two-step methodological quantitative-qualitative research design was performed: retrospective descriptive analysis of the Orizon database of patients with at least one claim of depression (F33, F38, or F39) in PHS (2013-2019) and experienced physicians perspective from an expert meeting. Results: 1,802 patients fulfilling the eligibility criteria counted BRL 74,978 million across the 4-year period. Over this period, nearly 60% of patients had a medical appointment (6.6 appointments per patient, on average), 61% had a psychologist, 9.8% had a psychiatrist appointment, and an average of 115.2 exams and 8.7 emergency visits per patient were performed. According to the experts, the economic impact of depression is more significant when considering the indirect costs related to productivity loss and impairment in occupational and interpersonal functioning. Conclusion: Identifying and diagnosing patients with depression and their real burden is challenging; even with significant costs identified in the claim database analyses in the Brazilian PHS, the real impact must be higher if indirect costs are considered. The depressive disorder should be prioritized in the Brazilian PHS to establish more adequate health policies.

Objetivo: O estudo teve como objetivo descrever o perfil e a carga econômica de pacientes com depressão na perspectiva do Sistema Único de Saúde (SUS). Métodos: Foi realizado um projeto de pesquisa quantitativo-qualitativo metodológico em duas etapas: análise descritiva retrospectiva do banco de dados Orizon de pacientes com pelo menos uma alegação de depressão (F33, F38 ou F39) no PHS (2013- 2019) e perspectiva de médicos experientes de uma reunião de especialistas. Resultados: 1.802 pacientes que preencheram os critérios de elegibilidade totalizaram R$ 74,978 milhões no período de 4 anos. Nesse período, cerca de 60% dos pacientes tiveram consulta médica (6,6 consultas por paciente, em média), 61% tiveram psicólogo, 9,8% consulta com psiquiatra e foram realizados em média 115,2 exames e 8,7 atendimentos de emergência por paciente . Segundo os especialistas, o impacto econômico da depressão é mais significativo quando considerados os custos indiretos relacionados à perda de produtividade e prejuízo no funcionamento ocupacional e interpessoal. Conclusão: Identificar e diagnosticar pacientes com depressão e sua real carga é desafiador; mesmo com custos significativos identificados nas análises da base de sinistros do SUS brasileiro, o impacto real deve ser maior se considerados os custos indiretos. O transtorno depressivo deve ser priorizado na APS brasileira para o estabelecimento de políticas de saúde mais adequadas.

Dilemmas and Perceptions regarding Medical Education in Hindi medium among Medical Community of Northern India: A Cross Sectional study

Introduction: The medical curriculum, the medium of instruction and evaluation in India, is primarily English. While it has the advantage of preparing Indian medical graduates to represent and interact globally, it also translates into learning difficulties for a substantial population of Indian medical students. Hindi is the common language of communication among majority of the population in Uttar Pradesh.Madhya Pradesh Government in India has already started the option of pursuing the allopathic graduate medical course in Hindi. There is paucity of data regarding opinion of medical professionals about implementation of Medical Education in Hindi in Uttar Pradesh and nearby states. Objective: To assess the attitude and opinion of medical students and medical professionals towards using Hindi in Medical Education. Method: A cross-st stsectional web-based online survey was conducted between 1 December 2022 and 31 January 2023. Undergraduate medical students, interns, residents and faculty from medical colleges, hospitals of Uttar Pradesh and neighbouring states (Uttarakhand and Bihar) were contacted to participate in this survey using pretested structured questionnaire. Results: A total of 1606 participants responded and answered the questionnaire and 1575 responses were found complete and used in analysis.Most participants (52.8%) believed that Medical Education in Hindi would attract more students from Hindi backgrounds to join the medical field. Similarly, 58.9% of participants were of the opinion that Medical Education in Hindi would improve communication with patients. However, about half of the participants (49.5%) perceived teaching in Hindi as a hurdle in acquiring higher education. Conclusion: More than half of the participants thought that medical education in Hindi will attract more students from Hindi backgrounds to join the medical field. Similarly, Medical Education in Hindi was perceived to improve communication skills with patients, at least where Hindi is a vernacular language by majority of the participants.

Guidance on the management of adverse reactions induced by poly(ADP-ribose) polymerase inhibitors / 浙江大学学报·医学版

The common adverse reactions caused by poly (ADP-ribose) polymerase (PARP) inhibitors include hematological toxicity, gastrointestinal toxicity and fatigue. The main prevention and treatment of hematological toxicity include: regular blood tests, referral to hematology department when routine treatment is ineffective, and being alert of myelodysplastic syndrome/acute myeloid leukemia. The key points to deal with gastrointestinal toxicity include: taking medicine at the right time, light diet, appropriate amount of drinking water, timely symptomatic treatment, prevention of expected nausea and vomiting, and so on. For fatigue, full assessment should be completed before treatment because the causes of fatigue are various; the management includes massage therapy, psychosocial interventions and drugs such as methylphenidate and Panax quinquefolius according to the severity. In addition, niraparib and fluzoparib can cause hypertension, hypertensive crisis and palpitation. Blood pressure and heart rate monitoring, timely symptomatic treatment, and multidisciplinary consultation should be taken if necessary. When cough and dyspnea occur, high resolution CT and bronchoscopy should be performed to exclude pneumonia. If necessary, PARP inhibitors should be stopped, and glucocorticoid and antimicrobial therapy should be given. Finally, more attention should be paid to drug interaction management, patient self-management and regular monitoring to minimize the risk and harm of adverse reactions of PARP inhibitors.

A onda pró-ciência em tempos de negacionismo: percepção da sociedade brasileira sobre ciência, cientistas e universidades na pandemia da COVID-19 / The pro-science wave in times of denialism: Brazilian society's perception of science, scientists, and universities during the COVID-19 pandemic

Resumo O artigo apresenta resultados de pesquisas sobre percepção pública da ciência na pandemia no Brasil, realizadas no Centro de Estudos SoU_Ciência, sediado na Universidade Federal de São Paulo (Unifesp). Com o intuito de responder à pergunta: "A pandemia da COVID-19 alterou a percepção da sociedade brasileira sobre ciência, cientistas e universidades?", realizamos estudos quantitativos e qualitativos entre agosto/2021 e julho/2022. Em levantamentos quantitativos nacionais de opinião pública, coletamos dados exclusivos de série histórica de enquetes sobre o tema no Brasil, e em grupos focais, aprofundamos estudos sobre percepção e posicionamento político de diferentes segmentos sociais. Em meio ao quadro de crescimento do negacionismo científico, retrocessos políticos e sociais, desmonte de políticas públicas, especificamente científicas e tecnológicas, decorrentes do impeachment de 2016 e da eleição de Bolsonaro em 2018, as pesquisas indicam, aparentemente contrariando a tendência política obscurantista, uma expressiva ampliação do interesse público pela ciência na pandemia no país. Este trabalho analisa a emergência de uma "onda pró-ciência" na opinião pública no Brasil, os fatores que propiciaram seu surgimento na pandemia e suas perspectivas na atualidade.

Abstract This article presents the results of our study on the public perception of science during the COVID-19 pandemic in Brazil, carried out at the Centro de Estudos SoU_Ciência, from Universidade Federal de São Paulo (UNIFESP). To answer the question: "Has the COVID-19 pandemic changed the perception of Brazilian society about science, scientists, and universities?", quantitative and qualitative studies were conducted between August 2021 and July 2022. In national quantitative public opinion surveys, we collected exclusive data from a historical series of polls on the subject in Brazil, and in focus groups, we deepened studies on the perception and political position of different social segments. Amid the growth of scientific denialism; political and social setbacks; and the dismantling of public policies, specifically scientific and technological, resulting from the impeachment of 2016 and the election of Bolsonaro in 2018, research indicates, apparently contrary to an obscurantist political tendency, a significant expansion of public interest in science during the pandemic in the country. This paper analyzes the emergence of a "pro-science wave" in public opinion in Brazil, the factors that led to its emergence during the pandemic, and its current prospects.

La memoria como práctica mediática discursiva frente a la reparación simbólica y la ley de víctimas / Memory as a Discursive Media Practice Vis-A-Vis Symbolic Reparation and the Victims' Law

Resumen El artículo aborda las diferentes perspectivas de opinión que se difunden en la Web entorno a la memoria, la reparación simbólica de las víctimas y frente a la Ley 1448. Tiene por objetivo analizar los núcleos conceptuales y de significado presentes en los diferentes documentos seleccionados.

Abstract The article addresses the different perspectives of opinion, which are dissemi nated on the Web around memory, symbolic reparation of victims and vis-a-vis Law 1448. It aims to analyze the conceptual and meaning cores present in the different selected documents.

An exploratory study using the OMI scale to assess the opinion toward mental illness among young adults

Background: Public perception of mental illness is critical for successful treatment seeking behaviour as well as for early diagnosis and surveillance of disease. Two hundred eleven young patients were interviewed at Department of psychiatry, Sir Sunderlal Hospital, Varanasi with the help of consecutive sampling method. Objective: To assess the opinion towards mental illness among young adults by using the opinion on mental illness scale (OMI). Methods: Data was collected using the opinion about mental illness scale (OMI) which consists of 51 questions out of which, 15 questions directly related to the cause, care, and management of mental illness were randomly selected and analyzed. Analysis was done showing Percentage and chisquare tests to see the significance of scores between the respondents. Results: The finding shows that more than 70% of respondents believe that mental illness is a consequence of bad behavior, lack of willpower, or negative beliefs and gap in the treatment seeking behavior and understanding the cause of disease was found. Conclusions: Opinions on Mental health have received increasing attention as a useful strategy to promote early identification of mental illness, reduce stigma and enhance help-seeking behaviors. As part of the National Mental Health Programme, there is a need to raise awareness in order to enhance understanding of mental illness in facilitating early diagnosis and treatment of disease.

Nuevas modalidades de interacción entre la industria farmacéutica y los médicos / New interaction modalities between the pharmaceutical industry and physicians

Resumen Debido a las restricciones sanitarias secundarias a la pandemia de COVID-19, diversas interacciones entre la industria farmacéutica y los médicos cambiaron. Una de ellas ha sido el método promocional de medicamentos a través de reuniones académicas en torno a padecimientos de interés financiero. Una modalidad reciente ha sido la promoción unilateral de un fármaco determinado por parte de la industria farmacéutica por medio de eventos académicos con la invitación de aparentes "expertos". Estas reuniones frecuentemente están sesgadas no hacia la atención óptima de un padecimiento, sino a la promoción comercial de un medicamento específico que pudiera o no ser la mejor opción o sin la consideración de alternativas terapéuticas asociadas. El Comité de Ética y Transparencia en la Relación Médico-Industria, de la Academia Nacional de Medicina de México, analiza esta nueva circunstancia y propone algunas consideraciones a la comunidad médica.

Abstract Due to sanitary restrictions secondary to the COVID-19 pandemic, various interactions between the pharmaceutical industry and physicians have changed. One of them has been the method for promoting medicinal products through academic meetings around diseases of financial interest. A recent modality has been unilateral promotion by the pharmaceutical industry through academic events with the invitation of so-called "experts" for the promotion of a specific drug; these meetings are often biased not towards optimal care of a disease, but rather towards commercial promotion of a specific drug, which may or may not be the best option, without considering associated therapeutic alternatives. The Committee of Ethics and Transparency in the Physician-Industry Relationship, of the National Academy of Medicine, analyzes this new circumstance and proposes some considerations to the medical community.

Opinión de los estudiantes de odontología de la FES Iztacala UNAM, sobre el proceso de evaluación a distancia antes de la pandemia por COVID-19: estudio transversal / Opinion of dental students at FES Iztacala UNAM on the distance evaluation process before the COVID-19 pandemic: a cross-sectional study

Introducción: El proceso de evaluación a distancia es una modalidad que ha sido utilizada en los últimos años. Sin embargo, la pandemia por COVID-19 ha ocasionado su rápida adaptación. El personal docente ha reportado las ventajas de este modo de evaluación; no obstante, la opinión de los estudiantes de odontología en torno a las ventajas y desventajas de esta modalidad no ha sido explorada. Objetivo: Explorar las ventajas y desventajas de las tecnologías de la información y comunicación (TIC), específicamente en el proceso de evaluación a distancia reportadas por estudiantes de odontología. Material y métodos: Se realizó un estudio transversal retrospectivo, en una muestra no aleatoria de 310 estudiantes de tercer año, distribuidos en cuatro generaciones, adscritos a la Facultad de Odontología de la FES Iztacala. Se administró un cuestionario estructurado para la medición de sus opiniones en torno a las evaluaciones a distancia. Se realizó un análisis descriptivo y bivariado. Resultados: De un total de los 382 estudiantes potencialmente elegibles, 310 aceptaron participar (96%). Conclusiones: La opinión mayoritaria fue la preferencia a los exámenes por Internet y mejor a distancia. Queda pendiente la duda: ¿cuál será el comportamiento cuando los estudios profesionales vuelvan a la normalidad después de la pandemia COVID-19? (AU)

Introduction: The process of distance assessment has been employed in the last years. However, COVID-19 pandemic has accelerated its adoption. Academic personnel have previously reported the benefits of this mode of assessments. Nevertheless, dentistry-students' opinions around the advantages and disadvantages of this mode of assessment has not been explored. Objective: Explore the advantages and disadvantages concerning the ICT skills specifically about the process of distance assessment of dental students. Material and methods: A retrospective cross-sectional study was conducted in a non-randomized sample of 310 of third-year students distributed in four years attending to the School of Dentistry at FES Iztacala. A structured questionnaire was distributed to measure students' opinions around the advantages and disadvantages of distance assessments. A descriptive and bivariate analysis was conducted. Results: Questionnaires were returned by 310 students (96% response rate). Conclusion: Students' perceptions of their ICT skills has increased, matched by better equipment and greater appreciation of e-learning (AU)

Would the Brazilian population support the alcohol policies recommended by the World Health Organization?

ABSTRACT OBJECTIVE To evaluate the support of the Brazilian population to the alcohol-policies proposed by the World Health Organization to decrease alcohol harm (specifically: to decrease alcohol availability and advertising, and to increase pricing). In addition, we evaluated the factors associated with being against those policies. METHODS Data from 16,273 Brazilians, aged 12-65 years, interviewed in the 3rd Brazilian Household Survey on Substance Use (BHSU-3) were analyzed. The BHSU-3 is a nationwide, probability survey conducted in 2015. Individuals were asked if they would be against, neutral, or in favor of seven alcohol policies grouped as: 1) Strengthen restrictions on alcohol availability; 2) Enforce bans or restrictions on alcohol advertising, sponsorship, and promotion; and 3) Raise prices on alcohol through excise taxes and pricing. Generalized linear models were fitted to evaluate factors associated with being against each one of those policies and against all of policies. RESULTS Overall, 28% of the Brazilians supported all the above mentioned policies, whereas 16% were against them. The highest rate of approval refers to restricting advertising (53%), the lowest refers to increasing prices (40%). Factors associated with being against all policies were: being male (AOR = 1.1; 95%CI: 1.0-1.3), not having a religion (AOR = 1.4; 95%CI: 1.1-1.8), being catholic (AOR = 1.3; 95%CI: 1.1-1.5), and alcohol dependence (AOR = 1.6; 95%CI: 1.1-2.4). CONCLUSIONS The Brazilian government could count on the support of most of the population to restrict alcohol advertising. This information is essential to tackle the lobby of the alcohol industry and its clever marketing strategy.

Líderes de opinión digital en tiempos de pandemia: el rol de la Asociación Nacional de Informadores de la Salud en Twitter frente al COVID-19 / Digital opinion leaders in the time of COVID-19: the role of the National Association of Health Reporters on Twitter in the struggle against the pandemic

La Asociación Nacional de Informadores de la Salud constituye una de las mayores asociaciones de prensa sectorial de España, con más de 700 miembros. Durante la crisis del COVID-19, su función en la gestión y difusión de información puede considerarse fundamental. El objetivo general de esta investigación fue analizar cómo se produce la comunicación entre los miembros de la Asociación Nacional de Informadores de la Salud en torno al COVID-19 en Twitter. Se descargaron todos los tuits e interacciones entre los asociados y se analizó la red generada por estos; se identificó a los miembros más influyentes a través de medidas de centralidad y se examinó el contenido de los tuits con mayor difusión y engagement. Tras identificar expresiones que aparecían con mayor frecuencia, se hizo un análisis semántico para extraer los temas más relevantes. Los datos mostraron una red poco cohesionada, donde los usuarios interactúan poco entre sí. Tanto la Asociación como sus miembros, se centran mayoritariamente en la difusión de mensajes fomentadores de concienciación, con información relevante relacionada con la enfermedad, la formación, la denuncia social y el humor. Un uso más coordinado e interactivo de la red social por parte de los miembros de la Asociación, sería deseable para aumentar el alcance y la difusión de sus mensajes(AU)

The National Association of Health Informants is one of the largest sectoral press associations in Spain, with more than 700 members. During the COVID-19 crisis, its role in the management and dissemination of information can be considered fundamental. The overall objective of this research was to analyze how communication occurs between members of the National Association of Health Informants regarding COVID-19 on Twitter. All tweets and interactions between associates were downloaded and the network generated by them was analyzed; the most influential members were identified through measures of centrality and the content of the tweets with the highest diffusion and engagement was examined. After identifying expressions that appeared more frequently, a semantic analysis was made to extract the most relevant topics. The data showed a poorly cohesive network, where users interact little with each other. Both the Association and its members focus mainly on the dissemination of awareness-raising messages, with relevant information related to the disease, training, social denunciation and humor. A more coordinated and interactive use of the social network by the members of the Association would be desirable to increase the reach and dissemination of their messages(AU)

La opinión pública colombiana sobre el acuerdo de paz 2016-2020: punitivismo, desconfianza y ostracismo / Colombian public opinion on the 2016-2020 peace agreement: punitivism, distrust and ostracism / Opinião pública colombiana sobre o acordo de paz de 2016-2020: punitivismo, desconfiança e ostracismo

Después de varias décadas de conflicto armado en Colombia, el Gobierno colombiano y las Farc-EP firmaron, en 2016, el Acuerdo Final para la terminación del conflicto y la construcción de una paz estable y duradera. No obstante, este acuerdo no fue refrendado por la ciudadanía, en un plebiscito celebrado ese mismo año. En 2018, ganó las elecciones presidenciales un candidato que prometió cambiar las condiciones del Acuerdos Final y modificar uno de sus principales instrumentos: la Jurisdicción Especial para la Paz (JEP). En ese contexto esta investigación se pregunta: ¿cuál es la opinión de los colombianos sobre el Acuerdo Final y la JEP? La investigación indaga en las opiniones de los colombianos a través de un análisis estadístico comparativo de tres encuestas de opinión de 2016, 2018 y 2020. Los resultados detallan los cambios actitudinales ocurridos en esos años, como la disminución del rechazo frontal a los Acuerdos de Paz y el leve incremento de las posibilidades de reintegración de los excombatientes a la vida civil. También, expone algunas reticencias al cambio, como la desconfianza persistente, la reafirmación del rechazo al indulto de los excombatientes (punitivismo) y a su participación política (ostracismo).

After several decades of armed conflict in Colombia, the Colombian Government and the Farc-EP signed, in 2016, the Final Agreement for the termination of the conflict and the construction of a stable and lasting peace. However, this agreement was not endorsed by the citizenry, in a plebiscite held that same year. In 2018, the presidential elections were won by a candidate who promised to change the conditions of the Final Agreement and to modify one of its main instruments: the Special Jurisdiction for Peace (JEP). In this context, this research asks: what is the opinion of Colombians on the Final Agreement and the SJP? The research inquiries into the opinions of Colombians through a comparative statistical analysis of three opinion polls from 2016, 2018 and 2020. The results detail the attitudinal changes that occurred in those years, such as the decrease in the frontal rejection of the Peace Accords and the slight increase in the possibilities of reintegration of ex-combatants to civilian life. It also exposes some reluctance to change, such as persistent distrust, the reaffirmation of the rejection of pardoning ex-combatants (punitivism) and their political participation (ostracism).

Após várias décadas de conflito armado na Colômbia, o governo colombiano e as FARC-EP assinaram, em 2016, o Acordo Final para o fim do conflito e a construção de uma paz estável e duradoura. Entretanto, este acordo não foi endossado pelos cidadãos em um plebiscito realizado no mesmo ano. Em 2018, as eleições presidenciais foram ganhas por um candidato que prometeu mudar as condições do Acordo Final e modificar um de seus principais instrumentos: a Jurisdição Especial para a Paz (JEP). Neste contexto, esta pesquisa pergunta: qual é a opinião dos colombianos sobre o Acordo Final e o SJP? A pesquisa investiga as opiniões dos colombianos através de uma análise estatística comparativa de três pesquisas de opinião de 2016, 2018 e 2020. Os resultados detalham as mudanças de atitude que ocorreram nesses anos, tais como a diminuição da rejeição direta dos Acordos de Paz e o leve aumento das possibilidades de reintegração de ex-combatentes na vida civil. Também expõe alguma relutância em mudar, como a desconfiança persistente, a reafirmação da rejeição do perdão de ex-combatentes (punitivismo) e de sua participação política (ostracismo).

Opinions of healthcare students on organ and tissue donation for transplantation / Opiniones de estudiantes del área de la salud sobre la donación de órganos y tejidos para trasplante / Opiniões de estudantes de saúde sobre a doação de órgãos e tecidos para transplante

ABSTRACT Objectives: to analyze the opinions of healthcare students on organ and tissue donation for transplantation. Methods: qualitative document analysis study, using the records of a database and analyzing data from two perspectives: 1) Lexical analysis, with the IRAMUTEQ software, and 2) Thematic content analysis. Results: from the analysis, 3 main categories were generated: 1) Organ and tissue donation as an act of love for others and an opportunity of a new beginning; 2) Clarification and awareness on organ and tissue donation; and 3) Importance of communicating the family and promoting organ and tissue donation. Final Considerations: despite being in favor of donation, students also recognize the presence of social taboos; the discussion in the family nucleus, promoting the theme and raising awareness in society are considered important. Additionally, the education of students is one of the possibilities of intervention for the issue.

RESUMEN Objetivos: analizar las opiniones de estudiantes de cursos de la salud sobre la donación de órganos y tejidos para trasplante. Métodos: se trata de un estudio cualitativo, con diseño de análisis documental, a partir del registro de un banco de datos, considerado bajo dos ópticas: 1) Análisis lexical, con el software IRAMUREQ, y 2) Análisis temático de contenido. Resultados: del análisis se generaron 3 categorías principales: 1) Donación de órganos y tejidos como acto de amor al prójimo y oportunidad de recomenzar; 2) Desmitificación y concienciación sobre la donación de órganos y tejidos; e 3) Importancia de comunicar a la familia y divulgar la donación de órganos y tejidos. Consideraciones Finales: a pesar de que los estudiantes hayan mostrado opiniones favorables hacia la donación, reconocen, también, la existencia de tabúes sociales, haciéndose necesaria la discusión en el núcleo familiar, la divulgación de la temática y la concienciación de la sociedad. Una de las posibilidades de intervención en la problemática es la educación de los alumnos.

RESUMO Objetivos: analisar as opiniões de estudantes de cursos da saúde sobre a doação de órgãos e tecidos para transplante. Métodos: estudo qualitativo, com desenho de análise documental, a partir de registro de um banco de dados, analisados sob duas óticas: 1) Análise lexical, com o software IRAMUREQ, e 2) Análise temática de conteúdo. Resultados: da análise, geraram-se 3 categorias principais: 1) Doação de órgãos e tecidos como ato de amor ao próximo e oportunidade de recomeço; 2) Desmistificação e conscientização sobre doação de órgãos e tecidos; e 3) Importância de comunicar a família e divulgar a doação de órgãos e tecidos. Considerações Finais: apesar dos estudantes demonstrarem opiniões favoráveis à doação, também reconhecem a presença de tabus sociais, sendo importante a discussão em núcleo familiar, a divulgação da temática e a conscientização da sociedade. Além disso, a educação dos discentes torna-se uma das possibilidades de intervenção na problemática.

Medical Affairs/Medical Science Liaison: Organizational Structure and Medical Contributions / 医薬品情報学

Objective: To identify the organizational structure and medical contributions of Medical Affairs/Medical Science Liaison (MA/MSL) and its impact on the spread of the coronavirus-19 (COVID-19) infection.Method: We conducted a web-based survey for 45 pharmaceutical companies based in Japan. The outcome of 43 questions related to organizational structure, business activities, key performance indicators (KPI), and indicators of medical contribution were analyzed and compared.Results: Responses were received from 43 pharmaceutical companies (95.6%; 26 Japanese and 17 foreign). The total number of MSLs exceeded 1,000 with an average of 30.1 MSLs/company. MSLs supervised an average of 21.8/MSL Key Opinion Leaders/Key Thought Leaders (KOLs/KTLs). There were eight MSL organizations per company on average, and Phase II/III had the most number of MSL organizations. Further, 22 companies (56.4%) had MSL organizations in the oncology area. All the companies were independent from departments mainly engaged in "sales and promotion activities," and the most common KPI was “collection insight from KOL/KTL.” Despite having medical qualifications and highly specialized degrees, training was provided continuously to improve expertise. Based on the life cycle of products, Japanese companies are promoting evidence generation and medical events with KOL/KTL supported by internal and external insights and foreign companies are promoting medical-education activities. Due to the COVID-19 pandemic, the number of “in person” activities have significantly decreased and that of "online" activities have increased considerably, and this trend might continue even after the end of the pandemic.Conclusion: The organizational structure and medical contribution of MA/MSL are partially different between Japanese and foreign companies. MSL continued to increase; however, the organization and activities were affected by the product.

Contributions of the Medical Affairs Department to Healthcare Professionals and the Effects of the New Coronavirus Disease 2019 Pandemic on the Contributions / 医薬品情報学

Objective: The purpose of this study was to assess the opinions of healthcare professional regarding the contributions of the Medical Affairs department. Furthermore, we aimed to identify factors influencing and reasons for the contributions in the new coronavirus disease 2019 (COVID-19) pandemic situation.Design/Methods: A web-based survey was conducted among healthcare professionals (Key Opinion Leader/Key Thought Leader, KOL/KTL) who had multiple contacts with the Medical Affairs department, Japan.Results: The responses of 141 KOL/KTLs in Japan were collected; 77.3% of the respondents indicated that the contributions of the Medical Affairs department exceeded their expectations (achieved the expected level of contribution). The most common responses were “the identification of unmet medical needs” and “the dissemination of medical and scientific information, providing advanced medical and scientific information;” other responses included “promoting sales of the company's drugs.” The requests from KOL/KTLs regarding quality were “knowledge about biological and clinical statistics” and “proposal and quick response ability from the perspective of medical staff and patients,” but these responses were partially different between physicians and pharmacists. COVID-19 has resulted in substantial changes, for example, “face-to-face” interactions have significantly decreased from 91.5 to 50.4% and “Online” interactions have significantly increased from 20.6 to 70.9%. However, the effects of the declaration of emergency state could not be identified. The KOL/KTLs requested to make the meeting times more appropriate, conduct in-depth two-way discussions, provide latest information, and discuss about professional manners and behaviors.Conclusion: In summary, regardless of the changes in the types of activities caused by COVID-19, the Medical Affairs department has made substantial contributions to healthcare professionals, who highly appreciated them. Furthermore, depending on responses of individuals whose expectations could not be met, areas of improvements have been suggested.

The self-confidence of dental students in oral surgery / La autoconfianza de los estudiantes de odontología en cirugía oral

ABSTRACT: The aim of this study is to evaluate the self-confidence of undergraduate students and thus to highlight the strengths and weaknesses of oral surgery education from the students' perspectives. A survey was conducted by preparing a questionnaire to assess the the self-confidence of students in performing oral surgery. Survey questions have been imported to Google Forms®. It was then electronically delivered to the students through the Turkish Dental Association. Regarding the data, besides the frequency and percentage distributions, the relationship between the variables was analyzed using the Chi-Square test. A total of 615 students, including 386 female and 229 male students, participated in this study. Of the students, 62.4% were 5th year and 37.56% were 4th year students. According to the survey, it was observed that male students and 5th year students were in general more confident in themselves. Students had low self-confidence in differentiating between odontogenic and non- odontogenic pain and recognizing malignant lesions or lesions with high malignant potential. In the oral surgery curriculum, subjects in which the students have issues should be identified and more emphasis should be placed on them. Oral pathology as well as head and neck anatomy courses should be emphasized further, priority should be given to case-based courses, and reminder presentations should be made at certain intervals. In addition, considering that practice is important for gaining self- confidence, students must practice more under the supervision of instructors in the areas in which they feel inadequate.

RESUMEN: El objetivo de este estudio es evaluar la autoconfianza de los estudiantes de pregrado y así resaltar las fortalezas y debilidades de la educación en cirugía oral desde la perspectiva de los estudiantes. Se realizó una encuesta mediante la elaboración de un cuestionario para evaluar la autoconfianza de los estudiantes en la realización de cirugía oral. Las preguntas de la encuesta se importaron a Google Forms®. Luego se les entregó electrónicamente a los estudiantes a través de la Asociación Dental Turca. En cuanto los datos, además de las distribuciones de frecuencia y porcentaje, se analizó tambien la relación entre las variables mediante la prueba Chi-Cuadrado. Se participaron 386 estudiantes femininas y 229 estudiantes masculinos en este estudio, un total de 615 personas. El 62,4% de los estudiantes eran del 5º año y el 37,56% eran estudiantes del 4º año. Según la encuesta, se observó que los estudiantes masculinos y los estudiantes del 5º año tenían en general más confianza en sí mismos. Los estudiantes tenían poca confianza en sí mismos para diferenciar entre dolor odontogénico y no odontogénico y reconocer lesiones malignas o lesiones malignas con alto potencial. En el plan de estudios de cirugía oral, se deben identificar las materias en las que los estudiantes tienen problemas y se debe poner más énfasis en ellas. Se debe enfatizar aún más los cursos de patología oral, así como de anatomía de cabeza y cuello. Se debe dar prioridad a los cursos basados en casos, y se deben hacer presentaciones recordatorias a ciertos intervalos. Además, considerando que la práctica es importante para aumentar la autoconfianza, los estudiantes deben practicar más bajo la supervisión de instructores en las áreas en las que se sienten inadecuados.