Concept Formation

概念形成
  • 文章类型: Journal Article
    背景:自我报告健康是调查和问卷调查中广泛使用的健康指标。当研究发现该措施与1970年代和1980年代的死亡率有关时,该措施引起了关注。该措施还与发病率和其他健康结果有关,例如卫生服务的利用。自我报告的健康对于年轻人来说是一个特别有用的衡量标准,因为这个年龄组通常在临床上是健康的。然而,众所周知,许多慢性疾病的潜伏期长,在生命早期开始。由于其预测性,自我报告的健康状况可用于估计年轻人当前和未来的健康状况。尽管它广泛使用,然而,自我报告的健康仍然是一个知之甚少的概念。本文提出了系统审查的方案,该方案将确定和综合定性研究,调查年轻人在评估他们的健康状况时考虑的因素,当他们谈论整体健康时。
    方法:审查的人群是10-24岁的年轻人,有或没有健康状况。我们将搜索MEDLINE(Ovid®)的数据库,PsycINFO(APAPsycNet),ProQuest社会学合集,和WebofScienceCoreCollection™。我们还将利用参考文献检查和正向引文搜索的技术,因为这一策略已被证明在社会科学系统评价中产生了更多的高质量研究。在初步搜索中使用了GoogleScholar和Google搜索;GoogleScholar将用于正向引用搜索。我们将包括用英语写的研究,德语,或芬兰语;没有较低的日期限制。一位审阅者将筛选所有引用。第二个审阅者将独立筛选20%的摘要样本。数据将由一名研究人员提取,另外两名研究人员将独立审查所有提取的数据,质量评估将由第一审核人完成。我们将利用质量框架来评估包含的文章和定性研究的主题综合。
    结论:本系统评价的结果将提高对健康自我评估过程中考虑的因素的理解;这将改善对定量研究结果的解释。此外,提高对健康概念的理解将有助于制定支持年轻人健康的健康政策和干预措施。
    背景:PROSPEROCRD42022367519.
    BACKGROUND: Self-reported health is a widely used health indicator in surveys and questionnaires. The measure gained attention when research identified its association with mortality in the 1970s and 1980s. The measure is also associated with morbidity and other health outcomes such as the utilisation of health services. Self-reported health is a particularly useful measure for young people because this age group is generally clinically healthy. However, it is known that many chronic conditions have long latency periods that are initiated early in life. Because of its predictive nature, self-reported health can be used to estimate young people\'s current and future health. Despite its widespread use, however, self-reported health remains a poorly understood concept. This paper presents the protocol for a systematic review that will identify and synthesise qualitative studies that investigate the factors that are considered by young people when they assess their health, and when they talk about health overall.
    METHODS: The population of the review is young people aged 10-24 years, with or without health conditions. We will search the databases of MEDLINE (Ovid®), PsycINFO (APA PsycNet), ProQuest Sociology Collection, and Web of Science Core Collection™. We will also utilise techniques of reference checking and forward citation searching, as this strategy has been shown to result in a higher number of high-quality studies in social science systematic reviews. Google Scholar and Google Search were used during preliminary searches; Google Scholar will be utilised for forward citation searching. We will include studies written in English, German, or Finnish; there will be no lower date limit. One reviewer will screen all citations. A second reviewer will independently screen a sample of 20% of the abstracts. Data will be extracted by one researcher, two other researchers will independently review all data extracted, and quality appraisal will be completed by the first reviewer. We will utilise the Quality Framework for the appraisal of included articles and thematic synthesis of qualitative studies.
    CONCLUSIONS: The results of this systematic review will improve the understanding of the factors that are considered during the self-assessments of health; this will improve the interpretation of the results of quantitative research. Also, an improved understanding of the conceptualisation of health will inform the development of health policies and interventions that support young people\'s health.
    BACKGROUND: PROSPERO CRD42022367519.
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  • 文章类型: Journal Article
    目的:本研究的目的是研究全球综合疾病监测(IDS)系统的概念化和可操作性及其有效性的证据。此外,以确定摩根等人提出的建议。得到证据的支持,以及哪些证据可以为国家的IDS发展提供信息。
    方法:该研究纳入了范围审查。
    方法:本综述总结了符合以下纳入标准的证据:参与者:任何卫生部门;概念:IDS;背景:全球。我们搜查了Medline,Embase,以及1998年至2022年之间的英文出版物的Epidemonikos。采用标准审查方法。一个定制的概念框架指导了叙事分析。这项范围审查是一项研究计划的一部分,该计划具有三个关键要素,其他研究是对国际国家公共卫生机构协会成员的疾病监测系统现状的调查,以及对七个国家监测系统的深入分析和案例研究,突出一体化的机遇和挑战。
    结果:八篇综述和五项主要研究,被评估为低质量,包括在内,主要研究非洲的IDS,人类部门,和传染病。没有报道在COVID-19大流行期间对疾病控制或IDS演变的影响。IDS和集成的描述各不相同。有效的IDS系统的先决条件主要与核心功能和资源需求的充分性有关。支持系统集成和数据共享的法律或法规没有得到解决。核心职能的提供和所需资源被描述为不足,融资是不可持续的,治理很差。启用者包括活动数据共享,机构之间的密切合作,清晰的报告渠道,垂直计划的整合,加强员工培训,并采用移动报告。而IDS和Morgan等人的概念框架。提出的原则在一定程度上反映在文献中突出强调的IDS优先事项中,证据基础仍然薄弱。
    结论:现有证据支离破碎,不完整,质量差。该综述发现缺乏关于IDS对疾病控制的影响的可靠评估研究。虽然缺乏证据并不意味着缺乏益处或效果,它应该表明有必要评估监测系统未来发展中集成的过程和影响。需要通用的IDS定义和构成IDS系统的部分的衔接。进一步稳健的影响评估,以及对其IDS系统的国家审查和评估,需要改善证据基础。
    OBJECTIVE: The objective of this study was to examine the conceptualisation and operationalisation of Integrated Disease Surveillance (IDS) systems globally and the evidence for their effectiveness. Furthermore, to determine whether the recommendations made by Morgan et al. are supported by the evidence and what the evidence is to inform country development of IDS.
    METHODS: The study incorporated a scoping review.
    METHODS: This review summarised evidence meeting the following inclusion criteria: Participants: any health sector; Concept: IDS; and Context: global. We searched Medline, Embase, and Epistemonikos for English publications between 1998 and 2022. Standard review methods were applied. A bespoke conceptual framework guided the narrative analysis. This scoping review is part of a research programme with three key elements, with the other studies being a survey of the International Association of National Public Health Institutes members on the current status of their disease surveillance systems and a deeper analysis and case studies of the surveillance systems in seven countries, to highlight the opportunities and challenges of integration.
    RESULTS: Eight reviews and five primary studies, which were assessed as being of low quality, were included, mostly examining IDS in Africa, the human sector, and communicable diseases. None reported on the effects on disease control or on the evolution of IDS during the COVID-19 pandemic. Descriptions of IDS and of integration varied. Prerequisites of effective IDS systems mostly related to the adequacy of core functions and resourcing requirements. Laws or regulations supporting system integration and data sharing were not addressed. The provision of core functions and resourcing requirements were described as inadequate, financing as non-sustainable, and governance as poor. Enablers included active data sharing, close cooperation between agencies, clear reporting channels, integration of vertical programs, increased staff training, and adopting mobile reporting. Whilst the conceptual framework for IDS and Morgan et al.\'s proposed principles were to some extent reflected in the highlighted priorities for IDS in the literature, the evidence base remains weak.
    CONCLUSIONS: Available evidence is fragmented, incomplete, and of poor quality. The review found a lack of robust evaluation studies on the impact of IDS on disease control. Whilst a lack of evidence does not imply a lack of benefit or effect, it should signal the need to evaluate the process and impact of integration in the future development of surveillance systems. A common IDS definition and articulation of the parts that constitute an IDS system are needed. Further robust impact evaluations, as well as country reviews and evaluations of their IDS systems, are required to improve the evidence base.
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  • 文章类型: Systematic Review
    背景:提高儿童的健康素养(HL)可能是下一代具有更多健康素养的机会。本范围审查的目的是概述如何在9-12岁儿童的健康促进背景下对HL进行概念化和描述。
    方法:根据PubMed中的PRISMAScR对\'健康素养\'和\'儿童\'和\'措施\'进行了系统和全面的搜索,Embase.com和通过EbscoinCINAHL,APAPsycInfo和ERIC。两名审稿人独立筛选标题和摘要,并评估有关资格的全文出版物。数据被系统地提取,根据以前发表的HL定义,使用演绎分析对提取的HL描述进行定性分析。
    结果:搜索提供了5,401个原始标题,其中包括26份合格出版物。我们发现学习成果的描述以及HL的能力有很大差异。大多数HL描述可以链接到文献中常用的HL定义,一些组合了几个HL维度。HL维度之间的描述各不相同,并不总是与健康促进相关。教育环境在HL促进健康方面发挥着重要作用。
    结论:HL的描述确实是多样化和复杂的,涵盖了广泛的主题。我们建议采用全面综合的方法来描述HL尺寸,特别是在促进儿童健康方面。通过考虑HL的不同维度及其在教育计划中的整合,孩子们可以从小就学习HL技能和能力。
    BACKGROUND: Increasing health literacy (HL) in children could be an opportunity for a more health literate future generation. The aim of this scoping review is to provide an overview of how HL is conceptualized and described in the context of health promotion in 9-12-year-old children.
    METHODS: A systematic and comprehensive search for \'health literacy\' and \'children\' and \'measure\' was performed in accordance with PRISMA ScR in PubMed, Embase.com and via Ebsco in CINAHL, APA PsycInfo and ERIC. Two reviewers independently screened titles and abstracts and evaluated full-text publications regarding eligibility. Data was extracted systematically, and the extracted descriptions of HL were analyzed qualitatively using deductive analysis based on previously published HL definitions.
    RESULTS: The search provided 5,401 original titles, of which 26 eligible publications were included. We found a wide variation of descriptions of learning outcomes as well as competencies for HL. Most HL descriptions could be linked to commonly used definitions of HL in the literature, and some combined several HL dimensions. The descriptions varied between HL dimensions and were not always relevant to health promotion. The educational setting plays a prominent role in HL regarding health promotion.
    CONCLUSIONS: The description of HL is truly diverse and complex encompassing a wide range of topics. We recommend adopting a comprehensive and integrated approach to describe HL dimensions, particularly in the context of health promotion for children. By considering the diverse dimensions of HL and its integration within educational programs, children can learn HL skills and competencies from an early age.
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  • 文章类型: Journal Article
    背景:基于社区的参与式研究(CBPR)是一种合作研究方法,可在研究过程的所有步骤中平等地吸引研究人员和社区利益相关者,以促进社会变革并增加研究相关性。社区咨询委员会(CAB)是一个CBPR工具,其中具有生活经验和社区组织的个人被纳入研究过程,并确保工作与社区优先事项保持一致。我们寻求(1)探索招聘和参与具有CAB生活经验的人的最佳实践,以及(2)确定有关最小化组织和社区成员之间的动力动力动力的文献范围,这些成员具有在CAB上一起工作的生活经验。
    方法:此范围审查将遵循Arksey和O\'Malley方法框架,由Levac等人通知,并将使用PRISMA(系统审查和荟萃分析的首选报告项目)图进行报告。已经为Embase开发了详细和强大的搜索策略,Medline和PsychINFO。将考虑在1990年1月1日至2023年3月30日之间发表的灰色文献参考文献和参考文献列表。两名审稿人将在标题/摘要和全文筛选的两个连续阶段中独立筛选参考文献。冲突将由协商一致或第三审稿人决定。主题分析将分三个阶段应用:开放编码、轴向编码和抽象。提取的数据将以表格格式和/或图形摘要记录和显示,描述性概述,讨论研究结果与研究问题的关系。此时,已经对同行评审和灰色文献进行了初步搜索。同行评审文献的搜索结果已被上传到Covidence进行回顾和相关性评估。
    背景:本次审查不需要正式的伦理批准。审查结果将为正在进行和未来的CBPR社区咨询委员会动态提供信息。
    背景:该协议已在开放科学框架(https://doi.org/10.17605/OSF)上进行了前瞻性注册。IO/QF5D3)。
    BACKGROUND: Community-based participatory research (CBPR) is a collaborative research approach that equally engages researchers and community stakeholders throughout all steps of the research process to facilitate social change and increase research relevance. Community advisory boards (CABs) are a CBPR tool in which individuals with lived experience and community organisations are integrated into the research process and ensure the work aligns with community priorities. We seek to (1) explore the best practices for the recruitment and engagement of people with lived experiences on CABs and (2) identify the scope of literature on minimising power dynamics between organisations and community members with lived experience who work on CABs together.
    METHODS: This scoping review will follow the Arksey and O\'Malley methodological framework, informed by Levac et al, and will be reported using a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram. Detailed and robust search strategies have been developed for Embase, Medline and PsychINFO. Grey literature references and reference lists of included articles published between 1 January 1990 and 30 March 2023 will be considered. Two reviewers will independently screen references in two successive stages of title/abstract and full-text screening. Conflicts will be decided by consensus or a third reviewer. Thematic analysis will be applied in three phases: open coding, axial coding and abstraction. Extracted data will be recorded and presented in a tabular format and/or graphical summaries, with a descriptive overview discussing how the research findings relate to the research questions. At this time, a preliminary search of peer-reviewed and grey literature has been conducted. Search results for peer-reviewed literature have been uploaded to Covidence for review and appraisal for relevance.
    BACKGROUND: Formal ethics approval is not required for this review. Review findings will inform ongoing and future CBPR community advisory board dynamics.
    BACKGROUND: The protocol has been registered prospectively on the Open Science Framework (https://doi.org/10.17605/OSF.IO/QF5D3).
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  • 文章类型: Review
    目标:本范围审查将现有文献绘制成学生和毕业生在大学到工作过渡期间的心理健康经历。本综述调查了这些研究的方法学特征,主要发现,以及这些研究用来概念化心理健康和转型的理论。
    方法:该项目使用了由Peters及其同事和JoannaBriggs研究所创建和开发的范围审查方法。该综述搜索了学术数据库,并筛选了符合预定纳入标准的现有研究。
    方法:使用一组搜索词搜索了七个学术数据库和GoogleScholar。
    纳入的研究检查了那些在3年内是大学最后一年的学生或大学毕业的参与者。包括自2000年以来以英语发表的任何国家的研究。该综述包括研究心理健康的负面维度。该评论排除了针对医学生和毕业生的研究。
    方法:检索了有关研究的基本信息及其在心理健康和大学工作过渡方面的发现。调查结果在表格和定性专题摘要中列出。
    结果:范围审查包括12项研究。心理健康通常没有明确定义,其理论基础也没有明确阐明。审查确定了因素,包括缺乏社会支持和经济不稳定,作为不良心理健康的来源。这些研究中的其他保护因素-预防心理健康问题的变量-被确定,比如职业准备和有一份好工作。
    结论:尽管方法学关注心理健康的消极方面,在大学到工作的过渡期间,人们的心理健康经历并不是一致的负面的。在未来的研究中明确的心理健康概念将有助于开发资源以改善福祉。
    背景:此范围审查遵循了以前在本期刊上发布的协议,并在OpenScienceFramework网站(https://osf.io/gw86x)上注册。
    OBJECTIVE: This scoping review maps the extant literature on students\' and graduates\' mental health experiences throughout their university-to-work transitions. The current review investigates the methodological features of the studies, the main findings, and the theories that the studies draw on to conceptualise mental health and transitions.
    METHODS: This project used a scoping review methodology created and developed by Peters and colleagues and the Joanna Briggs Institute. The review searched academic databases and screened existing studies that met predetermined inclusion criteria.
    METHODS: Seven academic databases and Google Scholar were searched with sets of search terms.
    UNASSIGNED: The included studies examined participants who were final-year university students or those who had graduated from university within a 3-year period. Studies published in English since 2000 and from any country were included. The review included studies examining the negative dimensions of mental health. The review excluded studies focusing on medical students and graduates.
    METHODS: Basic information about the studies and their findings on mental health and university-to-work transitions was retrieved. The findings are presented in tables and in a qualitative thematic summary.
    RESULTS: The scoping review included 12 studies. Mental health was often not explicitly defined and it\'s theoretical foundations were not clearly articulated. The review identified factors, including a lack of social support and economic precarity, as sources of adverse mental health. Other protective factors in these studies-variables that guard against mental health problems-were identified, such as career preparedness and having a good job.
    CONCLUSIONS: Despite the methodological focus on the negative aspects of mental health, people\'s mental health experiences during university-to-work transitions are not uniformly negative. Clear conceptualisations of mental health in future studies will aid in developing resources to improve well-being.
    BACKGROUND: This scoping review adhered to a protocol previously published in this journal and that is registered on the Open Science Framework website (https://osf.io/gw86x).
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  • 文章类型: Review
    催眠是一种古老的身心干预措施,在过去十年中,随着研究的激增而重新引起了人们的兴趣,记录了其临床有效性。然而,理论家之间普遍存在理论争议和误解,临床医生,和公众,阻碍理解,接受,复制,使用催眠。提供足够的信息,消除误解,促进更平衡的观点,有必要促进催眠在临床和研究环境中的实施和采用。这篇评论重新审视了整个历史中催眠的概念化及其周围的理论争议,同时强调了它们的会合点和临床意义。尽管存在二分法,关于催眠镇痛作用的理论方法似乎达成了广泛的一致,关键组件,和词汇。Further,理论强调了催眠反应的关键因素。例如,社会理论强调社会和背景变量,而国家理论强调生物心理社会机制和个体因素。基于理论,术语催眠治疗或临床催眠被推荐用于指催眠在心理治疗和医疗环境中的治疗用途,分别。这篇综述总结了一个模型,该模型整合了各种理论和证据,并提出了催眠作为一种复杂的多方面干预措施,包括多个程序。现象,及影响因素。这篇综述旨在加深我们对催眠的理解,并促进其在研究和临床环境中更快地采用和充分实施,除了指导研究以证据为基础的催眠实践。通过促进有关催眠程序的知识,该综述可以具有重要的研究和临床意义,现象,及影响因素。
    Hypnosis is an ancient mind-body intervention that has regained interest with the surge of research in the last decade documenting its clinical validity. Yet, theoretical controversies and misconceptions prevail among theorists, clinicians, and the general public, impeding the understanding, acceptance, replication, and use of hypnosis. Providing adequate information, which dispels misconceptions and promotes more balanced views, is warranted to facilitate the implementation and adoption of hypnosis in clinical and research settings. This review re-examines the conceptualisation of hypnosis throughout history and the theoretical controversies surrounding it while highlighting their meeting points and clinical implications. Despite dichotomies, a broad agreement appears across theoretical approaches regarding hypnotic analgesia effects, key components, and vocabulary. Further, theories highlight key factors of hypnotic responding. For instance, social theories highlight social and contextual variables, whereas state theories highlight biopsychosocial mechanisms and individual factors. Based on theories, the terms hypnotherapy or clinical hypnosis are recommended to refer to the therapeutic use of hypnosis in psychotherapeutic and medical contexts, respectively. This review concludes with a model that integrates various theories and evidence and presents hypnosis as a complex multifaceted intervention encompassing multiple procedures, phenomena, and influencing factors. This review intends to deepen our understanding of hypnosis, and promote its more rapid adoption and adequate implementation in research and clinical contexts, in addition to steering research towards evidence-based hypnotic practice. The review can have important research and clinical implications by contributing to advancing knowledge regarding hypnotic procedures, phenomena, and influencing factors.
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  • 文章类型: Journal Article
    目的:这篇综述的目的是为了更好地理解1970年至今关于女同性恋的同盟权是如何定义的,同性恋,双性恋,变性人,酷儿,两个精神,以及以英语为主要口语的健康环境中的其他(LGBTQ2S+)组。
    背景:LGBTQ2S+个体经历了根植于歧视的健康不平等。在健康环境中纠正这种歧视的激进主义通常被称为同盟。allyship的定义,然而,保持模棱两可。更清楚地了解如何在健康环境中定义和实施allyship是支持LGBTQ2S+群体健康的组成部分。
    方法:1970年至今的英文文献,利用与加拿大和美国LGBTQ2S+群体相关的医疗保健和/或健康环境中的联盟概念,澳大利亚,新西兰,英国也将包括在内。
    方法:此范围审查将根据JBI范围审查方法进行。要搜索的数据库将包括MEDLINE(OVID),CINAHL(EBSCOhost),APAPsycINFO(EBSCOhost),LGBTQ+源(EBSCOhost),Scopus,和WebofScience,以及ProQuest论文和灰色文学论文。两名独立审稿人将筛选标题,摘要,和全文文章;差异将通过协商一致或与第三审稿人解决。将使用研究团队开发的提取工具提取数据。研究结果将以表格/图表形式呈现,并附有叙述性摘要,以突出与医疗保健环境中LGBTQ2S+个人/团体的当代联盟概念化相关的关键主题,以及对卫生专业实践和健康结果的影响。
    背景:开放科学框架osf.io/2rek9.
    OBJECTIVE: The objective of this review is to better understand how allyship is defined in the literature from 1970 to the present with regard to lesbian, gay, bisexual, transgender, queer, two-spirit, and other (LGBTQ2S+) groups within health settings where English is the primary spoken language.
    BACKGROUND: LGBTQ2S+ individuals experience health inequities rooted in discrimination. Activism to redress this discrimination in health settings is frequently termed allyship. Definitions of allyship, however, remain ambiguous. A clearer understanding of how allyship is defined and operationalized within health settings is integral to supporting the health of LGBTQ2S+ groups.
    METHODS: Literature in English from 1970 to the present that utilizes the concept of allyship within health care and/or health settings in relation to LGBTQ2S+ groups in Canada and the United States, Australia, New Zealand, and the United Kingdom will be included.
    METHODS: This scoping review will be conducted in accordance with the JBI methodology for scoping reviews. Databases to be searched will include MEDLINE (OVID), CINAHL (EBSCOhost), APA PsycINFO (EBSCOhost), LGBTQ+ Source (EBSCOhost), Scopus, and Web of Science, along with ProQuest Dissertations and Theses for gray literature. Two independent reviewers will screen titles, abstracts, and full-text articles; discrepancies will be resolved by consensus or with a third reviewer. Data will be extracted using an extraction tool developed by the research team. Findings will be presented in tabular/diagram format along with a narrative summary to highlight key themes that relate to contemporary conceptualizations of allyship with LGBTQ2S+ individuals/groups within health care settings and the implications for health professional practice and health outcomes.
    BACKGROUND: Open Science Framework osf.io/2rek9.
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  • 文章类型: Systematic Review
    目标:全球各个教育级别的各个学科在考试中答案改变的价值上充满了矛盾。因此,本次范围界定综述的目的是探索当前与研究生和本科生阶段答案变化相关的证据,重点是护理教育.
    方法:范围审查由Arksey和O'Malley的范围审查框架指导。该团队使用系统评论和Meta分析的首选报告项目扩展为范围审查指南来报告结果。
    方法:使用已识别的关键字,例如答案更改,回溯和测试明智,研究人员从多个数据库中找到了49项相关研究。在应用预定的纳入标准后,包括来自所有学科的本科生或研究生,还有十个有待审查。
    方法:先验方案是:改变测试答案会降低分数。使用作者设计的抽象工具将研究随机分配给每个研究人员进行第一次和第二次审查。口头和解是对每篇文章的第三次也是最后一次审查。
    结果:范围审查显示,答案的变化产生了更多的错误答案。此外,答案变化的总分提高高达45.15%。
    结论:10篇文章的研究结果综合驳斥了假设,即答案变化会对正确答案的数量产生负面影响,并可能降低总体考试成绩。本次范围界定审查的结果支持允许答案更改。然而,审查的研究中不同的研究方法也表明有必要对该主题进行进一步研究。
    OBJECTIVE: Various disciplines at all education levels worldwide are steeped in contradictions regarding the value of answer changing on exams. Therefore, the purpose of this scoping review was to explore the current evidence related to answer changing at the graduate and undergraduate level with a focus on nursing education.
    METHODS: The scoping review was guided by Arksey and O\'Malley\'s scoping review framework. The team used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guideline to report the findings.
    METHODS: Using identified keywords such as answer changing, backtracking and test wiseness, researchers located forty-nine relevant studies from multiple databases. After applying the predetermined inclusion criteria including college students from all disciplines at the undergraduate or graduate level, ten remained for review.
    METHODS: The a priori protocol was; changing answers on tests will lower scores. Studies were randomly assigned to each researcher for a first and second review using an author designed abstraction tool. Verbal reconciliation was the third and final review of each article.
    RESULTS: The scoping review revealed that answer changes produced more wrong to right answers. In addition, total score improvements with answer changes were as high as 45.15 %.
    CONCLUSIONS: The synthesis of findings from 10 articles refuted assumptions that answer changing would negatively impact the number of correct responses and potentially lower the overall exam score. The findings from this scoping review support permitting answer changes. However, the varied research approaches in the studies reviewed also suggest the need to conduct further research on the topic.
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  • 文章类型: Review
    背景:最近全球卫生系统受到冲击和压力的推动,关于卫生系统弹性的各种研究已经出现。我们的目的是描述如何在实证研究和先前的评论中实施卫生系统弹性。我们将这些与更广泛的领域中的核心概念化和弹性特征进行比较(具体来说,工程,社会生态,组织和社区复原力概念),追踪不同的学校,健康文献中韧性的概念和应用。
    方法:我们在Pubmed数据库中搜索了与\'弹性\'和\'卫生系统\'相关的概念。对纳入的研究进行了两项单独的分析:根据所涵盖的部分卫生系统,共进行了n=87项关于卫生系统韧性的实证研究,威胁类型,弹性阶段,弹性范式,和建立复原力的方法;总共有n=30条审查获得了全文审查,并根据审查类型进行了表征,审查中确定的复原力概念,和理论框架或潜在的弹性概念化。
    结果:健康与韧性的交集显然在学术话语中变得越来越重要,自2018年以来,大多数论文在各种期刊上发表,并应对外部威胁。或参考更频繁的医院危机管理。大多数研究集中于卫生系统的总体弹性(从而对外部冲击或压力的反应),或对医院内的弹性(从而对定期电击和手术)。对社区和初级保健的关注较少,无论是正式的还是非正式的。虽然大多数出版物没有明确研究范式,“弹性工程”是最突出的一个,其次是“社区复原力”和“组织复原力”。恢复力的社会生态系统根源应用最少,证实了我们在健康复原力文献中转化概念应用有限的发现。
    结论:我们的审查表明,该领域是零散的,特别是在使用非健康弹性领域的弹性范例和方法时,以及使用这些的卫生系统设置。考虑到复杂和自适应的卫生系统内部和之间的连接,这种分散和孤立的方法可能会有问题,从社区演员到当地人,区域,或国家公共卫生组织进行二级保健。如果没有一个全面的定义和框架来捕捉这些相互依存关系,操作化,衡量和提高弹性仍然具有挑战性。
    BACKGROUND: Prompted by recent shocks and stresses to health systems globally, various studies have emerged on health system resilience. Our aim is to describe how health system resilience is operationalised within empirical studies and previous reviews. We compare these to the core conceptualisations and characteristics of resilience in a broader set of domains (specifically, engineering, socio-ecological, organisational and community resilience concepts), and trace the different schools, concepts and applications of resilience across the health literature.
    METHODS: We searched the Pubmed database for concepts related to \'resilience\' and \'health systems\'. Two separate analyses were conducted for included studies: a total of n = 87 empirical studies on health system resilience were characterised according to part of health systems covered, type of threat, resilience phase, resilience paradigm, and approaches to building resilience; and a total of n = 30 reviews received full-text review and characterised according to type of review, resilience concepts identified in the review, and theoretical framework or underlying resilience conceptualisation.
    RESULTS: The intersection of health and resilience clearly has gained importance in the academic discourse with most papers published since 2018 in a variety of journals and in response to external threats, or in reference to more frequent hospital crisis management. Most studies focus on either resilience of health systems generally (and thereby responding to an external shock or stress), or on resilience within hospitals (and thereby to regular shocks and operations). Less attention has been given to community-based and primary care, whether formal or informal. While most publications do not make the research paradigm explicit, \'resilience engineering\' is the most prominent one, followed by \'community resilience\' and \'organisational resilience\'. The social-ecological systems roots of resilience find the least application, confirming our findings of the limited application of the concept of transformation in the health resilience literature.
    CONCLUSIONS: Our review shows that the field is fragmented, especially in the use of resilience paradigms and approaches from non-health resilience domains, and the health system settings in which these are used. This fragmentation and siloed approach can be problematic given the connections within and between the complex and adaptive health systems, ranging from community actors to local, regional, or national public health organisations to secondary care. Without a comprehensive definition and framework that captures these interdependencies, operationalising, measuring and improving resilience remains challenging.
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  • 文章类型: Meta-Analysis
    尽管《联合国禁止酷刑公约》和其他国际条约禁止,全世界有无数人遭受酷刑,和卫生保健从业者在全球越来越多地遇到难民酷刑幸存者在他们的临床实践。方法,地理分布,全球酷刑的频率没有得到很好的描述,这限制了医疗保健从业人员充分诊断和治疗酷刑后遗症的能力。
    对酷刑方法的共性进行排名,并确定与之相关的世界区域。
    对于本系统综述和荟萃分析,OvidMEDLINE,OvidEmbase,WebofScience,从成立到2021年7月,搜索了Cochrane图书馆。
    纳入的研究是同行评审的英文文章,包含了经历过酷刑的个体的独立样本,并概述了所经历的酷刑类型。排除的研究未进行同行评审,缺乏独立的样本人口,或者没有指定酷刑方法。文章由两名独立和盲目的审稿人选择纳入,还有第三个,独立审查员解决了差异。总的来说,266篇文章-最初确定为全面审查的1739项研究中的15.3%-符合纳入标准。
    数据抽象和质量评估遵循系统评价和荟萃分析指南的首选报告项目。数据由2个独立和盲审稿人提取到预定义的模板中,还有第三个,独立审查员解决了差异。使用Downs和Black检查表评估偏倚风险。
    酷刑方法按其平均频率排名,报告研究的数量,以及这些方法发生的国家数量。
    总共筛选了9937个标题和摘要,和266项研究,涵盖103604名个体(13350名男性,5610名女性,和84644未指定)进行了分析。报告了105个国家的酷刑;21种方法占所有报告方法的84%,10种方法占所有身体酷刑的78%。前3种方法是殴打或钝器创伤(在208项研究和59个国家/地区中报告;平均频率,62.4%;95%CI,57.7%-67.1%),电酷刑(在114项研究和28个国家报告;平均频率,17.2%;95%CI,15.0%-19.4%),和饥饿或脱水(在26个国家的65项研究中报告;平均频率,12.7%;95%CI,10.2%-15.2%)。根据唐斯和布莱克评估工具,50项研究被评为好或优,216项被评为一般或差。
    这项研究的结果表明,酷刑仍然普遍存在。尽管存在无数的酷刑方法,有限的数量占了报告的酷刑的绝大多数。所以可以开发靶向治疗,需要进一步调查以更好地阐明与最常见的酷刑方法相关的后遗症,这里描述。
    Despite its prohibition by the United Nations Convention against Torture and other international treaties, torture has been perpetrated against countless individuals worldwide, and health care practitioners globally are increasingly encountering refugee torture survivors in their clinical practices. The methods, geographic distribution, and frequency of torture globally are not well described, which limits health care practitioners\' ability to adequately diagnose and treat the sequelae of torture.
    To rank the commonness of torture methods and identify the regions of the world with which they are associated.
    For this systematic review and meta-analysis, Ovid MEDLINE, Ovid Embase, Web of Science, and The Cochrane Library were searched from inception to July 2021.
    Included studies were peer-reviewed articles in English, contained an independent sample population of individuals who experienced torture, and outlined the type(s) of torture experienced. Excluded studies were not peer reviewed, lacked an independent sample population, or did not specify torture methods. Articles were chosen for inclusion by 2 independent and blinded reviewers, and a third, independent reviewer resolved discrepancies. Overall, 266 articles-15.3% of the 1739 studies initially identified for full review-met the inclusion criteria.
    Data abstraction and quality assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted by 2 independent and blinded reviewers into predefined templates, and a third, independent reviewer resolved discrepancies. The risk of bias was evaluated using the Downs and Black Checklist.
    Torture methods were ranked by their average frequencies, numbers of reporting studies, and numbers of countries wherein the methods occurred.
    A total of 9937 titles and abstracts were screened, and 266 studies encompassing 103 604 individuals (13 350 men, 5610 women, and 84 644 unspecified) were analyzed. Torture was reported for 105 countries; 21 methods accounted for 84% of all reported methods and 10 methods accounted for 78% of all physical tortures. The top 3 methods were beating or blunt-force trauma (reported in 208 studies and 59 countries; average frequency, 62.4%; 95% CI, 57.7%-67.1%), electrical torture (reported in 114 studies and 28 countries; average frequency, 17.2%; 95% CI, 15.0%-19.4%), and starvation or dehydration (reported in 65 studies in 26 countries; average frequency, 12.7%; 95% CI, 10.2%-15.2%). According to the Downs and Black appraisal tool, 50 studies were rated as good or excellent and 216 as fair or poor.
    The findings of this study suggest that torture remains widespread. Although innumerable torture methods exist, a limited number account for the vast majority of reported tortures. So that targeted therapies may be developed, additional investigation is needed to better elucidate the sequelae associated with the most common torture methods, described here.
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