Diversity

多样性
  • 文章类型: Journal Article
    背景和目的:临床实践指南(CPG)对全球医疗实践产生了重大影响。然而,由几个医学协会产生的CPG的作者并不能代表他们所处理的领域和人口,因为来自种族和族裔少数群体的妇女和个人作为作者的代表性不足。我们假设,由美国儿科学会(AAP)制作的CPG的作者中,来自少数民族和种族群体的妇女和个人也将代表不足。方法:在这项横断面研究中,性别,种族,对2010年1月至2023年5月发表的AAP制作的CPG的作者和小组委员会参与者的种族构成进行了分析,并与2010年和2021年美国人口以及2010年和2022年美国医学院儿科教师进行了比较。结果:女性(39.7%,所有位置的127/320,和42.5%,85/200的指定作者职位)和女医生(35.2%,101/287的所有位置,和36.4%,64/176的指定作者职位)在美国人口普查和儿科教师中的代表比例明显不足,而男性和男性医生的代表比例明显过高。来自所有种族和族裔群体的女性和女性医生以及来自少数种族和族裔群体的男性和男性医生在美国人口普查和儿科教师中的比例明显不足。没有黑人被确认为作者。结论:产生CPG的医学社会应认识到这些不平等现象,并确保适当的作者多样性。
    Background and Objectives: Clinical practice guidelines (CPGs) have significantly influenced medical practice worldwide. Nevertheless, the authorship of CPGs produced by several medical societies has not been representative of the field and population they address, as women and individuals from racial and ethnic minority groups have been underrepresented as authors. We hypothesized that women and individuals from minoritized racial and ethnic groups would also be underrepresented as authors of CPGs produced by the American Academy of Pediatrics (AAP). Methods: In this cross-sectional study, the gender, race, and ethnic composition of authors and subcommittee participants of AAP-produced CPGs published from January 2010 through May 2023 were analyzed and compared to the 2010 and 2021 U.S. population and 2010 and 2022 U.S. medical school pediatric faculty. Results: Women (39.7%, 127/320 of all positions, and 42.5%, 85/200 of named author positions) and women physicians (35.2%, 101/287 of all positions, and 36.4%, 64/176 of named author positions) were significantly underrepresented-while men and men physicians were significantly overrepresented-from their respective composition in the U.S. Census and pediatric faculty. Women and women physicians from all racial and ethnic groups and men and men physicians from minority racial and ethnic groups were significantly underrepresented-from their respective composition in the U.S. Census and pediatric faculty. No Black man was identified as an author. Conclusions: Medical societies that produce CPGs should be cognizant of these inequities and ensure appropriate authorship diversity.
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  • 文章类型: Systematic Review
    背景:存活脓毒症运动(SSC)指南对各种患者人群和医院环境的普遍性一直存在争议。对支持该指南的临床证据的多样性和代表性的定量评估将有助于评估建议的普遍性并确定战略研究目标和优先事项。在这项研究中,我们在原始研究中评估了患者的多样性,在性方面,种族/民族,和地理位置。我们还评估了研究第一位和最后一位作者在性别和地理代表性方面的多样性。
    方法:确定了支持2021年SSC成人指南建议的所有临床研究。包括原始临床研究,而社论,reviews,非临床研究,荟萃分析被排除。对于符合条件的研究,我们记录了男性患者的比例,每个代表种族/族裔分组的百分比(如有),以及进行这些活动的国家。我们还记录了第一位和最后一位作者的性别和位置。世界银行的分类用于对国家进行分类。
    结果:SSC指南包括六个部分,基于351项临床研究的85项建议。男性患者的比例为47%至62%。大多数研究没有报告纳入患者的种族/民族分布;当他们这样做时,大多数是白人患者(68-77%)。大多数研究是在高收入国家进行的(77-99%),其中包括欧洲/中亚(33-66%)和北美(36-55%)。此外,大多数第一/最后作者是男性(55-93%)和来自高收入国家(77-99%)。
    结论:为了提高SCC指南的普遍性,利益相关者应制定策略,以增强临床研究的多样性和代表性。尽管临床研究中纳入的患者在性别方面有合理的代表性,证据没有反映种族/民族和地理位置的多样性.为证据做出贡献的第一作者和最后作者之间也缺乏多样性。
    BACKGROUND: The generalizability of the Surviving Sepsis Campaign (SSC) guidelines to various patient populations and hospital settings has been debated. A quantitative assessment of the diversity and representation in the clinical evidence supporting the guidelines would help evaluate the generalizability of the recommendations and identify strategic research goals and priorities. In this study, we evaluated the diversity of patients in the original studies, in terms of sex, race/ethnicity, and geographical location. We also assessed diversity in sex and geographical representation among study first and last authors.
    METHODS: All clinical studies cited in support of the 2021 SSC adult guideline recommendations were identified. Original clinical studies were included, while editorials, reviews, non-clinical studies, and meta-analyses were excluded. For eligible studies, we recorded the proportion of male patients, percentage of each represented racial/ethnic subgroup (when available), and countries in which they were conducted. We also recorded the sex and location of the first and last authors. The World Bank classification was used to categorize countries.
    RESULTS: The SSC guidelines included six sections, with 85 recommendations based on 351 clinical studies. The proportion of male patients ranged from 47 to 62%. Most studies did not report the racial/ ethnic distribution of the included patients; when they did so, most were White patients (68-77%). Most studies were conducted in high-income countries (77-99%), which included Europe/Central Asia (33-66%) and North America (36-55%). Moreover, most first/last authors were males (55-93%) and from high-income countries (77-99%).
    CONCLUSIONS: To enhance the generalizability of the SCC guidelines, stakeholders should define strategies to enhance the diversity and representation in clinical studies. Though there was reasonable representation in sex among patients included in clinical studies, the evidence did not reflect diversity in the race/ethnicity and geographical locations. There was also lack of diversity among the first and last authors contributing to the evidence.
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  • 文章类型: Practice Guideline
    目的:这份2023年更新的协议总结了美国临床内分泌学协会(AACE)制定临床实践指南和其他指导文件的新框架,其中包括对方法的更改。进程,和政策。
    方法:AACE在过去几年中根据美国国家医学科学院关于制定值得信赖的临床实践指南的标准和医学专业协会理事会制定专业协会临床指南的原则,严格审查了其指导文件的开发过程,以确定需要改进的领域。
    结果:用于制定指导文件的新AACE框架包含了许多变化,包括修订后的利益冲突(COI)政策;在开发过程中加强对相关COI的收集和管理的承诺;公开呼吁作者成员;对作者的新要求;新的多样性,股本,和包容性(DEI)政策;纳入DEI审议的新的委员会进程;以及通过建议评估分级,开发和评估(等级)方法,以提高证据评估的质量并标准化建议等级和声明,在其他改进中。
    结论:AACE修订了其政策,并采用了一种全新的指南开发方法,以支持提升临床内分泌学实践以改善患者护理的使命。通过使用循证医学框架,并通过不断评估和改进其制定指南的过程,AACE致力于提供值得信赖的,没有偏见,和最新的信息,以确保临床医生和患者对AACE内容的信心。Further,AACE希望这些增强措施能够促进更多的协作发展方式,并增加与全球医学界的互动,以改善全球健康。
    OBJECTIVE: This 2023 updated protocol summarizes the American Association of Clinical Endocrinology\'s (AACE\'s) new framework for the development of clinical practice guidelines and other guidance documents that includes changes to methodology, processes, and policies.
    METHODS: AACE has critically reviewed its development processes for guidance documents over the last several years against the National Academy of Medicine Standards for Developing Trustworthy Clinical Practice Guidelines and the Council of Medical Specialty Societies Principles for Development of Specialty Society Clinical Guidelines to determine areas for improvement.
    RESULTS: The new AACE framework for development of guidance documents incorporates many changes, including a revised conflicts of interest (COI) policy; strengthened commitment to collection of disclosures and management of relevant COI during development; open calls to membership for authors; new requirements for authors; new diversity, equity, and inclusion (DEI) policy; new empanelment process that incorporates consideration of DEI; and adoption of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to increase the quality of evidence assessment and standardize recommendation grades and statements, among other improvements.
    CONCLUSIONS: AACE has revised its policies and adopted a completely new methodology for guideline development in support of the mission to elevate the practice of clinical endocrinology to improve patient care. With the use of an evidence-based medicine framework and by continually assessing and improving its processes for development of guidance, AACE strives to deliver trustworthy, unbiased, and up-to-date information that ensures clinician and patient confidence in AACE content. Further, AACE hopes that these enhancements foster a more collaborative approach to development and increase engagement with the worldwide medical community to improve global health.
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  • 文章类型: Journal Article
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    作为一名新技术人员开始在病毒学研究实验室工作,研究生,或者博士后可能很复杂,令人生畏,令人困惑,和压力。从实验室后勤到基本期望再到科学细节,有很多东西要学。为了帮助新的实验室成员调整和Excel,介绍了在病毒学实验室工作和繁荣发展的一系列指南。虽然指南可能对新的实验室成员最有帮助,大家,包括主要调查人员,鼓励使用一套已发布的指南作为资源,以最大限度地利用所有实验室成员的时间和精力。这里涉及的主题是安全,健康,balance,团队合作,完整性,阅读,研究,写作,说话,和时间表。
    Starting work in a virology research laboratory as a new technician, graduate student, or postdoc can be complex, intimidating, confusing, and stressful. From laboratory logistics to elemental expectations to scientific specifics, there is much to learn. To help new laboratory members adjust and excel, a series of guidelines for working and thriving in a virology laboratory is presented. While guidelines may be most helpful for new laboratory members, everyone, including principal investigators, is encouraged to use a set of published guidelines as a resource to maximize the time and efforts of all laboratory members. The topics covered here are safety, wellness, balance, teamwork, integrity, reading, research, writing, speaking, and timelines.
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  • 文章类型: Journal Article
    The value of including race as part of the patient identifier in care and medical education has been a topic of debate among clinicians, medical educators, and sociologists.1,2,6,7,8 The perceived benefit of using racial identifiers is that it may allow physicians to predict the risk of disease and inform drug therapy.9 This association is thought to be useful to medical students and trainees as they form their clinical knowledge base. However, there is a larger body of evidence that the use of race leads to bias and stereotyping by physicians. In many cases, patients are assigned to racial categorizations that are inconsistent with their self-reported identities.1,15 It is unclear which medical schools have a policy that explicitly detail their stance on this topic. In this article, we propose a frame of thinking to guide medical educators as they develop policies on race as patient identifiers.
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  • 文章类型: Journal Article
    Consumption of contaminated meat, milk, and water are among the major routes of human campylobacteriosis. This study aimed to determined the genetic diversity of C. coli and C. jejuni isolated from meat, milk, and water samples collected from different locations. From the 376 samples (meat = 248, cow milk = 72, and water = 56) collected, a total of 1238 presumptive Campylobacter isolates were recovered and the presence of the genus Campylobacter were detected in 402 isolates, and from which, 85 and 67 isolates were identified asC. jejuni and C. coli respectively. Of which, 71 isolates identified as C. coli (n = 35) and C. jejuni (n = 36) were randomly selected from meat, milk, and water samples and were genotyped using enterobacterial repetitive intergenic consensus PCR (ERIC-PCR). The digital images of the ERIC-PCR genotype were analyzed by GelJ v.2.0 software. The diversity and similarity of the isolates were assessed via an unweighted-pair group method using average linkages clustering algorithm. The results showed that the 36 C. jejuni strains separated into 29 ERIC-genotypes and 4 clusters while the 35 C. coli were delineated into 29 ERIC-genotypes and 6 clusters. The study revealed the genetic diversity among C. coli and C. jejuni strains recovered from different matrices characterized by Gelj.
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