Global health

全球卫生
  • 文章类型: Journal Article
    背景:该协议概述了一项范围审查,目的是在现有的健康指南和健康技术评估(HTA)中识别和探索行星健康考虑因素。从这次审查中获得的见解将作为塑造未来建议分级的基础,评估,发展,和行星健康评估(等级)指南。
    方法:我们将坚持JBI方法进行范围审查。我们将在包括MEDLINE在内的各种数据库中对所有语言的结果进行全面搜索和筛选,EMBASE,CINAHL,全球卫生,卫生系统证据,Greenfile,和环境问题。此外,我们将使用GIN库等资源补充此搜索,BIGG数据库,认识论,等级指南存储库,Gradepro指南开发工具数据库,MAGICapp,NICE网站,世卫组织网站,以及使用Google隐身模式手动探索未发布的相关文档。两名独立审稿人将根据资格标准筛选和评估已确定文件的全文。将从每个全文中提取以下信息:文档标题;第一作者的名字;出版年份;语言;文档类型;文档作为指南或HTA;主题/学科;文档目的/研究目标;开发/赞助组织;进行研究/指南/HTA报告的国家;提供的行星健康或相关概念的定义;从事的行星健康专家的类型;评估行星健康使用的生物多样性/健康影响评估的建议方法;对地球健康的社会周期的使用的数据分析将涉及描述性统计和定向内容分析的结合,结果以叙述格式显示,并以表格和图形显示。
    结论:最终评审结果将提交给开放获取的同行评审期刊,以供发表。研究结果还将在相关的行星健康会议和讲习班上传播。
    背景:开放科学框架(https://osf.io/3jmsa)。
    BACKGROUND: This protocol outlines a scoping review with the objective of identifying and exploring planetary health considerations within existing health guidelines and health technology assessments (HTA). The insights gained from this review will serve as a basis for shaping future Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidance on planetary health.
    METHODS: We will adhere to the JBI methodology for scoping reviews. We will conduct a comprehensive search and screening of results in all languages across various databases including MEDLINE, EMBASE, CINAHL, Global Health, Health Systems Evidence, Greenfile, and Environmental Issues. Additionally, we will supplement this search with resources such as the GIN library, BIGG database, Epistemonikos, GRADE guidelines repository, GRADEpro Guideline Development Tool Database, MAGICapp, NICE website, WHO websites, and a manual exploration of unpublished relevant documents using Google incognito mode. Two independent reviewers will screen and assess the full texts of identified documents according to the eligibility criteria. The following information from each full text will be extracted: document title; first author\'s name; publication year; language; document type; document as a guideline or HTA; the topic/discipline; document purpose/study objective; developing/sponsoring organization; the country in which the study/guideline/HTA report was conducted; definition of planetary health or related concept provided; types of planetary health experts engaged; study methods; suggested methods to assess planetary health; use of secondary data on planetary health outcomes; description for use of life cycle assessment; description for assessing the quality of life cycle; population/intended audience; interventions; category; applicable planetary health boundaries; consideration of social justice/global equity; phase of intervention in life cycle related to planetary health addressed; the measure of planetary health impact; impact on biodiversity/land use; one health/animal welfare mention; funding; and conflict of interest. Data analysis will involve a combination of descriptive statistics and directed content analysis, with results presented in a narrative format and displayed in tables and graphs.
    CONCLUSIONS: The final review results will be submitted to open-access peer-reviewed journals for publication when they become available. The research findings will also be disseminated at relevant planetary health conferences and workshops.
    BACKGROUND: Open Science Framework ( https://osf.io/3jmsa ).
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:移徙与健康是全球卫生的关键优先事项,对于保护和促进移徙者的健康至关重要。为了更好地了解有关移民健康的现有证据,至关重要的是绘制研究出版物活动和关于移民和流动人口健康的证据。本文提出了一种搜索策略协议,用于对有关全球移民健康(GMH)的科学文章进行文献计量分析,利用全球研究人员和学者网络的专业知识。该议定书旨在促进绘制有关国际移民及其家人健康的研究和证据,包括关于人类跨国流动的研究。
    方法:将开发一种使用Scopus的系统搜索策略,以绘制有关GMH的科学文章。搜索策略将建立在以前的文献计量研究的基础上,并将有两个主要的搜索组成部分:(1)“国际移民人口”,涵盖跨越国际边界的特定运动,和(2)“健康”。将实施最终搜索策略,以确定要筛选的最终文章集,以进行文献计量分析。标题和摘要筛选将排除不相关文章,并根据预定义的主题和子主题对相关文章进行分类。以下方法的组合将用于筛选:应用完全自动化(即,DistillerSR的机器学习工具)和/或半自动化(即,EndNote,MSExcel)工具,和手动筛选。相关文章将使用MSExcel进行分析,Biblioshiny和VOSviewer,它创建了围绕GMH的研究出版活动的视觉映射。该协议是与全球南方的学术研究人员和政策制定者合作开发的,以及移民健康和研究专家网络,在文献计量学专家的指导下。
    背景:该方案将使用公开可用的数据,并且不会直接涉及人类参与者;将不需要进行道德审查。文献计量分析(以及可能从协议中产生的其他研究)的结果将通过学术出版物传播,为旨在改善国际移徙者及其家人健康的政策和干预措施提供信息。
    BACKGROUND: Migration and health are key priorities in global health and essential for protecting and promoting the health of migrants. To better understand the existing evidence on migration health, it is critical to map the research publication activity and evidence on the health of migrants and mobile populations. This paper presents a search strategy protocol for a bibliometric analysis of scientific articles on global migration health (GMH), leveraging the expertise of a global network of researchers and academics. The protocol aims to facilitate the mapping of research and evidence on the health of international migrants and their families, including studies on human mobility across international borders.
    METHODS: A systematic search strategy using Scopus will be developed to map scientific articles on GMH. The search strategy will build upon a previous bibliometric study and will have two main search components: (1) \'international migrant population\', covering specific movements across international borders, and (2) \'health\'. The final search strategy will be implemented to determine the final set of articles to be screened for the bibliometric analysis. Title and abstract screening will exclude irrelevant articles and classify the relevant articles according to predefined themes and subthemes. A combination of the following approaches will be used in screening: applying full automation (ie, DistillerSR\'s machine learning tool) and/or semiautomation (ie, EndNote, MS Excel) tools, and manual screening. The relevant articles will be analysed using MS Excel, Biblioshiny and VOSviewer, which creates a visual mapping of the research publication activity around GMH. This protocol is developed in collaboration with academic researchers and policymakers from the Global South, and a network of migration health and research experts, with guidance from a bibliometrics expert.
    BACKGROUND: The protocol will use publicly available data and will not directly involve human participants; an ethics review will not be required. The findings from the bibliometric analysis (and other research that can potentially arise from the protocol) will be disseminated through academic publications, conferences and collaboration with relevant stakeholders to inform policies and interventions aimed at improving the health of international migrants and their families.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:本研究旨在评估38个低收入和中等收入国家(LMICs)实现世界卫生组织(WHO)心血管疾病(CVD)指南建议的二级预防目标的患病率。
    方法:我们汇集了2013年至2020年间38个低收入国家的全国代表性横断面调查。治疗,根据WHO的建议,对自我报告有CVD病史的个体进行代谢和生活方式目标评估.使用多变量Poisson回归模型评估指南依从性的患病率与社会人口统计学特征之间的关联。
    结果:合并样本包括126106名参与者,其中9821人(6.8%[95%CI6.4-7.2])报告有CVD病史。总的来说,使用抗高血压药物的CVD患者达到治疗目标的患病率为22.7%(95%CI,21.0-24.5%),阿司匹林占19.6%(17.9-21.4%),他汀类药物占13.6%(12.0-15.44%)。BMI达到代谢目标的患病率为54.9%(52.5-57.3%),39.9%(37.7-42.2%)的血压,总胆固醇的46.1%(43.6-48.6%),空腹血糖占84.9%(83.1-86.5%)。不吸烟达到生活方式目标的患病率为83.2%(81.5-84.7%),83.1%(81.2-84.9%)不喝酒,65.5%(63.1-67.7%)的足够体力活动和16.2%(14.5-18.0%)的健康饮食。只有6.1%(5.1-7.4%)达到了三个治疗目标,16.0%(14.3-17.9%)实现了四个代谢目标,6.9%(5.8%-8.0%)实现了四项生活目标。中高收入国家在实现治疗方面优于低收入国家,非饮酒和饮食目标。年轻和女性与代谢目标的较差实现相关。
    结论:在LMIC中,达到治疗指南中建议的目标,心血管疾病患者的新陈代谢和健康生活方式明显偏低.这凸显了迫切需要有效,系统的二级预防策略,以改善CVD管理。
    BACKGROUND: This study aimed to estimate the prevalence of achieving the secondary prevention targets recommended in the World Health Organization (WHO) guidelines for cardiovascular disease (CVD) in 38 low-income and middle-income countries (LMICs).
    METHODS: We pooled nationally representative cross-sectional surveys from 38 LMICs between 2013 and 2020. Treatment, metabolic and lifestyle targets were assessed for individuals with a self-reported history of CVD according to WHO\'s recommendations. Associations between the prevalence of guideline adherence and sociodemographic characteristics were assessed using multivariate Poisson regression models.
    RESULTS: The pooled sample included 126 106 participants, of whom 9821 (6.8% [95% CI 6.4-7.2]) reported a history of CVD. Overall, the prevalence of achieving treatment targets in patients with CVD was 22.7% (95% CI, 21.0-24.5%) for antihypertensive drugs, 19.6% (17.9-21.4%) for aspirin, and 13.6% (12.0-15.44%) for statins. The prevalence of achieving metabolic targets was 54.9% (52.5-57.3%) for BMI, 39.9% (37.7-42.2%) for blood pressure, 46.1% (43.6-48.6%) for total cholesterol, and 84.9% (83.1-86.5%) for fasting blood glucose. The prevalence of achieving lifestyle targets was 83.2% (81.5-84.7%) for not smoking, 83.1% (81.2-84.9%) for not drinking, 65.5% (63.1-67.7%) for sufficient physical activity and 16.2% (14.5-18.0%) for healthy diet. Only 6.1% (5.1-7.4%) achieved three treatment targets, 16.0% (14.3-17.9%) achieved four metabolic targets, and 6.9% (5.8-8.0%) achieved four lifestyle targets. Upper-middle income countries were better than low-income countries at achieving the treatment, non-drinking and dietary targets. Being younger and female were associated with poorer achievement of metabolic targets.
    CONCLUSIONS: In LMICs, achieving the targets recommended in the guideline for treatment, metabolism and healthy lifestyles for patients with CVD is notably low. This highlights an urgent need for effective, systematic secondary prevention strategies to improve CVD management.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    在过去的一个世纪里,强调食物模式作为提供必需营养素的手段的饮食建议已获得广泛接受。在整个生命阶段提供重要营养和能量的食物的必要性需要当地资源和文化习俗的参与,以预防营养缺乏疾病。自1980年代以来,旨在宣传慢性病的饮食指南依靠流行病学研究来预测哪些饮食模式与降低慢性病风险相关或与健康结果的联系。饮食指南很广泛,通常建议避免单一营养素的过量或缺乏。由于缺乏支持整个生命周期中更具体指导的强大科学数据,因此对这些建议进行微调的努力面临挑战。消费者对饮食指南持怀疑态度,因为媒体对新研究的报道往往与公认的营养教条相冲突。已经发布了使个人和地球健康保持一致的指示,以支持可持续饮食模式的概念。我们是否真的有一个基于科学的数据库来支持饮食指南仍然是一个持续争论的问题,如本文所述。
    Over the past century, dietary recommendations emphasizing food patterns as means to deliver essential nutrients have garnered widespread acceptance. The necessity for foods supplying vital nutrients and energy throughout various life stages requires the involvement of local resources and cultural practices to prevent nutrient deficiency diseases. Since the 1980s, dietary guidelines aimed at adverting chronic diseases have relied on epidemiological research to predict which dietary patterns correlate with reduced risk of chronic disease or links to health outcomes. Dietary guidelines have been broad, typically recommending avoiding excess or deficiency of single nutrients. Efforts to fine-tune these recommendations face challenges due to a scarcity of robust scientific data supporting more specific guidance across the life cycle. Consumers have become skeptical of dietary guidelines, because media coverage of new studies is often in conflict with accepted nutrition dogma. Indications to align individual and planet\'s health have been issued supporting the concept of sustainable dietary patterns. Whether we really have a science-based databank to support dietary guidelines is still a matter of ongoing debate, as presented in this paper.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    模拟在应对全民医疗挑战方面发挥着关键作用,减少教育不平等,提高死亡率,发病率和患者经验。它增强了医疗保健流程和系统,为组织内安全文化的发展做出了重大贡献。事实证明,它具有成本效益,并成功地提高了团队绩效,培养劳动力韧性,改善患者预后。通过国际合作,与六大洲67个国家/地区的50个协会进行了迭代协商过程。此过程揭示了全球范围内常见的医疗保健挑战和模拟实践。本声明的预期受众包括决策者,医疗机构领导人,健康教育机构,和模拟从业者。它旨在就广泛采用示范模拟实践的关键优先事项达成共识,使全球患者和医疗保健工作人员受益。
    结论:提倡模拟为患者提供的益处,员工和组织至关重要,以及促进其采用和融入整个医疗保健领域的日常学习和实践。低成本,应该利用高影响力的模拟方法来扩大全球可访问性,并融入系统改进过程以及本科和研究生课程。机构和政府一级的支持至关重要,必须在政治方面采取统一一致的做法,战略和财务承诺。必须适当地使用模拟,采用基于证据的质量保证方法,遵守公认的最佳实践标准。这些标准包括教师发展,评估,认证,认证,和认证。我们必须努力提供公平和可持续的高质量,上下文相关的基于模拟的学习机会,坚定坚持公平原则,多样性和包容性。这应该得到补充,重新强调这一领域的研究和学术。
    我们敦促决策者和领导者正式承认并接受模拟在医疗保健实践和教育中的好处。这包括对持续支持的承诺和在教育中应用模拟的任务,培训,和临床环境。我们倡导医疗保健系统和教育机构致力于实现高质量医疗保健和改善患者预后的目标。这一承诺应包括在护理人员职业生涯的所有阶段和水平上为个人和跨专业团队提供基于模拟的学习机会的推广和资源支持,符合最佳实践标准。我们呼吁模拟从业者将医疗保健模拟作为不可或缺的学习工具,坚持最佳实践标准,保持对终身学习的承诺,并坚持他们对患者安全的热情倡导。这个声明,国际合作的结果,旨在就广泛采用有利于全球患者和医疗工作者的示范性模拟实践的关键优先事项达成共识。
    UNASSIGNED: Simulation plays a pivotal role in addressing universal healthcare challenges, reducing education inequities, and improving mortality, morbidity and patient experiences. It enhances healthcare processes and systems, contributing significantly to the development of a safety culture within organizations. It has proven to be cost-effective and successful in enhancing team performance, fostering workforce resilience and improving patient outcomes.Through an international collaborative effort, an iterative consultation process was conducted with 50 societies operating across 67 countries within six continents. This process revealed common healthcare challenges and simulation practices worldwide. The intended audience for this statement includes policymakers, healthcare organization leaders, health education institutions, and simulation practitioners. It aims to establish a consensus on the key priorities for the broad adoption of exemplary simulation practice that benefits patients and healthcare workforces globally.
    CONCLUSIONS: Advocating for the benefits that simulation provides to patients, staff and organizations is crucial, as well as promoting its adoption and integration into daily learning and practice throughout the healthcare spectrum. Low-cost, high-impact simulation methods should be leveraged to expand global accessibility and integrate into system improvement processes as well as undergraduate and postgraduate curricula. Support at institutional and governmental level is essential, necessitating a unified and concerted approach in terms of political, strategic and financial commitment.It is imperative that simulation is used appropriately, employing evidence-based quality assurance approaches that adhere to recognized standards of best practice. These standards include faculty development, evaluation, accrediting, credentialing, and certification.We must endeavor to provide equitable and sustainable access to high-quality, contextually relevant simulation-based learning opportunities, firmly upholding the principles of equity, diversity and inclusion. This should be complemented with a renewed emphasis on research and scholarship in this field.
    UNASSIGNED: We urge policymakers and leaders to formally acknowledge and embrace the benefits of simulation in healthcare practice and education. This includes a commitment to sustained support and a mandate for the application of simulation within education, training, and clinical environments.We advocate for healthcare systems and education institutions to commit themselves to the goal of high-quality healthcare and improved patient outcomes. This commitment should encompass the promotion and resource support of simulation-based learning opportunities for individuals and interprofessional teams throughout all stages and levels of a caregiver\'s career, in alignment with best practice standards.We call upon simulation practitioners to champion healthcare simulation as an indispensable learning tool, adhere to best practice standards, maintain a commitment to lifelong learning, and persist in their fervent advocacy for patient safety.This statement, the result of an international collaborative effort, aims to establish a consensus on the key priorities for the broad adoption of exemplary simulation practice that benefits patients and healthcare workforces globally.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:在过去十年中,社区卫生信息系统变得越来越复杂和以证据为基础,它们现在是许多低收入和中等收入国家中使用最广泛的卫生信息系统。本研究旨在就社区卫生信息系统(CHISs)的关键功能和互操作性优先事项达成共识。
    方法:在系统选择的CHIS专家小组中进行了Delphi研究。这个令人印象深刻的专家库代表了一系列全球领先的卫生机构,性别和区域平衡以及其专业领域的多样性。通过五轮迭代调查和后续访谈,专家们达成了高度共识。我们通过与10位社区卫生工作者(CHW)领导人进行的一系列焦点小组讨论补充了Delphi研究结果。
    结果:今天的CHIS有望适应广泛的本地背景要求,并支持和改善护理服务。一旦与单个角色类型(CHW)关联,这些系统现在预计会吸引其他最终用户,包括患者,supervisors,临床医生和数据管理者。在30项世卫组织分类的医疗服务提供者数字卫生干预措施中,专家认为23人(77%)对CHISs很重要。病例管理和护理协调功能占当今CHIS预期核心功能的三分之一以上(37个中的14个,38%),比例高于任何其他类别。互操作性的最高优先级用例包括CHIS到健康管理信息系统的每月报告和CHIS到电子病历转介。
    结论:今天的CHISs有望功能丰富,为了支持社区卫生系统中的一系列用户角色,并高度适应当地的上下文需求。未来的互操作性努力,如一般的CHISs,预计不仅要有效地移动数据,而且要以可衡量地改善护理的方式加强社区卫生系统。
    BACKGROUND: Information systems for community health have become increasingly sophisticated and evidence-based in the last decade and they are now the most widely used health information systems in many low-income and middle-income countries. This study aimed to establish consensus regarding key features and interoperability priorities for community health information systems (CHISs).
    METHODS: A Delphi study was conducted among a systematically selected panel of CHIS experts. This impressive pool of experts represented a range of leading global health institutions, with gender and regional balance as well as diversity in their areas of expertise. Through five rounds of iterative surveys and follow-up interviews, the experts established a high degree of consensus. We supplemented the Delphi study findings with a series of focus group discussions with 10 community health worker (CHW) leaders.
    RESULTS: CHISs today are expected to adapt to a wide range of local contextual requirements and to support and improve care delivery. While once associated with a single role type (CHWs), these systems are now expected to engage other end users, including patients, supervisors, clinicians and data managers. Of 30 WHO-classified digital health interventions for care providers, experts identified 23 (77%) as being important for CHISs. Case management and care coordination features accounted for more than one-third (14 of 37, 38%) of the core features expected of CHISs today, a higher proportion than any other category. The highest priority use cases for interoperability include CHIS to health management information system monthly reporting and CHIS to electronic medical record referrals.
    CONCLUSIONS: CHISs today are expected to be feature-rich, to support a range of user roles in community health systems, and to be highly adaptable to local contextual requirements. Future interoperability efforts, such as CHISs in general, are expected not only to move data efficiently but to strengthen community health systems in ways that measurably improve care.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:COVID-19大流行影响了世卫组织所有成员国。我们将每个成员国的COVID-19治疗指南与WHOCOVID-19治疗指南进行了比较和对比。
    方法:与卫生部或访问国家传染病网站以及其他相关机构和专家联系,以获取COVID-19治疗的国家指南(NG)。只有当他们描述了COVID-19的特定药物治疗时,NGs才被包括在内,这些治疗是根据疾病的严重程度分层的。我们使用经修改的公共版本指南报告清单(RIGHT-PVG)调查清单进行了回顾性审查,并根据WHO指南进行了衍生的比较指标。
    结果:COVID-19治疗NGs可从194个世卫组织成员国中的109个获得。指南和疾病严重程度分层存在很大差异。许多NG中的治疗建议与WHO指南大不相同。总体而言,在2022年末,93%的NGs推荐了至少一种在大型随机试验中被证明无效的治疗方法。并没有被世卫组织推荐。尽管有压倒性的证据表明其益处,但在近10%的NG中,不建议在严重疾病中使用皮质类固醇。当按每年的国内生产总值进行分层时,来自低资源环境国家的NGs显示出最大的差异,人类发展指数和全球卫生安全指数。
    结论:我们的研究仅限于容易获得的NG,它并不反映该领域推荐药物的可用性。SARS-CoV-2大流行开始三年后,可用的COVID-19NG在治疗建议上有很大差异,通常与世界卫生组织的指导方针不同,通常建议无效,负担不起或不可用的药物。
    The COVID-19 pandemic affected all WHO member states. We compared and contrasted the COVID-19 treatment guidelines of each member state with the WHO COVID-19 therapeutic guidelines.
    Ministries of Health or accessed National Infectious Disease websites and other relevant bodies and experts were contacted to obtain national guidelines (NGs) for COVID-19 treatment. NGs were included only if they delineated specific pharmacological treatments for COVID-19, which were stratified by disease severity. We conducted a retrospective review using the adapted Reporting Checklist for Public Versions of Guidelines (RIGHT-PVG) survey checklist and a derived comparative metric based on the WHO guidelines was performed.
    COVID-19 therapeutics NGs could be obtained from 109 of the 194 WHO member states. There was considerable variation in guidelines and in disease severity stratifications. Therapeutic recommendations in many NGs differed substantially from the WHO guidelines. Overall in late 2022, 93% of NGs were recommending at least one treatment which had proved to be ineffective in large randomised trials, and was not recommended by WHO. Corticosteroids were not recommended in severe disease in nearly 10% of NGs despite overwhelming evidence of their benefit. NGs from countries with low-resource settings showed the greatest divergence when stratified by gross domestic product per year, Human Development Index and the Global Health Security Index.
    Our study is limited to NGs that were readily accessible, and it does not reflect the availability of recommended medicines in the field. Three years after the start of the SARS-CoV-2 pandemic, available COVID-19 NGs vary substantially in their therapeutic recommendations, often differ from the WHO guidelines, and commonly recommend ineffective, unaffordable or unavailable medicines.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:临床和公共卫生指南有助于指导临床实践和政策,基于现有的最佳证据。世界卫生组织(WHO)和许多国家的国家卫生机构已经发布了身体活动和久坐行为指南。尽管审查的证据存在重大重叠,这些准则因司法管辖区而异。这项研究旨在审查用于制定全球和国家身体活动和久坐行为指南的过程,并检查它们在多大程度上符合推荐的制定指南的方法标准。
    方法:我们从七个司法管辖区(WHO,澳大利亚,加拿大,Japan,荷兰,英国,和美国)。我们对每一套准则的评价都很高,中等,或与开发过程严格相关的标准质量低。
    结果:我们观察到不同司法管辖区和不同标准的指南制定过程的质量差异。在明确描述所选择的证据并说明建议与支持证据之间的明确联系方面,准则获得了最高的总体评级。准则收到的标准总体评级最弱,这些标准与明确描述用于制定建议的方法以及在发布之前报告专家的外部审查有关。根据选定的标准进行评估,最强有力的进程是由世卫组织和加拿大进行的。
    结论:就可接受的指南制定过程达成一致,以及不同类型证据的纳入和评估程序,将有助于加强和调整未来的指导方针。
    BACKGROUND: Clinical and public health guidelines serve to direct clinical practice and policy, based on the best available evidence. The World Health Organization (WHO) and national health bodies of many countries have released physical activity and sedentary behaviour guidelines. Despite significant overlap in the body of evidence reviewed, the guidelines differ across jurisdictions. This study aimed to review the processes used to develop global and national physical activity and sedentary behaviour guidelines and examine the extent to which they conform with a recommended methodological standard for the development of guidelines.
    METHODS: We extracted data on nine sets of guidelines from seven jurisdictions (WHO, Australia, Canada, Japan, the Netherlands, United Kingdom, and United States). We rated each set of guidelines as high, medium, or low quality on criteria related to the rigour of the development process.
    RESULTS: We observed variation in the quality of guidelines development processes across jurisdictions and across different criteria. Guidelines received the strongest overall ratings for criteria on clearly describing the evidence selected and stating an explicit link between the recommendations and the supporting evidence. Guidelines received the weakest overall ratings for criteria related to clearly describing the methods used to formulate the recommendations and reporting external review by experts prior to publication. Evaluated against the selected criteria, the strongest processes were undertaken by the WHO and Canada.
    CONCLUSIONS: Reaching agreement on acceptable guideline development processes, as well as the inclusion and appraisal procedures of different types of evidence, would help to strengthen and align future guidelines.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:全球范围内的手术活动越来越多。随着如此巨大的增长,高收入国家成员和中低收入国家成员之间存在不良互动的潜在风险,导致方案失败,效果不佳,和/或低影响。
    方法:关于文化能力和道德行为的关键概念是由大学外科医生学会全球学术外科委员会与全球学术外科协会合作提出的。这两个社会都确保了高收入国家和中低收入国家的积极参与。
    结果:该指南通过以下建议为高收入国家成员与中低收入国家合作伙伴合作提供了文化能力和道德行为的框架:(1)准备与中低收入国家合作;(2)流程标准化;(3)与当地社区合作;(4)实践限制;(5)患者自主权和同意;(6)学员;(7)潜在的(灰色地带和陷阱;
    结论:本文提供了一个可操作的框架,以解决高收入国家-中低收入国家全球外科合作中潜在的文化能力和道德行为问题。
    BACKGROUND: There are an increasing number of global surgery activities worldwide. With such tremendous growth, there is a potential risk for untoward interactions between high-income country members and low-middle income country members, leading to programmatic failure, poor results, and/or low impact.
    METHODS: Key concepts for cultural competency and ethical behavior were generated by the Academic Global Surgery Committee of the Society for University Surgeons in collaboration with the Association for Academic Global Surgery. Both societies ensured active participation from high-income countries and low-middle income countries.
    RESULTS: The guidelines provide a framework for cultural competency and ethical behavior for high-income country members when collaborating with low-middle income country partners by offering recommendations for: (1) preparation for work with low-middle income countries; (2) process standardization; (3) working with the local community; (4) limits of practice; (5) patient autonomy and consent; (6) trainees; (7) potential pitfalls; and (8) gray areas.
    CONCLUSIONS: The article provides an actionable framework to address potential cultural competency and ethical behavior issues in high-income country - low-middle income country global surgery collaborations.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    非传染性疾病(NCDs)造成了重大的全球卫生挑战,不健康的饮食被认为是一个主要的危险因素。钠和钾,是人体健康必需的矿物质,在各种身体功能中起重要作用,它们的摄入量不平衡会对健康产生重大影响,特别是关于高血压和心血管疾病。这篇综述汇编了来自全球著名卫生组织的膳食钠和钾摄入量建议,并将全球指南与日本的膳食参考摄入量(DRI)指南进行了比较。世界卫生组织(WHO)等组织的钠和钾摄入指南,美国心脏病学会(ACC)和美国心脏协会(AHA),美国人饮食指南(DGA)欧洲食品安全局(EFSA)和日本展览变体的DRI。与其他亚洲国家相比,日本历史上较高的钠目标与东南亚的传统腌制食品有助于高钠摄入量。相反,日本的低钾目标与亚洲其他国家提倡富含水果和蔬菜的饮食形成鲜明对比。日本正在努力与全球建议保持一致,这反映了一种考虑社会习惯的分级方法。虽然协调国际努力至关重要,通过为文化和饮食习惯习惯定制指南,欣赏区域多样性至关重要。实施以科学研究为依据的针对具体情况的指导方针,有助于促进健康饮食和减轻非传染性疾病负担的全球努力。推荐钠和钾的每日饮食摄入目标的全球指南显示出差异。这些差异受到多种因素的影响,包括文化饮食习惯,社会经济地位,健康优先事项,和可用的科学研究。每个人口都应遵循其所在地区的建议。
    Non-communicable diseases (NCDs) cause a significant global health challenge, with unhealthy diets identified as a major risk factor. Sodium and potassium, which are essential minerals for human health, play important roles in various bodily functions, and an imbalance in their intake can have significant health implications, particularly concerning hypertension and cardiovascular diseases. This review compiles dietary sodium and potassium intake recommendations from prominent global health organizations and compares global guidelines to Japan\'s Dietary Reference Intake (DRI) guidelines. Sodium and potassium intake guidelines from organizations such as the World Health Organization (WHO), American College of Cardiology (ACC) and American Heart Association (AHA), Dietary Guidelines for Americans (DGA), European Food Safety Authority (EFSA), and DRI for Japanese exhibit variations. Compared to other Asian countries, Japan\'s historically higher sodium goal aligns with Southeast Asia where traditional preserved foods contribute to high sodium intake. Contrarily, Japan\'s lower potassium goal contrasts with other countries in Asia promoting a diet rich in fruits and vegetables. The ongoing effort by Japan to align with global recommendations reflects a gradation approach considering social habits. While harmonizing international efforts is essential, appreciating regional diversities is paramount through tailoring guidelines to cultural and dietary habit practices. Implementing context-specific guidelines informed by scientific research can contribute to global efforts in promoting healthy diets and reducing the burden of NCDs. Global guidelines that recommended the daily dietary intake goal for sodium and potassium exhibit variations. These disparities are influenced by diverse factors, including cultural dietary habits, socioeconomic status, health priorities, and available scientific research. Each population should follow the recommendations of their region.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号