Reasons

原因
  • 文章类型: Systematic Review
    背景:未完成的护理在全球医疗保健环境中越来越受到关注。鉴于他们的负面结果,持续评估那些通常被推迟或错过的护理干预措施至关重要,以及根本原因和后果。COVID-19在全球范围内的大流行使医疗机构难以维持其护理的可持续性和连续性,这也影响了未完成的护理现象。然而,到目前为止,尚未对COVID-19大流行期间进行的研究进行总结。这项研究的主要目的是系统地回顾这种情况的发生,原因,以及COVID-19大流行期间医疗机构患者护理未完成的后果。
    方法:在PROSPERO(CRD42023422871)中注册的系统评价。使用了系统审查和荟萃分析声明指南的首选报告项目以及用于横断面研究的JoannaBriggs研究所关键评估工具。MEDLINE-PubMed,护理和相关健康文献的累积指数,和Scopus从2020年3月到2023年5月进行了搜索,使用在该领域建立的关键字作为错过的护理,未完成的护理,或隐含的配给。
    结果:纳入了主要在欧洲和亚洲国家进行的25项研究,并被评估为具有良好的方法学质量。使用了以下工具:MISSCARE调查(=14);巴塞尔护理配给范围(=1),也以其修订形式(=2)和关于疗养院(=2);感知内隐护理配给(=4);重症监护病房遗漏护理(=1);和未完成护理调查(=1)。在一些国家的研究中出现的未完成的护理干预措施的顺序与大流行前的数据基本一致(例如,口腔护理,步行)。然而,国家和国家间出现了一些有趣的变化。相反,在大流行期间,与护士的情绪状态和幸福感接近的劳动力资源和原因被一致提到对未完成的护理影响最大。没有一项研究调查了未完成的护理的后果。
    结论:在大流行期间,有两大洲领导了该领域的研究:欧洲,这项研究已经很成熟,亚洲,这项研究是新的。虽然未完成的护理发生似乎是基于整个欧洲预先建立的模式(例如,关于基本面需求),亚洲国家出现了新的模式。其中的原因,研究结果的同质性与大流行前记录的结果一致.
    BACKGROUND: Unfinished nursing care is becoming increasingly more of a concern in worldwide healthcare settings. Given their negative outcomes, it is crucial to continuously assess those nursing interventions that are commonly postponed or missed, as well as the underlying reasons and consequences. The worldwide COVID-19 pandemic has made it difficult for health facilities to maintain their sustainability and continuity of care, which has also influenced the unfinished nursing care phenomenon. However, no summary of the studies conducted during the COVID-19 pandemic was produced up to now. The main aim of this study was to systematically review the occurrence of, reasons for, and consequences of unfinished nursing care among patients in healthcare settings during the COVID-19 pandemic.
    METHODS: Systematic review registered in PROSPERO (CRD42023422871). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guideline and the Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies were used. MEDLINE-PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched from March 2020 up to May 2023, using keywords established in the field as missed care, unfinished nursing care, or implicit rationing.
    RESULTS: Twenty-five studies conducted mainly in European and Asiatic countries were included and assessed as possessing good methodological quality. The following tools were used: the MISSCARE Survey (= 14); the Basel Extent of Rationing of Nursing Care (= 1), also in its revised form (= 2) and regarding nursing homes (= 2); the Perceived Implicit Rationing of Nursing Care (= 4); the Intensive Care Unit-Omitted Nursing Care (= 1); and the Unfinished Nursing Care Survey (= 1). The order of unfinished nursing care interventions that emerged across studies for some countries is substantially in line with pre-pandemic data (e.g., oral care, ambulation). However, some interesting variations emerged at the country and inter-country levels. Conversely, labour resources and reasons close to the emotional state and well-being of nurses were mentioned homogeneously as most affecting unfinished nursing care during the pandemic. None of the studies investigated the consequences of unfinished nursing care.
    CONCLUSIONS: Two continents led the research in this field during the pandemic: Europe, where this research was already well established, and Asia, where this research is substantially new. While unfinished care occurrence seems to be based on pre-established patterns across Europe (e.g., regarding fundamentals needs), new patterns emerged across Asiatic countries. Among the reasons, homogeneity in the findings emerged all in line with those documented in the pre-pandemic era.
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  • 文章类型: Journal Article
    背景:脱离抗逆转录病毒疗法(ART)护理是HIV感染者无法实现病毒载量抑制的重要原因。
    方法:我们搜索了2015年1月至2022年12月的两个数据库和会议摘要,以寻找报告脱离ART护理原因的研究。我们包括在采用“治疗所有”或“选项B+”政策后进行的定量(主要是调查)和定性(深入访谈或焦点小组)研究。我们使用归纳方法对原因进行分类:我们报告研究中报告原因的频率,并为原因开发了概念框架。
    结果:我们确定了21项研究,这些研究报告了“全面治疗”时代脱离ART护理的原因,主要在非洲国家:对艾滋病毒感染者的一般人群进行了六项研究,9名孕妇或产后妇女,6名选定人群(吸毒人群各一名,与世隔绝的土著社区,男人,女人,青少年和与男性发生性关系的男性)。报告的原因是:副作用或其他抗逆转录病毒片剂问题(15项研究);缺乏ART的感知益处(13项研究);心理,心理健康或药物使用(13项研究);对耻辱或保密的担忧(14项研究);缺乏社会或家庭支持(12项研究);社会经济原因(16项研究);与医疗机构相关的原因(11项研究);以及急性近端事件,如意外活动(12项研究)。脱离接触的最常见原因是意外事件,社会经济原因,ART副作用或缺乏ART的感知益处。概念上,研究描述了潜在的脆弱性因素(个体,人际关系,结构和医疗保健),但通常意外的近端事件(例如意外的移动性)是脱离接触发生的触发因素。
    结论:人们脱离了对个人的ART护理,人际关系,结构和医疗保健原因,这些原因相互重叠和相互作用。虽然艾滋病毒方案无法预测和解决可能导致脱离接触的所有事件,一种认识到这种冲击将会发生的方法可能会有所帮助。
    结论:卫生服务应侧重于通过欢迎ART服务来鼓励客户参与护理的方式,以人为本,更灵活,同时提供依从性干预措施,如咨询和同伴支持。
    BACKGROUND: Disengagement from antiretroviral therapy (ART) care is an important reason why people living with HIV do not achieve viral load suppression become unwell.
    METHODS: We searched two databases and conference abstracts from January 2015 to December 2022 for studies which reported reasons for disengagement from ART care. We included quantitative (mainly surveys) and qualitative (in-depth interviews or focus groups) studies conducted after \"treat all\" or \"Option B+\" policy adoption. We used an inductive approach to categorize reasons: we report how often reasons were reported in studies and developed a conceptual framework for reasons.
    RESULTS: We identified 21 studies which reported reasons for disengaging from ART care in the \"Treat All\" era, mostly in African countries: six studies in the general population of persons living with HIV, nine in pregnant or postpartum women and six in selected populations (one each in people who use drugs, isolated indigenous communities, men, women, adolescents and men who have sex with men). Reasons reported were: side effects or other antiretroviral tablet issues (15 studies); lack of perceived benefit of ART (13 studies); psychological, mental health or drug use (13 studies); concerns about stigma or confidentiality (14 studies); lack of social or family support (12 studies); socio-economic reasons (16 studies); health facility-related reasons (11 studies); and acute proximal events such as unexpected mobility (12 studies). The most common reasons for disengagement were unexpected events, socio-economic reasons, ART side effects or lack of perceived benefit of ART. Conceptually, studies described underlying vulnerability factors (individual, interpersonal, structural and healthcare) but that often unexpected proximal events (e.g. unanticipated mobility) acted as the trigger for disengagement to occur.
    CONCLUSIONS: People disengage from ART care for individual, interpersonal, structural and healthcare reasons, and these reasons overlap and interact with each other. While HIV programmes cannot predict and address all events that may lead to disengagement, an approach that recognizes that such shocks will happen could help.
    CONCLUSIONS: Health services should focus on ways to encourage clients to engage with care by making ART services welcoming, person-centred and more flexible alongside offering adherence interventions, such as counselling and peer support.
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  • 文章类型: Systematic Review
    目的:描述糖尿病患者入院的原因。
    方法:我们搜索了Emcare,Embase,Medline,和GoogleScholar数据库,用于基于人群的研究,描述了糖尿病患者住院的原因。我们收录了1980年至2022年以英文发表的文章。对于每一项研究,我们确定了最常见的入院原因。使用纽卡斯尔渥太华质量评估工具对研究进行了质量评估。
    结果:从所有来源的搜索中检索到6920篇研究文章。在筛选了这些标题和摘要之后,我们回顾了135篇论文的全文,最后纳入了42项研究的数据。在25篇论文中报道了糖尿病总发病率:5篇报道了1型糖尿病,10篇文章报道了2型糖尿病,其余两篇文章分别报道了1型和2型糖尿病。在25个总和2型糖尿病研究中,报告了广泛类别的住院分布,在19/25(76%)的研究中,心血管疾病(CVD)是导致入院的主要原因.在按亚类报告心血管疾病入院的19项研究中,在58%的研究中,缺血性心脏病或冠心病是主要的心血管疾病亚型.入院的其他常见原因是感染,肾脏疾病,内分泌,营养,代谢和免疫紊乱。在1型糖尿病患者中,急性糖尿病并发症是入院的主要原因。
    结论:心血管疾病是糖尿病患者入院的主要原因,以缺血性或冠心病为主要亚型。
    OBJECTIVE: To describe the reasons for hospital admission among people with diabetes.
    METHODS: We searched Emcare, Embase, Medline and Google Scholar databases for population-based studies describing the causes of hospitalisation among people with diabetes. We included articles published in English from 1980 to 2022. For each study, we determined the most frequent reasons for admission. Studies were assessed for quality using the Newcastle Ottawa quality assessment tool.
    RESULTS: 6920 research articles were retrieved from the search of all sources. After screening the titles and abstracts of these, we reviewed the full text of 135 papers and finally included data from 42 studies. Admissions among the total diabetes were reported in 25 papers: 5 articles reported type 1 diabetes alone, 10 articles reported type 2 diabetes alone and the remaining 2 articles reported type 1 and type 2 diabetes separately. Among the 25 total and type 2 diabetes studies that reported the distribution of hospitalisations in broad categories, cardiovascular diseases (CVD) were the leading cause of admission in 19/25 (76%) of studies. Among the 19 studies that reported CVD admissions by subcategories, ischaemic or coronary heart disease was the leading subtype of CVD in 58% of studies. The other common causes of admissions were infections, renal disorders, endocrine, nutritional, metabolic and immunity disorders. In people with type 1 diabetes, acute diabetes complications were the leading cause of admission.
    CONCLUSIONS: CVD are the leading cause of hospital admission for people with diabetes, with ischaemic or coronary heart disease as the predominant subtype.
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  • 文章类型: Journal Article
    背景:与年轻的成年人相比,老年人在急诊科(ED)的就诊率更高,健康状况更差。老年人更可能需要额外的资源和住院。非特定的,非典型的,老年人疾病表现的复杂性挑战了当前的ED分诊系统。老年人的急性疾病通常在ED中被遗漏或通常被伪装成社会或功能问题。如果缺乏诊断清晰度或无法从急诊室安全排出,那么老年人可能会被标记为“社会接纳”(或另一个同义词),经常导致负面的健康后果。
    目的:本范围审查旨在描述和综合有关患者特征的现有证据,不良事件,以及标记为“社会接纳”(和其他同义词使用的术语)的老年人的健康结果,以及在ED或医院环境中患有非急性或非特异性投诉的患者。
    方法:MEDLINE文献检索,Embase,Scopus,PsycINFO,和CINAHL完成。筛选相关参考列表。数据已使用EndNote软件和CovidenceWeb应用程序进行管理。如果患者年龄≥65岁,并被认为是“社会入院”(或其他同义术语),或者如果他们向ED提出非急性或非特异性投诉,则包括原始数据。两名审查小组成员已经审查了标题和摘要,并将审查全文文章。分歧可以通过协商一致或与第三位审稿人讨论来解决。这项审查不需要研究伦理批准。
    结果:截至2023年1月,我们已经完成了标题和摘要筛选,并开始了全文筛选。正在检索和/或翻译一些剩余的全文文章。我们正在从纳入的研究中提取数据。数据将以叙述和描述性的方式呈现,总结关键概念,患者特征,以及标记为“社会入院”(以及其他同义使用的术语)的患者以及患有非急性和非特异性投诉的患者的健康结果。我们预计将于2023年春季发布首批结果。
    结论:老年人的急性疾病并不总是容易识别的。我们希望更好地了解病人的特点,不良事件,以及被标记为“社会入院”的老年人的健康结果,“以及那些有非急性或非特异性投诉的人。我们的目标是确定未来研究的优先事项,并确定可能告知医疗保健提供者照顾这些脆弱的患者的知识差距。
    未经批准:DERR1-10.2196/38246。
    BACKGROUND: Older adults have a higher visit rate and poorer health outcomes in the emergency department (ED) compared to their younger counterparts. Older adults are more likely to require additional resources and hospital admission. The nonspecific, atypical, and complex nature of disease presentation in older adults challenges current ED triage systems. Acute illness in older adults is often missed or commonly disguised in the ED as a social or functional issue. If diagnostic clarity is lacking or safe discharge from the ED is not feasible, then older adults may be labelled a \"social admission\" (or another synonymous term), often leading to negative health consequences.
    OBJECTIVE: This scoping review aims to describe and synthesize the available evidence on patient characteristics, adverse events, and health outcomes for older adults labelled as \"social admission\" (and other synonymously used terms), as well as those with nonacute or nonspecific complaints in the ED or hospital setting.
    METHODS: A literature search of MEDLINE, Embase, Scopus, PsycINFO, and CINAHL was completed. Relevant reference lists were screened. Data have been managed using EndNote software and the Covidence web application. Original data have been included if patients are aged ≥65 years and are considered a \"social admission\" (or other synonymously used term) or if they present to the ED with a nonacute or nonspecific complaint. Two review team members have reviewed titles and abstracts and will review full-text articles. Disagreements are resolved by consensus or in discussion with a third reviewer. This review does not require research ethics approval.
    RESULTS: As of January 2023, we have completed the title and abstract screening and have started the full-text screening. Some remaining full-text articles are being retrieved and/or translated. We are extracting data from included studies. Data will be presented in a narrative and descriptive manner, summarizing key concepts, patient characteristics, and health outcomes of patients labelled as a \"social admission\" (and other synonymously used terms) and of those with nonacute and nonspecific complaints. We expect the first results for publication in Spring 2023.
    CONCLUSIONS: Acute illness in the older adult is not always easily identified. We hope to better understand patient characteristics, adverse events, and health outcomes of older adults labelled as a \"social admission,\" as well as those with nonacute or nonspecific complaints. We aim to identify priorities for future research and identify knowledge gaps that may inform health care providers caring for these vulnerable patients.
    UNASSIGNED: DERR1-10.2196/38246.
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  • 文章类型: Journal Article
    未经评估:职业科学和职业治疗通常认为职业促进健康和福祉。然而,这种观点忽略了许多被视为非法的职业,不健康,或者冒险,比如吸毒。由于它与健康的负面影响,吸毒被认为在人们的生活中没有意义或意义。
    UNASSIGNED:这项研究探讨了个人如何在其生活背景下感知和描述其使用大麻的含义。从职业角度来看。
    UNASSIGNED:使用Levac等人进行了范围审查。对Arksey和O'Malley框架的修改。为了检查同行评审的文献,使用与大麻和含义相关的术语搜索了7个数据库。描述性统计被用来描述选定的研究,反身性主题分析确定了交叉研究主题。
    未经评估:选择了14项研究。大多数研究自2008年以来已发表,其中5篇在过去两年中发表。在研究中确定了四个主题:(a)保存生命;(b)浏览日常生活的常规;(c)了解自我,身份,和归属感;(d)扩大世界观。
    UNASSIGNED:在这项研究中揭示了大麻的使用,以支持导航职业程序,增强职业库和参与度,归属感,和集体用户身份。因此,药物滥用治疗实践,包括职业治疗师提供的,应该认识到使用大麻在人们生活中的潜在意义。使用减少伤害的方法,职业治疗师可以承认客户使用大麻来管理他们的日常生活的方式,同时还专注于支持客户减少大麻的不良影响。随着个人越来越多地从事生活中重要的职业,他们对大麻使用的需求和含义可能会发生变化,从而可能减少其使用并改变其身份结构。
    UNASSIGNED: Occupational science and occupational therapy typically perceive occupations as promoting health and well-being. However, this perspective overlooks the many occupations that are viewed as illegal, unhealthy, or risky, such as drug use. Due to its negative association with health, drug use is perceived as not holding significance or meaning in people\'s lives.
    UNASSIGNED: This study explores how individuals perceive and describe the meaning of their cannabis use in the context of their lives, from an occupational perspective.
    UNASSIGNED: A scoping review was conducted using Levac et al.\' modifications to Arksey and O\'Malley\'s framework. To examine the peer-reviewed literature, 7 databases were searched using terms related to cannabis and meaning. Descriptive statistics were used to describe the selected studies, and reflexive thematic analysis identified cross-study themes.
    UNASSIGNED: Fourteen studies were selected. Most studies have been published since 2008, with 5 published in the last 2 years. Four themes were identified across the studies: (a) preserving life; (b) navigating the routines of everyday life; (c) understanding the self, identity, and belonging; and (d) expanding the view of the world.
    UNASSIGNED: Cannabis use was revealed in this study as a support for navigating occupational routines and enhancing occupational repertoires and engagement, feelings of belonging, and collective user identities. As such, substance abuse treatment practices, including those provided by occupational therapists, should recognize the potential significance of cannabis use within people\'s lives. Using a harm reduction approach, occupational therapists can acknowledge the ways in which clients use cannabis to manage their daily routines, while also focusing on supporting clients to reduce the ill-effects of cannabis. As individuals become more engaged in occupations that are significant in their lives, their need for and meaning of cannabis use may change leading to a possible reduction in its use and a shift in their identity construction.
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  • 文章类型: Journal Article
    为了实现疫苗接种的全部好处,通过研究地方疫苗接种障碍,了解疫苗接种率低的根本原因是关键。本系统文献综述旨在确定撒哈拉以南非洲地区社区成员对儿童和青少年未接种疫苗和疫苗接种不足的原因。PubMed,WebofScience,PsycINFO,非洲医学指数,和非洲期刊在线数据库进行了搜索,以识别2010年至2020年之间发表的文章。共包括37篇文章。由于17项研究没有单独报告未接种疫苗和疫苗接种不足的原因,我们将这两种结果视为“不完全疫苗接种”。疫苗接种不完全的最常见原因与护理人员的时间限制有关,缺乏有关疫苗接种的知识,医疗保健设施中疫苗/人员不可用,错过了接种疫苗的机会,看护者对轻微副作用的恐惧,疫苗接种服务难以获得,和护理人员的疫苗接种信念。
    To achieve the full benefits of vaccination, it is key to understand the underlying causes of low vaccination by researching the barriers to vaccination at a local level. This systematic literature review aims to identify the reasons given by community members for the non-vaccination and under-vaccination of children and adolescents in sub-Saharan Africa. PubMed, Web of Science, PsycINFO, African Index Medicus, and African Journals Online databases were searched to identify articles published between 2010 and 2020. A total of 37 articles were included. As 17 studies did not report the reasons for non-vaccination and under-vaccination separately, we considered these two outcomes as \"incomplete vaccination\". The most common reasons for incomplete vaccination were related to caregiver\'s time constraints, lack of knowledge regarding vaccination, the unavailability of vaccines/personnel in healthcare facilities, missed opportunities for vaccination, caregiver\'s fear of minor side effects, poor access to vaccination services, and caregiver\'s vaccination beliefs.
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  • 文章类型: Journal Article
    背景:未完成的护理(UNC)概念,当护士被迫推迟或省略所需的护理时,由于任务未完成,已经在很大程度上进行了调查,错过的护理,和内隐配给护理。然而,尚未发布有关UNC前身的现有证据摘要。这项研究的目的是确定和总结迄今为止在主要研究中记录的UNC的前身。
    方法:根据系统评价和Meta分析指南的首选报告项目进行系统评价。MEDLINE,CINAHL,Scopus,我们在PROSPERO数据库中搜索了报告2004年后至2020年1月21日发表的前因与UNC之间关系的定量研究.已仔细检查了二级研究的参考清单,以确定其他研究。两名审稿人独立确定了研究并评估了他们的资格,研究小组解决了分歧。质量评估基于乔安娜·布里格斯研究所的关键评估工具,根据研究设计。对数据提取网格进行了试验,然后将其用于提取数据。出现的先例采用归纳法进行了主题分类。
    结果:纳入58项研究;其中,54是横截面,三个是队列研究,一个是准实验研究。它们主要在美国和医院环境中进行。迄今为止,UNC的前身已经在(A)单位进行了调查(例如,工作负载,非护理任务),(b)护士(例如,年龄,性别),和(c)患者水平(临床不稳定)。
    结论:在单位级别,强烈建议提供足够的员工水平,处理不可预测的工作负载的策略,并促进良好的实践环境,以减少或最小化UNC。相比之下,在护士和病人层面,关于可以减少UNC发生的可改变因素,没有明确的趋势。出现的先例图可用于设计干预研究,旨在将研究从仅仅描述性转变为评估干预措施有效性的研究。
    BACKGROUND: Unfinished Nursing Care (UNC) concept, that express the condition when nurses are forced to delay or omit required nursing care, has been largely investigated as tasks left undone, missed care, and implicit rationing of nursing care. However, no summary of the available evidence regarding UNC antecedents has been published. The aim of this study is to identify and summarise antecedents of UNC as documented in primary studies to date.
    METHODS: A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. MEDLINE, CINAHL, SCOPUS, and PROSPERO databases were searched for quantitative studies reporting the relationships between antecedents and UNC published after 2004 up to 21 January 2020. The reference lists of secondary studies have been scrutinised to identify additional studies. Two reviewers independently identified studies and evaluated them for their eligibility and disagreements were resolved by the research team. The quality appraisal was based on the Joanna Briggs Institute Critical Appraisal tools, according to the study designs. A data extraction grid was piloted and then used to extract data. The antecedents that emerged were thematically categorised with an inductive approach.
    RESULTS: Fifty-eight studies were included; among them, 54 were cross-sectional, three were cohort studies, and one was a quasi-experimental study. They were conducted mainly in the United States and in hospital settings. The UNC antecedents have been investigated to date at the (a) unit (e.g., workloads, non-nursing tasks), (b) nurse (e.g., age, gender), and (c) patient levels (clinical instability).
    CONCLUSIONS: At the unit level, it is highly recommended to provide an adequate staff level, strategies to deal with unpredictable workloads, and to promote good practice environments to reduce or minimise UNC. By contrast, at the nurse and patient levels, there were no clear trends regarding modifiable factors that could decrease the occurrence of UNC. The map of antecedents that emerged can be used to design interventional studies aimed at changing research from merely descriptive to that which evaluates the effectiveness of interventions.
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  • 文章类型: Journal Article
    目的:为了提出道德问题,道德论据,以及在类器官模型的伦理文献中发现的原因。
    方法:在这篇关于伦理文献原因的系统综述中,我们根据预定义的标准选择了来源:(1)出版物提到了与生物医学研究中的类器官模型的创建和/或使用直接相关的道德原因或论点;(2)这些道德原因和论点得到了显着解决,不仅仅是顺便提到,或构成工作主体的很大一部分;(3)出版物经过同行评审并发表在学术文章中,book,国家级报告,工作文件,或博士论文;(4)收集的出版物为英文。
    方法:每篇文章都是出于可识别的道德原因而深入阅读的,arguments,和担忧。然后对这些进行归纳分类和综合,以创建更广泛的原因类别,并最终创建了一个总体概念方案。
    结果:在最初收集的266个来源中,共包括并分析了23个来源。发现了五个伦理问题和论点的主题:动物实验;临床应用和实验;商业化和同意;类器官本体论和道德地位;和研究伦理和研究完整性。然后将这些主题进一步细分为子主题和主题。鉴于所发现主题的广泛性,我们将重点描述由更深入的原因和论点组成的主题,而不是很少,传递提及或担忧。
    结论:类器官的伦理需要在多个领域进一步研究,因为大部分讨论都没有作为深入的论点提出。在整个类器官伦理学文献中,这种情绪也得到了回应。
    OBJECTIVE: To present the ethical issues, moral arguments, and reasons found in the ethical literature on organoid models.
    METHODS: In this systematic review of reasons in ethical literature, we selected sources based on predefined criteria: (1) The publication mentions moral reasons or arguments directly relating to the creation and/or use of organoid models in biomedical research; (2) These moral reasons and arguments are significantly addressed, not as mere passing mentions, or comprise a large portion of the body of work; (3) The publication is peer-reviewed and published in an academic article, book, national-level report, working paper, or Ph.D. thesis; (4) The publications collected are in English.
    METHODS: Each article was read in-depth for identifiable moral reasons, arguments, and concerns. These were then inductively classified and synthesized to create broader categories of reasons, and eventually an overarching conceptual scheme was created.
    RESULTS: A total of twenty-three sources were included and analyzed out of an initial 266 collected sources. Five themes of ethical issues and arguments were found: Animal Experimentation; Clinical Applications and Experiments; Commercialization and Consent; Organoid Ontology and Moral Status; and Research Ethics and Research Integrity. These themes are then further broken down into sub-themes and topics. Given the extensive nature of the topics found, we will focus on describing the topics that comprised of more in-depth reasons and arguments rather than few, passing mentions or concerns.
    CONCLUSIONS: The ethics of organoids requires further deliberation in multiple areas, as much of the discussions are not presented as in-depth arguments. Such sentiments are also echoed throughout the organoid ethics literature.
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  • 文章类型: Journal Article
    Understanding the motivations for e-cigarette use among college and university students is essential for developing and implementing effective interventions. Evaluating existing literature is necessary to identify methodological gaps and limitations and improve the quality of future research.
    We aimed to evaluate the quality of the methods and statistical analyses and integrate evidence addressing motivations for e-cigarette use among college and university students.
    An integrative literature review was conducted by two researchers to identify and evaluate peer-reviewed, quantitative, and mixed methods research exploring motivations for e-cigarette use among college and university students. A systematic analytic method of data reduction was used to identify alignment and divergence of the data, gaps in the literature, and methodological limitations.
    Fifteen quantitative studies and three mixed methods studies published between 2015-2020 were included. Most studies were cross-sectional, used convenience sampling, and lacked psychometric and assumptions testing. Half performed regression analyses, however, very few adhered to research and statistical reporting standards.
    Current literature provides a foundation for developing and implementing interventions aimed to prevent e-cigarette use and encourage cessation. Future research should incorporate stronger sampling methods and research designs, as well as the use of rigorous statistical analyses in conjunction with thorough reporting.
    Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2021.1990332.
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  • 文章类型: Journal Article
    目的:2型糖尿病(T2DM)是许多随机对照试验(RCTs)的主题。由于研究的中止,RCT的有效性可能受到减员偏差的威胁。本系统评价的目的是评估患者退出这些随机对照试验的原因。
    方法:在PubMed,科克伦图书馆,WebofScience,和Scopus数据库是根据系统审查和荟萃分析(PRISMA)流程图的首选报告项目进行的。目的是获得2017年1月之前公布的所有相关盲法随机对照试验,其中合成药物的有效性,在T2DM中,将维生素/矿物质与安慰剂或活性对照进行了比较.使用Jadad评分评估随机对照试验的质量。停药原因的频率是基于安慰剂/主动对照的治疗提出的,国家/国际水平的研究,和出版年。由于异质性,未进行Meta分析。
    结果:总体而言,包括由640,780名受试者组成的1368篇文章。在大多数RCT(75.0%)中,对干预组和安慰剂组进行了比较.大多数纳入的研究(96%)被归类为高质量类别(Jadad评分≥3)。在国际研究中发现,报告的戒断病例比例最高,在日本进行的国家RCT,和2011年出版的RCT。从这些研究中退出的143,794名参与者中,有91,669人(63.75%)报告了退出原因。主要报告原因为“不良影响”(24.04%),“撤回同意”(16.10%),和“缺失数据”(11.08%)。报告的退出原因的变化是基于国家或公布的年份。具有三盲设计的随机对照试验以及应用抗高脂血症和抗肥胖药物的随机对照试验,显示报告退出的可能性明显更高。
    结论:在2型糖尿病患者的盲性随机对照试验中报告的停药比例高与药物不良反应有关。总的来说,辍学的总人数和原因不令人满意。
    OBJECTIVE: Type 2 diabetes mellitus (T2DM) is the subject of numerous randomized controlled trials (RCTs). The validity of RCTs may be threatened by attrition bias due to the discontinuation of the study. The aim of this systematic review is to evaluate the reasons of patient\'s withdrawal from these RCTs.
    METHODS: A systematic literature search on PubMed, Cochrane Library, Web of Science, and Scopus databases was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. The aim was to obtain all relevant blinded RCTs published before January 2017 in which the effectiveness of synthetic drugs, vitamins/minerals were compared to that of placebo or active control in T2DM. The quality of RCTs was assessed using the Jadad score. The frequency of withdrawal reasons was presented based on treatments with placebo/active control, national/international level of the studies, and publication year. Meta-analysis was not performed due to the heterogeneity.
    RESULTS: Overall, 1368 articles comprising of 640,780 subjects were included. In the majority of the RCTs (75.0%), the intervention and the placebo arms were compared. Most of the included studies (96%) were classified in the high-quality category (Jadad score≥3). The highest proportion of reported withdrawal cases was found in international studies, national RCTs conducted in Japan, and RCTs published in 2011. The withdrawal reasons were reported for 91,669 (63.75%) of the total 143,794 participants who had withdrawn from these studies. The main reported reasons were \"adverse effects\" (24.04%), \"withdraw consent\" (16.10%), and \"missing data\" (11.08%). Variations in the reported withdrawal reasons were based on the country or published year. RCTs with triple blinded design as well as those in which anti-hyperlipidemia and anti-obesity medications were applied, showed significantly higher probability of reported the withdrawal.
    CONCLUSIONS: High proportion of reported discontinuation in blinded RCTs on patients with T2DM was related to drug adverse effects. Overall, the total number and reason of drop out were unsatisfactory.
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