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  • 文章类型: Journal Article
    脓毒症占全球可预防死亡的很大比例,早期治疗已被发现是降低死亡率的主要因素。在急救环境中早期识别败血症至关重要,因为这将缩短住院时间以及抗生素治疗和初始复苏的时间。我们的目的是探索与评估怀疑患有急性感染的成年人的急救提供者对败血症的认识或对败血症的认识有关的现有文献。我们的范围审查是作为国际复苏联络委员会(ILCOR)连续证据评估过程的一部分进行的,以更新2024ILCOR科学共识和治疗建议。我们搜查了Embase,Medline,和Cochrane数据库从成立到2023年1月17日,在2023年11月21日和2023年12月2日进行了更新搜索。灰色文献检索于2023年8月29日进行。人群包括患有急性疾病的成年人,表现出严重感染的体征和症状。结果包括败血症识别或外行急救提供者对败血症的认识。在审查了4380个潜在来源后,四项审查(三项系统审查和一项范围审查),11项观察性研究,27个网站符合纳入标准。没有研究直接针对我们的PICOST(人口,干预,比较器,结果,研究设计,和时间框架)问题,因为在急救设置中没有执行任何操作。3项系统评价和9项观察性研究评估早期预警评分检测脓毒症和预测脓毒症继发不良结局的能力,结果不一致。但许多人发现筛选工具是有用的。一项范围审查和一项观察性研究发现,公众对败血症的知识和认识是可变的,并且取决于医疗保健工作。location,教育水平,种族,性别,和年龄。灰色文献来源列出的与败血症相关的体征和症状主要属于九个一般类别,作为教育公众认识败血症的一种手段。尽管这次范围界定审查没有发现任何直接解决我们结果的研究,它强调了未来研究需要更好地了解急救环境中脓毒症的认识.
    Sepsis accounts for a significant proportion of preventable deaths worldwide and early treatment has been found to be a mainstay of decreasing mortality. Early identification of sepsis in the first-aid setting is critical as this results in a shorter time to hospital presentation and management with antibiotics and initial resuscitation. Our aim was to explore the existing literature related to either sepsis recognition or awareness of sepsis by first-aid providers who are evaluating an adult suspected of an acute infection. Our scoping review was performed as part of the International Liaison Committee on Resuscitation\'s (ILCOR) continuous evidence evaluation process to update the 2024 ILCOR Consensus on Science with Treatment Recommendations. We searched Embase, Medline, and Cochrane databases from their inception to January 17, 2023, with updated searches performed on November 21, 2023, and December 2, 2023. The gray literature search was conducted on August 29, 2023. The population included adults presenting with an acute illness exhibiting signs and symptoms of a severe infection. Outcomes included sepsis recognition or awareness of sepsis by a lay first-aid provider. After reviewing 4380 potential sources, four reviews (three systematic reviews and one scoping review), 11 observational studies, and 27 websites met the inclusion criteria. No study directly addressed our PICOST (Population, Intervention, Comparator, Outcomes, Study Design, and Timeframe) question as none were performed in the first-aid setting. Three systematic reviews and nine observational studies that assessed the ability of early warning scores to detect sepsis and predict adverse outcomes secondary to sepsis had inconsistent results, but many found the screening tools to be useful. One scoping review and one observational study found public knowledge and awareness of sepsis to be variable and dependent upon healthcare employment, location, education level, ethnicity, sex, and age. Signs and symptoms associated with sepsis as listed by gray literature sources fell primarily under nine general categories as a means of educating the public on sepsis recognition. Although this scoping review did not identify any studies that directly addressed our outcomes, it highlights the need for future research to better understand the recognition of sepsis in first-aid settings.
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  • 文章类型: Journal Article
    近年来,使用人工智能算法对色素性皮肤病变进行分类的准确性有了显著提高。智能分析和分类系统明显优于皮肤科医生和肿瘤学家使用的视觉诊断方法。然而,由于缺乏通用性和潜在错误分类的风险,此类系统在临床实践中的应用受到严重限制。在临床病理实践中成功实施基于人工智能的工具需要对现有模型的有效性和性能进行全面研究,以及潜在研究发展的进一步有希望的领域。本系统综述的目的是调查和评估人工智能技术用于检测色素性皮肤病变的恶性形式的准确性。对于这项研究,从电子科学出版商中选择了10,589篇科学研究和评论文章,其中171篇文章被纳入本系统综述。所有选定的科学文章都根据所提出的神经网络算法从机器学习到多模态智能架构进行分发,并在手稿的相应部分进行了描述。这项研究旨在探索自动皮肤癌识别系统,从简单的机器学习算法到基于高级编码器-解码器模型的多模态集成系统,视觉变压器(ViT),以及生成和尖峰神经网络。此外,作为分析的结果,未来的研究方向,前景,并讨论了进一步开发用于对色素性皮肤病变进行分类的自动神经网络系统的潜力。
    In recent years, there has been a significant improvement in the accuracy of the classification of pigmented skin lesions using artificial intelligence algorithms. Intelligent analysis and classification systems are significantly superior to visual diagnostic methods used by dermatologists and oncologists. However, the application of such systems in clinical practice is severely limited due to a lack of generalizability and risks of potential misclassification. Successful implementation of artificial intelligence-based tools into clinicopathological practice requires a comprehensive study of the effectiveness and performance of existing models, as well as further promising areas for potential research development. The purpose of this systematic review is to investigate and evaluate the accuracy of artificial intelligence technologies for detecting malignant forms of pigmented skin lesions. For the study, 10,589 scientific research and review articles were selected from electronic scientific publishers, of which 171 articles were included in the presented systematic review. All selected scientific articles are distributed according to the proposed neural network algorithms from machine learning to multimodal intelligent architectures and are described in the corresponding sections of the manuscript. This research aims to explore automated skin cancer recognition systems, from simple machine learning algorithms to multimodal ensemble systems based on advanced encoder-decoder models, visual transformers (ViT), and generative and spiking neural networks. In addition, as a result of the analysis, future directions of research, prospects, and potential for further development of automated neural network systems for classifying pigmented skin lesions are discussed.
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  • 文章类型: Journal Article
    性虐待是一个有很多后果的健康问题。认识和讨论过去的性虐待已被证明对医疗保健专业人员具有挑战性。提高性虐待受害者的整体医疗质量,医疗保健专业人员需要接受适当的培训。本文旨在概述卫生保健专业人员的培训方法,并报告其有效性。
    进行了范围审查。2022年12月,在六个数据库中进行了广泛搜索。研究选择由两名独立评审者进行,其次是质量评估和数据提取。
    在筛选标题和摘要以及随后的全文评估以进行质量评估之后,选择了七篇文章,主要由非随机试验组成,在总共1299名医疗保健专业人员中进行了表演。所有研究均被评估为中等至较差的质量。参加者参加了培训课程,持续时间多种多样,设置,格式和方法。结果显示自我感知或测量知识的改善,讨论性暴力的技能和信心。几乎没有研究临床实践的变化。当混合教学被动方法时,培训课程最有效,如讲座和视频,积极的参与战略,比如讨论和角色扮演,被应用了。及时迭代以加强对获得的知识和技能的保留也有助于提高效率。参与者最喜欢在小型环境中获得反馈并分享个人经验的机会。
    本范围审查总结了如何有效地培训卫生保健专业人员。讨论了衡量培训课程有效性的缺点和困难。医疗保健提供者对过去性虐待的识别和讨论可以使用多种主动和被动训练方法的交替组合进行有效训练,并有反馈和个人经历的空间。
    UNASSIGNED: Sexual abuse is a health issue with many consequences. Recognizing and discussing past sexual abuse has proven to be challenging for health care professionals. To improve overall quality of health care for sexual abuse victims, health care professionals need to be properly trained. The aim of this paper is to provide an overview of training methods for health care professionals and to report on their effectiveness.
    UNASSIGNED: A scoping review was conducted. A broad search was executed in six databases in December 2022. Study selection was performed by two independent reviewers, followed by quality assessment and data extraction.
    UNASSIGNED: After screening of titles and abstracts and later full-text assessment for quality appraisal, seven articles were selected, consisting mostly of non-randomized trials, performed among a total of 1299 health care professionals. All studies were assessed to be of moderate to poor quality. The participants attended training courses with a wide variety of durations, settings, formats and methods. The outcomes showed improvements in self-perceived or measured knowledge, skills and confidence to discuss sexual violence. Changes in clinical practice were scarcely investigated. Training courses were most effective when a mix of didactic passive methods, such as lectures and videos, and active participatory strategies, such as discussions and roleplay, were applied. Timely iteration to reinforce retention of gained knowledge and skills also contributed to effectiveness. Participants most enjoyed incorporating opportunities for receiving feedback in small settings and sharing personal experiences.
    UNASSIGNED: This scoping review summarizes on how to effectively train health care professionals. Flaws and difficulties in measuring the effectiveness of training courses were discussed. Recognition and discussion of past sexual abuse by health care providers can be effectively trained using an alternating mix of multiple active and passive training methods with room for feedback and personal experiences.
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  • 文章类型: Journal Article
    背景:情绪与疾病之间存在相互影响。因此,情绪的主题已经得到越来越多的关注。
    目的:本研究的主要目的是对过去十年来情绪识别技术的发展进行全面回顾。这篇评论旨在通过研究情感识别技术在不同环境中的实际应用来深入了解情感识别技术的趋势和现实世界的影响,包括医院和家庭环境。
    方法:本研究遵循系统审查的首选报告项目(PRISMA)指南,并包括对4个电子数据库的搜索,即,PubMed,WebofScience,谷歌学者和IEEEXplore,确定2013年至2023年之间发表的合格研究。使用关键评估技能计划(CASP)标准评估研究的质量。研究的关键信息,包括研究人群,应用场景,和采用的技术方法,进行了总结和分析。
    结果:在对44项研究的系统文献综述中,我们从三个不同的角度分析了情绪识别技术在医学领域的发展和影响:“应用场景,多种模式的\“\”技术,“和”临床应用。“确定了以下三个影响:(i)情感识别技术的进步促进了医疗保健专业人员在医院和家庭环境中进行远程情感识别和治疗。(二)从传统的主观情绪评价方法向以客观生理信号为基础的多模态情绪识别方法转变。这一技术进步有望提高医疗诊断的准确性。(三)在整个诊断过程中情绪与疾病之间不断发展的关系,干预,和治疗过程对实时情绪监测具有临床意义。
    结论:这些发现表明,情感识别技术与智能设备的集成导致了应用系统和模型的发展,为识别和干预情绪提供技术支持。然而,动态或复杂环境中情绪变化的连续识别将是未来研究的重点。
    BACKGROUND: There is a mutual influence between emotions and diseases. Thus, the subject of emotions has gained increasing attention.
    OBJECTIVE: The primary objective of this study was to conduct a comprehensive review of the developments in emotion recognition technology over the past decade. This review aimed to gain insights into the trends and real-world effects of emotion recognition technology by examining its practical applications in different settings, including hospitals and home environments.
    METHODS: This study followed the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines and included a search of 4 electronic databases, namely, PubMed, Web of Science, Google Scholar and IEEE Xplore, to identify eligible studies published between 2013 and 2023. The quality of the studies was assessed using the Critical Appraisal Skills Programme (CASP) criteria. The key information from the studies, including the study populations, application scenarios, and technological methods employed, was summarized and analyzed.
    RESULTS: In a systematic literature review of the 44 studies that we analyzed the development and impact of emotion recognition technology in the field of medicine from three distinct perspectives: \"application scenarios,\" \"techniques of multiple modalities,\" and \"clinical applications.\" The following three impacts were identified: (i) The advancement of emotion recognition technology has facilitated remote emotion recognition and treatment in hospital and home environments by healthcare professionals. (ii) There has been a shift from traditional subjective emotion assessment methods to multimodal emotion recognition methods that are grounded in objective physiological signals. This technological progress is expected to enhance the accuracy of medical diagnosis. (iii) The evolving relationship between emotions and disease throughout diagnosis, intervention, and treatment processes holds clinical significance for real-time emotion monitoring.
    CONCLUSIONS: These findings indicate that the integration of emotion recognition technology with intelligent devices has led to the development of application systems and models, which provide technological support for the recognition of and interventions for emotions. However, the continuous recognition of emotional changes in dynamic or complex environments will be a focal point of future research.
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  • 文章类型: Journal Article
    药用植物物种的知识对于保护药用植物和保护生物多样性是必要的。植物学家专家对这些植物的分类和鉴定是复杂而耗时的活动。本系统综述的主要目的是系统地评估先前关于深度学习方法在分类和识别药用植物物种方面的应用和使用的研究工作。我们的目标是通过利用深度学习技术,按照与药用植物物种分类和识别相关的PRISMA指南进行系统评价。这篇综述涵盖了2018年1月至2022年12月之间发表的研究。最初,我们通过标题确定了1644项研究,关键字,抽象筛选在应用我们的资格标准后,我们选择了31项研究进行全面和严格的审查.这篇综述的主要发现是(1)选定的研究是在16个不同的国家进行的,印度以29%的纸张贡献领先,其次是印度尼西亚和斯里兰卡。(2)在进行图像增强和预处理技术的研究中,有67.7%使用了私有数据集。(3)在96.7%的研究中,研究人员使用了植物叶片器官,其中74%的人利用叶片形状进行药用植物物种的分类和识别。(4)在83.8%的研究中,使用预训练模型的迁移学习作为未来的提取技术。(5)64.5%的论文使用卷积神经网络(CNN)作为深度学习分类器。(6)缺乏对特定国家本土药用植物的全球可用和公共数据集的需求,以及用于药用植物分类和识别的深度学习方法的可信赖性是本文献综述中可观察到的研究空白。因此,需要进一步的调查和不同利益相关者之间的合作,以实现上述研究差距。
    Knowledge of medicinal plant species is necessary to preserve medicinal plants and safeguard biodiversity. The classification and identification of these plants by botanist experts are complex and time-consuming activities. This systematic review\'s main objective is to systematically assess the prior research efforts on the applications and usage of deep learning approaches in classifying and recognizing medicinal plant species. Our objective was to pinpoint systematic reviews following the PRISMA guidelines related to the classification and recognition of medicinal plant species through the utilization of deep learning techniques. This review encompassed studies published between January 2018 and December 2022. Initially, we identified 1644 studies through title, keyword, and abstract screening. After applying our eligibility criteria, we selected 31 studies for a thorough and critical review. The main findings of this reviews are (1) the selected studies were carried out in 16 different countries, and India leads in paper contributions with 29%, followed by Indonesia and Sri Lanka. (2) A private dataset has been used in 67.7% of the studies subjected to image augmentation and preprocessing techniques. (3) In 96.7% of the studies, researchers have employed plant leaf organs, with 74% of them utilizing leaf shapes for the classification and recognition of medicinal plant species. (4) Transfer learning with the pre-trained model was used in 83.8% of the studies as a future extraction technique. (5) Convolutional Neural Network (CNN) is used by 64.5% of the paper as a deep learning classifier. (6) The lack of a globally available and public dataset need for medicinal plants indigenous to a specific country and the trustworthiness of the deep learning approach for the classification and recognition of medicinal plants is an observable research gap in this literature review. Therefore, further investigations and collaboration between different stakeholders are required to fulfilling the aforementioned research gaps.
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  • 文章类型: Journal Article
    脑电图(EEG)是神经科学和技术交叉的先驱工具,对人类情感提供前所未有的见解。通过这次全面审查,我们探索与基于脑电图的情绪识别相关的挑战和机遇。虽然最近的文献表明有希望的高准确率,这些主张需要对其真实性和适用性进行严格审查。这篇文章强调了从大量脑电图设备和数据源中推广发现的重大挑战,以及数据收集的困难。此外,受控实验室设置和真正的情感体验之间的差异在情感研究的范式中提出了一个悖论。我们主张采取平衡的方法,强调批判性评估的重要性,方法标准化,并承认情感的活力,以更全面地理解人类的情感景观。
    Electroencephalography (EEG) stands as a pioneering tool at the intersection of neuroscience and technology, offering unprecedented insights into human emotions. Through this comprehensive review, we explore the challenges and opportunities associated with EEG-based emotion recognition. While recent literature suggests promising high accuracy rates, these claims necessitate critical scrutiny for their authenticity and applicability. The article highlights the significant challenges in generalizing findings from a multitude of EEG devices and data sources, as well as the difficulties in data collection. Furthermore, the disparity between controlled laboratory settings and genuine emotional experiences presents a paradox within the paradigm of emotion research. We advocate for a balanced approach, emphasizing the importance of critical evaluation, methodological standardization, and acknowledging the dynamism of emotions for a more holistic understanding of the human emotional landscape.
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  • 文章类型: Systematic Review
    目的:调查医疗专业人员识别和管理住院老年人谵妄的障碍。
    方法:混合方法系统综述。
    CRD42020187932。
    方法:MEDLINE,EMBASE,搜索了PsycINFO和CINAHL(2007年至2023年2月)。
    方法:纳入的研究集中于医护人员对医院病房或急诊科65岁及以上患者谵妄的识别和管理。加强严谨,结果筛选由两名研究者独立进行.定性和定量数据分别列表并分组。比较数据以确定相似性和差异性。所有研究均进行了质量评价。
    结果:包括43项研究;24项定量研究,16种定性方法和三种混合方法。数据综合强调了定性和定量结果之间的协同作用。障碍反映在六个主题中:(1)医疗保健专业人员的知识和理解;(2)沟通;(3)劳动力发展;(4)跨专业工作;(5)混杂因素;(6)组织约束。
    结论:意义重大,对于在医院经历谵妄的老年人,是否以及如何识别和管理它存在差异。为防止不良后果,筛查最佳实践指导,承认,诊断和管理老年人谵妄需要达成共识并广泛传播。支持医疗保健专业人员使用综合方法来照顾这些患者人群至关重要,如何让患者及其家人和朋友参与和沟通,如何识别和管理有额外需求的患者的谵妄,例如,患有痴呆症和/或学习障碍的人。医院需要制定政策和指导,以识别和管理向病房或急诊科就诊的老年人的谵妄。需要一种IT基础架构,将评估和护理管理计划集成到患者电子记录中,并使其能够在医院的团队内部和团队之间访问。初级和社区护理设置。
    本次系统评价没有患者或公众的贡献。
    可以更好地支持医疗保健专业人员,以便能够在老年人急性住院期间识别和管理谵妄。这包括最大限度地为痴呆症患者提供最佳护理,让家人和朋友参与,以帮助了解患者的基线状态和变化,并在此过程中支持家人和朋友。意义重大,对医院IT基础设施的关注是必要的,整合筛选,患者电子记录中的评估和护理管理计划,并使护理机构中照顾该患者人群的医疗保健专业人员可以访问这些计划。
    结论:这项研究解决了什么问题?谵妄是老年住院患者的常见病,但它始终被低估,这对患者和组织的结局有影响。为了帮助解决这个问题,了解医疗专业人员识别和管理这一患者人群谵妄的障碍至关重要.主要发现是什么?医疗保健专业人员识别和管理该患者人群谵妄的障碍被综合为六个主题:(1)医疗保健专业人员的知识和理解,(2)沟通;(3)劳动力发展;(4)跨专业工作;(5)混杂因素;(6)组织约束。这项研究将在何处以及对谁产生影响?这项原始系统评价的结果可以为医院政策和方案做出贡献,以识别和管理老年患者的谵妄。这些发现可以为在急性住院期间照顾老年人的从业者以及在出院后对患者进行随访的初级和社区环境中的从业者的劳动力专业发展做出有意义的贡献。对于研究人员来说,研究结果表明了一些研究建议,包括调查护士和其他医疗保健专业人员的教育计划对疾病的识别和管理以及理解的影响,以及调查如何最好地支持患者及其家人和从业者经历的与谵妄相关的痛苦。
    此系统评价是根据系统评价和荟萃分析的首选报告项目进行报告的(Page等。,2021)。
    OBJECTIVE: To investigate barriers to healthcare professionals recognizing and managing delirium in hospitalized older people.
    METHODS: A mixed-methods systematic review.
    UNASSIGNED: CRD42020187932.
    METHODS: MEDLINE, EMBASE, PsycINFO and CINAHL were searched (2007 to February 2023).
    METHODS: Included studies focused on healthcare professionals\' recognition and management of delirium for patients aged 65 years and over in a hospital ward or emergency department. Enhancing rigour, screening of results was conducted independently by two researchers. Qualitative and quantitative data were tabulated separately and grouped. Data were compared to identify similarities and differences. All studies were quality appraised.
    RESULTS: 43 studies were included; 24 quantitative, 16 qualitative and three mixed-methods. Data synthesis highlighted synergy between qualitative and quantitative findings. Barriers were reflected in six themes: (1) healthcare professionals\' knowledge and understanding; (2) communication; (3) workforce development; (4) interprofessional working; (5) confounders; and (6) organizational constraints.
    CONCLUSIONS: Of significance, for older adults in hospital experiencing delirium, there is variability in whether and how well it is recognized and managed. To prevent adverse outcomes best practice guidance for screening, recognizing, diagnosing and managing delirium in older people needs to be agreed and disseminated widely. Supporting healthcare professionals to care for this patient population using an integrated approach is essential, how to involve and communicate with patients and their family and friends, how to recognize and manage delirium for patients with additional needs, e.g., those living with dementia and/or a learning disability. Hospitals need to have policy and guidance in place for the recognition and management of delirium in older adults presenting to a ward or to an emergency department. An IT infrastructure is needed that integrates assessments and care management plans in patient electronic records and makes them accessible within and across teams in hospital, primary and community care settings.
    UNASSIGNED: There was no patient or public contribution to this systematic review.
    UNASSIGNED: Healthcare professionals can be better supported to be able to recognize and manage delirium during an acute hospital stay for older adults. This includes maximizing best care for those patients living with dementia, involving families and friends to help understand patients\' baseline status and changes and supporting families and friends during this process. Of significance, attention to hospital IT infrastructures is warranted, integrating screening, assessment and care management plans in patients\' electronic records and making these accessible to healthcare professionals caring for this patient population across care settings.
    CONCLUSIONS: What problem did the study address? Delirium is a common condition experienced by older hospitalized patients, but it is consistently under-recognized which has implications for patient and organization outcomes. To help address this, understanding barriers to healthcare professionals recognizing and managing delirium for this patient population is paramount. What were the main findings? Barriers to healthcare professionals recognizing and managing delirium for this patient population were synthesized in six themes: (1) healthcare professionals\' knowledge and understanding, (2) communication; (3) workforce development; (4) interprofessional working; (5) confounders; and (6) organizational constraints. Where and on whom will the research have an impact? The findings of this original systematic review can contribute to hospital policy and protocol for the recognition and management of delirium in older patients. The findings can meaningfully contribute to workforce professional development for practitioners caring for older people during an acute hospital stay and for practitioners in primary and community settings involved in the follow-up of patients post hospital discharge. For researchers, the findings indicate several research recommendations including investigating the impact of an education programme for nurses and other healthcare professionals on the recognition and management of the condition and understanding and investigating how best to support delirium-related distress experienced by patients and their families and practitioners.
    UNASSIGNED: This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Page et al., 2021).
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  • 文章类型: Journal Article
    本文报告了范围审查,探讨了文献中对家庭和针对残疾妇女(WWD)的家庭暴力(FDV)的理解,构成了两部分系列的第二篇文章,第一次批评FDV和残疾的分类和测量。我们报告了审查中包含的定性研究的结果,主要是解释性和批判性的取向。范围审查包括43篇文章,其中15个包含在这里,因为他们直接从WWD的角度利用数据。进行了反身性主题分析,利用归纳和演绎编码,作者之间的协商。分析强调了基于残疾的虐待的经验,日常生活中的能力主义和性别歧视的联系,以及WWD的正义和韧性的含义。基于残疾的虐待主要是由亲密伴侣实施的,包括基于财务和身体残疾的虐待,被用来利用和维持孤立的局面。性别歧视和可行的期望,假设,和态度在社区内的日常接触中趋同,工人和系统。然而,WWD报道了抵抗策略,愈合,应对,并在FDV之后继续前进,并指出可以做些什么来促进正义,个人和系统内。根据AxelHonneth的承认理论对调查结果进行了讨论,以强调可以增强承认和尊重以实现充分获得公民身份的机制,特别是,让WWD摆脱暴力。
    This article reports on a scoping review exploring understandings of family and domestic violence (FDV) against women with disability (WWD) within the literature and constitutes the second article in a two-part series, the first critiquing the categorization and measurement of FDV and disability. We report findings from qualitative studies included in the review, predominantly interpretivist and critical in orientation. The scoping review included 43 articles, 15 of which are included here, as they draw upon data directly from the perspectives of WWD. Reflexive thematic analysis was conducted, utilizing both inductive and deductive coding, and consultation between the authors. The analysis highlighted experiences of disability-based abuse, the nexus of ableism and sexism within the everyday, and meanings of justice and resilience for WWD. Disability-based abuse was perpetrated primarily by intimate partners, including financial and physical disability-based abuse, and was used to exploit and perpetuate situations of isolation. Sexist and ableist expectations, assumptions, and attitudes converged in everyday encounters within the community, with workers and systems. However, WWD reported strategies of resistance, healing, coping, and moving on in the aftermath of FDV and indicated what can be done to promote justice, both personally and within systems. The findings were discussed drawing on Axel Honneth\'s theory of recognition to highlight the mechanisms by which recognition and respect can be enhanced to enable full access to citizenship, in particular, for WWD to live free from violence.
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  • 文章类型: Journal Article
    背景:患者参与研究是指研究人员与患者之间的合作(即,具有生活经验的个人,包括非正式的护理人员)在发展或进行研究。提供非金融(例如,合著者,礼物)或财务(例如,酬金,工资)对患者伴侣的补偿可以证明对患者伴侣的时间和精力的赞赏。然而,关于患者伴侣目前如何因参与研究而获得补偿的情况知之甚少。我们试图评估报告患者伴侣补偿的患病率,报告的具体薪酬做法(非财务和财务),并确定好处,挑战,提供经济补偿的障碍和促成因素。
    方法:我们在WebofScience和Scopus中引用了报告患者和公众参与情况指南(GRIPPI和II)报告清单(2021年10月)对研究进行了系统评价。以患者为研究伙伴的研究符合资格。两名独立的审稿人筛选了全文,并使用标准化的数据抽象表格从纳入的研究中提取了数据。提取了与补偿方法(财务和非财务)有关的数据,并报告了在财务上补偿患者合作伙伴的障碍和促成因素。由于审查的目的是描述患者伴侣补偿的范围,因此未进行正式的质量评估。定量数据以描述性方式呈现,定性数据进行了主题分析。
    结果:搜索确定了843项研究,其中316项研究符合条件。在316项研究中,91%(n=288)报告向患者伴侣提供某种补偿。报告的最常见的非经济补偿方法是对研究成果的非正式承认(65%,n=206)和共同作者(49%,n=156)。79项研究(25%)报告提供经济补偿(即,酬金,salf),32(10%)报告没有提供经济补偿,和205(65%)的研究没有报告经济补偿。两个主要障碍是缺乏支持补偿的资金和缺乏机构政策或指导。两个经常报告的推动者在制定项目预算和充足的项目资金时正在考虑财务补偿。
    结论:在报告患者参与研究的一组已发表研究中,大多数向患者合作伙伴提供非财务补偿方法。研究人员可能需要指导和支持,以克服提供经济补偿的障碍。
    术语“患者参与研究”用于描述与患者进行的研究,而不是“对”病人。重要的是,研究人员认识到患者合作伙伴的时间和专业知识。为了更好地了解患者伴侣的识别方法,我们回顾了已发表的研究:(1)评估报告经济补偿的频率,(2)确定患者伴侣是如何被报告为被补偿的,(3)了解什么好处,挑战,提供经济补偿可能存在障碍和促成因素。我们引用《患者和公众参与报告指南》(GRIPP)指南对文章进行了系统回顾。我们包括所有研究设计,如果患者作为合作伙伴。仅患者为参与者的研究被排除在外。收集的数据包括有关患者合作伙伴补偿的详细信息(财务和非财务实践)以及与财务补偿相关的挑战。对数值数据进行了描述性分析。文本数据由两名审稿人编码,并整理成总体主题。我们的搜索确定了316篇论文。其中,91%的人报告向患者伴侣提供补偿。最常见的方法是承认(65%)和共同作者(49%)。只有79项研究(25%)报告为患者伴侣提供经济补偿。资金有限和缺乏机构指导被认为是可能阻止研究人员提供经济补偿的两个关键障碍。我们的审查发现,非财务补偿方法的报告频率高于财务补偿。研究人员在为患者伴侣提供经济补偿时可能需要更多的支持。
    BACKGROUND: Patient engagement in research refers to collaboration between researchers and patients (i.e., individuals with lived experience including informal caregivers) in developing or conducting research. Offering non-financial (e.g., co-authorship, gift) or financial (e.g., honoraria, salary) compensation to patient partners can demonstrate appreciation for patient partner time and effort. However, little is known about how patient partners are currently compensated for their engagement in research. We sought to assess the prevalence of reporting patient partner compensation, specific compensation practices (non-financial and financial) reported, and identify benefits, challenges, barriers and enablers to offering financial compensation.
    METHODS: We conducted a systematic review of studies citing the Guidance for Reporting the Involvement of Patients and the Public (GRIPP I and II) reporting checklists (October 2021) within Web of Science and Scopus. Studies that engaged patients as research partners were eligible. Two independent reviewers screened full texts and extracted data from included studies using a standardized data abstraction form. Data pertaining to compensation methods (financial and non-financial) and reported barriers and enablers to financially compensating patient partners were extracted. No formal quality assessment was conducted since the aim of the review is to describe the scope of patient partner compensation. Quantitative data were presented descriptively, and qualitative data were thematically analysed.
    RESULTS: The search identified 843 studies of which 316 studies were eligible. Of the 316 studies, 91% (n = 288) reported offering a type of compensation to patient partners. The most common method of non-financial compensation reported was informal acknowledgement on research outputs (65%, n = 206) and co-authorship (49%, n = 156). Seventy-nine studies (25%) reported offering financial compensation (i.e., honoraria, salary), 32 (10%) reported offering no financial compensation, and 205 (65%) studies did not report on financial compensation. Two key barriers were lack of funding to support compensation and absence of institutional policy or guidance. Two frequently reported enablers were considering financial compensation when developing the project budget and adequate project funding.
    CONCLUSIONS: In a cohort of published studies reporting patient engagement in research, most offered non-financial methods of compensation to patient partners. Researchers may need guidance and support to overcome barriers to offering financial compensation.
    The term patient engagement in research is used to describe research that is conducted “with” patients, rather than “on” patients. It is important that researchers recognize patient partners for their time and expertise. In order to gain a better understanding of approaches to recognition for patient partners we reviewed published studies to: (1) assess how often financial compensation is reported, (2) identify how patient partners are reported as being compensated, and (3) understand what benefits, challenges, barriers and enablers might exist to offering financial compensation. We conducted a systematic review of articles citing the Guidance for Reporting the Involvement of Patients and the Public (GRIPP) guidelines. We included all study designs if patients were engaged as partners. Studies in which patients were participants only were excluded. Data collected included information about details of patient partner compensation (financial and non-financial practices) as well as challenges relating to financial compensation. Numerical data were analysed descriptively. Textual data were coded by two reviewers and collated into overarching themes. Our search identified 316 papers. Of these, 91% reported offering compensation to patient partners. Most common methods were acknowledgement (65%) and co-authorship (49%). Only 79 studies (25%) reported offering financial compensation to patient partners. Limited funding and lack of institutional guidance were identified as two key barriers that may be preventing researchers from offering financial compensation. Our review found that non-financial methods of compensation are reported more often than financial compensation. Researchers may require more support when offering financial compensation to patient partners.
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  • 文章类型: Journal Article
    对过敏反应的早期识别对于早期治疗至关重要,并且通常发生在急救环境中。然而,急救人员识别过敏反应的能力尚不清楚.我们试图检查有关急救人员识别过敏反应能力的证据。我们的范围审查是作为国际复苏联络委员会(ILCOR)连续证据评估程序的一部分进行的,以更新2020年ILCOR科学共识和治疗建议。我们搜查了Medline,Embase,科克伦,以及2010年至2022年9月的灰色文献。人群包括经历过敏反应的成人和儿童,并向急救提供者描述任何特定症状。识别过敏反应是主要结果。两名研究人员(DM和PC)审查了摘要,并提取和评估了数据。通过与ILCOR急救工作队的讨论和共识,解决了审稿人之间的差异。在957次点击中,17项研究符合纳入标准:一项综述和荟萃分析,两项实验研究,和14项观察性研究。我们没有发现任何直接针对我们的PICOST(人口,干预,Control,结果,研究设计,和时间框架),因为在急救设置中没有执行任何操作。文章包括可能作为患者和父母的急救提供者的个人(n=5),教师,学生或学校工作人员(n=8),护理人员和患者(n=2)或保姆(n=1)。所有纳入的研究均在高收入国家进行。我们的范围审查发现,过敏反应的体征和症状不是特异性的,并且不允许急救提供者容易识别。研究集中于教育(n=10)和协议(n=2),发现两者都可能对过敏反应的识别和管理产生积极影响。虽然我们没有发现任何直接解决急救人员识别过敏反应能力的临床研究,未来研究教育方法和行动计划可能有助于提高急救人员对过敏反应的识别.
    Early recognition of anaphylaxis is critical to early treatment and often occurs in the first aid setting. However, the ability of first aid providers to recognize anaphylaxis is unknown. We sought to examine the evidence regarding first aid providers\' ability to recognize anaphylaxis. Our scoping review was performed as part of the International Liaison Committee on Resuscitation (ILCOR) continuous evidence evaluation processes to update the 2020 ILCOR Consensus on Science with Treatment Recommendations. We searched Medline, Embase, Cochrane, and the gray literature from 2010 to September 2022. The population included adults and children experiencing anaphylaxis with a description of any specific symptom to a first aid provider. Recognition of anaphylaxis was the primary outcome. Two investigators (DM and PC) reviewed abstracts and extracted and assessed the data. Discrepancies between the reviewers were resolved by discussion and consensus with the ILCOR First Aid Task Force. Out of 957 hits, 17 studies met inclusion criteria: one review and meta-analysis, two experimental studies, and 14 observational studies. We did not identify any studies that directly addressed our PICOST (Population, Intervention, Control, Outcomes, Study Design, and Timeframe) as none were performed in the first aid setting. Articles included individuals who may be first aid providers as patients and parents (n=5), teachers, students or school staff (n=8), caregivers and patients (n= 2) or nannies (n=1). All included studies were conducted in high-income countries. Our scoping review found that signs and symptoms of anaphylaxis were not specific and did not allow for easy identification by the first aid provider. Studies focused on education (n=10) and protocols (n=2) and found that both could have a positive impact on anaphylaxis recognition and management. While we did not identify any clinical studies that directly addressed the ability of first aid providers to identify anaphylaxis, future studies examining education methods and action plans may help improve the identification of anaphylaxis by first aid providers.
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