health research

健康研究
  • 文章类型: Journal Article
    背景:卫生政策的规划和管理与循证研究直接相关。为了获得最严格的研究结果,重要的是要有代表性的样本。然而,研究中往往不考虑少数民族。迁移,平等,多样性问题是研究人员需要考虑的重要优先事项。本系统综述(SR)的目的是探索研究少数民族语言使用者在健康与社会保健研究(HSCR)中的经验的文献。
    方法:进行文献的ASR。利用SPIDER框架和Cochrane原则进行了审查。搜索了五个数据库,最初产生5311篇论文。在PROSPERO:https://www中开发并发布了SR协议。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42020225114analysis。
    结果:在两位审稿人的标题和摘要审查之后,包括74篇论文,并提供了一个叙述叙述。确定了六个主题:1.医疗保健方面的差异;2.产妇保健;3.心理健康;4。卫生研究方法学;5.移民和少数民族医疗保健;6。医疗保健方面的种族和种族差距。结果显示,在招聘方面仍然存在语言障碍(包括语言能力)和文化障碍,可能会影响结果的有效性。几篇论文承认语言障碍,但没有采取行动减少语言障碍。
    结论:尽管研究强调了过去40年的文化,有必要承认这一点,并嵌入在研究过程中。我们建议未来的研究应该包括语言的细节,这样读者就可以理解样本组成,以便能够以最好的方式解释结果。认识到文化和语言的重要性。如果语言不被认为是研究的一个重要方面,这项研究的结果不能严格,因此有效性受到损害。
    BACKGROUND: The planning and management of health policy is directly linked to evidence-based research. To obtain the most rigorous results in research it is important to have a representative sample. However, ethnic minorities are often not accounted for in research. Migration, equality, and diversity issues are important priorities which need to be considered by researchers. The aim of this systematic review (SR) is to explore the literature examining the experiences of minority language users in Health and Social Care Research (HSCR).
    METHODS: A SR of the literature was conducted. SPIDER framework and Cochrane principles were utilised to conduct the review. Five databases were searched, yielding 5311 papers initially. A SR protocol was developed and published in PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020225114analysis.
    RESULTS: Following the title and abstract review by two reviewers, 74 papers were included, and a narrative account was provided. Six themes were identified: 1. Disparities in healthcare; 2. Maternal health; 3. Mental health; 4. Methodology in health research; 5. Migrant and minority healthcare; 6. Racial and ethnic gaps in healthcare. Results showed that language barriers (including language proficiency) and cultural barriers still exist in terms of recruitment, possibly effecting the validity of the results. Several papers acknowledged language barriers but did not act to reduce them.
    CONCLUSIONS: Despite research highlighting cultures over the past 40 years, there is a need for this to be acknowledged and embedded in the research process. We propose that future research should include details of languages spoken so readers can understand the sample composition to be able to interpret the results in the best way, recognising the significance of culture and language. If language is not considered as a significant aspect of research, the findings of the research cannot be rigorous and therefore the validity is compromised.
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  • 文章类型: Journal Article
    这项工作介绍了基于FHIR第4版的NFDI4Health元数据模式的FHIR®规范:我们创建了16个配置文件,以促进临床、流行病学,和公共卫生研究数据。尽管广泛的MDS以及语义标准中缺少的概念带来了挑战,它标志着将信息技术标准应用于健康研究的重大进步。
    This work presents the Fast Healthcare Interoperability Resources (FHIR®) specification of the NFDI4Health Metadata schema based on FHIR Version 4: We created 16 profiles to facilitate the integration of clinical, epidemiological, and public health study data. Despite challenges arising from the extensive MDS as well as missing concepts in semantic standards, it marks a significant advance in applying information technology standards to health research.
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  • 文章类型: Journal Article
    医学科学必须基于可靠和科学的证据,并需要持续的研究。从事研究可以让学生和教师探索新的领域,质疑现有的范式,并发现医疗挑战的创新解决方案。作为特产,社区医学在解决公共卫生问题方面发挥着关键作用。然而,社区医学居民在生物医学研究中的参与度仍然欠佳,这可能会阻碍针对印度背景的循证实践的产生。这项研究是为了寻找社区医学居民的兴趣和参与度,以及影响他们对生物医学研究兴趣的因素。方法对北方邦社区医疗居民进行在线调查,从2024年2月到4月,使用具有半结构化的GoogleForms,预先测试的问卷。结果一百九十六名居民参与研究,其中女性(52.6%;103/196)超过男性(47.4%;93/196)。大多数参与者是三年级居民(40.8%)。大多数参与者似乎对生物医学研究感兴趣(83.2%),并认为生物医学研究基础课程(BCBR)有助于开展研究项目(75%)。大约一半的人以前有研究项目的经验,横断面研究是最常见的(75.9%)研究设计。提高研究技能和为医学知识做出贡献的愿望成为主要动力。另一方面,由于学术和教育活动负担过重而缺乏时间被视为进行研究的最常见障碍。结论发现大多数参与者对研究活动感兴趣。提高研究技能的机会,渴望为医疗兄弟会服务,对简历的积极影响是进行研究的主要激励因素。难以节省时间,小知识,导师的不良支持被认为是重要的障碍。
    Introduction Medical science must be based on sound and scientific evidence and requires continuous research. Engaging in research allows students and faculty to explore new frontiers, question existing paradigms, and discover innovative solutions to medical challenges. As a specialty, community medicine plays a pivotal role in addressing public health issues. However, the engagement of community medicine residents in biomedical research remains suboptimal, which may impede the generation of evidence-based practices tailored to the Indian context. This study was conducted to find the interest and engagement of community medicine residents, and factors influencing their interest in biomedical research. Methods An online survey was conducted among community medicine residents of Uttar Pradesh, from February to April 2024, using Google Forms having a semi-structured, pretested questionnaire. Results One hundred and ninety-six residents participated in the study, where females (52.6%; 103/196) outnumbered males (47.4%; 93/196). The majority of participants were third-year residents (40.8%). Most participants seemed interested in biomedical research (83.2%) and thought that Basic Course in Biomedical Research (BCBR) helps conduct research projects (75%). Around half had previous experience in research projects, with cross-sectional studies being the most common (75.9%) study design. Enhancing research skills and a desire to contribute to medical knowledge emerged as primary motivators. On the other hand, the lack of time due to being overburdened with academic and educational activities was seen as the most common barrier to conducting research. Conclusions The majority of participants were found interested in research activities. The opportunity to improve research skills, desire to serve the medical fraternity, and a positive impact on resumes were the leading motivating factors for conducting research. Difficulty in sparing time, little knowledge, and poor support from mentors were found as important barriers.
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  • 文章类型: Journal Article
    背景:在欧洲,在一般数据保护条例的范围内,创建了越来越多的数字基础设施,以允许大规模访问患者的健康数据及其用于研究。当研究在患者同意的基础上进行时,对于许多研究人员来说,传统的特定研究同意似乎太麻烦了。目前正在不同的背景下讨论和引入替代的同意模式。
    目的:本研究探讨了利益相关者对道德,legal,以及有关德国大学医学中心健康数据研究同意模型的实际问题。
    方法:对德国大学医学中心的医学研究人员进行了半结构化焦点小组访谈,健康IT专家,数据保护官,患者代表。使用软件支持的结构化定性内容分析对访谈进行了分析。
    结果:利益相关者认为,与分层同意相比,广泛同意的实施和管理的难度略低。患者代表赞成具体同意,与分层同意作为一种可能的替代方案。所有利益攸关方都对信息材料难以理解感到遗憾。提到口头信息和视频是一种改进手段。患者代表怀疑研究人员是否有足够的数据安全专业知识来充当唯一的信息提供者。如果获得健康数据研究同意是医疗预约的一部分,他们担心会受到不适当的压力。IT专家和其他利益相关者认为撤回同意是一项重大挑战,并呼吁采用数字同意管理解决方案。一方面,将健康数据转移到非欧洲国家和营利性组织被视为研究的必要条件。另一方面,这些行为者存在数据安全问题。在某些条件下,未经同意的研究在法律上是可能的,但所有利益相关者团体都认为存在问题。尽管原因和程度不同。
    结论:应做出更多努力来确定哪些选择应包括在健康数据研究同意书中。数字工具可以改善患者信息并促进同意管理。在国家和欧盟层面,需要对未经同意的研究进行统一和严格的规定。获得健康数据研究的同意应独立于医疗预约,和其他人员应接受数据安全培训,以提供有关健康数据研究的信息。
    BACKGROUND: In Europe, within the scope of the General Data Protection Regulation, more and more digital infrastructures are created to allow for large-scale access to patients\' health data and their use for research. When the research is performed on the basis of patient consent, traditional study-specific consent appears too cumbersome for many researchers. Alternative models of consent are currently being discussed and introduced in different contexts.
    OBJECTIVE: This study explores stakeholder perspectives on ethical, legal, and practical concerns regarding models of consent for health data research at German university medical centers.
    METHODS: Semistructured focus group interviews were conducted with medical researchers at German university medical centers, health IT specialists, data protection officers, and patient representatives. The interviews were analyzed using a software-supported structuring qualitative content analysis.
    RESULTS: Stakeholders regarded broad consent to be only marginally less laborious to implement and manage than tiered consent. Patient representatives favored specific consent, with tiered consent as a possible alternative. All stakeholders lamented that information material was difficult to understand. Oral information and videos were mentioned as a means of improvement. Patient representatives doubted that researchers had a sufficient degree of data security expertise to act as sole information providers. They were afraid of undue pressure if obtaining health data research consent were part of medical appointments. IT specialists and other stakeholders regarded the withdrawal of consent to be a major challenge and called for digital consent management solutions. On the one hand, the transfer of health data to non-European countries and for-profit organizations is seen as a necessity for research. On the other hand, there are data security concerns with regard to these actors. Research without consent is legally possible under certain conditions but deemed problematic by all stakeholder groups, albeit for differing reasons and to different degrees.
    CONCLUSIONS: More efforts should be made to determine which options of choice should be included in health data research consent. Digital tools could improve patient information and facilitate consent management. A unified and strict regulation for research without consent is required at the national and European Union level. Obtaining consent for health data research should be independent of medical appointments, and additional personnel should be trained in data security to provide information on health data research.
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  • 文章类型: Journal Article
    性别平等一直是《地平线2020》的一个贯穿各领域的问题,有三个目标:决策中的性别平衡、各级项目团队的性别平衡和平等机会,并将性别维度纳入研究和创新内容。从2017年到2022年,欧盟资助,与国家机构合作,“GENDER-NETPlus”下的13个跨国项目,探讨了如何将性别和性别最好地纳入社会科学研究,人文学科,和健康研究。随着项目接近完成,来自这些跨学科团队的40名研究人员于2022年11月会面,分享经验,讨论挑战,并考虑将性别和性别纳入研究的最佳方法。这里,我们总结了本次研讨会的思考,并为i)如何计划研究(例如,如何定义性别和/或性别及其维度,假设的理由,识别最能回答研究问题的数据),ii)如何进行(例如,调整定义和尺寸,进行试点研究,以确保正确使用术语并进行修改,直到达成共识),以及iii)如何分析和报告关注任何现实世界影响的发现。
    Gender equality has been a crosscutting issue in Horizon 2020 with three objectives: gender balance in decision-making, gender balance and equal opportunities in project teams at all levels, and inclusion of the gender dimension in research and innovation content. Between 2017 and 2022, the EU funded, in collaboration with national agencies, 13 transnational projects under \"GENDER-NET Plus\" that explored how to best integrate both sex and gender into studies ranging from social sciences, humanities, and health research. As the projects neared completion, forty researchers from these interdisciplinary teams met in November 2022 to share experiences, discuss challenges, and consider the best ways forward to incorporate sex and gender in research. Here, we summarize the reflections from this workshop and provide some recommendations for i) how to plan the studies (e.g., how to define sex and/or gender and their dimensions, rationale for the hypotheses, identification of data that can best answer the research question), ii) how to conduct them (e.g., adjust definitions and dimensions, perform pilot studies to ensure proper use of terminology and revise until consensus is achieved), and iii) how to analyze and report the findings being mindful of any real-world impact.
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  • 文章类型: Journal Article
    背景:少数民族人口经历了巨大的健康和社会护理差距;尽管经历了更大的疾病负担,这些群体在健康和社会护理研究中的代表性不足。因此,相关研究可能不太适用于这些人群。REPRESENT研究旨在探索少数民族和其他人口的健康和社会护理经验,他们的研究兴趣和适当的研究实践。
    方法:2022年5月至9月,对英格兰一些少数民族社区的成员进行了焦点小组和半结构化访谈。数据是音频记录的,使用NVivo12进行转录和主题编码。严谨是通过广泛取样确定的,迭代数据收集和分析。
    结果:52名少数民族成员进行了集体访谈和一对一访谈。与会者包括以下小组的代表:非洲加勒比,东欧,吉普赛旅行者,女同性恋,同性恋,双性恋,变性人,酷儿,双性恋和无性系+,难民/寻求庇护者,索马里和南亚社区。还对少数民族医疗保健提供者和研究人员进行了采访。确定了三个总体类别:健康信息,医疗服务经验,健康和社会护理问题以及健康研究。卫生和社会护理服务挑战主要归因于歧视,延迟服务,文化相关性差,语言和文化障碍。最有影响力的信息来源是当地社区组织和口碑。主要的健康和社会护理问题是慢性长期健康状况,心理健康,孕产妇健康和儿童发育。研究建议涉及了解参与的动机,改善沟通和赋予社区权力。最重要的研究重点是长期的健康状况,健康促进和教育,早期护理干预和了解社区需求。
    结论:健康和社会护理提供中的歧视和偏见对种族健康不平等的恶化具有严重影响。医疗保健委托当局和政策制定者可以利用少数族裔群体对药房服务和社区组织的偏好,以改善获得护理的机会。提高研究兴趣和参与度需要了解个人社区需求,社区敏感性,研究的相关性和文化适宜性。
    少数民族患者和公众参与和参与小组以及社区咨询委员会的成员支持REPRESENT研究设计,概念化和报告开发。
    BACKGROUND: Ethnic minority populations experience significant health and social care disparities; despite experiencing a greater burden of diseases, these groups are underrepresented in health and social care research. Consequently, related research can be less applicable to these population groups. The REPRESENT study aims to explore the health and social care experiences of ethnic minorities and other minoritised populations, their research interests and appropriate research practices.
    METHODS: Focus groups and semistructured interviews were conducted between May and September 2022 with members of a number of ethnic minority communities in England. Data were audio recorded, transcribed and thematically coded using NVivo 12. Rigour was determined through extensive sampling, iterative data collection and analysis.
    RESULTS: Fifty-two ethnic minority members were engaged in group interviews and one-to-one interviews. Participants included representatives of the following groups: African Caribbean, Eastern European, Gypsy Travellers, Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual+, Refugee/Asylum Seekers, Somali and South Asian communities. Interviews were also conducted with ethnic minority healthcare providers and researchers. Three overarching categories were identified: health information, medical service experiences, health and social care concerns and health research. Health and social care services challenges were mostly attributed to discrimination, delayed services, poor cultural relevance and language and cultural barriers. The most influential information sources were local community organisations and word-of-mouth. The main health and social care concerns were chronic long-term health conditions, mental health, maternal health and child development. Recommendations for research involved understanding the motivations for participation, improving communication and empowering communities. Top research priorities were long-term health conditions, health promotion and education, early care interventions and understanding community needs.
    CONCLUSIONS: Discrimination and bias in health and social care provision have severe implications for worsening ethnic health inequalities. Healthcare commissioning authorities and policymakers can leverage the preference of ethnic minority groups for pharmacy services and community organisations to improve access to care. Improving research interest and engagement requires understanding individual community needs, community sensitivity, research relevance and cultural appropriateness.
    UNASSIGNED: Members of ethnic minority Patient and Public Involvement and Engagement group and Community Advisory Board supported the REPRESENT study design, conceptualisation and report development.
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  • 文章类型: Journal Article
    这篇透视文章从有生活经验的人的角度描述了在研究会议和事件中参与有痴呆症生活经验的人的经历,研究人员,学员,观众和其他人。我们概述了不同事件的参与示例,并描述了一个视频项目,由有生活经验的人发起,传达关于成为加拿大衰老神经变性联盟(CCNA)年度合作伙伴论坛和科学日的整体合作者的不同观点。我们还报告了来自受众的评估数据,并提出了一系列促进这种参与的提示和策略。包括支持有生活经验的人的实际考虑。
    This perspective article describes the experiences of engaging people with lived experience of dementia in research meetings and events from the perspectives of people with lived experience, researchers, trainees, audience members and others. We outline examples of engagement from different events and describe a video project, initiated by people with lived experience, conveying diverse views about becoming integral collaborators in the Canadian Consortium on Neurodegeneration in Aging (CCNA) annual Partners Forum and Science Days. We also report evaluation data from audiences and present a series of tips and strategies for facilitating this engagement, including practical considerations for supporting people with lived experience.
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  • 文章类型: Journal Article
    本文试图强调在根据伦理原则评估人类医学研究时,必须将研究可持续性纳入其中的重要性。使用对最近文献的范围界定回顾,研究可持续性的复杂性得到了强调,围绕这一重要主题的关键主题和概念得到了认可和讨论。确定了总体上缺乏指导文件,并提出了实际解决这一缺陷的建议。目前正在试行的研究可持续性评估工具的一个例子已经提供,供伦理委员会和机构审查委员会可能进行调整和使用,以在研究批准过程中加强可持续性的概念和纳入。
    This article attempts to highlight the importance of including research sustainability as imperative when assessing human medical research in terms of ethical principles. Using a scoping review of recent literature, the complexity of research sustainability is highlighted with key themes and concepts surrounding this important topic being recognized and discussed. An overall paucity of guidance documents was identified and recommendations have been made to practically address this deficiency. An example of a research sustainability evaluation tool which is currently being piloted has been provided for possible adaptation and use by Ethics Committees and Institutional Review Boards to bolster the concept and inclusion of sustainability during the research approval process.
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  • 文章类型: Journal Article
    对研究环境影响的担忧已经在研究领域得到了阐述,但是问题仍然存在,关于什么样的角色责任适合研究人员,如果有的话。本文的研究问题是:使用数据密集型方法的英国卫生研究人员对他们的责任考虑其研究的环境影响有什么看法?使用数据密集型方法对英国卫生研究人员进行了26次访谈。与会者表示希望对他们的研究对环境的影响负责,然而,他们无法巩固这一点,因为经常有障碍阻止他们承担这样的职责。他们提出了解决这个问题的策略,主要与监管监控自己行为的需要有关。本文讨论了采用这种监管方法作为使用新自由主义批判促进研究人员角色责任的机制的含义。
    Concerns about research\'s environmental impacts have been articulated in the research arena, but questions remain about what types of role responsibilities are appropriate to place on researchers, if any. The research question of this paper is: what are the views of UK health researchers who use data-intensive methods on their responsibilities to consider the environmental impacts of their research? Twenty-six interviews were conducted with UK health researchers using data-intensive methods. Participants expressed a desire to take responsibility for the environmental impacts of their research, however, they were unable to consolidate this because there were often obstacles that prevented them from taking such role responsibilities. They suggested strategies to address this, predominantly related to the need for regulation to monitor their own behaviour. This paper discusses the implications of adopting such a regulatory approach as a mechanism to promote researchers\' role responsibilities using a neo-liberal critique.
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  • 文章类型: Journal Article
    目的:青少年参与健康研究至关重要,但由于对诸如同意等问题缺乏明确性,因此很复杂。这项研究旨在了解在澳大利亚进行研究的人如何在涉及青少年的健康研究中导航研究伦理,通过定性访谈。
    方法:目的抽样被用于招募23名参与青少年健康研究的研究人员,使用半结构化的深度访谈。在获得知情同意后,通过缩放和录音进行访谈。主题分析用于构建主题,并使用NVivo组织数据。
    结果:从数据中出现了两个截然不同的位置:(1)将青少年视为天生脆弱,他们对研究的参与是在风险和保护方面理解的,以及(2)青少年对研究的参与是在赋权方面理解的,强调他们在参与研究方面做出决策的能力。我们通过三个关键主题追踪这些位置,特别是关于道德委员会的作用:(1)由于对青少年生活的低等或优越的知识而竞争的职位,(2)竞争头寸导致规避风险或授权方法,(3)对涉及把关和象征主义的征得同意过程的思考。
    结论:我们的研究强调了一个有争议的话题,即伦理委员会对青少年需求的要求。大多数参与者认为当前的研究道德标准对研究人员或青少年本身不利。尽管将来也必须研究对道德委员会的看法,我们的研究提供了对经验和观念如何塑造研究人员与研究伦理机构互动的初步理解。
    OBJECTIVE: Adolescent participation in health research studies is critical yet complex given the lack of clarity around issues such as consent. This study aimed to understand how those conducting research in Australia navigate research ethics in health research involving adolescents, through qualitative interviews.
    METHODS: Purposive sampling was used to recruit 23 researchers involved in adolescent health research using semi-structured in-depth interviews. Interviews were conducted via Zoom and audio-recorded after obtaining informed consent. Thematic analysis was used to construct themes and data were organised using NVivo.
    RESULTS: Two contrasting positions emerged from the data: (1) framing of adolescents as inherently vulnerable, their participation in research understood in terms of risk and protection and (2) adolescent engagement in research is understood in terms of empowerment, emphasising their capacity to make decisions about research participation. We traced these positions through three key themes, particularly in relation to the role of ethics committees: (1) competing positions as a result of inferior or superior knowledge about adolescent lives, (2) competing positions resulting in a risk averse or an empowerment approach, and (3) reflections on processes of obtaining consent which involves gatekeeping and tokenism.
    CONCLUSIONS: Our study highlights the contentious topic of navigating ethics committee requirements for the needs of adolescents. Majority of participants felt the current research ethics establishment is not favourable for researchers or adolescents themselves. While it is imperative that perceptions of ethics committees also be studied in the future, our study provides preliminary understanding of how experiences and perceptions shape how researchers interact with the research ethics establishment.
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