translational health research

转化健康研究
  • 文章类型: Journal Article
    There is an increasing emphasis on transdisciplinary research to address the complex challenges faced by health systems. However, research has not adequately explored how members of transdisciplinary research teams perceive, understand, and promote transdisciplinary collaboration. As such, there is a need to investigate collaborative behaviors, knowledge, and the impacts of transdisciplinary research. To address this gap, we conducted a longitudinal realist evaluation of transdisciplinary collaboration within a 5-year National Health and Medical Research Council-funded Center of Research Excellence in Transdisciplinary Frailty Research. The current study aimed to explore researchers\' perceptions and promotion of transdisciplinary research specifically within the context of frailty research using qualitative methods. Participants described transdisciplinary research as a collaborative and integrative approach that involves individuals from various disciplines working together to tackle complex research problems. However, participants often used terms like interdisciplinary and multidisciplinary interchangeably, indicating that a shared understanding of transdisciplinary research is needed. Barriers to transdisciplinary collaboration included time constraints, geographical distance, and entrenched collaboration patterns. To overcome these challenges, participants suggested implementing strategies such as creating a shared vision and goals, establishing appropriate collaboration systems and structures, and role modeling collaborative behaviors, values, and attitudes. Our findings underscore the need for practical knowledge in developing transdisciplinary collaboration and leadership skills across different career stages. In the absence of formal training, sustained and immersive programs that connect researchers with peers, educators, and role models from various disciplines and provide experiential learning opportunities, may be valuable in fostering successful transdisciplinary collaboration.
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  • 文章类型: Journal Article
    脊髓损伤(SCI)代表了临床修复治疗的迫切需要,因为它对患者产生了很大程度上不可逆和破坏性的影响。以及社会的巨大社会经济负担。虽然正在探索不同的方法,治疗恢复失去的功能仍然不可用。嗅鞘细胞(OEC)移植在可行性方面是一种有前途的方法,安全,功效有限;然而,尽管进行了多项临床试验,但报告的临床结局的高度变异性阻碍了其翻译.这篇立场论文的目的是对以前基于OEC移植的临床试验进行深入分析,确定现有的挑战和差距,最后提出了提高OEC治疗标准化的策略。我们回顾了使用OEC移植进行SCI修复的临床试验的研究设计和方案,以研究结果如何以及为什么显示变异性。凭借这些知识以及我们作为在OEC研究领域具有积极经验的生物学家和临床医生团队的经验,我们提供有关细胞来源的建议,细胞纯度和表征,移植剂量和形式,和康复。最终,这篇立场论文旨在作为设计基于OEC移植治疗SCI修复的有效临床试验的路线图.
    Spinal cord injury (SCI) represents an urgent unmet need for clinical reparative therapy due to its largely irreversible and devastating effects on patients, and the tremendous socioeconomic burden to the community. While different approaches are being explored, therapy to restore the lost function remains unavailable. Olfactory ensheathing cell (OEC) transplantation is a promising approach in terms of feasibility, safety, and limited efficacy; however, high variability in reported clinical outcomes prevent its translation despite several clinical trials. The aims of this position paper are to present an in-depth analysis of previous OEC transplantation-based clinical trials, identify existing challenges and gaps, and finally propose strategies to improve standardization of OEC therapies. We have reviewed the study design and protocols of clinical trials using OEC transplantation for SCI repair to investigate how and why the outcomes show variability. With this knowledge and our experience as a team of biologists and clinicians with active experience in the field of OEC research, we provide recommendations regarding cell source, cell purity and characterisation, transplantation dosage and format, and rehabilitation. Ultimately, this position paper is intended to serve as a roadmap to design an effective clinical trial with OEC transplantation-based therapy for SCI repair.
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    文章类型: Journal Article
    CONICET\'s Translational Health Research Network is coordinating efforts to advance in translational medicine. Health researchers initiate and focus their research with the aim of improving the health and quality of life of the population. An efficient research system should address health problems relevant to the population resulting in interventions and outcomes important for patients and health professionals. Recommendations to achieve this involve large thematic areas like (a) to set research priorities; (b) to improve research methodology; (c) to make research management and regulation transparent; (d) to increase accessibility to all results; and (e) to improve research dissemination. The recent COVID-19 pandemic has been a clear demonstration of how the country\'s research system has united the most diverse disciplines to jointly provide solutions to address it. An active and transparent mechanism to identify priorities in the country and to unite funding and research efforts to provide solutions to those priorities is proposed. Translational health research means the joint work of the most diverse health research disciplines in order to jointly obtain efficient and effective interventions to improve the health and quality of life of the population.
    La Red de Investigación Traslacional en Salud del CONICET está coordinando esfuerzos para avanzar en la medicina traslacional. Los investigadores en salud comienzan y dirigen sus investigaciones con el objetivo de mejorar la salud y calidad de vida de la población. Un sistema de investigación eficiente debe abordar los problemas de salud de importancia para las poblaciones y las intervenciones y resultados que los pacientes y los profesionales de la salud consideren importantes. Las recomendaciones tienen que ver con grandes grupos temáticos que son (a) explicitar la relevancia de la investigación y, por tanto, sus prioridades (b) mejorar la metodología de investigación (c) transparentar la gestión y regulación de la investigación (d) aumentar la accesibilidad a todos los resultados relevantes, y (e) mejorar la manera en que se difunde la investigación. La reciente pandemia de COVID-19 ha sido una clara demostración de cómo el sistema de investigación del país ha unido las más diversas disciplinas para, en forma conjunta, brindar soluciones para enfrentarla. La reciente experiencia consolida que haya un mecanismo activo y transparente de identificación de prioridades en el país y la unión de esfuerzos de financiamiento y de investigadores en brindar soluciones a dichas prioridades. La investigación traslacional en salud significa el trabajo mancomunado de las más diversas disciplinas de investigación en salud para, en forma conjunta, obtener intervenciones efi caces y efectivas que impacten en la mejoría de la salud y la calidad de vida de la población.
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  • 文章类型: Evaluation Study
    通过应用卫生研究产生的知识通常是决策者和从业人员无法轻易获得或采取行动的形式,这阻碍了它的实施。我们的目标是确定可以支持为政策和实践提供信息的知识生产的研究活动。要做到这一点,我们研究了一种操作研究方法,以改善应用健康研究结果的产生。
    对多学科应用健康研究项目的业务研究贡献进行了为期2年的定性研究,该项目成功地快速告知了国家政策。对该项目的研究团队和咨询小组的所有成员(患者和健康专业代表和学者)进行了半结构化访谈(n=20)。参与者(>150小时)和非参与者(>15小时)的观察重点是尝试支持知识生产的过程和经验。使用QSRNVivo软件对数据进行主题分析。
    运筹学发挥了知识调解的作用,这种作用是以问题为中心的方法,并且意图执行那些产生易于实施的知识所必需的任务,但超出了项目其他学科的职权范围。发现该角色的三个特征可以支持这一点:通过捕获一系列卫生专业人员和患者观点以及定量和定性研究证据,吸引和融合不同的观点来改善服务;通过以可访问和吸引不同受众的形式创建和呈现证据来使数据有意义,使他们能够理解它的实际用途;并通过建立信誉来保持感知的客观性和严谨性,感知的中立性和对研究稳健性的信心,以便团结不同的专业人员创造性地思考全系统服务的改进。
    我们的研究为多学科应用健康研究项目中的知识调解活动提供了有用的经验见解,这些研究项目支持可访问,实践相关和可操作的知识。结合这些活动,或者一个专门的角色,在此类项目中调解知识生产可能有助于提高研究成果在常规医疗保健中的应用,并值得进一步考虑。
    Knowledge produced through applied health research is often of a form not readily accessible to or actionable by policymakers and practitioners, which hinders its implementation. Our aim was to identify research activities that can support the production of knowledge tailored to inform policy and practice. To do this, we studied an operational research approach to improving the production of applied health research findings.
    A 2-year qualitative study was conducted of the operational research contribution to a multidisciplinary applied health research project that was successful in rapidly informing national policy. Semi-structured interviews (n = 20) were conducted with all members of the project\'s research team and advisory group (patient and health professional representatives and academics). These were augmented by participant (> 150 h) and non-participant (> 15 h) observations focusing on the process and experience of attempting to support knowledge production. Data were analysed thematically using QSR NVivo software.
    Operational research performed a knowledge mediation role shaped by a problem-focused approach and an intent to perform those tasks necessary to producing readily implementable knowledge but outwith the remit of other disciplinary strands of the project. Three characteristics of the role were found to support this: engaging and incorporating different perspectives to improve services by capturing a range of health professional and patient views alongside quantitative and qualitative research evidence; rendering data meaningful by creating and presenting evidence in forms that are accessible to and engage different audiences, enabling them to make sense of it for practical use; and maintaining perceived objectivity and rigour by establishing credibility, perceived neutrality and confidence in the robustness of the research in order to unite diverse professionals in thinking creatively about system-wide service improvement.
    Our study contributes useful empirical insights about knowledge mediation activities within multidisciplinary applied health research projects that support the generation of accessible, practice-relevant and actionable knowledge. Incorporating such activities, or a dedicated role, for mediating knowledge production within such projects could help to enhance the uptake of research findings into routine healthcare and warrants further consideration.
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  • 文章类型: Journal Article
    尽管现代医学取得了巨大进展,但尚未实现对胰岛素抵抗的严格控制或血糖正常的恢复。随着分子生物学的发展,组学技术,对接研究,在硅药理学中,影响该疾病分子发病机制的酶和受体调节剂被认为是抗糖尿病治疗的最新靶点。目前正在开发基于影响疾病的不同信号通路的上调或下调的治疗性分子靶标。植物协同性抗糖尿病治疗在经典和非经典药物系统中都很流行。然而它的化疗概况,结构和药代动力学验证等待对此类制剂的国际认可。专注于基准产品开发的转化健康研究及其向患者床边的顺序过渡,使制药RD面临着开发生物豁免协议的挑战。药代动力学模拟模型和体外-体内相关性的建立可以帮助替代体内生物利用度研究,并为扩大规模和批准后的修改提供质量控制手段。这篇综述试图带来不同的色调,突出植物协同作用,通过不同的信号通路和单一保护伞下的生物豁免研究,抗糖尿病药物的分子靶向。
    Despite tremendous strides in modern medicine stringent control over insulin resistance or restoration of normoglycemia has not yet been achieved. With the growth of molecular biology, omics technologies, docking studies, and in silico pharmacology, modulators of enzymes and receptors affecting the molecular pathogenesis of the disease are being considered as the latest targets for anti-diabetic therapy. Therapeutic molecular targets are now being developed basing on the up or down regulation of different signaling pathways affecting the disease. Phytosynergistic anti-diabetic therapy is in vogue both with classical and non-classical medicinal systems. However its chemo-profiling, structural and pharmacokinetic validation awaits providing recognition to such formulations for international acceptance. Translational health research with its focus on benchside product development and its sequential transition to patient bedside puts the pharma RDs to a challenge to develop bio-waiver protocols. Pharmacokinetic simulation models and establishment of in vitro-in vivo correlation can help to replace in vivo bioavailability studies and provide means of quality control for scale up and post approval modification. This review attempts to bring different shades highlighting phyto-synergy, molecular targeting of antidiabetic agents via different signaling pathways and bio-waiver studies under a single umbrella.
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  • 文章类型: Journal Article
    In contrast to previous studies, which focus upon the professional dynamics of translational health research between clinician scientists and social scientists (inter-professional contestation), we focus upon contestation within social science (intra-professional contestation). Drawing on the empirical context of Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) in England, we highlight that although social scientists accept subordination to clinician scientists, health services researchers attempt to enhance their position in translational health research vis-à-vis organisation scientists, whom they perceive as relative newcomers to the research domain. Health services researchers do so through privileging the practical impact of their research, compared to organisation scientists\' orientation towards development of theory, which health services researchers argue is decoupled from any concern with healthcare improvement. The concern of health services researchers lies with maintaining existing patterns of resource allocation to support their research endeavours, working alongside clinician scientists, in translational health research. The response of organisation scientists is one that might be considered ambivalent, since, unlike health services researchers, they do not rely upon a close relationship with clinician scientists to carry out research, or more generally, garner resource.
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