• 文章类型: Journal Article
    背景:该协议概述了一项范围审查,目的是在现有的健康指南和健康技术评估(HTA)中识别和探索行星健康考虑因素。从这次审查中获得的见解将作为塑造未来建议分级的基础,评估,发展,和行星健康评估(等级)指南。
    方法:我们将坚持JBI方法进行范围审查。我们将在包括MEDLINE在内的各种数据库中对所有语言的结果进行全面搜索和筛选,EMBASE,CINAHL,全球卫生,卫生系统证据,Greenfile,和环境问题。此外,我们将使用GIN库等资源补充此搜索,BIGG数据库,认识论,等级指南存储库,Gradepro指南开发工具数据库,MAGICapp,NICE网站,世卫组织网站,以及使用Google隐身模式手动探索未发布的相关文档。两名独立审稿人将根据资格标准筛选和评估已确定文件的全文。将从每个全文中提取以下信息:文档标题;第一作者的名字;出版年份;语言;文档类型;文档作为指南或HTA;主题/学科;文档目的/研究目标;开发/赞助组织;进行研究/指南/HTA报告的国家;提供的行星健康或相关概念的定义;从事的行星健康专家的类型;评估行星健康使用的生物多样性/健康影响评估的建议方法;对地球健康的社会周期的使用的数据分析将涉及描述性统计和定向内容分析的结合,结果以叙述格式显示,并以表格和图形显示。
    结论:最终评审结果将提交给开放获取的同行评审期刊,以供发表。研究结果还将在相关的行星健康会议和讲习班上传播。
    背景:开放科学框架(https://osf.io/3jmsa)。
    BACKGROUND: This protocol outlines a scoping review with the objective of identifying and exploring planetary health considerations within existing health guidelines and health technology assessments (HTA). The insights gained from this review will serve as a basis for shaping future Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidance on planetary health.
    METHODS: We will adhere to the JBI methodology for scoping reviews. We will conduct a comprehensive search and screening of results in all languages across various databases including MEDLINE, EMBASE, CINAHL, Global Health, Health Systems Evidence, Greenfile, and Environmental Issues. Additionally, we will supplement this search with resources such as the GIN library, BIGG database, Epistemonikos, GRADE guidelines repository, GRADEpro Guideline Development Tool Database, MAGICapp, NICE website, WHO websites, and a manual exploration of unpublished relevant documents using Google incognito mode. Two independent reviewers will screen and assess the full texts of identified documents according to the eligibility criteria. The following information from each full text will be extracted: document title; first author\'s name; publication year; language; document type; document as a guideline or HTA; the topic/discipline; document purpose/study objective; developing/sponsoring organization; the country in which the study/guideline/HTA report was conducted; definition of planetary health or related concept provided; types of planetary health experts engaged; study methods; suggested methods to assess planetary health; use of secondary data on planetary health outcomes; description for use of life cycle assessment; description for assessing the quality of life cycle; population/intended audience; interventions; category; applicable planetary health boundaries; consideration of social justice/global equity; phase of intervention in life cycle related to planetary health addressed; the measure of planetary health impact; impact on biodiversity/land use; one health/animal welfare mention; funding; and conflict of interest. Data analysis will involve a combination of descriptive statistics and directed content analysis, with results presented in a narrative format and displayed in tables and graphs.
    CONCLUSIONS: The final review results will be submitted to open-access peer-reviewed journals for publication when they become available. The research findings will also be disseminated at relevant planetary health conferences and workshops.
    BACKGROUND: Open Science Framework ( https://osf.io/3jmsa ).
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  • 文章类型: Journal Article
    背景:孕前健康有可能改善父母,怀孕和婴儿结局。本范围审查旨在(1)提供战略概述,政策,指导方针,框架,以及英国和爱尔兰提供的解决孕前健康和护理的建议,确定有针对性的常见方法和健康影响因素;(2)进行审核,以探索医疗保健专业人员对范围审查中发现的资源的认识和使用,验证和语境相关的北爱尔兰的发现。
    方法:灰色文献资源是通过Google高级搜索确定的,Nice,OpenAire,ProQuest和相关的公共卫生和政府网站。如果已发布,则包括资源,reviewed,或在2011年1月至2022年5月之间更新。将数据提取到Excel中并使用NVivo进行编码。审查设计包括“健康生殖年”患者和公众参与和参与咨询小组的参与。
    结果:搜索确定了273个资源,随后对北爱尔兰的医疗保健专业人员进行的审计发现了另外五个与孕前健康相关的资源。确定了广泛的资源类型,孕前健康通常不是审查资源的唯一重点。资源提出了改善孕前健康和护理的方法,例如需要提高意识和获得护理的机会,概念前的咨询,多学科合作,并采用生命课程方法。许多行为(例如,叶酸摄入量,吸烟),生物医学(例如,精神和身体健康状况),以及环境和社会(例如,剥夺)因素在审查的资源中进行了识别和处理。特别是,先前存在的身体健康状况经常被提及,解决心理因素和心理健康的资源较少。总的来说,有更多的关注女性,而不是男人的,行为。
    结论:本范围审查综合了英国和爱尔兰现有的资源,以确定影响孕前健康和护理的各种常见方法和因素。需要努力落实已确定的资源(例如,战略,准则),以支持育龄人群获得孕前护理并优化其孕前健康。
    BACKGROUND: Preconception health has the potential to improve parental, pregnancy and infant outcomes. This scoping review aims to (1) provide an overview of the strategies, policies, guidelines, frameworks, and recommendations available in the UK and Ireland that address preconception health and care, identifying common approaches and health-influencing factors that are targeted; and (2) conduct an audit to explore the awareness and use of resources found in the scoping review amongst healthcare professionals, to validate and contextualise findings relevant to Northern Ireland.
    METHODS: Grey literature resources were identified through Google Advanced Search, NICE, OpenAire, ProQuest and relevant public health and government websites. Resources were included if published, reviewed, or updated between January 2011 and May 2022. Data were extracted into Excel and coded using NVivo. The review design included the involvement of the \"Healthy Reproductive Years\" Patient and Public Involvement and Engagement advisory panel.
    RESULTS: The searches identified 273 resources, and a subsequent audit with healthcare professionals in Northern Ireland revealed five additional preconception health-related resources. A wide range of resource types were identified, and preconception health was often not the only focus of the resources reviewed. Resources proposed approaches to improve preconception health and care, such as the need for improved awareness and access to care, preconceptual counselling, multidisciplinary collaborations, and the adoption of a life-course approach. Many behavioural (e.g., folic acid intake, smoking), biomedical (e.g., mental and physical health conditions), and environmental and social (e.g., deprivation) factors were identified and addressed in the resources reviewed. In particular, pre-existing physical health conditions were frequently mentioned, with fewer resources addressing psychological factors and mental health. Overall, there was a greater focus on women\'s, rather than men\'s, behaviours.
    CONCLUSIONS: This scoping review synthesised existing resources available in the UK and Ireland to identify a wide range of common approaches and factors that influence preconception health and care. Efforts are needed to implement the identified resources (e.g., strategies, guidelines) to support people of childbearing age to access preconception care and optimise their preconception health.
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  • 文章类型: Journal Article
    背景:原始的“BETTER”(建立在现有的工具上,以改善初级保健中的慢性病预防和筛查)方法包括在40-65岁的参与者之间进行以预防为重点的访问,以及“预防从业者”(PP),授权参与者为癌症和慢性病设定可实现的预防和筛查目标。BETTER成功适应加拿大经济贫困社区(BETERHEALTH)。我们的目标是对指南进行审查,为18-39岁收入较低的年轻人采用“更好的健康”方法做准备。由于可预防的慢性病的患病率高于收入较高的同龄人,因此已知死亡率较早。
    方法:我们搜索了多个电子数据库和灰色文献,以获取有关预防/筛查的临床实践指南,并包括符合以下标准的指南:2008-2020年在加拿大或以下任何国家以英文出版(澳大利亚,爱尔兰,新西兰,苏格兰,美国和英国);并解决了预防或筛查问题。我们使用研究与评估指南(AGREE)II工具和提取的数据(出版物细节,recommendations,和质量/作者报告的证据水平)来自总得分为5或更高的来源。最终建议是在与不同利益攸关方的投入协调后汇编的(共同调查员,PPs,和社区咨询委员会)。
    结果:我们总共纳入了85个指南,并为18-39岁的21个主题制定了42项建议的最终列表。具体建议属于以下主题:癌症,心血管疾病,糖尿病,肥胖,生活方式(酒精;健康的营养/身体活动);健康的关系和健康的性行为,免疫接种,口腔健康,健康的社会决定因素,和物质使用。
    结论:我们确定了针对18-39岁成年人的个人水平预防/筛查行动的循证指南,并与低收入人群相关,这将直接为制定和实施更好的生活干预措施提供信息。
    BACKGROUND: The original \'BETTER\' (Building on Existing Tools To Improve Chronic Disease Prevention and Screening in Primary Care) approach consisted of a prevention-focused visit between participants aged 40-65 years and a \"Prevention Practitioner\" (PP), who empowered the participant to set achievable prevention and screening goals for cancers and chronic diseases. BETTER was successfully adapted for economically deprived communities (BETTER HEALTH) in Canada. Our objective was to conduct a review of guidelines in preparation for adapting the \'BETTER HEALTH\' approach for younger adults aged 18-39 years living with lower income, a group known to have earlier mortality due to a higher prevalence of preventable chronic diseases than their peers with higher income.
    METHODS: We searched multiple electronic databases and grey literature for clinical practice guidelines on prevention/screening and included those that met the following criteria: published in English from 2008-2020 in Canada or any of the following countries (Australia, Ireland, New Zealand, Scotland, United States and England); and addressed prevention or screening. We assessed quality using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and extracted data (publication details, recommendations, and Quality/Level of evidence as reported by authors) from sources with overall scores of 5 or higher. Final recommendations were compiled after harmonization with input from diverse stakeholders (co-investigators, PPs, and the Community Advisory Committee).
    RESULTS: We included a total of 85 guidelines, and developed a final list of 42 recommendations for 18-39 year-olds across 21 topics. Specific recommendations fell under the following topics: cancers, cardiovascular disease, diabetes, obesity, lifestyle (alcohol; healthy nutrition/physical activity); healthy relationships and healthy sexuality, immunization, oral health, social determinants of health, and substance use.
    CONCLUSIONS: We identified evidence-based guidelines on individual-level prevention/screening actions for adults 18-39 years old and relevant for those living with lower income which will directly inform development and implementation of the BETTER LIFE intervention.
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  • 文章类型: Journal Article
    造血干细胞移植(HCT)中出血性膀胱炎(HC)的最佳管理存在争议,对于化疗毒性继发的早发性HC(EOHC)和BK多瘤病毒(BKPyV)相关的HC,由于缺乏对照试验,特别是指儿科设置。事实上,临床实践主要基于欧洲白血病感染会议的指南,第6版,它考虑了成人和儿童人群,但得出的结论是,尽管在理解发病机制方面取得了很大进展,流行病学,和风险因素,这种并发症仍然代表着缺乏预防和治疗选择的无法满足的临床需求.此外,《美国临床肿瘤学会指南》对化疗毒性的治疗独立于患者人群进行了定义。来自意大利医学协会(AIEOP)的造血细胞移植和传染病工作组(WG)的专家小组达成了共识,以确定预防的最佳做法,诊断,和儿科HCT设置中HC的管理。
    The optimal management of hemorrhagic cystitis (HC) in hematopoietic stem cell transplantation (HCT) is debated, both for early onset HC (EOHC) secondary to chemotherapy toxicity and BK Polyomavirus (BKPyV)-related HC, due to the lack of controlled trials, particularly referred to pediatric setting. Actually, clinical practice is mainly based on guidelines of the European Conference on Infections in Leukemia, 6th edition, which considers both adult and pediatric populations but concludes that, despite much progress in understanding the pathogenesis, epidemiology, and risk factors, this complication still represents a disabling unmet clinical need with limited prophylactic and therapeutic options. Additionally, the Guidelines of the American Society of Clinical Oncology define the management of chemotherapeutic toxicity independently from the patients\' population. A panel of experts belonging to the Hematopoietic Cell Transplant and Infectious Disease Working Group (WG) of Associazione Italiana di Emato-Oncologia Pediatrica (AIEOP) developed a consensus to define the best practices in prevention, diagnosis, and management of HC in pediatric HCT setting.
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  • 文章类型: Journal Article
    本文研究了具有大时滞的离散时间领导者跟随多智能体系统的共识问题。基于两个假设,通过利用归一化加权矩阵设计了一种新颖的完全分布式协议,完全取决于相对输出测量。它表明,对于任意大但有界的输入和通信延迟,它们是恒定的,并且是完全已知的,所提出的协议及其截断版本都可以有效地解决共识问题。进一步假设追随者只包含输入延迟,那么允许的延迟可以是时变的和不同的。所提出的协议不依赖于有向通信拓扑的全局信息,从而确保针对通信拓扑中的改变的鲁棒性。数值算例验证了该方法的有效性。
    This paper investigates the consensus problem for discrete-time leader-following multi-agent systems subject to large time delays. Building upon two assumptions, a novel fully distributed protocol is devised by utilizing a normalized weighting matrix, depending solely on the relative output measurement. It is shown that, for arbitrarily large yet bounded input and communication delays that are constant and exactly known, the consensus problem can be effectively addressed by both the proposed protocol and its truncated version. Assuming further that followers incorporate solely input delays, then the permitted delays can be time-varying and different. The proposed protocols do not rely on global information of the directed communication topology, thus ensuring robustness against alterations in the communication topology. A numerical example is employed to validate the effectiveness of the suggested approach.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    目的:临床实践指南(CPGs)对于基于循证医学的标准化患者护理至关重要。然而,CPG作者之间存在财务利益冲突(COI)可能会损害他们的可信度。这项研究旨在检查日本精神病学CPG作者中COI的程度和大小。
    方法:对制药公司披露的付款进行的横断面分析评估了个人演讲付款的普遍性和规模,在2016年至2020年期间,向CPG咨询并撰写有关日本双相情感障碍和重度抑郁症的文章。
    结果:这项研究发现,93.3%的作者在5年内收到了付款,付款总额超过400万美元。每位作者的平均付款额为51403美元(IQR:9982美元-111567美元),由于付款明显集中在少数作者中,包括CPG主席。尽管有这些广泛的财务关系,只有一小部分作者在CPG中披露了他们的COIs。这些大量的个人付款是由制药公司生产CPG中列出的新抗抑郁药和安眠药。
    结论:这项研究发现,在日本,超过93%的针对重度抑郁症和双相情感障碍的CPG作者从制药行业获得了大量的个人付款。调查结果强调了与国际COI管理标准的偏差,并建议日本需要对精神病学CPG采取更严格的COI政策。
    OBJECTIVE: Clinical practice guidelines (CPGs) are essential for standardising patient care based on evidence-based medicine. However, the presence of financial conflicts of interest (COIs) among CPG authors can undermine their credibility. This study aimed to examine the extent and size of COIs among authors of psychiatry CPGs in Japan.
    METHODS: This cross-sectional analysis of disclosed payments from pharmaceutical companies assesses the prevalence and magnitude of personal payments for lecturing, consulting and writing to CPGs for bipolar disorder and major depressive disorder in Japan between 2016 and 2020.
    RESULTS: This study found that 93.3% of authors received payments over a 5-year period, with total payments exceeding US$4 million. The median payment per author was US$51 403 (IQR: US$9982-US$111 567), with a notable concentration of payments among a small number of authors, including the CPG chairperson. Despite these extensive financial relationships, only a fraction of authors disclosed their COIs in the CPGs. These large amounts of personal payments were made by pharmaceutical companies manufacturing new antidepressants and sleeping aids listed in the CPGs.
    CONCLUSIONS: This study found that more than 93% of authors of CPGs for major depressive disorder and bipolar disorder in Japan received considerable amounts of personal payments from the pharmaceutical industry. The findings highlight deviations from international COI management standards and suggest a need for more stringent COI policies for psychiatry CPGs in Japan.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    GRADE方法的开发是为了提供准则制定的标准化方法。GRADE提高了准则制定过程中不同步骤的透明度。然而,等级不应被视为消除所有不确定性并解决科学界所有辩论的灵丹妙药。当指南基于低质量证据时,在罕见疾病如血友病的背景下尤其如此。
    The GRADE approach was developed to provide a standardized approach to guideline development. GRADE has increased the transparency of the different steps in the guideline development process. However, GRADE should not be seen as the magic bullet that removes all uncertainty and resolves all debates in the scientific community. This is especially true in the context of rare disease such as hemophilia when a guideline is based on low-quality evidence.
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  • 文章类型: Journal Article
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