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1.
Int J Radiat Oncol Biol Phys ; 106(2): 243-252, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31288053

RESUMO

PURPOSE: A large proportion of preclinical or translational studies using radiation have poor replicability. For a study involving radiation exposure to be replicable, interpretable, and comparable, its experimental methodology must be well reported, particularly in terms of irradiation protocol, including the amount, rate, quality, and geometry of radiation delivery. Here we perform the first large-scale literature review of the current state of reporting of essential experimental physics and dosimetry details in the scientific literature. METHODS AND MATERIALS: For 1758 peer-reviewed articles from 469 journals, we evaluated the reporting of basic experimental physics and dosimetry details recommended by the authoritative National Institute of Standards and Technology symposium. RESULTS: We demonstrate that although some physics and dosimetry parameters, such as dose, source type, and energy, are well reported, the majority are not. Furthermore, highly cited journals and articles are systematically more likely to be lacking experimental details related to the irradiation protocol. CONCLUSIONS: These findings show a crucial deficiency in the reporting of basic experimental details and severely affect the reproducibility and translatability of a large proportion of radiation biology studies.


Assuntos
Física , Radiobiologia , Radiometria , Reprodutibilidade dos Testes , Bibliometria , Pesquisa Biomédica/estatística & dados numéricos , Congressos como Assunto , Humanos , Fator de Impacto de Revistas , Exposição à Radiação , Dosagem Radioterapêutica , Padrões de Referência , Fatores de Tempo , Pesquisa Médica Translacional/estatística & dados numéricos
2.
Phys Ther ; 100(2): 225-237, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-31750521

RESUMO

BACKGROUND: Providing physical therapists with evidence-based and consensus-derived guidelines to manage postoperative shoulder patients is essential; these guidelines should be readily available and provide clinically applicable information. Knowledge translation (KT) initiatives that encourage interaction between clinicians and researchers, that have multifaceted components and use a variety of strategies, can significantly change practice. OBJECTIVE: The objective of this study was to determine the uptake and acceptability of standardized postoperative shoulder guidelines with an accompanying online KT resource through evaluation of website analytics and a quantitative survey. DESIGN: A multi-pronged approach was used to assess uptake and acceptability of the guidelines and online KT resource. METHODS: Website analytics of usage and geographical location of users was measured as were physical therapist survey responses. RESULTS: Website analytics revealed that 5406 individuals used the online resource between October 2012 and September 2013 with the average visit lasting 8 minutes; only 47% of users were within the guideline developers' surgical referral region. Physical therapists who used the new shoulder guidelines were very satisfied or satisfied (96%) with the guidelines, reporting they promoted patient-specific clinical decision-making extremely or very well (68%). They viewed the online KT resource positively, with 79% rating it as "very useful" or "quite useful." Physical therapists from regions beyond those expected to use the new shoulder guidelines were also aware of the website and also rated it as very useful. LIMITATIONS: The survey sample was relatively small and did not directly assess patient outcomes. CONCLUSIONS: An online KT web resource developed in conjunction with standardized postoperative shoulder guidelines was perceived as useful based on website analytics and survey responses. Active KT strategies such as this can improve uptake and dissemination of best practice in physical therapy.


Assuntos
Internet das Coisas/estatística & dados numéricos , Fisioterapeutas/estatística & dados numéricos , Cuidados Pós-Operatórios/normas , Guias de Prática Clínica como Assunto , Reabilitação/normas , Manguito Rotador/cirurgia , Alberta , Consenso , Análise de Dados , Prática Clínica Baseada em Evidências/normas , Feminino , Humanos , Acesso à Internet/estatística & dados numéricos , Masculino , Determinação de Necessidades de Cuidados de Saúde , Fisioterapeutas/educação , Cuidados Pós-Operatórios/estatística & dados numéricos , Reabilitação/estatística & dados numéricos , Ombro/cirurgia , Inquéritos e Questionários/estatística & dados numéricos , Fatores de Tempo , Pesquisa Médica Translacional/estatística & dados numéricos
3.
BMC Genomics ; 20(1): 868, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31730456

RESUMO

BACKGROUND: With the rise of precision medicine efforts worldwide, our study objective was to describe and map the emerging precision medicine landscape. A Google search was conducted between June 19, 2017 to July 20, 2017 to examine how "precision medicine" and its analogous terminology were used to describe precision medicine efforts. Resulting web-pages were reviewed for geographic location, data type(s), program aim(s), sample size, duration, and the key search terms used and recorded in a database. Descriptive statistics were applied to quantify terminology used to describe specific precision medicine efforts. Qualitative data were analyzed for content and patterns. RESULTS: Of the 108 programs identified through our search, 84% collected only biospecimen(s) and, of those that collected at least two data types, 42% mentioned both Electronic Health Records (EHR) and biospecimen. Given the majority of efforts limited to biospecimen(s) use, genetic research seems to be prioritized in association with precision medicine. Roughly, 54% were found to collect two or more data types, which limits the output of information that may contribute to understanding of the interplay of genetic, lifestyle, and environmental factors. Over half were government-funded with roughly a third being industry-funded. Most initiatives were concentrated in the United States, Europe, and Asia. CONCLUSIONS: To our knowledge, this is the first study to map and qualify the global precision medicine landscape. Our findings reveal that precision medicine efforts range from large model cohort studies involving multidimensional, longitudinal data to biorepositories with a collection of blood samples. We present a spectrum where past, present, and future PM-like efforts can fall based on their scope and potential impact. If precision medicine is based on genes, lifestyle and environmental factors, we recommend programs claiming to be precision medicine initiatives to incorporate multidimensional data that can inform a holistic approach to healthcare.


Assuntos
Registros Eletrônicos de Saúde/estatística & dados numéricos , Genética Médica/métodos , Medicina de Precisão/estatística & dados numéricos , Terminologia como Assunto , Pesquisa Médica Translacional/estatística & dados numéricos , Ásia , Big Data , Coleta de Amostras Sanguíneas/métodos , Europa (Continente) , Interação Gene-Ambiente , Humanos , Estilo de Vida , Estados Unidos
4.
BMJ ; 367: l5766, 2019 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-31645328

RESUMO

OBJECTIVE: To determine the extent to which late stage development of new drugs relies on support from public funding. DESIGN: Cohort study. SETTING: All new drugs containing one or more new molecular entities approved by the US Food and Drug Administration (FDA) between January 2008 and December 2017 via the new drug application pathway. MAIN OUTCOME MEASURES: Patents or drug development histories documenting late stage research contributions by a public sector research institution or a spin-off company, as well as each drug's regulatory approval pathway and first-in-class designation. RESULTS: Over the 10 year study period, the FDA approved 248 drugs containing one or more new molecular entities. Of these drugs, 48 (19%) had origins in publicly supported research and development and 14 (6%) originated in companies spun off from a publicly supported research program. Drugs in these groups were more likely to receive expedited FDA approval (68% v 47%, P=0.005) or be designated first in class (45% v 26%, P=0.007), indicating therapeutic importance. CONCLUSIONS: A review of the patents associated with new drugs approved over the past decade indicates that publicly supported research had a major role in the late stage development of at least one in four new drugs, either through direct funding of late stage research or through spin-off companies created from public sector research institutions. These findings could have implications for policy makers in determining fair prices and revenue flows for these products.


Assuntos
Ensaios Clínicos como Assunto/economia , Aprovação de Drogas/economia , Setor Público/economia , Pesquisa Médica Translacional/economia , Ensaios Clínicos como Assunto/estatística & dados numéricos , Estudos de Coortes , Aprovação de Drogas/legislação & jurisprudência , Aprovação de Drogas/estatística & dados numéricos , Humanos , Patentes como Assunto/estatística & dados numéricos , Setor Público/estatística & dados numéricos , Pesquisa Médica Translacional/estatística & dados numéricos , Estados Unidos , United States Food and Drug Administration/legislação & jurisprudência , United States Food and Drug Administration/estatística & dados numéricos
5.
Haemophilia ; 25(4): 595-602, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31329368

RESUMO

INTRODUCTION: Inhibitor formation against coagulation factor VIII (FVIII) is an unresolved serious problem in replacement therapy for the X-linked bleeding disorder haemophilia A. Although FVIII inhibitors have been extensively studied, much of the basic mechanism of this immune response remains to be uncovered. AIM: Within the NHLBI State of the Science Workshop on Factor VIII Inhibitors, Working Group 3 identified three scientific priorities for basic and translational research on FVIII inhibitor formation. METHODS: A larger list of potential areas of research was initially developed as a basis for subsequent prioritization. Each scientific goal was further evaluated based on required effort, potential impact, approach, methods, technologies and models. RESULTS: The three priorities include the following: activation signals and immune regulation that shape the response to FVIII (including innate immunity, microbiome, adaptive immunity and regulatory T cell studies in humans); utility of animal models and non-animal approaches (in silico, genetic, single-cell/sorted population "omics," in vitro) to help predict inhibitor formation and identify novel therapeutics; and impact of the source of FVIII, its structure and von Willebrand factor on immunogenicity and tolerance. CONCLUSIONS: Early interactions between FVIII and the immune system, biomarker development and studies in different patient groups (previously treated or untreated, with or without inhibitor formation, patients undergoing immune tolerance induction or gene therapy) deserve particular emphasis. Finally, linking basic to clinical studies, development of a repository for biospecimens and opportunities for interdisciplinary research training are important components to solving the urgent problem of inhibitor formation.


Assuntos
Pesquisa Biomédica/educação , Educação , Fator VIII/imunologia , Hemofilia A/imunologia , National Heart, Lung, and Blood Institute (U.S.) , Pesquisa Médica Translacional/estatística & dados numéricos , Hemofilia A/tratamento farmacológico , Humanos , Estados Unidos
6.
J Cancer Res Ther ; 15(2): 269-271, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30964096

RESUMO

Although this is an exciting time for translational medicine, systematic approaches and strategies to conduct translational research are sparse. We highlight in this editorial the opportunities to collaborate across disciplines and to forge new interdisciplinary collaborative ventures from the perspective of epidemiology. We specifically outline some feasible research areas, wherein Translational Epidemiology may readily speed up the translation of research for Precision Medicine.


Assuntos
Neoplasias/epidemiologia , Pesquisa Médica Translacional , Suscetibilidade a Doenças , Humanos , Longevidade , Neoplasias/diagnóstico , Neoplasias/etiologia , Neoplasias/terapia , Farmacogenética , Medicina de Precisão , Pesquisa Médica Translacional/estatística & dados numéricos
7.
J Clin Epidemiol ; 109: 117-124, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30771447

RESUMO

OBJECTIVE: The objective of this study was to identify relevant outcomes and measures to inform a systematic review (SR) on the comparative effectiveness of geriatrician-led care models. STUDY DESIGN AND SETTING: In the modified Delphi to select outcomes for inclusion in the SR, knowledge users (KUs) from Ontario, Alberta, and Saskatchewan rated outcome importance using a Likert scale. A survey was then completed by geriatricians to determine optimal measures for selected outcomes. Findings were analyzed using frequencies, means, and standard deviations (SDs). RESULTS: Thirty-three KUs (patients, caregivers, policymakers and geriatricians) rated 27 outcomes in round 1 of the modified Delphi. Top-rated outcomes included function (mean 6.85 ± SD 0.36), cognition (6.47 ± SD 0.72), and quality of life (6.38 ± SD 0.91). Twenty-three KUs participated in round 2 and rated 24 outcomes. Top-rated outcomes in round 2 were function (6.87 ± SD 0.34), quality of life (6.45 ± SD 1.10), and cognition (6.43 ± SD 0.73). The survey was completed by 22 geriatricians and the highest ranked measures were Activities of Daily Living (function), Mini-Mental State Examination (cognition), and the Medical Outcomes Study SF-36 (quality of life). CONCLUSION: We identified the most relevant outcomes and measures for patients, caregivers, policymakers, and geriatricians, allowing us to tailor the SR to KU needs.


Assuntos
Enfermagem Geriátrica/estatística & dados numéricos , Geriatras/psicologia , Projetos de Pesquisa/normas , Revisões Sistemáticas como Assunto , Pesquisa Médica Translacional/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Técnica Delfos , Feminino , Geriatras/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos de Pesquisa/estatística & dados numéricos , Pesquisa Médica Translacional/estatística & dados numéricos
8.
Am J Phys Med Rehabil ; 98(4): 331-338, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30300231

RESUMO

Bibliometrics use statistical methods to measure the scholarly impact of publications. Bibliometrics are categorized as conventional metrics or alternative metrics. Conventional metrics have often been considered the standard to measure the impact of publication-related scholarship. With the growing popularity of social media and ease of instantaneous distribution of information globally, alternative metrics have become an important complementary measure of scholarly activity. Bibliometrics may provide a standard performance measurement that may be used for tenure and/or promotion among academic institutions. The alternative metric industry has shown considerable growth with increasingly improved algorithms working towards standardization. Together, conventional metrics and alternative metrics may synergistically complement each other to provide an accelerated translation from research to clinical care that may lead to tremendous benefits in patients. All physicians and other healthcare professionals should receive training in bibliometrics and understand the potential impact of professional social media use.


Assuntos
Algoritmos , Bibliometria , Editoração/estatística & dados numéricos , Pesquisa Médica Translacional/estatística & dados numéricos , Humanos
9.
J Spinal Cord Med ; 42(1): 102-122, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29485334

RESUMO

CONTEXT: Current treatment of spinal cord injury (SCI) focuses on cord stabilization to prevent further injury, rehabilitation, management of non-motor symptoms, and prevention of complications. Currently, no approved treatments are available, and limited treatment options exist for symptoms and complications associated with chronic SCI. This review describes the pharmacotherapy landscape in SCI from both commercial and research and development (R&D) standpoints through March 2015. METHODS: Information about specific compounds has been obtained through drug pipeline monographs in the Pharmaprojects® (Citeline, Inc., New York, New York, USA) drug database (current as of a search on May 30, 2014), websites of individual companies with compounds in development for SCI (current as of March 24, 2015), and a literature search of published R&D studies to validate the Pharmaprojects® source for selected compounds (current as of March 24, 2015). RESULTS: Types of studies conducted and outcomes measured in earlier phases of development are described for compounds in clinical development Currently four primary mechanisms are under investigation and may yield promising therapeutic targets: 1) neuronal regeneration; 2) neuroprotection (including anti-inflammation); 3) axonal reconnection; and 4) neuromodulation and signal enhancement. Many other compounds are no longer under investigation for SCI are mentioned; however, in most cases, the reason for terminating their development is not clear. CONCLUSION: There is urgent need to develop disease-modifying therapy for SCI, yet the commercial landscape remains small and highly fragmented with a paucity of novel late-stage compounds in R&D.


Assuntos
Desenvolvimento de Medicamentos/economia , Tratamento Farmacológico/economia , Traumatismos da Medula Espinal/tratamento farmacológico , Pesquisa Médica Translacional/economia , Desenvolvimento de Medicamentos/estatística & dados numéricos , Tratamento Farmacológico/estatística & dados numéricos , Humanos , Pesquisa Médica Translacional/estatística & dados numéricos
11.
Clin. transl. oncol. (Print) ; 20(12): 1612-1616, dic. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-173768

RESUMO

Introduction: Madrid’s CNIO (Spanish National Oncological Research Center) ranks among the three first institutions in the world, specifically dedicated to cancer research. CNIO research mainly focuses on three aspects: use of stem cells to fix problematic cancer damage, searches for genes that cause cancer disease, and use of drug design to manage oncological disorders. Objectives: The main goal of this study is to determine the effectiveness of the ‘translation’ of basic discoveries generated at this cancer research center, into new interventions aimed at preventing and treating various types of cancer, with bibliometric criteria. Methods: A corpus of published articles and citations received by CNIO between 1998 and 2016 has been retrieved from the Web of Science (WoS) database. Bibliometric indicators considered here are: citation practices, use of journals on the basis of their impact factors, scientific literature citing CNIO publications, and international connectedness of CNIO researchers. Results: A total of 3510 articles were published by CNIO between 1998 and 2016, 23% of which in journals with impact factors between 10 and 15 and above 15. Along the same period, the institution received 135,769 citations published in more than 5800 journals, where the most important citing journals were the Plos One with 3.6% of all the citing articles, Oncotarget with 1.8%, and Scientific Reports with 1.2%. The highest number of citations was 18,005 in 2007; in terms of average citation rate, the first ranked CNIO research program was in the area of experimental therapeutics (77.79%), followed by molecular oncology (68.1%). This position was provided by the active growth in citation to the articles whose themes are related to the problems of the consequences of the design of preclinical drug candidates and the study of oncological disorders. Conclusions: From this study on a number of bibliometric characteristics of the Spanish National Oncological Research Center (CNIO), we conclude that the publication activity (since 2006 its scientific production has increased in about 83%), the number of high-quality journals used per year, the high influence, and impact of the journals and organizations citing the institution, consolidate its image as a top-notch oncological research center


No disponible


Assuntos
Humanos , Pesquisa Médica Translacional/estatística & dados numéricos , Oncologia/tendências , Pesquisa Biomédica/estatística & dados numéricos , Sociedades Científicas/estatística & dados numéricos , Relatório de Pesquisa , Indicadores de Produção Científica , Publicações/estatística & dados numéricos , Indicadores Bibliométricos
14.
J Ayub Med Coll Abbottabad ; 30(2): 308-311, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29938444

RESUMO

One of frequently asked question by medical and dental students / researchers is how to determine the sample size. Sample size calculations is necessary for approval of research projects, clearance from ethical committees, approval of grant from funding bodies, publication requirement for journals and most important of all justify the authenticity of study results. Determining the sample size for a study is a crucial component. The goal is to include sufficient numbers of subjects so that statistically significant results can be detected. Using too few subjects' will result in wasted time, effort, money; animal lives etc. and may yield statistically inconclusive results. There are numerous situations in which sample size is determined that varies from study to study. This article will focus on the sample size determination for hypothesis testing that involves means, one sample t test, two independent sample t test, paired sample and one-way analysis of variance.


Assuntos
Projetos de Pesquisa/estatística & dados numéricos , Pesquisa Médica Translacional/estatística & dados numéricos , Interpretação Estatística de Dados , Humanos , Tamanho da Amostra
15.
Pac Symp Biocomput ; 23: 247-258, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29218886

RESUMO

A growing number of academic and community clinics are conducting genomic testing to inform treatment decisions for cancer patients (1). In the last 3-5 years, there has been a rapid increase in clinical use of next generation sequencing (NGS) based cancer molecular diagnostic (MolDx) testing (2). The increasing availability and decreasing cost of tumor genomic profiling means that physicians can now make treatment decisions armed with patient-specific genetic information. Accumulating research in the cancer biology field indicates that there is significant potential to improve cancer patient outcomes by effectively leveraging this rich source of genomic data in treatment planning (3). To achieve truly personalized medicine in oncology, it is critical to catalog cancer sequence variants from MolDx testing for their clinical relevance along with treatment information and patient outcomes, and to do so in a way that supports large-scale data aggregation and new hypothesis generation. One critical challenge to encoding variant data is adopting a standard of annotation of those variants that are clinically actionable. Through the NIH-funded Clinical Genome Resource (ClinGen) (4), in collaboration with NLM's ClinVar database and >50 academic and industry based cancer research organizations, we developed the Minimal Variant Level Data (MVLD) framework to standardize reporting and interpretation of drug associated alterations (5). We are currently involved in collaborative efforts to align the MVLD framework with parallel, complementary sequence variants interpretation clinical guidelines from the Association of Molecular Pathologists (AMP) for clinical labs (6). In order to truly democratize access to MolDx data for care and research needs, these standards must be harmonized to support sharing of clinical cancer variants. Here we describe the processes and methods developed within the ClinGen's Somatic WG in collaboration with over 60 cancer care and research organizations as well as CLIA-certified, CAP-accredited clinical testing labs to develop standards for cancer variant interpretation and sharing.


Assuntos
Técnicas de Diagnóstico Molecular/estatística & dados numéricos , Neoplasias/diagnóstico , Neoplasias/genética , Acesso à Informação , Carcinoma Ductal Pancreático/diagnóstico , Carcinoma Ductal Pancreático/genética , Criança , Biologia Computacional/métodos , Bases de Dados Genéticas/estatística & dados numéricos , Perfilação da Expressão Gênica/estatística & dados numéricos , Genes p53 , Variação Genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Técnicas de Diagnóstico Molecular/normas , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/genética , Medicina de Precisão , Pesquisa Médica Translacional/normas , Pesquisa Médica Translacional/estatística & dados numéricos
17.
Clin Pharmacol Ther ; 103(2): 296-303, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28913827

RESUMO

Concerns have been expressed that large numbers of nonvalue-added reports have been accumulating in adverse drug reaction (ADR) databases, for example, via patient support programs. We performed an assessment of the impact of such reports, which we refer to as "precautionary reports," on safety signal detection in the Netherlands. The case narratives of ADR reports of three case products were screened with text-mining algorithms to identify those reports that lack a causal relationship with the suspected medicinal product. We demonstrate that precautionary reports impede the optimal use of the pharmacovigilance system by, on the one hand, masking safety signals and, on the other hand, creating spurious signals. The precautionary reporting bias and its suppressing effect on statistical signal detection results in an altered adverse event safety profile. The findings from this study highlight the need for a better alignment between regulatory authorities and marketing authorization holders regarding pharmacovigilance guidelines.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos , Mineração de Dados/métodos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Medicina Baseada em Evidências/métodos , Pesquisa Médica Translacional/métodos , Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos , Algoritmos , Animais , Viés , Mineração de Dados/estatística & dados numéricos , Bases de Dados Factuais , Difosfonatos/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Antagonistas dos Receptores de Endotelina/efeitos adversos , Eritropoetina/efeitos adversos , Medicina Baseada em Evidências/estatística & dados numéricos , Humanos , Modelos Animais , Modelos Teóricos , Países Baixos , Segurança do Paciente , Reprodutibilidade dos Testes , Medição de Risco , Pesquisa Médica Translacional/estatística & dados numéricos
18.
Rev. panam. salud pública ; 42: e22, 2018. graf
Artigo em Inglês | LILACS | ID: biblio-961801

RESUMO

ABSTRACT This work had two objectives: (1) to identify the extent of the problem and gaps pertaining to hypertension control in Latin America and the Caribbean (LAC) and (2) to identify the potential role for late-stage (T4) translation research to tackle the current and future hypertension burden in that region. We explored the extent of the problem and the potential opportunities to use late-stage (T4) translation research to address it. We analyzed calls to action and policies implemented within several LAC countries and also at the regional level. Some LAC countries are currently developing comprehensive plans for controlling noncommunicable diseases. Additionally, the Pan American Health Organization (PAHO) is working on implementing a comprehensive plan of action within the PAHO Strategy for the Prevention and Control of Noncommunicable Diseases. These endeavors underscore the need for and the relevance of implementing effective, evidence-based, affordable interventions for treating and controlling hypertension. In these efforts, late-stage (T4) translation research can help to determine the best strategies for delivery of hypertension control. This late-stage (T4) translation research should involve all relevant stakeholders and partners in order to best enhance and scale up appropriate, affordable, and sustainable public health interventions.


RESUMEN El presente trabajo tuvo dos objetivos: 1) establecer la magnitud del problema y las brechas en cuanto al control de la hipertensión en América Latina y el Caribe, y 2) determinar la posible función de la última fase (T4) de la investigación sobre traslación de los resultados a productos para hacer frente a la carga actual y futura de la hipertensión en la región. Exploramos la magnitud del problema y las oportunidades de usar última fase (T4) de la investigación sobre traslación de los resultados a productos para abordarlo. Analizamos los llamamientos a la acción y las políticas aplicadas en varios países de América Latina y el Caribe, y también en el plano regional. Actualmente, algunos países de América Latina y el Caribe están elaborando planes integrales para controlar las enfermedades no transmisibles. Además, la Organización Panamericana de la Salud (OPS) está trabajando en la ejecución de un plan de acción integral en el marco de su Estrategia para la prevención y el control de las enfermedades no transmisibles. Estos cometidos destacan la necesidad y la relevancia de las intervenciones eficaces, basadas en la evidencia y asequibles para el tratamiento y el control de la hipertensión. En el marco de estos esfuerzos, la última fase (T4) de la investigación sobre traslación de los resultados a productos puede ayudar a determinar las mejores estrategias para las prestaciones relacionadas con el control de la hipertensión. Esta última fase (T4) debe incluir a todos los interesados directos y asociados pertinentes para mejorar y ampliar las intervenciones de salud pública apropiadas, asequibles y sostenibles.


RESUMO Este estudo teve dois objetivos: (1) identificar o alcance do problema e as lacunas referentes ao controle da hipertensão na América Latina e no Caribe (ALC) e (2) identificar o papel em potencial da pesquisa translacional de fase T4 para combater a carga atual e futura da hipertensão na região. Foi investigado o alcance do problema e as oportunidades em potencial para usar pesquisa translacional de fase T4 para abordar o problema. Foram analisadas convocações à ação e políticas adotadas em vários países da ALC e ao nível regional. Alguns países da ALC estão em fase de elaboração de planos abrangentes para controlar as doenças não transmissíveis. Além disso, a Organização Pan-Americana da Saúde (OPAS) está trabalhando na implementação de um plano de ação integral como parte da Estratégia da OPAS para Prevenção e Controle de Doenças Não Transmissíveis. Esses esforços destacam a necessidade e a importância de implementar intervenções com base científica que sejam eficazes e acessíveis para tratar e controlar a hipertensão. Para tal, a pesquisa translacional de fase T4 pode contribuir para determinar as melhores estratégias para realizar o controle da hipertensão. Este tipo de pesquisa deve envolver todos os interessados diretos e parceiros relevantes a fim de expandir e aprimorar as intervenções de saúde pública que sejam adequadas, acessíveis e sustentáveis.


Assuntos
Humanos , Saúde Pública , Pesquisa Médica Translacional/estatística & dados numéricos , Hipertensão/prevenção & controle , Índias Ocidentais , América Latina
19.
Occup Ther Int ; 2017: 2305402, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29097962

RESUMO

Translational research is redefined in this paper using a combination of methods in statistics and data science to enhance the understanding of outcomes and practice in occupational therapy. These new methods are applied, using larger data and smaller single-subject data, to a study in hippotherapy for children with developmental disabilities (DD). The Centers for Disease Control and Prevention estimates DD affects nearly 10 million children, aged 2-19, where diagnoses may be comorbid. Hippotherapy is defined here as a treatment strategy in occupational therapy using equine movement to achieve functional outcomes. Semiparametric ratio estimator (SPRE), a single-subject statistical and small data science model, is used to derive a "change point" indicating where the participant adapts to treatment, from which predictions are made. Data analyzed here is from an institutional review board approved pilot study using the Hippotherapy Evaluation and Assessment Tool measure, where outcomes are given separately for each of four measured domains and the total scores of each participant. Analysis with SPRE, using statistical methods to predict a "change point" and data science graphical interpretations of data, shows the translational comparisons between results from larger mean values and the very different results from smaller values for each HEAT domain in terms of relationships and statistical probabilities.


Assuntos
Deficiências do Desenvolvimento , Terapia Assistida por Cavalos , Terapia Ocupacional , Pesquisa Médica Translacional , Adolescente , Animais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Projetos Piloto , Pesquisa Médica Translacional/estatística & dados numéricos , Adulto Jovem
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