Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 19.135
Filtrar
1.
Public Health Res Pract ; 31(4)2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34753165

RESUMO

OBJECTIVES: We examine how health policy and systems research (HPSR) is produced and funded in 14 post-Soviet states to inform possible strategies to improve the supply and quality of research and advance evidence-based health policy making in these states. STUDY TYPE: Mixed methods. METHODS: Using mixed methods - secondary data analysis, desk review and in-depth interviews - this qualitative study is exploratory and explanatory.The secondary data analysis involved a comparative analysis of available data from: a) the 'fiscal space' (national economic resources) - using gross domestic expenditure on research and development for the years 2013-2018; and b) capacity for HPSR - using the number of published papers and average citation per paper (as a quality proxy) in the years 2015-2019. To explain the secondary data analysis findings, we used the approach proposed by Hallerberg et al., highlighting the importance of institutional context, actors, and their incentives and influence in budget allocation decisions. The desk review of available documents and 32 in-depth interviews were conducted remotely to obtain insights on the context and actors. The interview transcripts were analysed using Nvivo 12 software with an inductive approach. RESULTS: In all studied countries, except the Baltic states, funding levels for HPSR remain inadequate. Most research and development funding is allocated to fundamental sciences and biomedical research - fields with more influential long-standing institutional legacies. The low volume and poor quality of published HPSR research appears to be adversely affecting the credibility of researchers in this field in the eyes of critical beneficiaries - policy makers, who do not prioritise and advocate for funding of HPSR. CONCLUSIONS: HPSR funding in most post-Soviet countries is caught in a vicious cycle of inadequate funding and poor quality. International collaborative projects focused on post-Soviet states and involving science funders, academic institutions and researchers from those countries may help strengthen HPSR capacity, improve research quality and help boost priority funding and the credibility of researchers in this field.


Assuntos
Política de Saúde , Pesquisa sobre Serviços de Saúde , Pessoal Administrativo , Humanos , Formulação de Políticas , Pesquisadores
2.
Zhongguo Zhen Jiu ; 41(11): 1276-80, 2021 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-34762384

RESUMO

Taking the clinical trial of acupuncture in treatment of postprandial distress syndrome as an example, this paper proposes that the acupuncture clinical trial protocol should be optimized in view of acupuncture prescription, acupuncture frequency and outcomes. Besides, the data quality of acupuncture clinical trial should be improved in consideration of data sharing and electronic data capture so as to provide a reference for the majority of researchers to optimize and implement acupuncture clinical trial.


Assuntos
Terapia por Acupuntura , Ensaios Clínicos como Assunto , Dispepsia/terapia , Humanos , Pesquisadores , Gastropatias/terapia , Resultado do Tratamento
3.
Psychol Sci Public Interest ; 22(1_suppl): 1S-18S, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34730037

RESUMO

Eyewitness misidentifications are almost always made with high confidence in the courtroom. The courtroom is where eyewitnesses make their last identification of defendants suspected of (and charged with) committing a crime. But what did those same eyewitnesses do on the first identification test, conducted early in a police investigation? Despite testifying with high confidence in court, many eyewitnesses also testified that they had initially identified the suspect with low confidence or failed to identify the suspect at all. Presenting a lineup leaves the eyewitness with a memory trace of the faces in the lineup, including that of the suspect. As a result, the memory signal generated by the face of that suspect will be stronger on a later test involving the same witness, even if the suspect is innocent. In that sense, testing memory contaminates memory. These considerations underscore the importance of a newly proposed recommendation for conducting eyewitness identifications: Avoid repeated identification procedures with the same witness and suspect. This recommendation applies not only to additional tests conducted by police investigators but also to the final test conducted in the courtroom, in front of the judge and jury.


Assuntos
Rememoração Mental , Reconhecimento Psicológico , Crime , Humanos , Polícia , Pesquisadores
4.
Elife ; 102021 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-34726155

RESUMO

A survey reveals that many researchers do not use appropriate statistical analyses to evaluate sex differences in biomedical research.


Assuntos
Pesquisa Biomédica , Caracteres Sexuais , Feminino , Humanos , Masculino , Projetos de Pesquisa , Pesquisadores
5.
BMC Res Notes ; 14(1): 405, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34727971

RESUMO

There has been an important global interest in Open Science, which include open data and methods, in addition to open access publications. It has been proposed that public availability of raw data increases the value and the possibility of confirmation of scientific findings, in addition to the potential of reducing research waste. Availability of raw data in open repositories facilitates the adequate development of meta-analysis and the cumulative evaluation of evidence for specific topics. In this commentary, we discuss key elements about data sharing in open repositories and we invite researchers around the world to deposit their data in them.


Assuntos
Acesso à Informação , Pesquisa Biomédica , Ciência , Humanos , Pesquisadores , Ciência/normas
6.
Artigo em Inglês | MEDLINE | ID: mdl-34769533

RESUMO

The use of research in public health policymaking is one of the prerequisites for successfully implemented health policies which have better population health as an outcome. This policy process is influenced by the actors involved under the policy umbrella, with inter-related contextual factors and specific structural and institutional circumstances. Our study investigates how policymakers' research capacities influence the use of research in the health policy process and identify areas where capacity-building interventions give the most meaning and impact. Furthermore, we investigate policymakers' research engagement and use this to inform public health policy in the public sector in Denmark. We collect and report data using Seeking, Engaging with, and Evaluation Research (SEER) methodology. Policymakers are reported to have research capacity, but it is questionable how those competences have actually been used in policymaking. Decision-makers were often not aware or did not know about the existing organizational tools and systems for research engagement and use and two third of respondents had not been part of any research activities or had any collaboration with researchers. Overall, research use in public health policymaking and evaluation was limited. As a conclusion, we propose that capacity-building interventions for increasing research use and collaboration in EIPM should be context-oriented, measurable, and sustainable in developing individual and organizational competences.


Assuntos
Formulação de Políticas , Saúde Pública , Fortalecimento Institucional , Política de Saúde , Humanos , Pesquisadores
8.
Trials ; 22(1): 789, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34749778

RESUMO

BACKGROUND: Evidence from previous studies is often used relatively informally in the design of clinical trials: for example, a systematic review to indicate whether a gap in the current evidence base justifies a new trial. External evidence can be used more formally in both trial design and analysis, by explicitly incorporating a synthesis of it in a Bayesian framework. However, it is unclear how common this is in practice or the extent to which it is considered controversial. In this qualitative study, we explored attitudes towards, and experiences of, trialists in incorporating synthesised external evidence through the Bayesian design or analysis of a trial. METHODS: Semi-structured interviews were conducted with 16 trialists: 13 statisticians and three clinicians. Participants were recruited across several universities and trials units in the United Kingdom using snowball and purposeful sampling. Data were analysed using thematic analysis and techniques of constant comparison. RESULTS: Trialists used existing evidence in many ways in trial design, for example, to justify a gap in the evidence base and inform parameters in sample size calculations. However, no one in our sample reported using such evidence in a Bayesian framework. Participants tended to equate Bayesian analysis with the incorporation of prior information on the intervention effect and were less aware of the potential to incorporate data on other parameters. When introduced to the concepts, many trialists felt they could be making more use of existing data to inform the design and analysis of a trial in particular scenarios. For example, some felt existing data could be used more formally to inform background adverse event rates, rather than relying on clinical opinion as to whether there are potential safety concerns. However, several barriers to implementing these methods in practice were identified, including concerns about the relevance of external data, acceptability of Bayesian methods, lack of confidence in Bayesian methods and software, and practical issues, such as difficulties accessing relevant data. CONCLUSIONS: Despite trialists recognising that more formal use of external evidence could be advantageous over current approaches in some areas and useful as sensitivity analyses, there are still barriers to such use in practice.


Assuntos
Pesquisadores , Teorema de Bayes , Humanos , Pesquisa Qualitativa , Reino Unido
9.
Health Res Policy Syst ; 19(1): 135, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34727926

RESUMO

BACKGROUND: There are increasing expectations for researchers and knowledge users in the health system to use a research partnership approach, such as integrated knowledge translation, to increase the relevance and use of research findings in health practice, programmes and policies. However, little is known about how health research trainees engage in research partnership approaches such as IKT. In response, the purpose of this scoping review was to map and characterize the evidence related to using an IKT or other research partnership approach from the perspective of health research trainees in thesis and/or postdoctoral work. METHODS: We conducted this scoping review following the Joanna Briggs Institute methodology and Arksey and O'Malley's framework. We searched the following databases in June 2020: MEDLINE, Embase, CINAHL and PsycINFO. We also searched sources of unpublished studies and grey literature. We reported our findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS: We included 74 records that described trainees' experiences using an IKT or other research partnership approach to health research. The majority of studies involved collaboration with knowledge users in the research question development, recruitment and data collection stages of the research process. Intersecting barriers to IKT or other research partnerships at the individual, interpersonal and organizational levels were reported, including lack of skills in partnership research, competing priorities and trainees' "outsider" status. We also identified studies that evaluated their IKT approach and reported impacts on partnership formation, such as valuing different perspectives, and enhanced relevance of research. CONCLUSION: Our review provides insights for trainees interested in IKT or other research partnership approaches and offers guidance on how to apply an IKT approach to their research. The review findings can serve as a basis for future reviews and primary research focused on IKT principles, strategies and evaluation. The findings can also inform IKT training efforts such as guideline development and academic programme development.


Assuntos
Pesquisadores , Pesquisa Médica Translacional , Humanos , Conhecimento
10.
Nature ; 599(7884): 331-334, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34759367
11.
Chimia (Aarau) ; 75(11): 936-942, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34798915

RESUMO

We present a short overview of the way Novartis chemists interact and collaborate with the academic chemistry community in Switzerland. This article exemplifies a number of collaborations, and illustrates opportunities to foster research synergies between academic and industrial researchers. It also describes established programs available to academic groups, providing them access to Novartis resources and expertise.


Assuntos
Indústrias , Pesquisadores , Humanos , Suíça
12.
Int J Equity Health ; 20(1): 240, 2021 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-34736455

RESUMO

Co-design as a participatory method aims to improve health service design and implementation. It is being used more frequently by researchers and practitioners in various health and social care settings. Co-design has the potential for achieving positive outcomes for the end users involved in the process; however, involvement of diverse ethnic minority population in the process remains limited. While the need to engage with diverse voices is identified, there is less information available on how to achieve meaningful engagement with these groups. Ethnic minorities are super-diverse population and the diversity between and within these groups need consideration for optimising their participation in co-design. Based on our experience of working with diverse ethnic minority groups towards the co-design of consumer engagement strategies to improve patient safety in cancer services as part of the two nationally-funded research projects in Australia, we outline reflections and practical techniques to optimise co-design with people from diverse ethnic backgrounds. We identify three key aspects of the co-design process pertinent to the involvement of this population; 1) starting at the pre-commencement stage to ensure diverse, seldom heard consumers are invited to and included in co-design work, 2) considering logistics and adequate resources to provide appropriate support to address needs before, during and beyond the co-design process, and 3) supporting and enabling a diversity of contributions via the co-design process.


Assuntos
Grupos Étnicos , Grupos Minoritários , Serviços de Saúde , Acesso aos Serviços de Saúde , Humanos , Pesquisadores
13.
AIDS Res Ther ; 18(1): 75, 2021 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-34663375

RESUMO

BACKGROUND: An increasing number of HIV cure trials involve combining multiple potentially curative interventions. Until now, considerations for designing and implementing complex combination HIV cure trials have not been thoroughly considered. METHODS: We used a purposive method to select key informants for our study. Informants included biomedical HIV cure researchers, regulators, policy makers, bioethicists, and community members. We used in-depth interviews to generate ethical and practical considerations to guide the design and implementation of combination HIV cure research. We analyzed the qualitative data using conventional content analysis focused on inductive reasoning. RESULTS: We interviewed 11 biomedical researchers, 4 community members, 2 regulators, 1 policy researcher, and 1 bioethicist. Informants generated considerations for designing and implementing combination interventions towards an HIV cure, focused on ethical aspects, as well as considerations to guide trial design, benefit/risk determinations, regulatory requirements, prioritization and sequencing and timing of interventions, among others. Informants also provided considerations related to combining specific HIV cure research modalities, such as broadly neutralizing antibodies (bNAbs), cell and gene modification products, latency-reversing agents and immune-based interventions. Finally, informants provided suggestions to ensure meaningful therapeutic improvements over standard antiretroviral therapy, overcome challenges of designing combination approaches, and engage communities around combination HIV cure research. CONCLUSION: The increasing number of combination HIV cure trials brings with them a host of ethical and practical challenges. We hope our paper will inform meaningful stakeholder dialogue around the use of combinatorial HIV cure research approaches. To protect the public trust in HIV cure research, considerations should be periodically revisited and updated with key stakeholder input as the science continues to advance.


Assuntos
Infecções por HIV , Infecções por HIV/tratamento farmacológico , Humanos , Pesquisa Qualitativa , Pesquisadores , Estados Unidos
14.
BMC Health Serv Res ; 21(1): 1077, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635125

RESUMO

BACKGROUND: Implementation science aims to embed evidence-based practice as 'usual care' using theoretical underpinnings to guide these processes. Conceptualising the complementary purpose and application of theoretical approaches through all stages of an implementation project is not well understood and is not routinely reported in implementation research, despite call for this. This paper presents the synthesis and a collective approach to application of a co-design model, a model for understanding need, theories of behaviour change with frameworks and tools to guide implementation and evaluation brought together with the Consolidated Framework for Implementation Research (CFIR). METHOD: Using a determinant framework such as the CFIR provides a lens for understanding, influencing, and explaining the complex and multidimensional variables at play within a health service that contribute to planning for and delivering effective patient care. Complementary theories, models, frameworks, and tools support the research process by providing a theoretical and practical structure to understanding the local context and guiding successful local implementation. RESULTS: This paper provides a rationale for conceptualising the multidimensional approach for implementation using the worked example of a pregnancy, birth, postnatal and early parenting education intervention for expectant and new parents at a large maternity hospital. CONCLUSION: This multidimensional theoretical approach provides useful, practical guidance to health service researchers and clinicians to develop project specific rationale for their theoretical approach to implementation projects.


Assuntos
Maternidades , Ciência da Implementação , Prática Clínica Baseada em Evidências , Feminino , Humanos , Gravidez , Pesquisadores
15.
BMJ Open ; 11(10): e043830, 2021 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-34697108

RESUMO

OBJECTIVE: Many studies have documented significant associations between religion and spirituality (R/S) and health, but relatively few prospective analyses exist that can support causal inferences. To date, there has been no systematic analysis of R/S survey items collected in US cohort studies. We conducted a systematic content analysis of all surveys ever fielded in 20 diverse US cohort studies funded by the National Institutes of Health (NIH) to identify all R/S-related items collected from each cohort's baseline survey through 2014. DESIGN: An R|S Ontology was developed from our systematic content analysis to categorise all R/S survey items identified into key conceptual categories. A systematic literature review was completed for each R/S item to identify any cohort publications involving these items through 2018. RESULTS: Our content analysis identified 319 R/S survey items, reflecting 213 unique R/S constructs and 50 R|S Ontology categories. 193 of the 319 extant R/S survey items had been analysed in at least one published paper. Using these data, we created the R|S Atlas (https://atlas.mgh.harvard.edu/), a publicly available, online relational database that allows investigators to identify R/S survey items that have been collected by US cohorts, and to further refine searches by other key data available in cohorts that may be necessary for a given study (eg, race/ethnicity, availability of DNA or geocoded data). CONCLUSIONS: R|S Atlas not only allows researchers to identify available sources of R/S data in cohort studies but will also assist in identifying novel research questions that have yet to be explored within the context of US cohort studies.


Assuntos
Pesquisadores , Espiritualidade , Estudos de Coortes , Humanos , Estudos Prospectivos , Religião , Inquéritos e Questionários
16.
BMC Med Ethics ; 22(1): 138, 2021 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-34645425

RESUMO

BACKGROUND: The H2020 i-CONSENT project has developed a set of guidelines that offer ethical recommendations and practical tools aimed at making the informed consent process in clinical studies more comprehensive, tailored, and inclusive. An analysis of the appropriateness of some of its novel recommendations was carried out by a group of experts representing different stakeholders. METHODS: An adaptation of the RAND/UCLA Appropriateness Method was used to assess the level of agreement on the recommendations among 14 representatives of different stakeholders, including patients, regulators, investigators, ethics experts, and the pharmaceutical industry. The process included two rounds of rating and a virtual meeting. RESULTS: Fifty-three recommendations were evaluated. After the first round, 34 recommendations were judged "appropriate"; 19 were judged "uncertain"; and none was judged "inappropriate". After the second round, 9 "uncertains" changed to "appropriate". All recommendations rated medians of 6.5-9 on a 1-9 scale (1 = "extremely inappropriate", 5 = "uncertain", 9 = "extremely appropriate"). The sections "General recommendations" and "Gender perspective during the consent process for clinical studies" showed the highest "uncertainty" rating. The four keys to improving the understanding of the ICP in clinical studies are to: (1) consider consent a two-way continuous interaction that begins at the first contact with the potential participant and continues until the end of the study; (2) improve investigators' communication skills; (3) co-create the information; and (4) use a layered approach, including information to compensate for the potential participant's possible lack of health literacy and a glossary of terms. CONCLUSIONS: The RAND/UCLA method has demonstrated validity for assessing the appropriateness of recommendations in ethical guidelines. The recommendations of the i-CONSENT guidelines were mostly judged "appropriate" by all stakeholders involved in the informed consent process.


Assuntos
Letramento em Saúde , Consentimento Livre e Esclarecido , Humanos , Projetos de Pesquisa , Pesquisadores
17.
J Law Med Ethics ; 49(3): 489-494, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34665099

RESUMO

The new NIH data sharing policy, effective January 2023, requires researchers to submit a data management and data sharing plan in their grant application. Expanded data sharing, encouraged by NIH to facilitate secondary research, will require informed consent documents to explain data sharing plans, limitations, and procedures.


Assuntos
Disseminação de Informação , Consentimento Livre e Esclarecido , Humanos , Políticas , Pesquisadores
18.
BMC Med Res Methodol ; 21(1): 225, 2021 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-34689742

RESUMO

BACKGROUND: There is a growing need for methods that acknowledge and successfully capture the dynamic interaction between context and implementation of complex interventions. Case study research has the potential to provide such understanding, enabling in-depth investigation of the particularities of phenomena. However, there is limited guidance on how and when to best use different case study research approaches when evaluating complex interventions. This study aimed to review and synthesise the literature on case study research across relevant disciplines, and determine relevance to the study of contextual influences on complex interventions in health systems and public health research. METHODS: Systematic meta-narrative review of the literature comprising (i) a scoping review of seminal texts (n = 60) on case study methodology and on context, complexity and interventions, (ii) detailed review of empirical literature on case study, context and complex interventions (n = 71), and (iii) identifying and reviewing 'hybrid papers' (n = 8) focused on the merits and challenges of case study in the evaluation of complex interventions. RESULTS: We identified four broad (and to some extent overlapping) research traditions, all using case study in a slightly different way and with different goals: 1) developing and testing complex interventions in healthcare; 2) analysing change in organisations; 3) undertaking realist evaluations; 4) studying complex change naturalistically. Each tradition conceptualised context differently-respectively as the backdrop to, or factors impacting on, the intervention; sets of interacting conditions and relationships; circumstances triggering intervention mechanisms; and socially structured practices. Overall, these traditions drew on a small number of case study methodologists and disciplines. Few studies problematised the nature and boundaries of 'the case' and 'context' or considered the implications of such conceptualisations for methods and knowledge production. CONCLUSIONS: Case study research on complex interventions in healthcare draws on a number of different research traditions, each with different epistemological and methodological preferences. The approach used and consequences for knowledge produced often remains implicit. This has implications for how researchers, practitioners and decision makers understand, implement and evaluate complex interventions in different settings. Deeper engagement with case study research as a methodology is strongly recommended.


Assuntos
Atenção à Saúde , Pesquisadores , Humanos , Narração
19.
BMC Med ; 19(1): 251, 2021 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-34696781

RESUMO

BACKGROUND: Adaptive designs offer great promise in improving the efficiency and patient-benefit of clinical trials. An important barrier to further increased use is a lack of understanding about which additional resources are required to conduct a high-quality adaptive clinical trial, compared to a traditional fixed design. The Costing Adaptive Trials (CAT) project investigated which additional resources may be required to support adaptive trials. METHODS: We conducted a mock costing exercise amongst seven Clinical Trials Units (CTUs) in the UK. Five scenarios were developed, derived from funded clinical trials, where a non-adaptive version and an adaptive version were described. Each scenario represented a different type of adaptive design. CTU staff were asked to provide the costs and staff time they estimated would be needed to support the trial, categorised into specified areas (e.g. statistics, data management, trial management). This was calculated separately for the non-adaptive and adaptive version of the trial, allowing paired comparisons. Interviews with 10 CTU staff who had completed the costing exercise were conducted by qualitative researchers to explore reasons for similarities and differences. RESULTS: Estimated resources associated with conducting an adaptive trial were always (moderately) higher than for the non-adaptive equivalent. The median increase was between 2 and 4% for all scenarios, except for sample size re-estimation which was 26.5% (as the adaptive design could lead to a lengthened study period). The highest increase was for statistical staff, with lower increases for data management and trial management staff. The percentage increase in resources varied across different CTUs. The interviews identified possible explanations for differences, including (1) experience in adaptive trials, (2) the complexity of the non-adaptive and adaptive design, and (3) the extent of non-trial specific core infrastructure funding the CTU had. CONCLUSIONS: This work sheds light on additional resources required to adequately support a high-quality adaptive trial. The percentage increase in costs for supporting an adaptive trial was generally modest and should not be a barrier to adaptive designs being cost-effective to use in practice. Informed by the results of this research, guidance for investigators and funders will be developed on appropriately resourcing adaptive trials.


Assuntos
Projetos de Pesquisa , Pesquisadores , Análise Custo-Benefício , Humanos , Recursos Humanos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...