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共2509条结果
  • 1.

    【2hr】Gene–environment interactions and vitamin D effects on cardiovascular risk

    包量

    机译 基因-环境相互作用和维生素D对心血管风险的影响
    摘要：
  • 2.

    【2hr】Surveillance and monitoring of antimicrobial resistance: limitations and lessons from the GRAM project

    包量

    机译 监测和监测抗菌素耐药性：GRAM项目的局限性和教训
    摘要：
  • 3.

    【2hr】C-peptide persistence in type 1 diabetes: ‘not drowning, but waving’?

    包量

    机译 1型糖尿病患者的C肽持久性：“不是溺水，而是招手”？
    摘要：
  • 4.

    【2hr】Response to ‘The implications of three major new trials for the effect of water, sanitation and hygiene on childhood diarrhea and stunting: a consensus statement’ by Cumming et al.

    包量

    机译 卡明等人针对“三项主要新试验对水，环境卫生和个人卫生对儿童腹泻和发育迟缓的影响的共识声明达成的共识”的回应。
    摘要：Please see related article:
  • 5.

    【2hr】Adaptive trials, efficiency, and ethics

    包量

    机译 适应性试验，效率和道德
    摘要：
  • 6.

    【2hr】Cannabis use in first episode psychosis: what we have tried and why it hasn’t worked

    包量

    机译 大麻在首发性精神病中的使用：我们尝试过的方法以及为何无效的方法
    摘要：
  • 7.

    【2hr】Challenges and opportunities in examining and addressing intersectional stigma and health

    包量

    机译 检查和解决交叉污名与健康的挑战与机遇
    摘要：Background‘Intersectional stigma’ is a concept that has emerged to characterize the convergence of multiple stigmatized identities within a person or group, and to address their joint effects on health and wellbeing. While enquiry into the intersections of race, class, and gender serves as the historical and theoretical basis for intersectional stigma, there is little consensus on how best to characterize and analyze intersectional stigma, or on how to design interventions to address this complex phenomenon. The purpose of this paper is to highlight existing intersectional stigma literature, identify gaps in our methods for studying and addressing intersectional stigma, provide examples illustrating promising analytical approaches, and elucidate priorities for future health research.
  • 8.

    【2hr】Stigma in health facilities: why it matters and how we can change it

    包量

    机译 卫生设施中的污名：为什么重要以及我们如何改变它
    摘要：Stigma in health facilities undermines diagnosis, treatment, and successful health outcomes. Addressing stigma is fundamental to delivering quality healthcare and achieving optimal health. This correspondence article seeks to assess how developments over the past 5 years have contributed to the state of programmatic knowledge—both approaches and methods—regarding interventions to reduce stigma in health facilities, and explores the potential to concurrently address multiple health condition stigmas. It is supported by findings from a systematic review of published articles indexed in PubMed, Psychinfo and Web of Science, and in the United States Agency for International Development’s Development Experience Clearinghouse, which was conducted in February 2018 and restricted to the past 5 years. Forty-two studies met inclusion criteria and provided insight on interventions to reduce HIV, mental illness, or substance abuse stigma. Multiple common approaches to address stigma in health facilities emerged, which were implemented in a variety of ways. The literature search identified key gaps including a dearth of stigma reduction interventions in health facilities that focus on tuberculosis, diabetes, leprosy, or cancer; target multiple cadres of staff or multiple ecological levels; leverage interactive technology; or address stigma experienced by health workers. Preliminary results from ongoing innovative responses to these gaps are also described.The current evidence base of stigma reduction in health facilities provides a solid foundation to develop and implement interventions. However, gaps exist and merit further work. Future investment in health facility stigma reduction should prioritize the involvement of clients living with the stigmatized condition or behavior and health workers living with stigmatized conditions and should address both individual and structural level stigma.
  • 9.

    【2hr】The Health Stigma and Discrimination Framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas

    包量

    机译 《健康污名和歧视框架》：一个全球性的贯穿各领域的框架，旨在为与健康有关的污名的研究，干预措施和政策提供信息
    摘要：Stigma is a well-documented barrier to health seeking behavior, engagement in care and adherence to treatment across a range of health conditions globally. In order to halt the stigmatization process and mitigate the harmful consequences of health-related stigma (i.e. stigma associated with health conditions), it is critical to have an explicit theoretical framework to guide intervention development, measurement, research, and policy. Existing stigma frameworks typically focus on one health condition in isolation and often concentrate on the psychological pathways occurring among individuals. This tendency has encouraged a siloed approach to research on health-related stigmas, focusing on individuals, impeding both comparisons across stigmatized conditions and research on innovations to reduce health-related stigma and improve health outcomes. We propose the Health Stigma and Discrimination Framework, which is a global, crosscutting framework based on theory, research, and practice, and demonstrate its application to a range of health conditions, including leprosy, epilepsy, mental health, cancer, HIV, and obesity/overweight. We also discuss how stigma related to race, gender, sexual orientation, class, and occupation intersects with health-related stigmas, and examine how the framework can be used to enhance research, programming, and policy efforts. Research and interventions inspired by a common framework will enable the field to identify similarities and differences in stigma processes across diseases and will amplify our collective ability to respond effectively and at-scale to a major driver of poor health outcomes globally.
  • 10.

    【2hr】Advances in the clinical management of type 2 diabetes: a brief history of the past 15 years and challenges for the future

    包量

    机译 2型糖尿病临床管理方面的进展：过去15年的简要历史和未来的挑战
    摘要：Remarkable progress has been made in some aspects of diabetes care over the last 15 years, but there have also been a rising number of challenges that differ between high and low-income countries. In high-income countries, a substantial increase in the use of preventative drugs for cardiovascular disease has lowered vascular complications and improved diabetes survival. More recently, new classes of diabetes drugs have emerged that can variably lower cardiovascular outcomes, new-onset heart failure and slow renal decline, thereby meaningfully increasing the diabetes armoury that should help patients to live even longer lives and with fewer complications. At the other end of the disease spectrum, we can now better prevent diabetes in people who are at elevated risk of developing it, whereas other new research has shown that diabetes remission is possible when lifestyle changes are made in the early years after diagnosis. The downside is that more people than ever before have type 2 diabetes, so despite such progress in high-income countries, the absolute burden of disease is rising. Furthermore, it is rising even faster in low and middle-income countries, where rising adiposity is driving a tidal wave of new diabetes cases; yet, healthcare systems are less able to cope, lacking sufficient drugs, trained personnel and integrated care systems. Thus, despite advances, the future challenges from rising diabetes rates worldwide are daunting.
  • 11.

    【2hr】What causes severe malaria and its complications in children? Lessons learned over the past 15 years

    包量

    机译 是什么导致儿童严重疟疾及其并发症？过去15年的经验教训
    摘要：Over the past 15 years, malaria mortality has reduced by approximately 50%. However, malaria still causes more than 400,000 deaths annually, most of which occur in African children under 5 years of age. Significant advances in understanding the pathogenesis of the disease provide a basis for future work to prevent severe malaria and its complications. Herein, we provide an overview of advances in our understanding of severe malaria in African children over the past 15 years, highlighting key complications and identifying priorities to further reduce malaria-associated mortality.
  • 12.

    【2hr】Advanced cell therapeutics are changing the clinical landscape: will mesenchymal stromal cells be a part of it?

    包量

    机译 先进的细胞疗法正在改变临床前景：间充质基质细胞会成为其中的一部分吗？
    摘要：During the past 15 years there have been dramatic changes in the medical landscape, particularly in oncology and regenerative medicine. Cell therapies have played a substantial part in this progress. Cellular immunotherapies can use immune cells, such as T cells or natural killer cells that, after functional modification ex vivo, exert powerful anti-cancer effects when given to the patient. Innovative technologies, such as re-programming terminally differentiated cells into pluripotent stem cells or into other cell types and applying specific enzymes to more precisely edit the human genome, are paving the way towards more potent cell and gene therapies.Mesenchymal stromal cells are promising cellular immunotherapeutics, which also have potential for use in tissue engineering strategies and other regenerative medicine applications. However, substantial gaps in our knowledge of their biology and therapeutic efficacy present major challenges to their sustainable implementation in the clinical routine.In this article, progress in the field of cell therapeutics during the past 15 years will be briefly discussed, with a focus on mesenchymal stromal cells, highlighting the impact of this field on patient care.
  • 13.

    【2hr】Digital health at fifteen: more human (more needed)

    包量

    机译 十五岁的数字健康：更多的人（需要更多）
    摘要：There is growing appreciation that the success of digital health – whether digital tools, digital interventions or technology-based change strategies – is linked to the extent to which human factors are considered throughout design, development and implementation. A shift in focus to individuals as users and consumers of digital health highlights the capacity of the field to respond to secular developments, such as the adoption of person-centred care and consumer health technologies. We argue that this project is not only incomplete, but is fundamentally ‘uncompletable’ in the face of a highly dynamic landscape of both technological and human challenges. These challenges include the effects of consumerist, technology-supported care on care delivery, the rapid growth of digital users in low-income and middle-income countries and the impacts of machine learning. Digital health research will create most value by retaining a clear focus on the role of human factors in maximising health benefit, by helping health systems to anticipate and understand the person-centred effects of technology changes and by advocating strongly for the autonomy, rights and safety of consumers.
  • 14.

    【2hr】Ethical challenges in global health-related stigma research

    包量

    机译 全球与健康相关的污名研究中的伦理挑战
    摘要：BackgroundIt is critically important to conduct research on stigmatized conditions, to include marginalized groups that experience stigma, and to develop interventions to reduce stigma. However, such research is ethically challenging. Though superficial reference is frequently made to these widely acknowledged challenges, few publications have focused on ethical issues in research on stigmatized groups or conditions. In fact, a brief literature review found only two such publications.
  • 15.

    【2hr】Commentary on a recent article on the effects of the ‘Daily Mile’ on physical activity, fitness and body composition: addressing key limitations

    包量

    机译 评论有关“每日里程”对身体活动，健身和身体成分的影响的最新文章：解决关键限制
    摘要：A recent pilot study by Chesham et al. in BMC Medicine established some initial effects of the Daily Mile™ using a quasi-experimental repeated measures design, with valid and reliable outcome assessments for moderate-to-vigorous physical activity, fitness and body composition. Their contribution is important and welcome, yet, alone, it is insufficient to justify the recent UK-wide adoption of the Daily Mile within the Childhood Obesity Plan. The study concluded that the Daily Mile had positive effects on moderate-to-vigorous physical activity, fitness and body composition, suggesting that intervention effectiveness was confirmed. However, only some of the significant limitations of the work were addressed. Herein, we identify and discuss six key limitations, which, combined, suggest a more tentative conclusion. In summary, evidence supporting the effectiveness of the Daily Mile is in its infancy and requires refinement to fully justify its widespread adoption. Further, we need to be cautious considering that the full range of its impacts, both positive and negative, remain to be fully established.
  • 16.

    【2hr】Response to Daly-Smith et al.’s commentary on ‘The Daily Mile makes primary school children more active, less sedentary and improves their fitness and body composition: a quasi-experimental pilot study’

    包量

    机译 回应达利·史密斯（Daly-Smith）等人的评论：“每日英里（Daily Mile）使小学生更加活跃，久坐不动，并改善了他们的身体素质和身体组成：一项半实验性试点研究”
    摘要：We thank Daly-Smith et al. for taking the time to read the results of our pilot research study, describing it as an important and welcome contribution. Nonetheless, the authors argue six points against our conclusion. We contend that we addressed three of these points in our original discussion and disagree with their remaining points. Overall, their Commentary adds little to the topic of research into the Daily Mile™ that we had not already raised in our discussion. Additionally, they attribute statements to us that we did not make and ignore the raising of key issues in our original article. Given this, we stand by our original peer-reviewed conclusion that introducing the Daily Mile™ to the primary school day appears to be an effective intervention for increasing levels of moderate to vigorous physical activity, reducing sedentary time, increasing physical fitness and improving body composition, and that these findings have relevance for teachers, policy-makers, public health practitioners and health researchers.
  • 17.

    【2hr】Monitoring progress in reducing maternal mortality using verbal autopsy methods in vital registration systems: what can we conclude about specific causes of maternal death?

    包量

    机译 在生命登记系统中使用口头验尸方法监测降低孕产妇死亡率的进展：关于孕产妇死亡的具体原因，我们可以得出什么结论？
    摘要：Reducing maternal mortality is a key focus of development strategies and one of the indicators used to measure progress towards achieving the Sustainable Development Goals. In the absence of medical certification of the cause of deaths that occur in the community, verbal autopsy (VA) methods are the only available means to assess levels and trends of maternal deaths that occur outside health facilities. The 2016 World Health Organization VA Instrument facilitates the identification of eight specific causes of maternal death, yet maternal deaths are often unsupervised, leading to sparse and generally poor symptom reporting to inform a reliable diagnosis using VAs. There is little research evidence to support the reliable identification of specific causes of maternal death in the context of routine VAs. We recommend that routine VAs are only used to capture the event of a maternal death and that more detailed follow-up interviews are used to identify the specific causes.Electronic supplementary materialThe online version of this article (10.1186/s12916-019-1343-4) contains supplementary material, which is available to authorized users.
  • 18.

    【2hr】DIABRISK-SL trial: further consideration of age and impact of imputations

    包量

    机译 DIABRISK-SL试用版：进一步考虑年龄和估算影响
    摘要：Type 2 diabetes mellitus (T2DM) is a major cause of morbidity and mortality worldwide. Early interventions may help to delay or prevent onset of cardiometabolic endpoints of clinical importance to T2DM patients.Wijesuriya et al. (BMC Med 15:146, 2017) published results of a randomised controlled trial in Sri Lanka testing the effect of two lifestyle modification programmes of varying intensity in participants aged 5–40 years with risk factors for T2DM. The intervention measured the impact of the two programmes on the primary composite endpoint consisting of various predictors of cardiometabolic disease. The authors concluded that the more intensive programme significantly reduced the incidence of predictors of cardiometabolic disease. Further, they delivered a large-scale intervention with restricted resources with widespread acceptance as demonstrated by the high uptake rate. However, we believe that further analysis is required to fully understand the potential for benefit, particularly in relation to age, retention and missing data.
  • 19.

    【2hr】Antenatal iron supplementation and birth weight in conditions of high exposure to infectious diseases

    包量

    机译 传染病高暴露条件下的产前补铁和出生体重
    摘要：BackgroundA recent cohort study among Papua New Guinean women surprisingly showed iron deficiency during pregnancy to be associated with increased birth weight. These findings seemingly contradict previous trial evidence that iron supplementation leads to increased birth weight, particularly in iron-deficient women, and hence require explanation.
  • 20.

    【2hr】Understanding the interactions between iron supplementation, infectious disease and adverse birth outcomes is essential to guide public health recommendations

    包量

    机译 了解铁补充剂，传染病和不良出生结局之间的相互作用对于指导公共卫生建议至关重要
    摘要：Pregnant women are highly susceptible to anaemia and iron deficiency due to the increased demands of pregnancy as well as other factors. Iron supplementation is recommended in pregnancy, yet the benefits on newborn outcomes are variable between populations, most likely due to the heterogeneity in the prevalence of iron deficiency, detrimental birth outcomes and infectious diseases. Furthermore, there are concerns regarding iron supplementation in malaria-endemic areas due to reports of increased risk of malaria in those receiving iron. This is compounded by limited knowledge of how iron deficiency, anaemia, malaria, and other infections may interact to influence birth outcomes. In a recent cohort study in Papua New Guinea, where there is a high burden of infections and iron deficiency, we found that iron deficiency in pregnancy was associated with a reduced risk of adverse birth outcomes. However, this effect could not be wholly explained by interactions between iron deficiency and malaria. We proposed that iron deficiency may confer a degree of protection against other infectious pathogens, which in turn caused improvements in birthweight. We argue that further studies in multiple populations are crucial to elucidate interactions between iron status, iron supplementation and birthweight as well as to understand the context-specific benefits of iron supplementation in pregnancy and inform public policy. Focus should be given to haematological studies on anaemia, haemodilution and iron absorption, as well as investigating infectious diseases and other nutritional deficiencies. This is a particular priority in resource-constrained settings where the prevalence of iron deficiency, poor nutrition, infections and poor birth outcomes are high. While current recommendations of iron supplementation and malaria prophylaxis to reduce the burden of poor pregnancy outcomes should be supported, the strength of evidence underpinning these must be improved and new insights should be garnered in order to maximise improvements in maternal and child health.Please see related article: .Please see related article: .
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