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Overview of Molecular Diagnostics in Irish Clinical Oncology 爱尔兰临床肿瘤学分子诊断概述
Pub Date : 2024-03-26 DOI: 10.12688/hrbopenres.13822.1
Tyler Medina, Seán O. Hynes, Maeve Lowery, Paddy Gillespie, Walter Kolch, Cathal Seoighe
Background Molecular diagnostics are critical for informing cancer patient care. In Ireland, the National Cancer Control Programme (NCCP) develops cancer therapy regimens, which include relevant information on molecular indications. Here, we present a collated overview of the current molecular indications of all NCCP systemic anti-cancer therapy regimens and the funding statuses of their associated drugs. Furthermore, we also provide estimates for the scale of required molecular testing in cancer therapy and for the clinical genetic sequencing capacity of Ireland, and provide a summary of current cancer clinical trials in Ireland which have molecular components. Methods Through a combination of web scraping, keyword search, and manual review, we performed a full review of all 757 indications included in the 476 therapy regimens published to date by the NCCP to identify therapy indications with explicit molecular criteria. For all cancer types identified in these indications, we obtained incidence rates in Ireland from National Cancer Registry Ireland to predict the number of patients yearly who stand to benefit from a molecular test. We then applied molecular subtype rates from published literature to estimate the number of patients who would then qualify for a relevant molecularly guided therapy. Results We identified 210 indications for 148 NCCP therapy regimens that include molecular criteria. These 210 molecular indications encompassed 85 genetic criteria, 137 cellular biomarker criteria, 57 molecularly informed drugs, and over 20 cancer types. We estimated that up to approximately 50% of cancer patients in Ireland could qualify for a molecular test and that the majority of tested patients would qualify for a treatment informed by a molecular test. Conclusions As personalised cancer medicine continues to develop in Ireland, this study will provide a baseline understanding of current practices. We anticipate that work such as this will help to inform planning in the healthcare system.
背景 分子诊断对癌症患者的治疗至关重要。在爱尔兰,国家癌症控制计划(NCCP)制定了癌症治疗方案,其中包括分子适应症的相关信息。在此,我们对所有 NCCP 系统性抗癌治疗方案的当前分子适应症及其相关药物的资金状况进行了整理概述。此外,我们还对癌症治疗中所需的分子检测规模和爱尔兰的临床基因测序能力进行了估算,并对爱尔兰目前包含分子检测内容的癌症临床试验进行了总结。方法 通过网络搜索、关键词搜索和人工审核相结合的方式,我们对 NCCP 迄今公布的 476 种治疗方案中包含的所有 757 种适应症进行了全面审核,以确定具有明确分子标准的治疗适应症。对于这些适应症中确定的所有癌症类型,我们从爱尔兰国家癌症登记处获得了爱尔兰的发病率,以预测每年可从分子检测中获益的患者人数。然后,我们应用已发表文献中的分子亚型率来估算符合相关分子指导疗法的患者人数。结果 我们为 148 种 NCCP 治疗方案确定了 210 项包含分子标准的适应症。这 210 项分子适应症包括 85 项基因标准、137 项细胞生物标志物标准、57 种分子指导药物和 20 多种癌症类型。我们估计,爱尔兰约有 50% 的癌症患者有资格接受分子检测,而大多数接受检测的患者将有资格接受分子检测所提供的治疗。结论 随着个性化癌症医疗在爱尔兰的不断发展,这项研究将提供对当前实践的基本了解。我们预计,这样的工作将有助于为医疗保健系统的规划提供信息。
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引用次数: 0
Hearing and vision support in people with dementia living at home: Outcomes  from the intervention development programme for the European SENSE-Cog Trial 为居家老年痴呆症患者提供听力和视力支持:欧洲 SENSE-Cog 试验干预发展计划的成果
Pub Date : 2024-03-26 DOI: 10.12688/hrbopenres.13869.1
Iracema Leroi, JP Connelly, W. Yeung, Catherine Molony
Background Hearing and vision loss are among the most common and disabling comorbidities in dementia and may worsen the trajectory of decline. Improving sensory function may be an accessible and cost-effective means of improving quality of life (QoL) and other outcomes for people with dementia (PwD). Here we describe the outcome of a multi-step intervention development programme for the components and implementation of a cross-national intervention to support hearing and vision in PwD in community settings. Methods We used the process of ‘intervention mapping’ and a set of mixed method sub-studies to develop the intervention for PwD with hearing and/or vision loss. This involved scoping the gaps in understanding, awareness, and service provision, modelling a prototype intervention, refining the prototype into a draft intervention, and finally field trialling the draft intervention for feasibility, acceptability, and tolerability. Input from the ‘patient and public voice’ (PPV) was interlinked with each step of the development programme (Miah et al., 2017). This paper synthesises the results of sub-studies leading to a description and logic model of the intervention which was then evaluated in a fully powered definitive trial. The sub-studies of the programme took place in participants’ own homes and in university or clinic settings in four EU countries: Cyprus, France, Greece, and the UK. The Expert Reference Group took place in Athens, Greece. We used quantitative and qualitative approaches to analyse the data from the different sub-studies. Results A multi-component psychosocial home-based ‘sensory intervention’ designed to optimise hearing and vision in PwD to improve QoL and other dementia-related and care partner-related outcomes. Conclusion This intervention represents the output of the iterative development of a complex intervention to fulfil an unmet need for PwD and sensory loss.
背景 听力和视力丧失是痴呆症最常见的致残性并发症之一,可能会加重病情的恶化。改善感官功能可能是提高痴呆症患者(PwD)生活质量(QoL)和其他成果的一种方便且具有成本效益的方法。在此,我们介绍了一项多步骤干预开发计划的成果,该计划旨在为社区环境中的痴呆症患者提供听力和视力支持,其组成部分包括跨国干预措施的开发和实施。方法 我们采用了 "干预映射 "流程和一套混合方法子研究来开发针对听力和/或视力受损的残疾人的干预措施。这包括对理解、认识和服务提供方面的差距进行调查,模拟干预原型,将原型改进为干预草案,最后对干预草案的可行性、可接受性和耐受性进行实地试验。来自 "患者和公众之声"(PPV)的意见与开发计划的每一步都相互关联(Miah 等人,2017 年)。本文综合了各项子研究的结果,得出了干预措施的描述和逻辑模型,然后在一项完全有效的确定性试验中对其进行了评估。该计划的子研究在四个欧盟国家的参与者家中、大学或诊所环境中进行:塞浦路斯、法国、希腊和英国。专家咨询小组会议在希腊雅典举行。我们采用定量和定性的方法来分析不同子研究的数据。结果 一项由多部分组成的以家庭为基础的心理社会 "感官干预 "旨在优化残疾人的听力和视力,从而改善其生活质量以及其他与痴呆症和护理伙伴相关的结果。结论 该干预措施是一项复杂干预措施的迭代开发成果,旨在满足残疾人和感官缺失者尚未得到满足的需求。
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引用次数: 0
Development of a Health Impact Assessment Implementation Model: Enhancing Intersectoral Approaches in Tackling Health Inequalities- A Mixed Methods Study Protocol 开发健康影响评估实施模型:在解决健康不平等问题中加强跨部门方法--混合方法研究规程
Pub Date : 2024-03-20 DOI: 10.12688/hrbopenres.13873.1
M. O'Mullane, Tara Kenny, Kirsty Nash, Sheena McHugh, Paul Kavanagh, Katherine Smith
Public health research presents compelling evidence that health is socially determined. To address structural inequalities and inequities in health, public policies require intersectoral development and implementation. Health Impact Assessment (HIA) is an established approach for analysing potentially detrimental health impacts of policies, programmes, and projects, as well as potentially positive impacts and opportunities. National public health policy, Healthy Ireland (2013–2025), endorses an intersectoral whole-of-system approach to ensure that health is a central part of all relevant policy areas. HIA is endorsed in this policy as one way to drive this agenda. Synergising with this policy commitment for HIA, the all-island Institute of Public Health Ireland produced revised HIA guidance in 2021. Two HIAs will be carried out as part of this project, including one at a local policy level, addressing the Cork City Development Plan (2022–2028), and the second HIA at a national policy level, addressing the Irish Government’s Climate Action Plan (2024). The updated HIA guidance will be used in the conduct of these HIAs. This research project involves a co-creation of a Health Impact Assessment Implementation Model by employing an action research approach with implementation science frameworks to the conduct of the two HIAs. Therefore, the process of doing the HIAs will form the basis for the research study. In order to enhance meaningful community involvement in HIA in Ireland, the project will co-create a Community Engagement Toolkit for HIA. This Model will strengthen researcher, policy actor, practitioner, community, and voluntary sector capacity to collaboratively develop and implement intersectoral and equitable policy responses to major population health issues.
公共卫生研究提出了令人信服的证据,证明健康是由社会决定的。为了解决结构性不平等和健康不公平问题,公共政策需要跨部门制定和实施。健康影响评估(HIA)是一种既定方法,用于分析政策、计划和项目对健康的潜在不利影响,以及潜在的积极影响和机遇。国家公共卫生政策《健康爱尔兰(2013-2025 年)》赞同采用跨部门的全系统方法,以确保健康成为所有相关政策领域的核心部分。该政策赞同将健康影响评估作为推动这一议程的方法之一。为配合这一健康影响评估政策承诺,爱尔兰全岛公共卫生研究所于 2021 年编制了经修订的健康影响评估指南。作为该项目的一部分,将开展两项 HIA,其中一项是地方政策层面的 HIA,涉及科克市发展计划(2022-2028 年);另一项是国家政策层面的 HIA,涉及爱尔兰政府的气候行动计划(2024 年)。在开展这些 HIA 时,将使用更新的 HIA 指南。本研究项目采用行动研究方法和实施科学框架,共同创建健康影响评估实施模型,以开展这两项健康影响评估。因此,进行健康影响评估的过程将成为研究的基础。为了加强爱尔兰社区有意义地参与 HIA,该项目将共同创建一个 HIA 社区参与工具包。该模式将加强研究人员、政策制定者、从业人员、社区和志愿部门的能力,以合作制定和实施跨部门和公平的政策,应对重大的人口健康问题。
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引用次数: 0
Understanding the determinants of the gender gap in physical activity and sports participation among young adults: a mixed-methods study 了解青壮年体育活动和运动参与方面性别差距的决定因素:一项混合方法研究
Pub Date : 2024-03-07 DOI: 10.12688/hrbopenres.13827.1
Hannah Cummins, Molly Byrne
Background An underexplored gender gap in physical activity (PA) and sport participation (SP) exists in those aged 18–24 in Ireland, with females less active than males. This research explored the determinants of PA and SP in both males and females through the lens of the Capability-Opportunity-Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework (TDF), to enhance our understanding of the gender gap. A mixed methods design was employed involving (1) a quantitative secondary analysis of existing data from the Irish Sports Monitor (ISM) 2019, an evaluation of Irish SP and PA conducted biennially by Sport Ireland, the governing body for sport development in the country, and (2) qualitative semi-structured interviews to explore determinants of PA and SP, using a framework analysis approach. Methods A secondary analysis of existing ISM 2019 data from 158 individuals was conducted to explore gender differences in PA and SP behaviours in relation to capability, opportunity, and motivation. To further explore these differences, individuals (n = 16, 75% female) aged 18–24 were then invited to take part in semi-structured interviews to better understand determinants of their PA and SP behaviours and explore their experiences of the gender gap. Results Despite the gender gap identified through the ISM 2019, a secondary analysis found no significant difference between genders on predictors of PA and SP based on overall COM-B scores. However, semi-structured interviews suggested gender differences regarding self-reported determinants of PA and SP, particularly within the domain of social influence. Conclusions Social influence may be an important factor to target, particularly in relation to perceived support and encouragement, to increase female engagement in PA and SP. More research is required to explore this potentiality.
研究背景 在爱尔兰,18-24 岁的青少年在体育锻炼(PA)和运动参与(SP)方面存在性别差异,女性比男性更不积极。本研究通过能力-机会-动机-行为(COM-B)模型和理论领域框架(TDF)的视角,探讨了男性和女性体育锻炼和运动参与的决定因素,以加深我们对性别差距的理解。我们采用了混合方法设计,包括:(1)对《2019 年爱尔兰体育监测报告》(ISM)中的现有数据进行二次定量分析,该报告是爱尔兰体育发展管理机构--爱尔兰体育局每两年对爱尔兰体育运动和运动能力进行一次评估;(2)采用半结构式定性访谈,使用框架分析方法探讨运动能力和体育运动的决定因素。方法 对来自 158 名个人的现有 2019 年国际体育管理数据进行了二次分析,以探索与能力、机会和动机有关的体育锻炼和运动行为的性别差异。为了进一步探究这些差异,研究人员邀请了 18-24 岁的个人(n = 16,75% 为女性)参加半结构式访谈,以更好地了解其 PA 和 SP 行为的决定因素,并探究他们对性别差距的体验。结果 尽管通过 2019 年 ISM 发现了性别差距,但二次分析发现,根据 COM-B 总分,在 PA 和 SP 的预测因素方面,两性之间没有显著差异。然而,半结构式访谈表明,在自我报告的运动量和运动时间的决定因素方面存在性别差异,尤其是在社会影响领域。结论 社会影响可能是一个重要的目标因素,特别是在感知到的支持和鼓励方面,以提高女性参与体育锻炼和运动的积极性。需要进行更多的研究来探索这一可能性。
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引用次数: 0
Protocol for a systematic review and critical discourse analysis of research on HIV pre-exposure prophylaxis programme use among gay, bisexual, and other men who have sex with men 对男同性恋、双性恋和其他男男性行为者中艾滋病毒暴露前预防方案使用情况的研究进行系统性审查和批判性论述分析的规程
Pub Date : 2024-02-29 DOI: 10.12688/hrbopenres.13841.1
David Comer, C. Noone
Background HIV pre-exposure prophylaxis (PrEP) is a pill that prevents the transmission of HIV from sexual partners living with HIV; it is frequently taken by gay, bisexual, and other men who have sex with men (gbMSM). PrEP is often provided through formal PrEP programmes. Research on these programmes may employ discourses shaped by heteronormativity and homophobia. Given that expert language influences how HIV prevention is understood and delivered, problematic discourses in research likely extends into PrEP programme implementation. This review will use critical discourse analysis (CDA) to explore research on PrEP programme implementation for gbMSM. Within this literature, we will identify interpretive repertoires used to discuss gbMSM; the subject positions afforded to gbMSM; and the implications of these interpretive repertoires and subject positions for gbMSM engaging with HIV PrEP programmes. Methods Relevant articles will be identified through timebound searching (2012-present) in ProQuest ASSIA, EBSCOhost PsycInfo, OVID Medline, OVID Embase, and EBSCOhost CINAHL, with forward and backward citation searching of included studies. Grey literature will be identified through ProQuest and Google Scholar. Screening will be conducted by two independent reviewers, who will conduct double screening for titles, abstracts, and full texts. Data will be analysed and synthesised using CDA informed by critical realism (CR). CDA focuses on relationships between language and power, including how language enables inequality. The analytic process will explore the background of included studies, identify overarching themes, analyse external and internal relations in included studies, and interpret the meaning of identified themes and relations. Conclusions Highlighting issues with discourses in PrEP implementation may enhance reflective engagement with assumptions underlying this research, preventing further stigmatisation of gbMSM’s sexual and protective practices. As PrEP programmes become more common globally, more diverse and inclusive perspectives in PrEP programme research may inform interventions that enhance their acceptability and ultimately their implementation.
背景 艾滋病毒暴露前预防(PrEP)是一种药片,可防止艾滋病毒从感染艾滋病毒的性伴侣处传播;男同性恋、双性恋和其他男男性行为者(gbMSM)经常服用这种药片。PrEP 通常通过正规的 PrEP 计划提供。对这些计划的研究可能会使用异性恋和仇视同性恋的话语。鉴于专家的语言会影响人们对艾滋病预防的理解和实施,研究中存在问题的论述很可能会延伸到 PrEP 计划的实施中。本综述将使用批判性话语分析(CDA)来探讨针对男男性行为者的 PrEP 计划实施研究。在这些文献中,我们将确定用于讨论 gbMSM 的解释性语汇;给予 gbMSM 的主体地位;以及这些解释性语汇和主体地位对参与 HIV PrEP 计划的 gbMSM 的影响。方法 将通过在 ProQuest ASSIA、EBSCOhost PsycInfo、OVID Medline、OVID Embase 和 EBSCOhost CINAHL 中进行限时检索(2012 年至今)来确定相关文章,并对纳入的研究进行正向和反向引文检索。灰色文献将通过 ProQuest 和 Google Scholar 查找。筛选将由两名独立审稿人进行,他们将对标题、摘要和全文进行双重筛选。将采用批判现实主义(Critical Realism,CR)的 CDA 方法对数据进行分析和综合。CDA侧重于语言与权力之间的关系,包括语言如何促成不平等。分析过程将探讨所纳入研究的背景,确定首要主题,分析所纳入研究的外部和内部关系,并解释所确定主题和关系的意义。结论 强调 PrEP 实施过程中的话语问题可能会加强对本研究基本假设的反思,从而防止进一步污名化男男性行为者的性行为和保护行为。随着 PrEP 计划在全球范围内的普及,在 PrEP 计划研究中采用更加多样化和更具包容性的视角可为干预措施提供信息,从而提高其可接受性,并最终提高其实施效果。
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引用次数: 0
Factors influencing the likelihood of accessing healthcare during the COVID-19 pandemic in Ireland: lessons for the future 影响爱尔兰 COVID-19 大流行期间就医可能性的因素:对未来的启示
Pub Date : 2024-02-26 DOI: 10.12688/hrbopenres.13829.1
Padraig Buggy, Mary Joyce, Ivan J. Perry, Mary R. Cahill
Background Implementation of public health measures during the first wave of the coronavirus disease (COVID-19) pandemic, including travel restrictions and physical distancing, may have impacted population behaviour in seeking medical care. Identifying barriers to accessing healthcare is important, especially for vulnerable groups. Methods Data were collected through a nationally representative cross-sectional telephone survey during the first period of easing of COVID-19 restrictions in May and June 2020. Secondary data analysis of the dataset was carried out to examine the factors influencing the likelihood of individuals avoiding General Practitioner (G.P.) and hospital-based care. Poisson regression analyses were conducted to estimate risk ratios with robust variance estimation of the association between selected demographic and self-reported health factors and the risk of avoiding G.P. and hospital-based healthcare. Results Of the 969 participants, 152 (15.7%) deliberately avoided contacting their G.P. about non COVID-19 related concerns while 81 (8.4%) reported avoiding hospitals. Three groups, women (Rate Ratio (RR): 1.75, 95% Confidence Interval (CI): 1.28 – 2.40), individuals who reported experiencing an adverse life event within the last 3 months (RR: 1.79, 95% CI: 1.33 – 2.40), and those at an increased risk of infection (RR: 1.65, 95% CI: 1.06 – 2.58) were more likely to avoid contact with their G.P. Individuals at a higher risk of avoiding hospital-based care were those aged 50 – 59 years (RR: 2.27, 95% CI: 1.03 – 4.98) and 70 years+ (RR: 2.73, 95% CI: 1.24 – 6.01), individuals at an increased risk of infection (RR: 2.07, 95% CI: 1.20 – 3.56), smokers (RR: 1.68, 95% CI: 1.02 – 2.77) and those who agreed they were “likely to catch COVID-19” (RR: 2.80, 95% CI: 1.25 – 6.25). Conclusion These findings highlight the importance of public health awareness and education regarding accessing healthcare during a pandemic and should be considered in future pandemic preparedness.
背景 在冠状病毒病(COVID-19)第一波大流行期间实施的公共卫生措施,包括旅行限制和物理距离,可能会影响人们的就医行为。识别就医障碍非常重要,尤其是对弱势群体而言。方法 在 2020 年 5 月和 6 月第一次放宽 COVID-19 限制期间,通过具有全国代表性的横断面电话调查收集数据。我们对数据集进行了二次数据分析,以研究影响个人避免接受全科医生(G.P.)和医院护理的因素。通过泊松回归分析,对选定的人口统计学因素和自我报告的健康因素与避免接受全科医生和医院医疗服务的风险之间的关系进行了风险比估算和稳健方差估算。结果 在969名参与者中,有152人(15.7%)故意避免就与COVID-19无关的问题与他们的全科医生联系,而81人(8.4%)报告说避免去医院。三个组别中,女性(比率比 (RR):1.75,95% 置信区间 (CI):1.28 - 2.40)、报告在过去 3 个月内经历过不良生活事件的人群(RR:1.79,95% CI:1.33 - 2.40)和感染风险较高的人群(RR:1.65,95% CI:1.06 - 2.58)更有可能避免与他们的普通医生联系。年龄在 50 - 59 岁(RR:2.27,95% CI:1.03 - 4.98)和 70 岁以上(RR:2.73,95% CI:1.24 - 6.01)、感染风险较高的人(RR:2.07,95% CI:1.20 - 3.56)、吸烟者(RR:1.68,95% CI:1.02 - 2.77)和认为自己 "可能感染 COVID-19 "的人(RR:2.80,95% CI:1.25 - 6.25)。结论 这些发现强调了在大流行期间开展有关获得医疗保健服务的公共卫生意识和教育的重要性,并应在未来的大流行准备工作中加以考虑。
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引用次数: 0
Impact of dietary fiber on gut microbiota composition, function and gut-brain-modules in healthy adults - a systematic review protocol. 膳食纤维对健康成年人肠道微生物群组成、功能和肠道-大脑模块的影响--系统综述方案。
Pub Date : 2024-02-26 eCollection Date: 2023-01-01 DOI: 10.12688/hrbopenres.13794.2
David Antoine Lachmansingh, Benjamin Valderrama, Thomaz Bastiaanssen, John Cryan, Gerard Clarke, Aonghus Lavelle

Background: The gut microbiota has been extensively implicated in health and disease. The functional outputs of the gut microbiota, such as microbial metabolites, are considered particularly important in this regard. Significant associations exist between alterations in the relative abundance of specific microbial taxa and mental health disorders. Dietary fiber has the potential to alter gut microbiota composition and function, modifying bacterial enzymatic function and the production of metabolites. As many taxa of microorganisms have enzymes capable of producing or degrading neurochemicals i.e. neuroactive gut brain modules, new predictive tools can be applied to existing datasets such as those harvested from dietary fiber interventions. We endeavor to perform a systematic review in order to identify studies reporting compositional gut microbiota alterations after interventions with dietary fiber in healthy individuals. We aim to also extract from the selected studies publicly available microbial genomic sequence datasets for reanalysis with a consistent bioinformatics pipeline, with the ultimate intention of identifying altered gut brain modules following dietary fiber interventions.

Methods: Interventional trials and randomized controlled studies that are originally published, including cross-over and non-crossover design and involving healthy adult humans will be included. A systematic search of PubMed/MEDLINE and EMBASE, two electronic databases, will be completed.

Discussion: Various types of dietary fiber have an impact on the gut microbiota composition, with some promoting the growth of particular taxa while others are reduced in relative abundance. Our search focuses on the impact of this food component on the microbiota of healthy individuals. Compositional gut microbial changes have been reported and our review will compile and update these observations after reanalysis of their datasets with a consistent bioinformatic pipeline. From this it may be possible to predict more detailed functional consequences in terms of neuroactive gut brain modules, of the compositional alterations in gut microbial taxa.

背景:肠道微生物群与健康和疾病有着广泛的联系。在这方面,肠道微生物群的功能输出(如微生物代谢物)被认为尤为重要。特定微生物类群相对丰度的改变与心理健康疾病之间存在着显著的关联。膳食纤维有可能改变肠道微生物群的组成和功能,改变细菌酶的功能和代谢物的产生。由于许多微生物类群都具有能够产生或降解神经化学物质(即具有神经活性的肠道脑模块)的酶,因此新的预测工具可应用于现有的数据集,如从膳食纤维干预措施中获得的数据集。我们努力进行系统性综述,以确定报告健康人膳食纤维干预后肠道微生物群组成改变的研究。我们还旨在从选定的研究中提取公开可用的微生物基因组序列数据集,利用一致的生物信息学管道进行重新分析,最终目的是确定膳食纤维干预后肠道大脑模块的改变:方法:将纳入最初发表的干预性试验和随机对照研究,包括交叉和非交叉设计以及涉及健康成年人的研究。将完成对 PubMed/MEDLINE 和 EMBASE 这两个电子数据库的系统检索:讨论:各种类型的膳食纤维会对肠道微生物群的组成产生影响,其中一些会促进特定类群的生长,而另一些则会降低相对丰度。我们的研究重点是这种食物成分对健康人微生物群的影响。已有关于肠道微生物组成变化的报道,我们的综述将在使用一致的生物信息学管道重新分析其数据集后,对这些观察结果进行汇编和更新。由此,我们有可能预测肠道微生物类群组成变化在神经活性肠道大脑模块方面产生的更详细的功能性后果。
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引用次数: 0
A protocol for a scoping review of methodologies used to explore patient experience in post-acute rehabilitation settings. 对用于探索急性期后康复环境中患者体验的方法进行范围审查的协议。
Pub Date : 2024-02-26 eCollection Date: 2023-01-01 DOI: 10.12688/hrbopenres.13672.2
Zsofia Torok, Aisling O'Keeffe, Andrew Darley, Áine Carroll

Background: Patient experience is routinely collected in the clinical environment in many different ways throughout various person-provider encounters, but so far limited research focused on understanding the methods of using it to improve the quality of healthcare. This paper presents a protocol for a methodological scoping review examining the methods of obtaining, analysing, reporting, and using patient experience data for quality improvement in rehabilitation settings.

Methods: The scoping review will be conducted according to the guidelines from the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and the methodological framework by Arksey & O'Malley. A comprehensive search of the literature will be performed using a three-step search strategy: an initial limited search of two databases was already performed and helped to identified relevant key words and index terms. The developed search string will be adapted and applied across four databases. This will be followed by search of the reference lists of selected sources and hand-search relevant data-hubs. Studies with a clear focus on patient experience or feedback collected or used for healthcare improvement in rehabilitation context, will be included. A data extraction framework will be developed and piloted to guide the literature screening and data charting. Qualitative content analysis will be employed to address research questions and the results will be presented - beside the descriptive format - as a map of data in chart and tabular formats.

Conclusions: This scoping review will show the extent and scope of the literature on the applied methods of collecting, communicating, and using patient experience for quality improvement in post-acute rehabilitation settings and will evaluate and map the evidence on these topics. The findings will inform a research project entitled "An exploration into the use of patient experience to inform improvement in a National Rehabilitation Hospital".

背景:在临床环境中,患者体验通常是通过各种不同的方式收集的,贯穿于人与医疗服务提供者的各种接触中,但迄今为止,专注于了解利用患者体验提高医疗质量的方法的研究十分有限。本文提出了一个方法学范围综述的方案,研究在康复机构中获取、分析、报告和使用患者体验数据以提高质量的方法:将根据乔安娜-布里格斯研究所(Joanna Briggs Institute,JBI)的《证据综合手册》指南和 Arksey & O'Malley 的方法论框架进行范围界定综述。将采用三步检索策略对文献进行全面检索:已对两个数据库进行了初步的有限检索,并帮助确定了相关的关键词和索引词。开发的搜索字符串将在四个数据库中进行调整和应用。随后将对选定资料来源的参考文献目录进行检索,并手工检索相关数据集。将纳入明确关注患者体验或收集或用于改善康复医疗的反馈的研究。将制定并试行一个数据提取框架,以指导文献筛选和数据制图。将采用定性内容分析来解决研究问题,除描述性格式外,还将以图表和表格形式展示数据图谱:本次范围界定综述将展示有关收集、交流和使用患者体验的应用方法的文献的程度和范围,以改善急性期后康复机构的质量,并将评估和绘制有关这些主题的证据图。研究结果将为题为 "探索利用患者体验为国家康复医院的改进提供信息 "的研究项目提供参考。
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引用次数: 0
Mapping the HealthPathways literature: a scoping review protocol 绘制健康之路文献:范围界定审查协议
Pub Date : 2024-02-20 DOI: 10.12688/hrbopenres.13737.1
A. McGlynn, Éidín Ní Shé, Teng Liaw, Tony Jackson, Ben Harris-Roxas
Objective: This scoping review will identify what literature exists on HealthPathways and make suggestions for the direction of future HealthPathways research. Background: HealthPathways is a free to access, password protected online tool containing practical, easy to use, localised clinical and referral information that is primarily aimed at GPs. HealthPathways originated in Canterbury, New Zealand in 2008. Since this time the program has spread and is being used in 50 health systems across New Zealand, Australia, and the United Kingdom (Streamliners, 2022a). Despite such large spread of the program there has been relatively little literature published on the utility, usefulness and cost-effectiveness of HealthPathways. This scoping review aims to identify and describe all current HealthPathways literature and make recommendations for the direction of future HealthPathways research. Methods: The Joanna Briggs Institute (JBI) methodology will be used to develop the scoping review. Databases included in the search include MEDLINE (PubMEd), Embase, CINAHL, Web of Science, Google Scholar, Emerald and Cochrane. The inclusion criteria are studies and grey literature on HealthPathways that are published in English, with no time limit. Grey literature will be identified through searching relevant credible organisations and websites. All results will be entered into Covidence to be assessed by two reviewers against a set tool. The PRISMA extension for scoping reviews will be used for reporting. Ethics approval is not required as only published information will be used. The research will be disseminated through publication in an open access peer reviewed journal. Conclusions: This protocol is published to make the process for the review transparent and replicable. The scoping review will highlight the extent of evidence that exists on HealthPathways and may provide direction for decision making and future research.
目标:本范围综述将确定现有的健康之路文献,并就未来健康之路研究的方向提出建议。背景介绍健康之路(HealthPathways)是一个免费访问、密码保护的在线工具,包含实用、易用、本地化的临床和转诊信息,主要面向全科医生。HealthPathways 于 2008 年起源于新西兰坎特伯雷。从那时起,该程序就开始推广,目前已在新西兰、澳大利亚和英国的 50 个医疗系统中使用(Streamliners,2022a)。尽管该计划得到了如此广泛的推广,但有关 HealthPathways 的实用性、有用性和成本效益的文献却相对较少。本范围综述旨在识别和描述目前所有的健康之路文献,并对未来健康之路的研究方向提出建议。研究方法:将采用乔安娜-布里格斯研究所 (Joanna Briggs Institute, JBI) 的方法进行范围界定综述。检索数据库包括 MEDLINE (PubMEd)、Embase、CINAHL、Web of Science、Google Scholar、Emerald 和 Cochrane。纳入标准是以英文发表的有关 HealthPathways 的研究和灰色文献,没有时间限制。灰色文献将通过搜索相关可信组织和网站来确定。所有结果都将输入 Covidence,由两名审稿人根据设定的工具进行评估。在报告时,将使用用于范围界定审查的 PRISMA 扩展工具。由于只使用已公布的信息,因此不需要伦理审批。研究成果将通过在公开的同行评审期刊上发表的方式进行传播。结论:发布本协议是为了使审查过程透明化并具有可复制性。范围界定审查将强调健康之路现有证据的范围,并为决策和未来研究提供方向。
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引用次数: 0
Exploring Breastfeeding Mothers’ and Lactation Consultants’ Experiences of Lactation Consultancy Throughout the Restrictions Put in Place Due to the COVID-19 Pandemic 探索母乳喂养母亲和催乳顾问在 COVID-19 大流行所实施的限制条件下接受催乳咨询的经历
Pub Date : 2024-02-19 DOI: 10.21203/rs.3.rs-2349921/v1
Anna Connolly, Anne Matthews
Background Breastfeeding rates in Ireland are among the lowest in the world. Lactation consultancy provides mothers with support and information on how to cope with any challenges they encounter. There is emerging evidence that COVID-19 restrictions impacted access to and the quality of breastfeeding support. The aim of this study was to explore breastfeeding mothers’ and lactation consultants’ experiences of breastfeeding support throughout the COVID-19 restrictions in Ireland. It also aimed to explore what adaptations had to be made to the delivery of lactation consultancy and how these changes impacted mothers’ experiences of breastfeeding support. Methods A qualitative research design was chosen. Semi-structured interviews were conducted with eight participants, three breastfeeding mothers and five lactation consultants. Interviews were conducted online via Zoom, audio-recorded and transcribed. The data were analysed using thematic analysis. Results Five key themes were identified: ‘Lack of Support’, ‘Adapting to COVID-19 Restrictions’, Emotional Response to COVID-19 and Restrictions’, Vaccination as a Barrier to and Facilitator of Support’ and Inconsistency of Lactation Support Across Ireland’. Both lactation consultants and mothers identified similar issues however, slight variations within lactation consultants' perceptions of mothers’ and mothers’ attitudes towards online services were seen. An unanticipated finding was the lack of support in hospitals pre-COVID-19. Conclusions Both mothers’ and lactation consultants’ experiences of lactation consultancy were impacted by the COVID-19 restrictions. Although exacerbated by COVID-19, the lack of support in hospitals existed before COVID-19. Provision of better breastfeeding support is required. Increased availability of lactation consultants and the implementation of breastfeeding rooms within hospitals is required in addition to debrief counselling sessions for lactation consultants. Further research is required to understand the unavailability of lactation consultants in hospital settings and to identify how to manage breastfeeding support in future emergency situations.
背景 爱尔兰是世界上母乳喂养率最低的国家之一。母乳喂养咨询为母亲们提供支持和信息,帮助她们应对遇到的任何挑战。有新证据表明,COVID-19 限制影响了母乳喂养支持的获取和质量。本研究的目的是探讨哺乳母亲和哺乳顾问在爱尔兰 COVID-19 限制期间获得母乳喂养支持的经验。本研究还旨在探讨在提供哺乳顾问服务时需要做出哪些调整,以及这些调整如何影响母亲们对母乳喂养支持的体验。研究方法 采用定性研究设计。对八名参与者(三名母乳喂养的母亲和五名哺乳顾问)进行了半结构化访谈。访谈通过 Zoom 在线进行,并进行了录音和转录。采用主题分析法对数据进行了分析。结果 确定了五个关键主题:缺乏支持"、"适应 COVID-19 限制"、"对 COVID-19 和限制的情绪反应"、"疫苗接种是支持的障碍和促进因素 "以及 "爱尔兰各地哺乳支持的不一致性"。哺乳顾问和母亲都发现了类似的问题,但哺乳顾问对母亲的看法和母亲对在线服务的态度略有不同。一个意料之外的发现是,COVID-19 之前的医院缺乏支持。结论 母亲和哺乳顾问的哺乳咨询经验都受到了 COVID-19 限制的影响。尽管 COVID-19 加剧了这种情况,但在 COVID-19 之前,医院就已经缺乏支持。需要提供更好的母乳喂养支持。除了为哺乳顾问提供汇报咨询外,还需要增加哺乳顾问的数量,并在医院内设立母乳喂养室。需要开展进一步的研究,以了解在医院环境中无法提供哺乳顾问的情况,并确定在未来紧急情况下如何管理母乳喂养支持。
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引用次数: 0
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