Specifications: Permanent – Full Time
Salary:  £64,000 per Annum  
Location: (Remote – Flexible) Candidates anywhere from the world will be considered; however, Cochrane’s Central Executive Team is only able to offer consultancy contracts outside these countries.
Closing date:  9 February, 2024 

Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters around the world. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into four directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

To lead and hold responsibility for Cochrane’s editorial operations, and to support the Deputy Operations Manager and Editor in Chief of Cochrane in achieving the strategic aims and delivering the objectives of the Cochrane Evidence Production and Methods Directorate (EPMD).   

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everything we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.  

You can expect:  

• An opportunity to truly impact health globally.  
• A flexible work environment  
• A comprehensive onboarding experiences.
• An environment where people feel welcome, heard, and included, regardless of their differences.

Cochrane welcomes applications from a wide range of perspectives, experiences, locations, and backgrounds; diversity, equity and inclusion are key to our values.

How to apply

• For further information on the role and how to apply
• The deadline to receive your application is 9th Feb, 2024.
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples. 
• Read our Recruitment Privacy Statement

Wednesday, January 24, 2024 Category: Jobs

急性心肌梗塞（俗称心脏病发作）后服用非维生素K拮抗剂口服抗凝剂（有助于防止血栓形成）有什么好处和坏处 关键信息 ·与安慰剂（虚拟治疗）相比：利伐沙班（rivaroxaban）降低急性心肌梗塞发生后的全因性死亡率（任何原因造成的死亡）及心血管相关死亡率（心血管疾病造成的死亡）。达比加群（dabigatran）降低全因性死亡率，但似乎无法降低心血管相关死亡率。阿哌沙班（apixaban）则与安慰剂效果差不多，无法降低急性心肌梗塞发生后的全因性死亡率及心血管相关死亡率。 ·与安慰剂相比，阿哌沙班和利伐沙班都提高了出血的风险。 ·有必要做非维生素K拮抗剂口服抗凝血剂互相比较的研究。 什么是急性心肌梗塞？ 急性心肌梗塞是指供給心肌的血流突然被阻断，导致组间损伤，造成危害生命的状况。临床上，如何替发生过急性心肌梗塞的病人选择最佳治疗方案仍是个挑战。自急性心肌梗塞康复的病人，尽管使用了抗凝血药物（预防血小板凝集成血栓）治疗，其死亡风险仍高。 我们为何要做该Cochrane综述？ 本综述的目的：探讨发生急性心肌梗塞后的病人，使用抗血小板药物加上非维生素K拮抗剂口服抗凝血剂（俗称新一代的血液稀释剂），比较单独使用抗血小板药物，是否更加安全且有效。非维生素K拮抗剂口服抗凝血剂透过延长血液凝集的时间或改变血栓形成的途径，达到预防血栓形成效果。 我们做了什么? 我们检索发生急性心肌梗塞后的病人，使用抗血...

Poster sessions are a key component of most academic conferences. However, rows of text-heavy posters can be difficult for attendees to navigate, particularly for those for whom English is not their native language, or who may be neurodivergent or disabled. Cochrane recently teamed up with researchers to introduce poster templates for the Cochrane Colloquium based on the latest research. The results from the 'real world' assessment are now available. We spoke with the researchers to find out more. 

Can you tell us a bit about your elite poster research team, so we have an understanding of how you are approaching academic posters?Sure! Our team includes Dr. Zen Faulkes, author of the book “Better Posters” and founder of the Better Posters blog; Dr. Mike Morrison, the psychologist who created a redesign for scientific posters that went viral and started the #BetterPoster movement; and Dr. Emily Messina and her colleagues at IPG Health Medical Communications (Noofa Hannan, Victoria Evans, and Anja Petersen) and Helios (James Wells).  

What do you see as the purpose of academic posters?
For all the criticism posters get, they have incredible potential and play a crucial role in science communication. A scientific poster session is one of the only learning environments in science where researchers walk into a room completely open to learning. So, a key function of scientific posters is to give scientists broad, serendipitous insight into work going on across their whole field. Poster sessions are also a great way to meet people with similar research interests. Networking is a key purpose of attending a poster session, but the job of the poster itself is to communicate key ideas quickly (and engagingly!) in a stressful and demanding, busy environment.

Most conference attendees can probably relate to this. Most academic posters follow the same format that they always have. What’s wrong with them?
Imagine that you’re standing in front of a wall where somebody has taped up printed pages of a scientific paper, and you’re trying to read all that dense text and those tiny figures on the pages from four feet away. Now imagine trying to do that while there are a hundred other similar ‘posters’ you would like to see in a short time, while also trying to listen in to what the presenters are saying. Now imagine trying to do that if you’re someone with low vision or a processing disorder that amplifies the lights and sounds in the room. It’s difficult to learn anything from the poster in that context, which is why people often just give up and ask the presenter to explain the study, or just walk away.

That’s the core problem with the traditional scientific poster design: it ignores the context of just how busy and overwhelming the room is. This could be because the traditional design was created decades ago when poster sessions were much smaller.

There is also a harmful feedback loop in scientific poster design, where authors with (typically) no design training feel like they need to ‘fill up all the space’ with text and figures to ‘show that they did work’, and then the poster session attendees learn just to accept that cluttered posters will always be the norm and have to make do with them.

We had over 300 posters at Cochrane Colloquium and walking through them you could see many people used the accessible template. It felt less mentally overwhelming and was fantastic to walk around and learn from them. Can you tell us a bit more about the templates offered?
The #BetterPoster template we provided was based on the latest research in instructional design, accessibility, and eye tracking. It was designed to teach people something (typically the main finding) from a far distance; making it possible for them to learn something from every poster in the room, not just the few that they stop at. Then, the remainder of the poster is designed to quickly communicate additional details (limitations, key figures, methods) still visible at about 3ft. The figures also include mini takeaways, to help people interpret graphs while also trying to, for example, pay attention to you, the presenter. Finally, it includes a QR code that people can scan to get the author’s contact details or read the whole paper. The template was just that – a starting point to make it easier for people to get creative and make their own accessible posters. It was wonderful seeing people use the template whilst also adding their own touches.

At the event you made observations, interviewed people, and did a survey of attendees afterwards. What did you learn?
It was a great three days at the Cochrane Colloquium, seeing the poster template being embraced and people’s response to it. We just got back from presenting our findings at the 2024 European Meeting of the International Society for Medical Publication Professionals. Our survey and interviews found that more accessible poster designs may improve engagement and communication at conferences. People found the posters with large figures and limited text to be more engaging; posters using the template were cited as memorable or informative; and they were also easier to understand. 

That's fantastic. This template was made specifically for the Cochrane Colloquium. What can researchers and those creating posters for any conference take away from this?
While the template was designed to the specifications of the Cochrane event, you can tailor them to any event that you need to present a poster at! We encourage all academics to download the template and adjust it as they need to. We're excited to see what you come up with; please tag pictures of your poster with #BetterPoster on social media so we can see them!

• Learn more about the research findings
• Learn more about the accessibility of different conference presentation formats
• Download the #BetterPoster template

Wednesday, January 31, 2024

新生儿消化道术后使用益生菌的好处和坏处 关键信息 ·怀孕35周后出生的婴儿，在接受过食道、胃或肠等消化道手术后，补充益生菌对血液感染风险影响很小或没有影响。 ·益生菌可能会增加肠道中“好”菌的比例，但我们不知道这对婴儿是否有任何真正的好处。 什么是益生菌？ 益生菌是活菌，食用后可能对健康有益。有证据显示，益生菌可以预防坏死性小肠结肠炎等肠道发炎性疾病，以及早产儿感染。 婴儿消化道手术有哪些风险？ 消化道手术会增加感染风险，感染会增加住院时间。而使用对抗细菌感染的药物进行抗生素治疗，以及手术本身所造成的压力，都会破坏消化道中的“好”菌。 我们想知道什么？ 我们想了解怀孕35周后出生，且接受胃或肠道手术的婴儿使用益生菌，是否能改善感染率、住院时间、死亡率、喂食状况以及肠胃道中“好”菌的比例。 我们做了什么？ 我们检索一些研究，这些研究将接受过消化道手术的婴儿随机分配为：实验组（给予益生菌），或安慰剂组（给予不含任何药物成分，但外观或口味都相同的假治疗），或不进行任何治疗。 我们发现了什么？ 有一项小型研究，对象是61位35周后出生且接受消化道手术的婴儿。其中30位婴儿在术后接受益生菌，30位接受安慰剂。 益生菌组中有13%的婴儿出现血液感染，而安慰剂组有19%。未呈现显著差异。 平均而言，益生菌组比安慰剂组的婴儿约提早15小时开始使用胃部进食。这种差异同样不显著。 其中39名婴儿经过...

Monday, January 22, 2024

Cochrane is an international, not-for-profit network of clinicians, patients and carers, researchers, and policy-makers creating high-quality healthcare evidence synthesises. Cochrane has a long and rich history of collaborating with healthcare consumers and this is the story of what breast cancer patients experienced when contributing to a Cochrane Review.  

In 1995, Nora Carbine and Liz Lostumbo, both former breast cancer patients, embarked on a transformative journey as attendees of the Leadership, Education, Advocacy, and Development (LEAD) program developed by the National Breast Cancer Coalition (US). Designed to equip patients with the necessary scientific and leadership essentials for becoming proactive advocates, this five-day initiative taught by notable scientists provided a platform for people with breast cancer to amplify their voices.  

One of the founders of LEAD and a course teacher was  Kay Dickerson MD, an epidemiologist and an active Cochrane member. Post-LEAD, Dr. Dickerson encouraged them to form a Journal Club, meeting monthly with her. Initially guided by Dr. Dickerson's article choices, the members eventually took the reins, presenting their findings on breast cancer research articles. Over a transformative two-year period, they developed their skills in scrutinizing research methods, assessing statistical validity, and distinguishing misinformation. Dr. Dickerson proposed to the group – would they be interested in leading on conducting a Cochrane systematic review on mastectomy to prevent breast cancer (prophylactic mastectomy)? 

A determined group of seven breast cancer advocates undertook the challenge to provide accessible information on prophylactic mastectomy for both patients and physicians, emphasizing the importance of informed decision-making. Guided by Dr. Dickerson and Davina Ghersi at Cochrane, they submitted their plan of study (Protocol) to Cochrane in 2000. They would gather at each other’s houses after work or on a Saturday morning and go through article after article, debating which ones to include and which to exclude. Despite one of the original members and driving force, Annette Drummond, becoming seriously ill with a recurrence of breast cancer, other members dropping out, and the abundance of evidence they had to wade through, the Cochrane review published in 2004, four years after this remarkable journey started.  

A unique feature of Cochrane reviews is that they are updated when new evidence is available. Classes in RevMan (Cochrane’s software for preparing and maintaining Cochrane and other systemic reviews) were taken and more people were added to the team, including an experienced reviewer. The first updated review was published in 2010. 

“Actress Angelina Jolie revealing her family history and her procedures coupled with the increasing availability of DNA testing, thrust the topic of mastectomy for breast cancer prevention into the limelight," says Liz Lostumbo. “We worried that women facing the decision of whether to undergo a prophylactic mastectomy might only encounter anecdotes in the popular media. We were particularly concerned about the lack of discussion concerning the quality of life for patients after mastectomy. The Cochrane review and its accompanying plain language summary became our means of addressing the critical gap in knowledge." 

For the third revision in 2018, they brought in more expertise and updated the wording, changing “prophylactic mastectomy” to “risk-reducing mastectomy”. The review is highly cited, has been made into a Cochrane Clinical Answer for clinicians, and has been included in three clinical guidelines. The plain language summary has been translated into 8 languages making it more accessible globally to patients making a decision and has been included in several Wikipedia articles.  

Nora and Liz note that they will hand other future updates to authors who can break the review into parts that ask more concise questions and produce more high-value conclusions – some of this work is already underway.  

“For us, the whole process of being the only group of patients to take on the responsibility of preparing a review and updating it was one of great satisfaction and pride,” says Nora Carbine. “We believe our work has helped thousands of women facing the decision of having a mastectomy to prevent breast cancer by providing evidence they need to be well informed to make their choice. We applaud Cochrane for giving us the opportunity and thank those who supported us in our endeavour.” 

Cochrane is extremely proud of Nora and Liz and all our patient and advocate volunteers. “While the work of Nora and Liz is extraordinary, it embodies the spirit of what Cochrane is trying to achieve.  We are proud to engage with patients to co-produce health evidence that is meaningful, easy to understand, and can be used for decision-making,” explains Richard Morley, Cochrane’s Consumer Engagement Officer. “The Cochrane Consumer Network has played a formal role since 1995 with over 2,000 members and Cochrane has a formal framework for involving patients, carers, and the public. While it’s likely most patients and caregivers aren’t as ambitious to author a Cochrane systematic review, we do hope this story is an inspiration for others to join our work.” From learning about health evidence and making informed health choices to volunteering to read over our plain language summaries on our volunteer hub Cochrane Engage, there are lots of ways you too can make a global impact on health! 

• Read a more detailed account of Nora and Liz’s story 
• Join Cochrane’s work as a patient, carer, or member of the public 

Tuesday, March 19, 2024 Category: The difference we make

无药物治疗用于新生儿气管内吸痰疼痛 关键信息 轻轻地将婴儿保持在膝盖弯曲的姿势（促进缩拢，当婴儿俯卧或脸朝上的仰卧或者头部偏向一侧并俯卧着肚子时即轻柔地将婴儿的手臂及腿放置靠近婴儿弯曲的身体中线位置）可能有效减轻机器通气新生儿气管内抽痰时的疼痛感。 什么是气管内抽痰？ 气管内管是一种易弯曲的塑料管，透过鼻子或嘴巴放置于气管内，以保持使用机械性通气新生儿的呼吸道畅通（机械性呼吸器用于帮助新生儿呼吸）。 气管内管尖端需要被抽吸以保持清洁、通畅及无分泌物，好让婴儿能吸到氧气。气管内抽吸是常规护理程序。对婴儿来说是疼痛且不舒服的。 我们想要了解什么？ 我们想了解如何在不使用药物的情況下减轻抽吸婴儿气管内时的疼痛。 我们做了哪些研究？ 我们检索了医学资料库中的临床研究，寻找减轻婴儿气管内抽吸时疼痛的方法。 我们发现了什么? 我们发现八项研究，包括386名婴儿。 我们评估了六种不同方法在不使用药物的情况下减轻婴儿气管内抽吸疼痛的效果，例如： – 轻柔地将婴儿抱在促进缩拢的位置； – 熟悉的气味（母乳气味）； – 使用糖溶液（蔗糖）； – 使用挤出的母乳； – 白噪音； – 襁褓。 主要研究结果 在使用呼吸器的新生儿中 促进缩拢可能会减轻气管内抽吸过程中的疼痛。 熟悉的气味和白噪音在气管内抽吸过程中几乎没有或没有影响。使用挤出的母乳或口服蔗糖显示出，在减轻气管内抽吸过程中的疼痛方面，两者都没有...

A new Cochrane Library Editorial has been published about the history of a recently updated Cochrane review on healthcare decision aids and its implications for practice. There is also an accompanying podcast where you can hear the current lead author explain the need for the review and its latest findings in under four minutes.

Decision aids are one type of tool that can be used to support the process of shared decision making between patients and their health professionals, a key element of person-centred care and health system improvements. A major update to the landmark Cochrane review on decision aids has just been published with an analysis of 209 studies involving 107,698 participants. It provides clear evidence of the benefits of the use of decision aids over usual care across a huge array of health options, ranging from choices about cancer screening to decisions about major elective surgery.

An accompanying editorial describes the influence of this review on practice for over 20 years, with successive updates responding to the changing understanding of decision aids and shared decision-making over this time. The review has been referred to in more than 90 clinical practice guidelines and has been one of the most cited reviews published in the Cochrane Library for over a decade. 

With more convincing evidence of the benefits of using decision aids now available, the editorial discusses implications for practice and highlights some remaining challenges of implementing decision aids. This Cochrane review will continue to be updated and the authors hope to see the findings not only reflected in many guidelines but implemented across many health systems. 

• Read the Cochrane Library editorial 
  Ryan RE, Hill S. Decision aids: challenges for practice when we have confidence in effectiveness. Cochrane Database of Systematic Reviews 2024, Issue 1. Art. No.: ED000164. DOI: 10.1002/14651858.ED000164.

• Read the Cochrane review
   Stacey D, Lewis KB, Smith M, Carley M, Volk R, Douglas EE, Pacheco-Brousseau L, Finderup J, Gunderson J, Barry MJ, Bennett CL, Bravo P, Steffensen K, Gogovor A, Graham ID, Kelly SE, Légaré F, Sondergaard H, Thomson R, Trenaman L, Trevena L. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews 2024, Issue 1. Art. No.: CD001431. DOI: 10.1002/14651858.CD001431.pub6.
  
  
  
  
• Listen to the podcast
  Current lead author, Dawn Stacey from the University of Ottawa and Ottawa Hospital Research Institute in Canada, explains the need for the review and its latest findings in under 4 minutes.
  
  

• Evidently Cochrane blog - Decision aids: helping people make better healthcare choices
  When faced with healthcare choices, how do we work out what to do? Decision aids can help, as can good conversations with our clinicians as part of shared decision-making, discussions that take into account clinical expertise, evidence and personal factors such as our preferences and circumstances. This blog includes Joanna’s story of her experience of making an important treatment decision but without the benefit of supportive discussions with her surgeon, plus some Cochrane evidence and useful UK resources.

Monday, January 29, 2024 Category: The difference we make

In celebration of 2024 International Women's Day (IWD), Cochrane is delighted to share a recording of an event showcasing a diverse panel of speakers discussing the IWD 2024 theme of #InspireInclusion

Tiffany Duque, Cochrane US Senior Officer, Panelist, and 2022 winner of the Anne Anderson Award says, "The 2024 IWD event was organized and hosted by our talented Cochrane US Mentees. This marks the third cohort through the Cochrane Mentoring program and the third IWD event. Hailing from 21 different countries, participants range from students to early career professionals, all poised for a bright future within Cochrane. We were delighted that they could once again host this cherished event. Thank you to everyone who attended and we invite everyone to watch the recording."

• #InspireInclusion in health: What is the first step? from Dr Luis Gabriel Cuervo Amore
•   Women in Science: Strategies to Call to Action from Dr Vivian Welch
•  Mentee & Mentor: different languages, different cultures, and how to foster inclusion together from Kehinde Ayomide Agubosim and Dr Karen Gibbs

Paola Andrenacci, Cochrane US Mentor Program Coordinator, and lead for this event, shares her excitement, "We are thrilled about the turn out to this webinar and so happy we can expand the reach with this recording. It was wonderful to bring together this dynamic group to discuss issues of inspiring inclusion in healthcare. Their diverse perspectives and experiences can help us identify barriers to equity and work towards solutions benefiting everyone. I encourage everyone to watch and share the recording! A special thank you to our  Moderators Maya Abdelwahab, Claudia De Santis, Julia Costa-Maria Carolina Isaza."

Related resources:

• VIDEO: 2023 International Women's Day Panel on embracing equality
• VIDEO: 2022 International Women's Day Panel on gender bias in health science and evidence synthesis
• VIDEO: 2021 International Women's Day Panel on diversity in health evidence synthesis
• Celebrating Anne Anderson and Cochrane diversity with new designs: an interview with artist Heather Tubwon
• Cochrane Indonesia’s Director reflects on her continued contributions to maternal and perinatal health and the work of Cochrane

 

Friday, March 8, 2024

对于接受非紧急髋关节或膝关节手术的患者来说，止血的最佳药物是什么？ 关键信息 • 氨甲环酸（Tranexamic acid, TXA）可能是一种有效的药物，可在髋关节或膝关节置换手术期间帮助血液凝固，从而减少出血量以及需要输血的情况（用捐赠的血液替换失去的血液）。 • 使用高剂量的TXA，并以多种方式给药（例如，以片剂服用和手术结束时注射到关节内）似乎效果最佳。 • 当以片剂形式给予时，TXA的效果可能与静脉注射相当。 • 似乎没有证据显示，较高剂量的TXA会增加腿部血栓或其他危害的风险。 背景 在髋关节或膝关节手术期间止血的重要性是什么？ 手术期间控制出血降低了病人发展成贫血并需要输血的可能性，这同时也减少了并发症的风险。当携带氧气的红血球（血红蛋白）数量低于正常水准时，就会出现贫血。这将导致疲劳、虚弱、晕眩、呼吸急促等症状，严重时可能危及性命。在手术期间预防失血有助于改善患者的手术结局、降低医疗成本，并保留供应有限的捐赠血液。 是否有可以帮助控制出血的药物？ 许多研究已探讨特定药物，如TXA，是否有助于在手术期间最小化失血量。大多数研究测试不同剂量的药物、不同的给药方式以及在手术前、期间或术后不同的使用时间。 我们想知道什么？ 我们想要了解药物是否能够减少接受髋关节或膝关节置换手术的病人的失血量，以及减少需要输血的情况。我们也想知道给予病人这种药物最有效的方式是什么。 我们做...

Monday, January 15, 2024

Specifications: Permanent – Full Time (1.0 FTE)
Salary:  £36,000 per Annum  
Location: (Remote – Flexible) Ideally based in the UK, Germany or Denmark. Candidates anywhere from the world will be considered; however, Cochrane’s Central Executive Team is only able to offer consultancy contracts outside these countries for 1-Year.
Closing date: 28 January 2024
 
Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters around the world. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into four directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

The Cochrane Support and Training Officer will work within the Cochrane Support Team, with special responsibility for providing training to internal Central Executive Team colleagues, Cochrane authors, and Cochrane Group staff. Training will focus on new Review Manager (RevMan) project and portfolio management features in 2024. The role also includes ongoing internal training responsibilities.   

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everything we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.  

You can expect:  

• An opportunity to truly impact health globally.  
• A flexible work environment  
• A comprehensive onboarding experiences.
• An environment where people feel welcome, heard, and included, regardless of their differences.

Cochrane welcomes applications from a wide range of perspectives, experiences, locations, and backgrounds; diversity, equity and inclusion are key to our values.

How to apply

• For further information on the role and how to apply
• The deadline to receive your application is 28th January 2024.
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正念强化育儿项目用于改善儿童及父母的结局 关键信息 • 正念强化育儿培训项目可能改善一些儿童和家长的结局，包括儿童情绪和行为调整、育儿技能、父母抑郁和焦虑、育儿压力和家长正念。 • 当正念育儿培训与基于技能的育儿培训项目结合时，可能会减轻育儿压力。 • 目前的证据有限，需要更多研究来证实我们的发现。 儿童情绪及行为障碍 情绪及行为障碍在儿童中很常见，其特征为一系列随着时间推移高度稳定的外化或内化行为。它们是儿童时期功能障碍的重要因素，并预测了青春期及未来时期较差的心理社会、学业和就业功能。情绪及行为障碍的普遍性、稳定性和长期结果凸显了在行为模式较为容易修正的童年时期进行干预的重要性。 为什么是正念强化育儿培训？ 育儿在儿童情绪及行为障碍的发展和/或维持中扮演着重要角色。传统的基于行为或技能的父母培训项目已被证明对一系列儿童和家长结局有积极的影响，但它们并不适合所有家长。造成这种情况的原因之一可能是父母的情感反应可能阻碍他们有效地运用育儿技能。纳入额外成分用于改善父母情绪反应的育儿项目可能会提高这些项目的结局。最近的研究显示，正念育儿干预可以通过改善父母调节情绪和压力的能力来促进父母和孩子的积极结局。因此，将正念育儿方法与传统的育儿培训项目相结合可能对父母及其孩子均有益。 我们想要发现什么？ 我们探讨了包含正念元素的基于行为或技能的父母培训项目—“正念强化”育儿培训项目—是否可以改...

医生使用危险信号来检查新发现背痛的患者的椎体骨折情况 编辑注释:  请参阅https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014461.pub2/full以查看有关此主题的最新综述；此综述已替换。 本综述描述了对一种常见做法的认识，即，当患者向家庭医生、背痛诊所或可治疗新发背痛的急诊室进行求医时，检查脊髓损伤。 医生通常会问一些问题，并检查背部，以判断脊柱骨折的可能性。 检查骨折的原因是，普通背痛和骨折的治疗方法不同。 骨折通常通过X光片进行诊断，然后通过休息、使用背部支架和服用止痛药进行治疗。 常见的背痛可以通过运动、脊椎按摩推拿和服用止痛药来治疗；而X射线、计算机断层扫描（computed tomography, CT）和磁共振成像扫描对诊断没有帮助。 骨折是少见的，在向家庭医生求医的病例中，骨折导致背痛占1%至4.5%。 纳入数千名患者在内的8项研究描述了29个不同的问题和用于检查脊柱骨折的体检测试。 这29个测试中的大多数都不准确。 四个最好的问题询问了类固醇的使用（这会导致骨质疏松）、病人年龄（超过74岁会增加骨折风险）和近期创伤（比如跌倒）。 使用最佳问题的组合似乎可以提高准确性。 例如，在表达主诉是背痛时，74岁以上女性的病因更有可能是骨折。 在急诊室，最能判断脊椎骨折的迹象是背部疼痛...

口服灭活霍乱疫苗预防霍乱 关键信息 接种两剂全细胞重组疫苗（(whole-cell plus recombinant vaccine, WC-rBS vaccine (Dukoral)），无论是否接种加强剂，均可在2年内减少霍乱病例。 两剂二价全细胞疫苗（bivalent whole-cell vaccine, BivWC vaccine (Shanchol)）可在5年内减少霍乱病例。 单剂Shanchol可在2年内减少霍乱病例和严重脱水的霍乱病例。 这些疫苗被认为是安全的，所有组别都报告了类似的副作用。 还需要进一步研究，以评估单剂Shanchol和两剂Dukoral在5年随访期间的有效性。 我们没有发现关于其他BivWC疫苗（如Euvichol或Euvichol-Plus）的试验。然而，所有BivWC疫苗杀死霍乱弧菌的能力都是相同的。因此，将Shanchol试验的结果应用于Euvichol和Euvichol-Plus是合理的。 什么是霍乱？ 霍乱是一种由 霍乱弧菌 引起的疾病。 人们吃了被霍乱弧菌污染的食物或喝了被霍乱弧菌污染的水就会被感染。霍乱遍布世界大部分地区，在卫生条件差或缺乏清洁水的地区，在人道主义危机期间尤其危险。霍乱患者可出现严重的腹泻，从而导致严重脱水。如果得不到治疗，许多人会死亡。 如何预防霍乱？ 霍乱疫苗已研发多年。口服霍乱疫苗具有成本效益，且易于管理。在人...

Monday, January 8, 2024