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集体领导会改善医护人员的临床实践、病人医疗护理质量和职工幸福感吗?

2 years 6 months ago
集体领导会改善医护人员的临床实践、病人医疗护理质量和职工幸福感吗? 关键信息 集体领导涉及多学科专业人员分享观点与知识。基于已有证据,本研究不能确定集体领导能明显改善医护人员临床实践、患者医疗护理质量或职工幸福感。本研究对上述结局指标的可信度介于中等到特别低之间,主要受制于纳入研究的人数与质量较低。 我们想从中发现什么? 本研究目的在于探索集体领导方式(相较于更中心化和等级化的领导模式)是否会改善医护人员的临床实践、患者医疗护理质量和职工幸福感。我们搜寻研究者比较了集体领导与中心化领导的研究。 我们做了什么? 本研究收集和分析了有关集体领导干预方式(以多学科分享决策和互动为特点)的所有相关研究。 我们发现了什么? 本研究发现3项相关研究(共955名受试者)。纳入研究分别在加拿大、伊朗和美国的医院开展。集体领导干预方式很可能改善领导力(3项研究,955名受试者),可能改善团队协作(1项研究,164名受试者),并可能稍微减少工作相关压力(1项研究,164名受试者)。研究无法确定集体领导对以下结果是否存在作用:临床实践(1项研究,60名受试者),住院病人死亡(1项研究,60名受试者)和职工缺勤(1项研究,60名受试者)。 证据的局限性是什么? 集体领导对改善医疗照护领导力的可信度为中等。证据显示集体领导对领导力策略有很大的影响。研究不太确定团队协作改善和工作相关压力减轻的结果的可信度。...

夹板治疗婴儿髋关节脱位和浅髋关节

2 years 6 months ago
夹板治疗婴儿髋关节脱位和浅髋关节 什么是髋关节脱位或浅髋关节? 当股骨末端的股骨头和关节窝不能结合在一起时,就会出现髋关节脱位或浅髋关节。医学术语是“发育性髋关节发育不良”(developmental dysplasia of the hip, DDH)。每1000名新生儿中就有10名出现浅髋关节,但髋关节脱位较为罕见,每1000名新生儿中就有1名出现髋关节脱位。髋关节可能“脱位”、不稳定(即在检查过程中容易从关节窝中掉出)或“稳定”(即在整个检查过程中位于关节内)。 这些髋关节如何治疗? 浅髋关节和髋关节脱位通常用髋关节夹板治疗。夹板控制腿的运动,引导髋关节进入关节窝,让髋关节自然改善。夹板既可以将腿固定在适当的位置,称为“静态夹板”,也可以让腿自由移动,称为“动态夹板”。有时,临床医生可能会建议使用体积较大的双层尿布,并轻轻地将双腿分开,以充当一种夹板。 我们想知道什么? 我们想知道夹板是否可以成功运用,以及是否在不同婴儿群体中,最佳治疗方法可能不同。我们聚焦于关节窝的发育、进一步手术的需要,以及治疗后长达2年内的任何并发症。我们还对父母告诉我们很重要的因素感兴趣,例如母乳喂养的能力以及父母与婴儿之间的联系。 我们做了什么? 我们检索了对6个月以下婴儿的浅髋关节和髋关节脱位进行夹板治疗的研究。我们关注将一种夹板与另一种夹板的成功进行比较的研究或者将夹板与未治疗进行比较的研究。...

Featured review: House modifications for preventing malaria

2 years 6 months ago

Installing mosquito screening over house windows and closing the gaps in house eaves can help reduce infection with Plasmodium parasites and the number of people with anaemia in the household, according to an updated Cochrane Review published this week. Householders can implement many of these house modifications themselves, providing a simple malaria prevention tool to complement existing vector control strategies.

The review author team, from the UK, Spain, South Africa, and Malawi, included one randomized controlled trial (RCT) and six cluster-RCTs, and noted an additional six ongoing trials. Trials assessed screening of windows, doors, eaves, ceilings, or any combination of these; this was either alone, or in combination with roof modification or eave tube installation (an insecticidal "lure and kill" device that reduces mosquito entry whilst maintaining some air flow).




The seven included trials, conducted in sub-Saharan Africa, showed that people living in modified houses were less likely to have Plasmodium parasites in their blood, and were less likely to experience moderate or severe anaemia. There was also a large reduction in the number of mosquitoes trapped indoors at night in some of the included trials.

This approach is not a new phenomenon; research from 1901 first demonstrated the effect of simple house screening techniques for protecting families in Italy from mosquito-related illness, and many householders globally continue to screen their homes to protect from nuisance insects. House modifications may provide an important, long-term, sustainable option to reduce malaria.

CIDG Research Associate and lead author Tilly Fox noted, “These results are encouraging, and the reduction in indoor mosquitoes will mean householders will be motivated to screen houses simply to reduce the nuisance factor as well as the health benefits”.

Professor Steve Lindsay from Durham University said, “It is gratifying to see the protective effect of house screening against malaria in different sites. For the future, innovative new solutions are needed to provide better and longer-lasting protection, including tougher screened windows, self-closing doors, and re-designing housing which will help keep the occupants healthy, comfortable, and secure.”

Fox T, Furnival-Adams J, Chaplin M, Napier M, Olanga EA. House modifications for preventing malaria. Cochrane Database of Systematic Reviews 2022, Issue 10. Art. No.: CD013398. DOI: 10.1002/14651858.CD013398.pub4.

Article originally published on Liverpool School of Tropical Medicine website

Friday, October 7, 2022
Lydia Parsonson

Cochrane seeks Director of Publishing and Technology - UK, remote

2 years 6 months ago

Specifications: Full Time (Permanent role)
Salary: £85,000 per annum
Location: UK, homebased and remote-working (attendance at meetings will be expected to pursue development and build relations)
Application Closing Date:  Wednesday 19 October 2022, 9am GMT

Cochrane aims to put evidence at the heart of health decision-making globally. We collaborate to produce trusted synthesized evidence, make it accessible to all, and advocate for its use.   Cochrane is seeking a Director of Publishing and Technology.

Cochrane is a charity and a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. They do this by synthesising research findings to produce the best available evidence on what works. Their work has been recognised as the international gold standard for high quality, trusted information.

As a member of the Executive Leadership Team, this role will lead the Publishing and Technology Directorate (comprising Cochrane Library partnership, Informatics and IT Services, product and business development) to drive high performance, organizational growth and financial returns to Cochrane.

Cochrane is seeking an ambitious individual who relishes a challenge, loves collaborative working, delivers results and has experience of successfully delivering strategy. The ideal candidates will possess an understanding and experience of leading the management and development of a portfolio of products and services that are appropriately priced to generate income.  You will support Cochrane to navigate a sustainable and realistic route to Open Access publishing, working with the leadership team, expert advisers, the Governing Board and our publisher (Wiley). Finally, you will be enterprising and a strategic thinker with the ability to seek and find creative solutions and foster innovation in your teams.

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

How to apply

To obtain the candidate pack and further information on how to apply please contact:

Abigail Barclay
Search Director
a.barclay@inspiredselection.com

PLEASE NOTE: The recruitment agency will be longlisting applications as soon as they receive them, so please apply early to register your interest. 

Thursday, October 6, 2022 Category: Jobs
Muriah Umoquit

The Robert Wood Johnson Foundation Awards $1M to Texas Christian University towards the Cochrane US Network

2 years 6 months ago

Funding will support the centering of racial health equality in systematic reviews through national consensus building.

The Robert Wood Johnson Foundation (RWJF) is the largest American philanthropic organization focused solely on health and healthcare. The recent grant of $1 Million awarded to members and partners of the Cochrane US Network, including Texas Christian University (TCU), RTI International, Campbell Collaboration, Marymount University, and Georgia College, will support critical research to center racial health equity in systematic reviews through national consensus building.  

RWJF defines health equity to means that everyone has a fair and just opportunity to be as healthy as possible, which requires removing obstacles to health such as poverty, discrimination, and their consequences.  Systematic reviews—rigorous and comprehensive syntheses and critical appraisal of evidence—is a gold standard research tool to improve dissemination of evidence-based practices that can reduce or eliminate disparities.  To date, guidance documents for systematic reviews have not routinely considered health equity when- selecting topics, considering outcomes, conducting critical appraisal, assessing applicability of evidence to specific populations or settings, nor when communicating findings to key stakeholders and communities.



Cochrane Senior Officer Us Network, Tiffany Duque, states “by establishing standards to improve the methods, conduct, and reporting of systematic reviews specific to racial health equity, Cochrane can help reduce racial health disparities in the US. With this Robert Wood Johnson funding we will assess the gaps in primary and secondary research to help improve and guide future evidence synthesis toward improved racial health equity.”



This award is the largest to date for the Cochrane US Network, which was established in 2019. Catherine Spencer, Cochrane CEO states, “Racial health equality is a priority topic for Cochrane, the US, and globally. We encourage Cochrane reviews to include explicit descriptions of methods, effects of the interventions, and ability to reduce inequalities in health and to promote their applicability to all population groups. Cochrane is proud to lend its leadership and expertise to this project.”

This prestigious collaboration of investigators and institutions will undertake a comprehensive and ambitious effort to listen to stakeholders and communities, perform landscape analyses of existing resources, and prioritize next steps as the first phase to centering racial health equity in systematic reviews.  Principal Investigators include awardee Dr. Dru Riddle (TCU), Dr. Meera Viswanathan (RTI), Dr. Vivian Welch (Campbell), Dr. Patricia Heyn (Marymount), Dr. Damian Francis (Georgia College), and Tiffany Duque (Cochrane).

Thursday, October 13, 2022
Lydia Parsonson

Announcing the 2023 Cochrane Colloquium in London, UK

2 years 6 months ago

Cochrane London 2023: Forward together for trusted evidence
4-6 September 2023
Central London, UK

Cochrane is an international non-profit network that provides evidence-based scientific knowledge to improve healthcare for all people worldwide. Cochrane Reviews summarise all available research on a specific health question. They are up-to-date, follow a rigorous scientific methodology, and are free from commercial conflicts of interest. Health professionals, patients, and policy makers trust Cochrane Reviews for their healthcare decision-making. Cochrane works with researchers, health professionals, patients, policy makers, and media representatives from around the world to make Cochrane Reviews relevant and usable.

Cochrane holds an annual conference, known as a Colloquium, that brings together Cochrane researchers, clinical professionals, early career professionals, patients and carers, policymakers, and anyone interested in evidence synthesis and evidence-based healthcare. The events are a mix of keynote speakers, training opportunities, workshops, presentations, and a lively social and networking atmosphere. They are an exciting opportunity for a community of evidence synthesis enthusiasts to share, learn, and connect.  

Cochrane was founded 30 years ago in Oxford and to mark this anniversary the colloquium will be held in the United Kingdom. It will take place at the QEII Centre in Westminster, Central London, hosted by Cochrane UK. The main programme will run from the 4th to the 6th of September, with satellite events and meetings on the 3rd September 2023.

This will be the first time the Cochrane community has come together since 2018 and in recognition of this, it is being designed to celebrate the diverse, global and cohesive nature of the collaboration that is Cochrane. As in previous years there will be stipends to make it possible for students, early career professionals and those from low-and middle-income countries to attend. The Colloquium theme is forward together for trusted evidence. 

Martin Burton, Director of Cochrane UK, said: “After 30 years of producing and advocating for the use of high-quality evidence, Cochrane can look back on many significant achievements.  Now we need to look forward together.”

Catherine Spencer, Cochrane CEO said, “The 2023 Cochrane Colloquium is an event for everyone with an interest in the use of evidence in healthcare decision making. We welcome those engaged in evidence production, co-production, dissemination, implementation and policy making, as well as those making individual healthcare decisions to join us for this exciting event.”

Registration will open in early 2023. Scientific programme will be announced in the coming months.

Tuesday, October 11, 2022
Muriah Umoquit

哪种激素疗法对卵巢早衰的女性更有效?

2 years 6 months ago
哪种激素疗法对卵巢早衰的女性更有效? 关键信息 我们只发现了三项研究,分别研究了三种不同情况下的各种激素疗法。 根据这些小型研究的数据,我们无法得出任何明确的结论。 需要进行充分的、规模足够大的研究,以研究早发性卵巢功能不全女性的最佳激素疗法,以提高她们健康怀孕的机会。 什么是卵巢早衰? 卵巢是一对对雌激素、孕酮和睾酮等激素作出反应并产生激素的腺体。它们在骨骼、心脏和生殖健康方面发挥着重要作用。卵巢早衰是一种影响约1%女性的疾病,表现为卵巢不能正常分泌激素。这会增加她们骨折、心脏疾病和不育的风险。如果女孩的第一次月经在16岁之前还没有开始,或者如果女性在40岁之前超过6个月不来月经,则可能会被诊断为卵巢早衰。还需要进行血液测试以确认各种激素的异常水平,这些激素与卵巢的功能有关。 卵巢早衰如何治疗? 卵巢早衰通常采用激素疗法进行治疗,这种疗法模拟正常工作的卵巢分泌激素。治疗的目的是平衡这种疾病对骨骼、心脏和血管以及生殖健康的负面影响。治疗可能包括通过口腔、皮肤贴片、注射或阴道给药途径给予不同剂量的不同激素。 我们想知道什么? 我们想找出最佳激素组合,使女性在卵巢早衰后能够生育。我们还想找出使用激素疗法治疗卵巢早衰后的不良影响。 我们做了什么? 我们遵循标准的Cochrane方法学程序来检索研究,比较和总结研究结果,并根据研究方法和研究规模等因素来评估证据质量。 我们发现了什么? 我...

Editorial: Achieving sustainable healthcare through deprescribing

2 years 6 months ago

A new Cochrane Library Editorial  has been published about the overtreatment with multiple medications and potentially inappropriate medications use in frail, older adults, and people with multimorbidity. 

The editorial introduces the Cochrane Library Special Collection on deprescribing which provides a summary of Cochrane Reviews on the topic. This collection of reviews highlight that deprescribing is likely feasible and safe and can lead to benefits in prescribing and clinical outcomes. However, they also highlight significant gaps in the literature and methodological challenges to both conducting deprescribing studies and systematic reviews of deprescribing. The editorial calls on the deprescribing research field to focus on universally accepted standards, definitions, and checklists and work collaboratively with Cochrane Sustainable Healthcare. 

Wednesday, October 5, 2022
Muriah Umoquit

成人大腿骨下部骨折的治疗

2 years 6 months ago
成人大腿骨下部骨折的治疗 关键信息 对于大腿下部分骨头(股骨远端)骨折患者的治疗,我们认为最好的比较方法是将金属棒放置在大腿骨内,对比将金属板放置在骨头外侧并用螺钉固定,但也使用其他方法。我们不确定哪种治疗更好,但有一些证据表明棒可以减少残疾。 哪种金属植入物最适合大腿骨下端的骨折仍存在不确定性。 需要进一步的研究来比较常用的手术方式。 为什么治疗股骨远端骨折很重要? 大腿骨下部(股骨远端)的断裂(骨折)会使人虚弱且疼痛。这些受伤后行动不便也是导致健康不佳的一个重要原因。有时,这些骨折发生在以前做过膝关节置换术的人身上;这会使骨折的治疗更加复杂。 治疗股骨远端骨折有哪些选择? 许多治疗方法已用于治疗这些损伤。过去,人们在床上用重物支撑腿部伸直进行治疗。最近则是在手术中使用金属植入物(手术固定)来修复断裂的股骨。手术固定的方法包括在股骨外侧使用钢板和螺钉或在股骨内使用棒以在骨折愈合时将骨头固定到位。这些植入物的技术变得越来越先进,组件“锁定”在一起,形成一个“锁定”装置。尽管取得了这些进步,但对这些损伤的最佳管理仍存在争议。 我们想知道什么? 我们想了解不同方法治疗成人股骨下段骨折的效果。效果包括:功能评分、疼痛、生活质量(quality of life, QoL)以及干预方法引起的任何并发症。 我们做了什么? 我们检索了截至2021年10月发表的随机对照临床试验(randomis...

上肢锻炼方案对肾衰竭患者的动静脉瘘成熟有效吗?

2 years 6 months ago
上肢锻炼方案对肾衰竭患者的动静脉瘘成熟有效吗? 问题是什么? 动静脉瘘(An arteriovenous fistula, AVF)是一种在动脉和静脉之间建立的特殊连接,即构建一根强健的、可以在血液透析治疗期间重复使用的血管。一旦在构建后使用,通常需要六到八周的时间来恢复(或成熟)。成熟的结果表现为连接的静脉变得更大、血流增加使其管壁变得更厚和更坚固。锻炼方案可能会缩短AVF及其功能成熟所需的时间,然而,应该进行什么类型的锻炼方案以及何时进行锻炼(在AVF构建前或后)仍不清楚。 我们做了什么? 我们检索了那些描述了上肢锻炼对肾衰竭患者AVF成熟作用研究的相关文献。我们从中收集了信息,并整合了这些信息来确定干预是否有帮助。我们检查了这些干预措施的质量,以此评判我们能在多大程度上确定我们观察到的效果是可靠的。 我们发现了什么? 我们发现了9项研究,涉及579名受试者;2项研究着眼于在AVF创建之前进行锻炼,7项研究着眼于在AVF构建之后进行锻炼。不幸的是,只有7项在AVF构建之后锻炼的研究可以用来分析。使用的锻炼方案类型有等张(在锻炼关节的同时使肌肉承受恒定重量的练习)和等长(肌肉收缩,周围关节没有任何移动)。 与不干预相比,等张运动可以促进超声成熟度;而与等张运动相比,等长运动可以改善超声和临床成熟度。与等张运动相比,等长运动也可能增加静脉大小和动脉血流量。纳入的研究中没有一项报告...

电磁导航或内窥镜引导方法:哪种更适合将饲管置入小肠?

2 years 6 months ago
电磁导航或内窥镜引导方法:哪种更适合将饲管置入小肠? 关键信息 - 由于缺乏稳健的证据,我们仍然不清楚在小肠中置入鼻饲管时,电磁导航下置入是否优于内窥镜引导下置入。 - 相比于内窥镜引导下置入,电磁导航下鼻饲管置入可能花费较少。 研究背景 对于治疗不健康、营养不良、或两者兼具,以及虽有正常肠道功能但无法进食的人而言,使用鼻饲管通过肠道来给予营养是重要的。对于有食物或液体进入气道的高风险的人(可能会导致肺炎,一种肺部的炎症状态),鼻饲管可以用来协助将营养和药物送到小肠。两种置入鼻饲管的方式都涉及将管子借由导丝经鼻腔、食道和胃进入小肠。虽然内窥镜引导下置入——用一条带有摄像头的薄且可弯曲的管子——是最常见的将导管插入小肠的方式,但是需要多个医疗专业人员在X线检查室确定置管是否成功,而不是在患者床旁就能完成。相比之下,一个受过培训的护士使用电脑屏幕,可以在患者的床旁进行电磁导航下导管置入,并确认其是否成功。 我们想从中发现什么? 我们想知道对于不健康和无法进食的人而言,电磁导航下置管是否比内窥镜引导下置管更好且更安全。 我们做了什么? 我们检索了比较电磁导航下置管和内窥镜引导下经鼻置管的研究。我们比较并总结了这些研究的结果,并根据研究方法和样本量等因素对证据质量进行了评价。我们探索了医生第一次置管时将管道送到小肠的成功率,以及这些研究中肺炎患者的比例。此外,我们评估了使用这两种不同方法...

Recording: 2022 Cochrane Lecture with Jimmy Volmink

2 years 6 months ago

In November 2022 Jimmy Volmink, the 'father of evidence-based medicine in Africa' and dedicated Cochrane member was the speaker for the 2022 Cochrane Lecture. 

Cochrane Lectures provide a forum for influential thinkers to deliver thought-provoking talks on the key challenges for the future Evidence-Based Medicine.

Cochrane’s vision is for a world in which “decisions about health and care are informed by high-quality evidence.” As a trusted source of evidence, the organisation is making a substantial contribution to the realisation of this ideal. Yet, more can be done to extend Cochrane’s global reach, and enhance its relevance and impact worldwide. In this year’s Cochrane Lecture, Professor James "Jimmy" Volmink called for the adoption of global health equity as a strategic priority for Cochrane, and explored ways this can be actioned through steps such as prioritising review topics, enabling participation and promoting diversity and inclusion.

Professor Volmink, the founding Director of the South African Cochrane Centre has a lifelong unwavering commitment to keep on 'banging the drum about inequality' to affect real change. Jimmy reflects on his personal and professional journey in this 'Recommended Dose' podcast.

Thursday, December 1, 2022
Muriah Umoquit

National Eye Institute Awards $5 Million for Cochrane Eyes and Vision US Project

2 years 6 months ago

The award supports critical research to help identify treatments to improve the lives of people suffering from debilitating eye diseases.

 The National Eye Institute (NEI) has awarded a $5 million grant to Tianjing Li, PhD, associate professor of ophthalmology at the University of Colorado School of Medicine, in a continuation of the NEI’s support of the Cochrane Eyes and Vision US Satellite (CEV US Satellite) at the Sue Anschutz-Rodgers Eye Center.

The award is one of the largest grants the CU Department of Ophthalmology has received from the NEI and ensures the project will remain on the CU Anschutz Medical Campus for the next five years.

“We are very grateful for NEI’s continued support in the research we are doing,” says Li. “It will help us grow new partnerships, produce trustworthy evidence, and ultimately improve the vision care our patients receive.”

The Cochrane Eyes and Vision (CEV) US Satellite is a team of US-based researchers and practitioners who review medical literature for content covering interventions to prevent or treat eye conditions and visual impairments and to help people adjust to visual impairment or blindness. CEV is a member review group of the Cochrane US Network, which formed in 2019.  Cochrane Senior Officer Tiffany Duque states "this grant is an exciting achievement for the US Network, and we thank Dr. Li for her continued efforts and dedication not only to CEV but also to the US Network. We look forward to the high-quality evidence that will result from this grant, and to engaging other US Cochrane Centers in ensuring national dissemination of this important work."

“Cochrane systematic reviews are published in the Cochrane Library, which contains high-quality, independent evidence to inform health care decision-making,” says Li, principal investigator for the CEV US Satellite. “These reviews are valuable sources of information for those receiving and providing care, as well as for policymakers and researchers. Our reviews have been highly cited by national and international practice guidelines.”

Although the reviews are written for health care professionals, each review can also help to assist patients and the public in making informed health care decisions. Topics for reviews are identified based on gaps in the literature, importance of the topics to influence practice, and from interest and suggestions of patients and experts in the field. Once a review topic has been identified, Li’s team works with eye doctors to produce the review, which is then peer reviewed and ultimately published in the Cochrane Library.

 “We are very proud of the program Dr. Tianjing Li has built here in the Sue Anschutz-Rodgers Eye Center,” says Naresh Mandava, MD, chair of the CU Department of Ophthalmology and Sue Anschutz-Rodgers Endowed Chair in Retinal Diseases. “Evidence-based medicine is critical to our understanding of disease and identifying effective therapies that will ultimately improve the lives of people suffering from debilitating eye diseases. The Cochrane project centered here at CU leads the way in this endeavor and we appreciate the National Eye Institute’s continued support of this important work.”

The project’s mission to promote informed health care decision-making and research is critical amid the current climate of increasing health care disparities and growth of health care misinformation from online sources.

“Vision health care should be based on science,” Li says. “In this era of data deluge, evidence-informed practice is needed more than ever.”

Since 2002, the CEV US Satellite has published more than 120 systematic reviews and more than 90 methodological papers and book chapters. The project has also trained more than 120,000 individuals in methods for systematic reviews and has informed hundreds of clinical practice guidelines in the United States and internationally.

Originally posted on the University of Colorado website

Wednesday, September 28, 2022
Muriah Umoquit

诊断为自闭症谱系障碍的学龄前儿童在一年或多年后保留诊断的比例如何?

2 years 6 months ago
诊断为自闭症谱系障碍的学龄前儿童在一年或多年后保留诊断的比例如何? 关键信息 -在研究环境下,10名被诊断患有自闭症的学龄前儿童中有9名在一年或多年后继续符合诊断标准。 -由于缺乏稳健性证据,这一发现可能无法推广到研究环境以外的儿童,当儿童保留其诊断时,我们无法确定何种儿童或研究因素造成了影响。 -未来的研究应侧重于设计一种稳健的研究,探索在临床实践中儿童是否随着时间的推移保留其自闭症诊断,以及哪些其他因素(如果有的话)可能会改变儿童保留诊断的可能性。 什么是自闭症? 自闭症(自闭症谱系障碍)是一种常见的神经发育疾病,通常会伴随终生。其特征是社交困难、兴趣受限和重复性行为。这些领域给每个人带来的挑战程度各不相同。 如何诊断自闭症? 通过评估个人是否符合一系列标准化的诊断标准来诊断自闭症。 儿童的自闭症诊断评估可能涉及儿科医生、儿童精神病学家、语言病理学家、职业治疗师和心理学家。这些卫生专业人员中的一名或多名可以观察和询问有关儿童的社交和沟通技能、兴趣受限和重复性行为方面的任何困难以及儿童如何处理和响应来自周围世界的感官信息的问题。这些专业人士可以单独或联合使用诊断评估工具来帮助做出诊断。 什么是诊断稳定性?它为何重要? 诊断稳定性指的是个人在一段时间后是否保留其诊断。自闭症的诊断稳定性非常重要,有助于健康专业人士、自闭症患者个人及其他们的家人了解自闭症谱系障碍诊断伴随终生的可能性...

非小细胞肺癌患者肺部手术前的运动训练

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非小细胞肺癌患者肺部手术前的运动训练 系统综述问题 肺癌手术前进行运动的益处和安全性如何? 研究背景 非小细胞肺癌的肺部手术为患者提供了治愈机会,但却伴随着术后肺部并发症的风险。术前运动训练可通过改善健康状况,降低肺部并发症的发生风险,并改善其他结局,例如胸腔引流管(术后将塑料管插入胸腔以排出可能存在的液体或空气)留置时间和住院时间。在2017年版的系统综述中,我们发现运动训练与降低术后肺部并发症的发生风险、缩短患者胸腔引流管的留置时间、缩短住院时间以及改善术前健康状况和肺功能有关。然而,相关证据的质量为低。 研究特征 目前的证据截止到2021年11月。本综述纳入了10项研究,包含636名受试者。 主要结果 与术前不接受运动训练的受试者相比,肺癌患者进行术前运动训练可大大降低术后肺部并发症的发生风险(55%)。运动期间没有副作用的报告。术前运动训练可能是安全的。术前训练可能会减少术后住院时间(约2天),并在训练计划完成后提高健康水平。但其对胸腔引流管留置时间影响的证据非常不确定。 证据质量 证据整体质量从极低到高不等,主要因为研究方法的局限性、纳入研究受试者数量较少以及合并结果的不一致性。 作者结论:  与未进行术前运动训练的NSCLC患者相比,术前运动训练可大大降低NSCLC患者术后肺部并发症的发生风险。同时还可以缩短术后住院时间,并改善接受肺切除术的NSCLC患者的...

体外光分离置换术用于儿童和青少年造血干细胞移植后急性移植物抗宿主病

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体外光分离置换术用于儿童和青少年造血干细胞移植后急性移植物抗宿主病 背景 急性移植物抗宿主病是造血干细胞移植(haematopoietic stem cell transplantation, HSCT;造血干细胞的移植)后的常见并发症。来自捐赠者的免疫细胞(白细胞)将接受移植者的细胞识别为外来细胞(“非自身”)。因此,移植的免疫细胞会攻击接受移植者的细胞。主要受累器官为皮肤、肝脏和肠道等。这些免疫反应可能引起急性炎症(突然肿胀),然后出现器官的慢性(长期)变化(例如纤维化;肺部瘢痕形成)。一线治疗通常包括免疫抑制剂(可降低人体免疫系统的强度),如皮质类固醇与其他免疫抑制剂联合治疗难治性病例(疾病对治疗产生耐药性)。这些免疫抑制药物的使用旨在抑制免疫介导的对接受移植者细胞的攻击。由于这些免疫抑制药物的有效性有限且副作用严重,导致了几种替代疗法的应用。 体外光分离置换术(extracorporeal photopheresis, ECP)是一种免疫调节疗法,从人体外周血液中收集免疫细胞。然后将这些免疫细胞暴露于光敏剂(一种对光照有反应的化学物质;如8-甲氧基补骨脂素(8‐methoxypsoralen)),然后经紫外线 - A照射后再重新输注回体内。该过程的免疫调节作用尚不完全清楚。 目前的一些临床实践建议,对于HSCT后发生急性移植物抗宿主病的儿童和青少年,可以考虑ECP。 研究...

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2 years 6 months ago
右雷佐生可以预防或减少接受蒽环类药物治疗的成人和儿童的心脏损伤吗? 系统综述问题 我们评价了关于药物右雷佐生预防或减少接受蒽环类化疗的儿童和成人癌症患者心脏损伤的有效性的证据。我们还研究了右雷佐生对除心脏损伤之外的抗肿瘤效果(即存活率和肿瘤缓解率)、生活质量和不良反应(即治疗的不良或有害影响)的可能效果。 研究背景 蒽环类药物是可用于各种癌症的有效化学疗法。然而,由于累积剂量(随时间给予的治疗总量),它存在损伤心脏(心脏毒性)的风险。心脏毒性可能导致亚临床心肌功能障碍(有证据表明心脏功能有限,但患者没有症状),这可能会发展为临床心力衰竭(患者有症状)。右雷佐生是一种有可能预防或减少这种损害的药物。 本综述是对之前发表的Cochrane综述的第三次更新。最初的综述是针对所有可能的心脏保护剂(保护心脏的药物),现在这部分只关注右雷佐生。 研究特征 证据截至2021年5月。 我们发现了13项关于右雷佐生的随机试验(将人们随机分配到两个或多个治疗组之一的临床研究):5项儿童研究(1252名患有白血病、淋巴瘤或实体瘤的儿童)和8项成人研究(1269名大多数被诊断患有乳腺癌的成年人)。 主要研究结果 我们的分析表明: - 在成人中,右雷佐生能够预防或减少接受蒽环类药物治疗的患者的心脏损伤; - 在儿童中,治疗组之间仅有一项心脏(心脏相关)结局存在差异来支持右雷佐生的作用;即合并的临床心力衰竭...

Cochrane seeks Publishing Systems Support Specialist

2 years 6 months ago

Location: Flexible location (remote working) – contract type dependent on location.
Specifications: Permanent employment contract if successful applicant based in UK, Germany or Denmark. Consultancy contract in other locations.
Salary: £36,000 per annum
Application Closing Date:  18 October 2022

Cochrane is a charity and a global, independent network of health practitioners, researchers, patient advocates and others, responding to the challenge of making vast amounts of research evidence useful for informing decisions about health. They do this by synthesising research findings to produce the best available evidence on what works. Their work has been recognised as the international gold standard for high quality, trusted information.

The core purpose of this role is to ensure that Cochrane systems are presented coherently to our users, are well-documented, tested, fit for purpose and that the user voice is heard in system development decision-making.

You will:

  • provide second-line expert support on software used by Cochrane authors and staff to write and edit Cochrane Reviews:
    • Editorial Manager (third-party software from Aries Systems)
    • project management features in RevMan Web (in-house review development software)
  • act as System Administrator for these systems, making configuration changes to optimise user experience
  • update supporting documentation and run demos to educate users on system configurations
  • input into projects and programmes of work which impact on Cochrane authors and staff
  • represent the user voice in system development, based on feedback received from support cases and training
  • use your knowledge to influence development priorities and project decisions that have an impact on system users

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

How to apply

  • For further information on the role and how to apply, please click here.  
  • The deadline to receive your application is by 18 October 2022.  
  • The supporting statement should indicate why you are applying for
  • Read our Recruitment Privacy Statement
Thursday, October 6, 2022 Category: Jobs
Lydia Parsonson