Family interventions for adults living with type 2 diabetes mellitus: A qualitative meta-synthesis

ObjectiveReview and synthesize qualitative research on family interventions for adults living with type 2 diabetes.MethodsA qualitative metasynthesis was conducted. Analysis used imported concepts from realist evaluation – context, mechanisms, and outcomes.ResultsSix studies met inclusion criteria in this qualitative systematic review. Powerful mechanisms were identified that occur outside the family intervention in the context of ethnic, racialized, and geographically defined groups. Many similarities were noted across contexts, such as low income. Mechanisms of interventions focused primarily on family member education. Outcomes were focused more on improving self-care behaviors, rather than family-oriented outcomes.ConclusionSystemic issues affecting social determinants of health set the context for family interventions for type 2 diabetes. When designing these interventions, intersectionality, scarcity, and family functioning may need to be considered.Practice implicationsEmphasis on education of family members may not be effective in improving diabetes outcomes, as many powerful mechanisms exist outside of these interventions.     

国内外超重和肥胖人群心理卫生相关研究的热点

目的:分析近20年超重和肥胖人群心理卫生相关研究,比较国内外该人群心理卫生相关研究热点。方法:检索万方、知网、PubMed数据库2000年1月-2020年4月收录的超重和肥胖人群心理相关研究,采用BICOMB、gCLUTO软件对关键词和主题词进行聚类和可视化分析。研究人群为中国人的研究定义为国内研究,其余均视为国外研究。结果:最终纳入国内研究661篇、国外研究3679篇。聚类分析显示,国内关注肥胖型多囊卵巢综合征、儿童青少年、肥胖合并症患者等;国外侧重于减重术后及暴食症患者、儿童青少年等。结论:国内外研究热点仅在儿童、青少年方面较为相似。国内在存在肥胖合并症的临床疾病领域发展较好,而国外所关注的减重术后患者生活质量及心理状况、正念疗法和认知行为疗法的运用等值得国内研究者借鉴。     

Construction of an intercultural preventive strategy of alcohol use in rural Mapuche communities: A community‐based participatory research

The research presented in this paper consists of a case study that analyses the elements necessary for a culturally grounded methodological strategy for the prevention of problematic alcohol consumption in rural Mapuche communities in the Araucanía region. To do this, we proposed to answer the questions: what are the particularities that alcohol consumption adopts in the local space? And what are the elements that should be considered for an intercultural preventive strategy for alcohol consumption? Oriented to the perspective of community‐based participatory research, data were collected through group interviews with the local community, participant observation and in‐depth interviews with people who consumed alcohol, were recovering from consumption and nondrinkers. A total of 84 people participated and the information gathered was analysed using ATLAS.ti software. The results show key aspects that must be considered for the design, including: strengthening the cultural identity, providing spaces for shared reflection in places where the community converges (schools and rural health centres), and problematising alcohol consumption from their own conceptions of normal and problematic consumption. Therefore, there is a need to focus on strengthening intracultural processes in community spaces, with a preventive strategy within the logic of action research, with increasing degrees of community participation.     

Broad consent versus dynamic consent in biobank research: Is passive participation an ethical problem?

In the endeavour of biobank research there is dispute concerning what type of consent and which form of donor–biobank relationship meet high ethical standards. Up until now, a ‘broad consent'' model has been used in many present-day biobank projects. However it has been, by some scholars, deemed as a pragmatic, and not an acceptable ethical solution. Calls for change have been made on the basis of avoidance of paternalism, intentions to fulfil the principle of autonomy, wish for increased user participation, a questioning of the role of experts and ideas advocating reduction of top–down governance. Recently, an approach termed ‘dynamic consent'' has been proposed to meet such challenges. Dynamic consent uses modern communication strategies to inform, involve, offer choices and last but not the least obtain consent for every research projects based on biobank resources. At first glance dynamic consent seems appealing, and we have identified six claims of superiority of this model; claims pertaining to autonomy, information, increased engagement, control, social robustness and reciprocity. However, after closer examination, there seems to be several weaknesses with a dynamic consent approach; among others the risk of inviting people into the therapeutic misconception as well as individualizing the ethical review of research projects. When comparing the two models, broad consent still holds and can be deemed a good ethical solution for longitudinal biobank research. Nevertheless, there is potential for improvement in the broad model, and criticism can be met by adapting some of the modern communication strategies proposed in the dynamic consent approach.     

CBL联合TBL教学法同步培养口腔正畸专业研究生临床和科研能力的效果研究

目的研究以案例为基础的学习(CBL)联合基于团队的学习(TBL)教学法同步培养口腔正畸专业研究生临床和科研能力的教学效果。方法选取中山大学光华口腔医学院口腔正畸专业2018级与2019级研究生共24人为研究对象,按随机数字表法分为两组,实验组采用CBL联合TBL教学法;对照组采用以讲授为基础的学习(LBL)传统教学法,教学内容主要包括口腔正畸学常见错牙合畸形的病例分析和相关研究。课程结束对两组学生进行临床和科研能力的考核,并采用问卷的形式调查实验组学生对CBL联合TBL教学法的评价。对两组考核评分结果进行独立样本t检验,并对问卷调查结果进行描述性分析。结果在临床思维方面,实验组和对照组研究生的考核分别为(8.8±0.8)和(7.9±0.9)分,差异有统计学意义(t=-2.67,P=0.014);在科研思维方面,实验组和对照组研究生的考核分别为(8.1±0.5)和(6.9±1.0)分,差异有统计学意义(t=-3.84,P<0.001)。学生评价CBL联合TBL教学法最主要的优点是“临床和科研相互融合启发”。结论CBL联合TBL教学法有助于同步提升口腔正畸专业研究生临床和科研能力。