The spectrum of knowledge synthesis methods: From big picture overview to targeted deep dive

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ノウソッチュウ ノ ハッショウリツ ハ キケン インシ ノ ウム ニ カンケイナク ハル ニ タカイ ： タカシマ ノウソッチュウ ハッショウ トウロク カラ ： 1988 2001

学位授与機関：　滋賀医科大学　博士（医学）第555号　平成20年3月25日Stroke. 39(3), p.745-752

Paradigms of approaches to research

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Health and Wellness Literacy Initiatives for Immigrant Populations Delivered Through Faith-Based Entities

Background: Health literacy has been shown to be low among immigrant populations globally, leading to limited ability to locate, access and use health information. Religious entities are often the initial contact for many immigrants regarding health and social supports, there are a lack of knowledge about how initiatives to improve health literacy of the immigrant population may be offered through faith-based entities. The objective of this proposed scoping review is to identify available evidence on health literacy initiatives delivered through faith-based entities for immigrant populations. Methods/Design: Using a scoping review framework we will complete a comprehensive search of relevant keywords in major academic and grey literature databases. Eligible articles will be identified through screening by two independent reviewers according to predefined inclusion and exclusion criteria to include articles relevant to our research question. Selected articles will be charted into data extraction tables for analysis, synthesis and presentation of narrative description and visual graphics. Discussion: This scoping review will identify and assess existing health literacy initiatives delivered through faith-based entities to improve health literacy of immigrant communities. This review will inform which initiatives are commonly practiced, and which immigrant groups are most benefitted from and can potentially be benefitted. It will also describe how to conduct those initiatives and what resources are needed and identify the stakeholders of such initiatives those needed to be engaged with to conduct a successful and acceptable program. The challenges and facilitators of those initiatives will also be identified

Research ethics: Overcoming the exploitative dynamic through ethical research

Research ethics is a framework of principles and guidelines designed to ensure that scientific inquiry protects participants’ rights and welfare while upholding integrity. Core principles includes respect for persons, beneficence, and justice which govern all research stages. Respect for persons requires informed consent, confidentiality, and additional safeguards for individuals with diminished autonomy. Beneficence involves maximizing benefits and minimizing harm. Justice demands equitable distribution of both research burdens and benefits. Despite these safeguards, exploitative dynamics persist when power imbalances enable researchers to pursue agendas at the expense of marginalized communities. Such dynamics manifest as tokenistic participation, extractive “helicopter” research, lack of reciprocity, disregard for local context, and unaddressed harms, all of which erode trust and compromise research validity. Mitigating these issues for ensuring ethical research requires proactive strategies at both the investigator and institutional levels. Researchers should co-design studies with community partners, implement participant-centered informed consent, ensure fair recruitment, prioritize participant welfare, establish benefit-sharing agreements, and maintain transparency and accountability. Academic institutions must bolster ethics infrastructures — streamlining review processes, providing ongoing ethics training, facilitating genuine community engagement, and fostering a culture that rewards ethical conduct. By embedding these measures into research design and oversight, the research community can prevent exploitation, honour participants’ dignity, and advance knowledge in an equitable manner. Upholding rigorous ethical standards not only safeguards scientific credibility but also builds public trust and contributes to a more just and inclusive society.

Ethical and Equitable Digital Health Research: Ensuring Self-Determination in Data Governance for Racialized Communities

Mozharul Islam and Arafaat A. Valiani contributed equally.Recent studies highlight the need for ethical and equitable digital health research that protects the rights and interests of racialized communities. We argue for practices in digital health that promote data self-determination for these communities, especially in data collection and management. We suggest that researchers partner with racialized communities to curate data that reflects their wellness understandings and health priorities, and respects their consent over data use for policy and other outcomes. These data governance approach honors and builds on Indigenous Data Sovereignty (IDS) decolonial scholarship by Indigenous and non-indigenous researchers and its adaptations to health research involving racialized communities from former European colonies in the global South. We discuss strategies to practice equity, diversity, inclusion, accessibility and decolonization (EDIAD) principles in digital health. We draw upon and adapt the concept of Precision Health Equity (PHE) to emphasize models of data sharing that are co-defined by racialized communities and researchers, and stress their shared governance and stewardship of data that is generated from digital health research. This paper contributes to an emerging research on equity issues in digital health and reducing health, institutional, and technological disparities. It also promotes the self-determination of racialized peoples through ethical data management

Kidney Function, Albuminuria and Life Expectancy

Background: Lower estimated glomerular filtration rate is associated with reduced life expectancy. Whether this association is modified by the presence or absence of albuminuria, another cardinal finding of chronic kidney disease, is unknown. Objective: Our objective was to estimate the life expectancy of middle-aged men and women with varying levels of eGFR and concomitant albuminuria. Design: A retrospective cohort study. Setting: A large population-based cohort identified from the provincial laboratory registry in Alberta, Canada. Participants: Adults aged ≥30 years who had outpatient measures of serum creatinine and albuminuria between May 1, 2002 and March 31, 2008. Measurements: Predictor : Baseline levels of kidney function identified from serum creatinine and albuminuria measurements. Outcomes : all cause mortality during the follow-up. Methods: Patients were categorized based on their estimated glomerular filtration rate (eGFR) (≥60, 45–59, 30–44, and 15–29 mL/min/1 · 73 m 2 ) as well as albuminuria (normal, mild, and heavy) measured by albumin-to-creatinine ratio or urine dipstick. The abridged life table method was applied to calculate the life expectancies of men and women from age 40 to 80 years across combined eGFR and albuminuria categories. We also categorized participants by severity of kidney disease (low risk, moderately increased risk. high risk, and very high risk) using the combination of eGFR and albuminuria levels. Results: Among men aged 50 years and with eGFR ≥60 mL/min/1.73 m 2 , estimated life expectancy was 24.8 (95% CI: 24.6–25.0), 17.5 (95% CI: 17.1–17.9), and 13.5 (95% CI: 12.6–14.3) years for participants with normal, mild and heavy albuminuria respectively. Life expectancy for men with mild and heavy albuminuria was 7.3 (95% CI: 6.9–7.8) and 11.3 (95% CI: 10.5–12.2) years shorter than men with normal proteinuria, respectively. A reduction in life expectancy was associated with an increasing severity of kidney disease; 24.8 years for low risk (95% CI: 24.6–25.0), 19.1 years for moderately increased risk (95% CI: 18.7–19.5), 14.2 years for high risk (95% CI: 13.5–15.0), and 9.6 years for very high risk (95% CI: 8.4–10.8). Among women of similar age and kidney function, estimated life expectancy was 28.9 (95% CI: 28.7–29.1), 19.8 (95% CI: 19.2–20.3), and 14.8 (95% CI: 13.5–16.0) years for participants with normal, mild and heavy albuminuria respectively. Life expectancy for women with mild and heavy albuminuria was 9.1 (95% CI: 8.5–9.7) and 14.2 (95% CI: 12.9–15.4) years shorter than the women with normal proteinuria, respectively. For women also a graded reduction in life expectancy was observed across the increasing severity of kidney disease; 28.9 years for low risk (95% CI: 28.7–29.1), 22.5 years for moderately increased risk (95% CI: 22.0–22.9), 16.5 years for high risk (95% CI: 15.4–17.5), and 9.2 years for very high risk (95% CI: 7.8–10.7). Limitations: Possible misclassification of long-term kidney function categories cannot be eliminated. Possibility of confounding due to concomitant comorbidities cannot be ruled out. Conclusion: The presence and degree of albuminuria was associated with lower estimated life expectancy for both gender and was especially notable in those with eGFR ≥30 mL/min/1.73 m 2 . Life expectancy associated with a given level of eGFR differs substantially based on the presence and severity of albuminuria

Unraveling research: Understanding scientific reasoning

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Undergraduate students’ perceptions of community engagement: A snapshot of a public research university in Canada

Students who participate in regular community engagement (CE) often experience benefits in different areas of their lives. Many academic institutions have implemented action plans to increase CE within the student population. At the University of Calgary, Canada, this is done primarily through its broader Eyes High strategy. As there remains a gap in the literature about students' perceptions of CE and their awareness of university CE strategies, this study aims to identify undergraduate students’ awareness of the Eyes High strategy, attitudes towards and levels of engagement, and challenges and potential methods to increase CE participation. Data was collected through a voluntary online survey (n=528). Participants were recruited through posters, social media, online faculty platforms and by faculty members. Survey results indicated students lacked knowledge regarding the Eyes High strategy. It was noted that students’ knowledge, attitudes and practices of CE increased as they spent more time at the university. The top perceived challenges to CE were lack of time, accessible information, support and incentives. To increase accessibility and student participation, we suggest introducing the Eyes High Strategy and CE activities early to the undergraduate population through workshops, credit-based courses and/or professional development requirements. Our data suggests that students are not well informed about the Eyes High strategy. There is thus a need for the university to build a campus-wide, student-informed initiative to proactively engage students. This research will serve as a gateway to further explore communicative methods that might better convey university priorities to students

Paradigms of approaches to research

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