Since 1994, the Harvard-wide Pediatric Health Services Research (HSR) Fellowship Program has excelled at training a new generation of investigators whose work is defining and addressing critical gaps in child health services research and the provision of primary care for children. Our training examines key issues such as access, quality, outcomes and cost-effectiveness of care.
(출처 : http://www.childrenshospital.org/cfapps/research/data_admin/Site2231/mainpageS2231P0.html)
소아 연구(Child health research)는 건강과 의료에 관한 지식을 발전시키기 위한 좋은 모델이다.
소아 연구와 관련한 최근의 문제들로부터 우리는
소아의 건강과 질병의 변화하는 양상에 어떻게 대처해야 하는지,
소아의 질병의 영향이 단순한 생존의 문제를 넘어
장기적으로 어떠한 영향을 미치는지에 대해 생각해 볼 수 있다.
변화하는 소아 연구의 환경에 대응하기 위해서는
혁신적인 파트너십이 필요하고,
소아 연구 분야의 잘 훈련된 연구자들이 필요하며,
새로 등장하는 기술을 잘 활용할 수 있어야 한다.
또한 강력한 사회적 힘(societal force)와 연계하여 괴팍한(fractious) 정치적 환경 속에서도
연구의 우선순위를 어린이들의 이익을 증진시키는 것에 둘 수 있어야 할 것이다.
Child health research at its best provides a model for the advancement of knowledge to improve health and health care. The challenges confronting pediatric research reflect the need to respond to the changing milieu of child health and disease and to look beyond survival to consider the longterm consequences of pediatric health and disease. This transition will require innovative partnerships, a cadre of welltrained investigators interested in child health, and creative use of emerging technologies. It will also require linkage of research priorities to larger societal forces and a renewed commitment to advancing the interests of children in an increasingly fractious policy world.
DESPITE A REMARKABLE RECORD OF ACCOMPLISHments, the pediatric research community faces mounting evidence that the nature and scope of current research are inadequate. The Editorial “Challenges to Excellence in Child Health Research,” by Zylke et al,1 casts this paradox in sharp relief by summarizing a series of articles suggesting that the quality and number of pediatric research studies lag behind research focused on adults.
A variety of technical challenges specific to child health research have been identified.2,3 Of central concern is the relative rarity of serious child health problems, which reflects the success of prior research and public health interventions to reduce traditional threats of acute, infectious diseases.
Moreover, improved medical and surgical therapies have transformed important conditions that were once fatal in early childhood into more manageable chronic conditions. However, for many chronic childhood illnesses, etiology is still unclear and therapies are suboptimal.
The shift in the epidemiology of childhood illness away from acute infectious diseases to chronic illness and acute injury highlights the need to develop novel research strategies.
Currently funded pediatric research networks could provide a strong foundation for expanded collaborative protocols.
For example, the National Institute of Child Health and Human Development Neonatal Research Network could be enhanced by expansion of clinical sites and longer-term outcome studies.4
Although this technical guidance is helpful, the true promise of this effort will be its ability to generate functioning, international collaborations and the financial support such initiatives require. Moreover, the expansion of electronic health records and the development of bioinformatics to integrate health information and biologic specimens create an environment in which every patient is a potential research participant and each can benefit from the contributions of others
At the same time, a continual pipeline of young basic, clinical, and public health scientists interested in advancing child health is needed.
Excellent examples of successful public and private programs that should be expanded include the National Institutes of Health (NIH) Pediatric Scientist Development Program, the Robert Wood Johnson Clinical Scholars Program, and training programs associated with the NIH Clinical and Translational Science Awards.
The transition in child health research must also confront the powerful influence of market forces in shaping research priorities.
Although private sector contributions to pediatric research remain important, these investments are dwarfed by funding dedicated to adult diseases.
Government initiatives (ie, the Orphan Drug Act, the Best Pharmaceuticals for Children Act, and the Pediatric Research Equity Act) have provided special financial or regulatory incentives to develop pediatric drugs and devices for small or orphan markets.7
New perspectives about pediatric origins of adult disease, social determinants of health, and long-term effects of early exposures and interactions suggest that the poor health of children (reflected in rates of prematurity, obesity, behavioral and developmental problems, etc) can be a harbinger of poor adult health.8
Collaboration will be central to strengthening child health research, with openness to unique partnerships. For example,improvements in child health are important to the health insurance industry.
In large measure, health policy is now synonymous with cost containment and when cost containment becomes the focus, child health issues are quickly marginalized
Pediatric and other community leaders need to continue to push an agenda for children that includes attention to child health research. Children are the poorest segment of US society and have a limited political voice. Moreover, poverty has never been more heavily concentrated in childhood than it is today.
Child health research at its best provides a model for the advancement of knowledge to improve health and health care. The challenges confronting pediatric research reflect the need to respond to the changing milieu of child health and disease and to look beyond survival to consider the longterm consequences of pediatric health and disease. This transition will require innovative partnerships, a cadre of welltrained investigators interested in child health, and creative use of emerging technologies. It will also require linkage of research priorities to larger societal forces and a renewed commitment to advancing the interests of children in an increasingly fractious policy world.
The transformation of child health research: innovation, market failure, and the public good.
Source
Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, 2015 Uppergate Dr, Atlanta, GA 30322, USA. barbara_stoll@oz.ped.emory.edu
'Articles (Medical Education) > 연구역량 개발' 카테고리의 다른 글
| 초보연구자들의 논문쓰기: 무엇을 어려워하고 무엇을 필요로하는가? (Academic Medicine, 2009) (0) | 2015.02.23 |
|---|---|
| 최고의 연구중심의과대학은? - 의과대학의 연구역량 평가를 위한 새로운 모델 - (Academic Medicine, 2015) (0) | 2015.02.11 |
| MD–PhD프로그램에서 전통적 생의학/임상의학 이외의 분야를 권장해야 하는가? (Academic Medicine, 2015) (0) | 2015.02.10 |
| (소아 질병 연구의) 차세대 의사-과학자 양성을 위하여 필요한 것 (0) | 2013.07.04 |
| 간극 좁히기 : 레지던트 기간 동안의 중개연구 훈련 프로그램 (0) | 2013.06.20 |