From immune system to health systems--challenges for health research

There are many similarities between the immune system and health systems. Both are knowledge-based learning systems with an ultimate common objective of maintaining the health of individuals and populations, respectively. The immune system learns from the environment, and knowledge and discovery are key drivers of health systems improvement and improving health status. But discovery goes well beyond immunology, virology and genomics, for example, in the quest to develop new drugs, vaccines and diagnostic tests. New ways must also be discovered to make sure that these products reach the people who need it most. We must discover ways for knowledge to be turned into effective policies, to inform the practice of healthcare and to inform the public and society at large. Only if discovery is seen in its broadest perspective will we be able to reach the goal of health for all.     

Community engagement in global health research that advances health equity

Community engagement is gaining prominence in global health research. So far, a philosophical rationale for why researchers should perform community engagement during such research has not been provided by ethics scholars. Its absence means that conducting community engagement is still often viewed as no more than a ‘good idea’ or ‘good practice’ rather than ethically required. In this article, we argue that shared health governance can establish grounds for requiring the engagement of low‐ and middle‐income country (LMIC) community members in global health research, where such research aims to help reduce health disparities. This philosophical basis has important implications for the ethical goals ascribed to engagement and the approach adopted to undertake it. We suggest the ethical goals of engagement in equity‐oriented global health research should include: (a) generating research topics and questions that reflect the key problems disadvantaged groups face in accessing healthcare, services and broader social determinants of health and (b) promoting the translation of research findings into policy and practice in ways that benefit the health of disadvantaged groups. We propose engagement practice should have the following features: deliberation with LMIC community members to make a range of project decisions, beginning with setting research topics and questions; inclusion of members of disadvantaged groups and those with the power to change policy and practice to benefit them; and purposeful structuring of deliberations to minimize the impact of power disparities between LMIC community members. Finally, we reflect on how these features differ from those typical of much current community engagement practice in LMICs.     

Defining research to improve health systems

Robert Terry and colleagues present working definitions of operational research, implementation research, and health systems research within the context of research to strengthen health systems.     

生态系统健康研究的一些基本问题探讨

目前有关生态系统健康研究的一些基本问题尚未达成共识。本文分析了健康、系统与生态系统3个与生态系统健康关联的概念,在此基础上,对生态系统健康的概念及其内涵、研究价值、研究的内容框架、研究的合理尺度以及生态系统质量诊断与质量等级评价进行了探讨。指出生态学上的生态系统是系统科学意义上系统的一类,整体性、稳定性和可持续性是生态系统的重要特征,生态系统健康可通过它的充分必要条件给出,即具备良好的整体性,能够维持较高的稳定性,并能实现良好的可持续性。生态系统质量标准分为质量诊断标准和质量等级评价标准,质量诊断是一种是与非的事实判断,而质量等级评价是一种价值判断。生态系统质量等级评价指标可分为限制可比型和非限制可比型两类。生态系统的复杂性决定了生态系统健康研究须借助于系统科学和非线性科学的理论与方法,生态系统病变的滞后性决定了生态系统健康研究必须加强生态系统质量预测与预警,而生态系统健康的跨学科性决定了生态系统健康研究需要生态学、环境学、医学、社会学以及经济学等领域研究人员的广泛合作。     

河流生态系统健康研究现状与展望——基于文献计量研究

河流生态系统健康是生态系统服务供给和流域可持续发展的基础,亟需从其内涵、影响、评价等方面进行系统归纳。运用文献计量梳理国内外文献,归纳了河流生态系统健康在河流自身、人类需求、管理目标3个方面的内涵;并从人类活动、土地利用、河流生境、水质、水量、气候变化等几个方面归纳了影响河流生态系统健康的主要因素和机理;明确了现有的河流生态系统健康评价方法,包括指示生物法、综合指标法、数学模型法等,总结了它们的优缺点和适用范围。最后,从河流生态系统健康的概念内涵、评价指标和水陆耦合等方面提出了存在的问题,建议进行流域整体的河流生态系统健康评价、跨区域的综合评价对比、多学科评价指标、河流廊道等几个方面的深入研究。