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It is playing a very important role because of its interaction with both basic and clinical&#46; We do not need to say that each of them has their own actors&#44; their own subjects and their own designs&#46; Once&#44; this formal scheme is put into practice&#44; things become more complex&#46; First&#44; there is no clear border among them&#46; Secondly&#44; the actors can play their part in both of the neighboring types&#46; Thirdly&#44; the institutions that host investigation programs have different aims and ideas about research classes&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">If we now consider pediatrics and taking into account its setting in the occidentalized world we can see that the care structures &#40;primary to tertiary&#41; seldom have the required machinery to assess a basic law of nature or its deviation&#46; In a few sectors of each country&#44; this may be possible&#44; for example&#44; Universities and Institutes financed by governments are normally sites where this can happen&#46; The journal Pediatric Research reflects in part this activity&#46; This is the reason why pediatrics following the general trend in clinical research tends to certain subtypes&#46; One subtype is based on the development of new diagnostic and therapeutic procedures and another is based on the evaluation of efficacy and safety of new treatments&#46; This part &#40;also known as clinical trials&#41; has proved to be very useful after evidence based techniques are used&#46; It is pertinent to mention here how reviews are regulated also by these techniques and search strategies&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Part of this clinical research is the epidemiological studies that sometimes are considered as a new branch of research&#44; they have the advantage that with a good design and a vigorous execution&#44; they can be put in practice at primary care level&#46; Retrospective clinical studies are not considered as real research&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The freedom to choose subjects has been and is an inherent characteristic of research&#46; Therefore the variety of lines can be infinite&#44; but if a pragmatic sense is present at the time of deciding the research object the present hot points should be considered&#46; I would like to refer to the five points of concern stated by CDC&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a> particularly because they have a particular significance for the near future&#46; They are&#58; <span class="elsevierStyleItalic">Antibiotic Resistance and Advanced Molecular Detection</span>&#59; <span class="elsevierStyleItalic">Preventing Prescription Drug Abuse and Overdoses</span>&#59; <span class="elsevierStyleItalic">Global Health Security</span>&#59; <span class="elsevierStyleItalic">HPV Vaccination</span>&#59; and <span class="elsevierStyleItalic">Poliomyelitis&#46;</span> These topics would be the focus of interest in pediatrics&#46; Each item could be expanded according to the facilities of each team as for example the study with an epidemiological base on global health on maternal&#44; newborn and child carried out by the Canadian group led by Z&#46; Bhutta&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a> Also the one from the Institute of Child Health &#40;London&#41; led by Prof&#46; T&#46;J&#46; Cole<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">4</span></a> on longitudinal growth of preemies below 32 weeks of gestation with a pure clinical base with minimal intervention&#46; A new research field with growing acceptance is literature search&#46; Archibald Cochrane is firmly connected with this important source of real knowledge that can be applied to the management of clinical problems&#46; During his participation in the Spanish Civil War in the British Ambulance Unit his advocacy for the randomized controlled trials was probably initiated&#46; That was the origin of the present Cochrane Library database of systematic reviews&#46; The unavoidable search strategy quoting the bibliographical resources&#44; the obtained references in each one&#44; the type of search&#44; the keywords and limits used is now a standard tool for an interested person or pediatric group&#46; The examples of meta-analysis or systematic reviews have been plentiful and helpful&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Clinical trials in pediatrics merit special mention due to the use of new medicines normally designed for adult treatments or for off-label use&#46; The European Medicines Agency &#40;EMA&#41; through its Pediatric Committee &#40;PDCO&#41; &#8216;is assessing the content of pediatric investigation plans and adopting opinion on them&#8217; among other important tasks&#44; one of which is to advise Member States on the content and format data to be collected for surveys on the uses of medicines in children&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">5</span></a> These rules must not be forgotten when participating in a multicenter study&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Finally I would like to refer to the barriers for research&#46; The first can be the attitude of responsible persons of pediatric departments which is perhaps influenced by the present R&#38;D restrictions&#46; Consequently this is focused more in clinical care or academic tasks&#46; A simple way to estimate this research is if in the previous two years they have been a publishing author or grant applicant&#46; The second is related to the skepticism generated by some drug development studies without clear or appropriate objectives with research participants either ill- or un-informed&#46; The third barrier is the journals&#8217; reasonable interest in publishing only the best submitted articles&#44; they as consequence promulgate every year the percentage of rejected manuscripts&#46; Yet&#44; undoubtedly those rejected manuscripts contain valuable research&#46; This uncertain threshold has a discouraging effect for researchers&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Despite these obstacles that should be known by researchers&#44; our present situation is somewhat optimistic&#46; For instance the presence of Spanish pediatricians as authors in the international panorama is nothing but growing&#46; If we consider the content of Anales of 20 years ago with the present one&#44; positive differences are clear as well as the steady growing impact factor of our journal&#46; Therefore young and senior pediatricians are asked to continue in this track because the benefits of research remain a central consideration in health care&#46;</p></span>"
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Editorial
Research in pediatrics nowadays
La investigación en pediatría a día de hoy
M. Moya
Pediatric Department, Universidad Miguel Hernández, Alicante, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">If we accept that there are two main classes of investigation&#58; <span class="elsevierStyleItalic">basic</span> and <span class="elsevierStyleItalic">applied</span>&#44; the first one has a leitmotif that is knowledge for its own sake&#44; frequently with no obvious or immediate application &#40;biochemical mechanisms&#44; cell function&#44; etc&#46;&#41;&#46; Basic investigation by its definition in a vast majority of cases falls outside our present field of pediatrics that is mainly addressed to specific clinical problems clearly representing applied research&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> It is important to consider that basic gains will lead to applied gains later on&#46; Basic and applied &#40;which we will now call clinical&#41; are not separated and most of the time they are connected through a third class more recently termed as <span class="elsevierStyleItalic">translational</span> research&#46; It is playing a very important role because of its interaction with both basic and clinical&#46; We do not need to say that each of them has their own actors&#44; their own subjects and their own designs&#46; Once&#44; this formal scheme is put into practice&#44; things become more complex&#46; First&#44; there is no clear border among them&#46; Secondly&#44; the actors can play their part in both of the neighboring types&#46; Thirdly&#44; the institutions that host investigation programs have different aims and ideas about research classes&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">If we now consider pediatrics and taking into account its setting in the occidentalized world we can see that the care structures &#40;primary to tertiary&#41; seldom have the required machinery to assess a basic law of nature or its deviation&#46; In a few sectors of each country&#44; this may be possible&#44; for example&#44; Universities and Institutes financed by governments are normally sites where this can happen&#46; The journal Pediatric Research reflects in part this activity&#46; This is the reason why pediatrics following the general trend in clinical research tends to certain subtypes&#46; One subtype is based on the development of new diagnostic and therapeutic procedures and another is based on the evaluation of efficacy and safety of new treatments&#46; This part &#40;also known as clinical trials&#41; has proved to be very useful after evidence based techniques are used&#46; It is pertinent to mention here how reviews are regulated also by these techniques and search strategies&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Part of this clinical research is the epidemiological studies that sometimes are considered as a new branch of research&#44; they have the advantage that with a good design and a vigorous execution&#44; they can be put in practice at primary care level&#46; Retrospective clinical studies are not considered as real research&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The freedom to choose subjects has been and is an inherent characteristic of research&#46; Therefore the variety of lines can be infinite&#44; but if a pragmatic sense is present at the time of deciding the research object the present hot points should be considered&#46; I would like to refer to the five points of concern stated by CDC&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a> particularly because they have a particular significance for the near future&#46; They are&#58; <span class="elsevierStyleItalic">Antibiotic Resistance and Advanced Molecular Detection</span>&#59; <span class="elsevierStyleItalic">Preventing Prescription Drug Abuse and Overdoses</span>&#59; <span class="elsevierStyleItalic">Global Health Security</span>&#59; <span class="elsevierStyleItalic">HPV Vaccination</span>&#59; and <span class="elsevierStyleItalic">Poliomyelitis&#46;</span> These topics would be the focus of interest in pediatrics&#46; Each item could be expanded according to the facilities of each team as for example the study with an epidemiological base on global health on maternal&#44; newborn and child carried out by the Canadian group led by Z&#46; Bhutta&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a> Also the one from the Institute of Child Health &#40;London&#41; led by Prof&#46; T&#46;J&#46; Cole<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">4</span></a> on longitudinal growth of preemies below 32 weeks of gestation with a pure clinical base with minimal intervention&#46; A new research field with growing acceptance is literature search&#46; Archibald Cochrane is firmly connected with this important source of real knowledge that can be applied to the management of clinical problems&#46; During his participation in the Spanish Civil War in the British Ambulance Unit his advocacy for the randomized controlled trials was probably initiated&#46; That was the origin of the present Cochrane Library database of systematic reviews&#46; The unavoidable search strategy quoting the bibliographical resources&#44; the obtained references in each one&#44; the type of search&#44; the keywords and limits used is now a standard tool for an interested person or pediatric group&#46; The examples of meta-analysis or systematic reviews have been plentiful and helpful&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Clinical trials in pediatrics merit special mention due to the use of new medicines normally designed for adult treatments or for off-label use&#46; The European Medicines Agency &#40;EMA&#41; through its Pediatric Committee &#40;PDCO&#41; &#8216;is assessing the content of pediatric investigation plans and adopting opinion on them&#8217; among other important tasks&#44; one of which is to advise Member States on the content and format data to be collected for surveys on the uses of medicines in children&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">5</span></a> These rules must not be forgotten when participating in a multicenter study&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Finally I would like to refer to the barriers for research&#46; The first can be the attitude of responsible persons of pediatric departments which is perhaps influenced by the present R&#38;D restrictions&#46; Consequently this is focused more in clinical care or academic tasks&#46; A simple way to estimate this research is if in the previous two years they have been a publishing author or grant applicant&#46; The second is related to the skepticism generated by some drug development studies without clear or appropriate objectives with research participants either ill- or un-informed&#46; The third barrier is the journals&#8217; reasonable interest in publishing only the best submitted articles&#44; they as consequence promulgate every year the percentage of rejected manuscripts&#46; Yet&#44; undoubtedly those rejected manuscripts contain valuable research&#46; This uncertain threshold has a discouraging effect for researchers&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Despite these obstacles that should be known by researchers&#44; our present situation is somewhat optimistic&#46; For instance the presence of Spanish pediatricians as authors in the international panorama is nothing but growing&#46; If we consider the content of Anales of 20 years ago with the present one&#44; positive differences are clear as well as the steady growing impact factor of our journal&#46; Therefore young and senior pediatricians are asked to continue in this track because the benefits of research remain a central consideration in health care&#46;</p></span>"
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Anales de Pediatría (English Edition)
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