British medical bulletin最新文献

{"title":"Variations in older people's emergency care use by social care setting: a systematic review of international evidence.","authors":"Kelly Brotherhood, Ben Searle, Gemma Frances Spiers, Camila Caiado, Barbara Hanratty","doi":"10.1093/bmb/ldad033","DOIUrl":"10.1093/bmb/ldad033","url":null,"abstract":"<p><strong>Background: </strong>Older adults' use of social care and their healthcare utilization are closely related. Residents of care homes access emergency care more often than the wider older population; however, less is known about emergency care use across other social care settings.</p><p><strong>Sources of data: </strong>A systematic review was conducted, searching six electronic databases between January 2012 and February 2022.</p><p><strong>Areas of agreement: </strong>Older people access emergency care from a variety of community settings.</p><p><strong>Areas of controversy: </strong>Differences in study design contributed to high variation observed between studies.</p><p><strong>Growing points: </strong>Although data were limited, findings suggest that emergency hospital attendance is lowest from nursing homes and highest from assisted living facilities, whilst emergency admissions varied little by social care setting.</p><p><strong>Areas timely for developing research: </strong>There is a paucity of published research on emergency hospital use from social care settings, particularly home care and assisted living facilities. More attention is needed on this area, with standardized definitions to enable comparisons between studies.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"32-44"},"PeriodicalIF":5.2,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10938536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138796940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wharton's jelly and osteoarthritis of the knee.","authors":"Adarsh Aratikatla, Nicola Maffulli, Manu Gupta, Ishana A Potti, Anish G Potty, Ashim Gupta","doi":"10.1093/bmb/ldad030","DOIUrl":"10.1093/bmb/ldad030","url":null,"abstract":"<p><strong>Introduction: </strong>The existing treatment modalities for knee osteoarthritis (OA) do not actually address the pathology. Biological therapies, including those using material derived from perinatal tissues, represent a ground-breaking approach to alleviating the symptoms of OA of the knee.</p><p><strong>Source of data: </strong>Current scientific literature published in PubMed (MEDLINE), Embase and Scopus databases. Trials registered in various clinical trial databases.</p><p><strong>Areas of agreement: </strong>Perinatal tissues including Wharton's jelly (WJ) and associated mesenchymal stem cells (MSCs) can be used for the management of knee OA.</p><p><strong>Areas of controversy: </strong>The efficacy of WJ and associated MSCs in the management of knee OA is still controversial.</p><p><strong>Growing points: </strong>The use of WJ and associated MSCs in the management of knee OA is safe and appears to be effective.</p><p><strong>Areas timely for developing research: </strong>The present published evidence suggests that WJ tissue and associated MSCs offer an encouraging alternative for the management of knee OA. The published in vitro, preclinical and clinical investigations demonstrate the therapeutic potential of WJ and promote further research in this field to provide symptomatic relief to patients suffering from OA, aiming also to regenerate the osteoarthritic hyaline cartilage, with disease-modifying effects. Future adequately powered randomized controlled trials should be undertaken to establish whether WJ is helpful in the management of OA of the knee.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"13-31"},"PeriodicalIF":5.2,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10993459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138796943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction of: Nutrition, adult hippocampal neurogenesis and mental health.","authors":"","doi":"10.1093/bmb/ldae001","DOIUrl":"10.1093/bmb/ldae001","url":null,"abstract":"","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"90"},"PeriodicalIF":6.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing the risks of nuclear war: the role of health professionals†.","authors":"Andy Haines, Ira Helfand, Arun Mitra, Tilman Ruff, Chris Zielinski","doi":"10.1093/bmb/ldad019","DOIUrl":"10.1093/bmb/ldad019","url":null,"abstract":"","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"89-91"},"PeriodicalIF":6.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10724453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10180664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to tackle health inequalities in cardiovascular risks for socioeconomically disadvantaged populations: a rapid review.","authors":"Yu Fu, Ge Yu, Naswa Maulana, Katie Thomson","doi":"10.1093/bmb/ldad025","DOIUrl":"10.1093/bmb/ldad025","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease (CVD) has shown significant health inequalities for people with low socioeconomic status associated with more risk factors. This review was to synthesize interventions that targeted CVD risks and outcomes among socioeconomically disadvantaged populations and to understand the impact associated with these interventions.</p><p><strong>Sources of data: </strong>Cochrane CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL were searched for records published in the last decade using a systematic search strategy, complemented by screening the reference lists and citation indexes. Nineteen studies were included and a narrative synthesis with the effect direction plot was undertaken in which studies, interventions, participants and outcomes were examined according to the intervention type focusing on behaviours, lifestyle, education, medication and monitoring.</p><p><strong>Areas of agreement: </strong>No universal definition of disadvantaged socioeconomic status was used with common factors relating to racial/ethnic minorities, low income and low or no health insurance. Mixed effects of interventions were reported on clinical outcomes including weight, body mass index, blood pressure, glycated haemoglobin and cholesterol.</p><p><strong>Areas of controversy: </strong>Inconsistent effect was reported due to a large variety of settings, participants and intervention components although they are considered necessary to address the complex health needs of socioeconomically disadvantaged populations.</p><p><strong>Growing points: </strong>There is inadequate evidence to determine whether any of the intervention types are effective in optimising lipids management for socioeconomically disadvantaged populations.</p><p><strong>Areas timely for developing research: </strong>Research is needed with mixed evidence using real world evaluation and lived experience combined with health economic evaluation, on both mental and physical health outcomes.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"22-41"},"PeriodicalIF":6.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10724464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41114810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of clinical trials-is it virtual?","authors":"Cho Ee Ng, Sarah Bowman, Jonathan Ling, Rachael Bagshaw, Angela Birt, Yan Yiannakou","doi":"10.1093/bmb/ldad022","DOIUrl":"10.1093/bmb/ldad022","url":null,"abstract":"<p><strong>Introduction: </strong>Participant recruitment to clinical trials is often sub-optimal. Decentralized clinical trials have the potential to address challenges in traditional site-based clinical trial recruitment.</p><p><strong>Sources of data: </strong>This review is based on recently published literature and the experience of running a large industry-sponsored interventional trial using both traditional and decentralized methods.</p><p><strong>Areas of agreement: </strong>Efficient delivery of clinical trials is essential to continue to provide therapeutic improvements in a timely and cost-efficient way. Clinical trial designs are constantly evolving to achieve effective trial delivery, manage the complexity of new therapeutic algorithms and conform to cultural developments.</p><p><strong>Areas of controversy: </strong>Digitally innovative decentralized clinical trials may be a solution to improve recruitment and retention. Although many trials incorporate digital innovations to reduce patient burden, decentralized clinical trials allow remote access to clinical research, potentially enhancing geographical diversity as well as reducing participant burden.</p><p><strong>Growing points: </strong>Areas for development currently being discussed are developing a 'recruitment platform' that exploits the reach of digital connectivity, automated identification of eligible participants from volunteers, employing technology for remote interaction and exploring the logistic process of delivering the interventions.</p><p><strong>Areas timely for relevant research: </strong>The focus of development must ensure that the overall impact will widen participation and reduce inequalities in healthcare.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"42-57"},"PeriodicalIF":6.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10185632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the challenges facing the paramedic profession in the United Kingdom.","authors":"Georgette Eaton","doi":"10.1093/bmb/ldad024","DOIUrl":"10.1093/bmb/ldad024","url":null,"abstract":"<p><strong>Background: </strong>The paramedic profession within the United Kingdom has been evolving at pace over the last 20 years. While they are most associated with their work in ambulance services, paramedics are now found throughout a range of clinical and academic settings.</p><p><strong>Sources of data: </strong>Literature Review.</p><p><strong>Areas of agreement: </strong>Despite emergence of the paramedic across the healthcare workforce, the understanding and awareness of the professional role and capabilities is poor. This could be due to a lack of representation within senior leadership roles and within health and social care policy.</p><p><strong>Areas of controversy: </strong>Understanding of the paramedic professional identity, from a philosophical and sociological perspective, remains incomplete.</p><p><strong>Growing points: </strong>A challenge for the future is to explore how the paramedic role can continue to develop across a range of clinical settings, while retaining its sui generis professional identity.</p><p><strong>Areas timely for developing research: </strong>Research to establish perspectives of and about the paramedic profession may assist in developing an understanding of identity and its place within the wider healthcare workforce.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"70-78"},"PeriodicalIF":6.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10724452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10238855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small interfering RNAs in the management of human osteoporosis.","authors":"Giuseppe Gargano, Giovanni Asparago, Filippo Spiezia, Francesco Oliva, Nicola Maffulli","doi":"10.1093/bmb/ldad023","DOIUrl":"10.1093/bmb/ldad023","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis results in reduced bone mass and consequent bone fragility. Small interfering RNAs (siRNAs) can be used for therapeutic purposes, as molecular targets or as useful markers to test new therapies.</p><p><strong>Sources of data: </strong>A systematic search of different databases to May 2023 was performed to define the role of siRNAs in osteoporosis therapy. Fourteen suitable studies were identified.</p><p><strong>Areas of agreement: </strong>SiRNAs may be useful in studying metabolic processes in osteoporosis and identify possible therapeutic targets for novel drug therapies.</p><p><strong>Areas of controversy: </strong>The metabolic processes of osteoporosis are regulated by many genes and cytokines that can be targeted by siRNAs. However, it is not easy to predict whether the in vitro responses of the studied siRNAs and drugs are applicable in vivo.</p><p><strong>Growing points: </strong>Metabolic processes can be affected by the effect of gene dysregulation mediated by siRNAs on various growth factors.</p><p><strong>Areas timely for developing research: </strong>Despite the predictability of pharmacological response of siRNA in vitro, similar responses cannot be expected in vivo.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"58-69"},"PeriodicalIF":6.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10542328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing patient-centred care in dentistry: a narrative review.","authors":"Camilla Böhme Kristensen, Koula Asimakopoulou, Sasha Scambler","doi":"10.1093/bmb/ldad026","DOIUrl":"10.1093/bmb/ldad026","url":null,"abstract":"<p><strong>Introduction: </strong>Patient-centred care (PCC) is widely used within the medical setting, but there is a need for more research on PCC implementation in dentistry.</p><p><strong>Sources of data: </strong>A narrative review was conducted with literature identified from the Ovid Interface, including several databases such as Embase and Medline.</p><p><strong>Areas of agreement: </strong>PCC is associated with better health outcomes for patients, and greater work satisfaction among healthcare professionals.</p><p><strong>Areas of controversy: </strong>Efforts to implement PCC in dentistry are lacking due to several issues including non-consensus about PCC definition and lack of explicit guidelines on how to implement PCC in dentistry.</p><p><strong>Growing points and areas timely for developing research: </strong>A theory-derived model of PCC explicitly designed for the dental setting was identified. This serves as a starting point to enhance PCC in dentistry, though further research is needed to empirically test the implementation of this model.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"79-88"},"PeriodicalIF":6.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10724466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41191931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated mortality among the second-generation (children of migrants) in Europe: what is going wrong? A review.","authors":"Matthew Wallace, Lucinda Hiam, Robert Aldridge","doi":"10.1093/bmb/ldad027","DOIUrl":"10.1093/bmb/ldad027","url":null,"abstract":"<p><strong>Introduction: </strong>The 'second-generation' (i.e. the children of migrants) represent one of the fastest growing subpopulations of the child and young adult populations in Europe today. The research so far appears to indicate that their mortality risk is elevated relative to people with non-migrant backgrounds.</p><p><strong>Sources of data: </strong>Peer-reviewed publications.</p><p><strong>Areas of agreement: </strong>Second-generation status is a clear marker of elevated mortality risk in Europe in early life (including stillbirth, perinatal, neonatal and infant mortality) and adulthood, particularly if the parent(s) were born outside of Europe. Socioeconomic inequality plays an important, albeit rarely defining, role in these elevated risks.</p><p><strong>Areas of controversy: </strong>It remains unclear what causes-of-death are driving these elevated mortality risks. The exact influence of (non-socioeconomic) explanatory factors (e.g. health care, racism & discrimination, and factors related to integration) on the elevated mortality risks of the second-generation also remains unclear.</p><p><strong>Growing points: </strong>The second-generation will continue to grow and diversify in Europe; we must intervene to address these inequalities now.</p><p><strong>Areas timely for developing research: </strong>Place more emphasis on the complexity of migration background, specific causes-of-death, and understanding the roles of explanatory factors beyond socioeconomic background.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":"5-21"},"PeriodicalIF":6.7,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10724460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}