British medical bulletin最新文献_第6页

Ethical challenges and principles in integrated care. 综合护理的伦理挑战和原则。

IF 6.7 2区医学

British medical bulletin Pub Date : 2023-06-21 DOI: 10.1093/bmb/ldac030

Alex McKeown

{"title":"Ethical challenges and principles in integrated care.","authors":"Alex McKeown","doi":"10.1093/bmb/ldac030","DOIUrl":"10.1093/bmb/ldac030","url":null,"abstract":"Introduction: Integrated care is an established approach to delivery in parts of the healthcare infrastructure, and an ideal which, it is claimed, should be realized system-wide. Its ethical weight derives from its defence of a view about how healthcare ought to operate. Although the goal of integration is laudable, it is ethically and practically complex, involving trade-offs.Sources of data: Considerable evidence attests to widespread enthusiasm for integration, given the need to prevent harm and extend the reach of scarce resources. Equally, evidence increasingly highlights the obstacles to successfully translating this ideal into practice.Areas of agreement: The principle that healthcare should be seamless, ensuring that patients do not come to harm through gaps in care enjoys broad agreement. There is a similar consensus that placing the patient's perspective at the centre of decision-making is vital, since this enables identification of these gaps.Areas of controversy: Integrating care by making it seamless entails blurring boundaries of care domains. This risks undermining the locus of responsibility for care decisions via confusion about who has ownership of specialist knowledge where domains overlap. There is a lack of consensus about how successful integration should be measured.Growing points: More research into the relative cost-effectiveness of upstream public health investment in preventing chronic ill-health caused by modifiable lifestyle factors vs integrating care for people already ill; further research into ethical implications of integration in practice, which can be obscured by the simplicity of the fundamental normative principle guiding integration in theory.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"146 1","pages":"4-18"},"PeriodicalIF":6.7,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10286793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9760624","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}

引用次数: 1

Correction to: Does femoroacetabular impingement syndrome affect range of motion? A systematic review with meta-analysis. 修正:股髋臼撞击综合征影响活动范围吗?荟萃分析的系统综述。

IF 6.7 2区医学

British medical bulletin Pub Date : 2023-06-21 DOI: 10.1093/bmb/ldad006

引用次数: 0

From the Archive 来自档案

2区医学

British medical bulletin Pub Date : 2023-06-01 DOI: 10.1093/bmb/ldad015

引用次数: 0

Ethical challenges and principles in integrated care and Optimizing lipid management—impact of the COVID 19 pandemic upon cardiovascular risk in England, 2023 2023年英国2019冠状病毒病大流行对心血管风险的影响

IF 6.7 2区医学

British medical bulletin Pub Date : 2023-06-01 DOI: 10.1093/bmb/ldad014

引用次数: 0

Children and bioethics: clarifying consent and assent in medical and research settings. 儿童与生物伦理:澄清医学和研究环境中的同意和同意。

IF 6.7 2区医学

British medical bulletin Pub Date : 2023-04-05 DOI: 10.1093/bmb/ldac038

Merle Spriggs

引用次数: 3

Does femoroacetabular impingement syndrome affect range of motion? A systematic review with meta-analysis. 股骨髋臼撞击综合征会影响活动范围吗？系统回顾与荟萃分析。

IF 6.7 2区医学

British medical bulletin Pub Date : 2023-04-05 DOI: 10.1093/bmb/ldac027

Davide Bruno Albertoni, Silvia Gianola, Silvia Bargeri, Ilda Hoxhaj, Alice Munari, Nicola Maffulli, Greta Castellini

{"title":"Does femoroacetabular impingement syndrome affect range of motion? A systematic review with meta-analysis.","authors":"Davide Bruno Albertoni, Silvia Gianola, Silvia Bargeri, Ilda Hoxhaj, Alice Munari, Nicola Maffulli, Greta Castellini","doi":"10.1093/bmb/ldac027","DOIUrl":"10.1093/bmb/ldac027","url":null,"abstract":"Background: It is unclear whether femoroacetabular impingement syndrome (FAIS) affect hip range of motion (ROM).Sources of data: We performed a systematic review with meta-analysis searching six electronic databases from inception to March 21, 2022. We included studies assessing hip ROM in FAIS, FAI morphology without symptoms (FAIm), and healthy controls. Mean differences between groups were measured in ROM degrees with 95% confidence interval (CI).Areas of agreement: A total of 17 studies (1702 hips) were included. Comparison of FAIS patients versus healthy controls showed that hip ROM was clinically and statistically reduced in FAIS for internal rotation (90° hip flexion, -8.01°, 95% CI: -11.21, -4.90; 0° hip flexion -6.38°, 95% CI: -9.79, -2.97); adduction (90° hip flexion, -4.74°, 95% CI: -8.13, -1.34); flexion (-5.41°, 95% CI: -7.05, -3.49), abduction (0° hip flexion, -5.76°, 95% CI: -8.38, -3.23), and external rotation (90° hip flexion, -3.5°, 95% CI: -5.32, -1.67) ranging from low to high certainty of evidence. Comparison of FAIm versus healthy controls showed no statistically significant differences in any direction of movement, albeit with uncertainty of evidence.Areas of controversy: The certainty of evidence was unclear, particularly for asymptomatic FAIm.Growing points: Hip ROM may be reduced in all directions except extension in FAIS compared to controls. Hip ROM may not be restricted in asymptomatic FAIm.Areas timely for developing research: Further studies are needed to resolve the uncertainty of evidence about ROM restrictions in asymptomatic FAIm compared to healthy controls.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"145 1","pages":"45-59"},"PeriodicalIF":6.7,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9334401","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}

引用次数: 0

Slowing down or returning to normal? Life expectancy improvements in Britain compared to five large European countries before the COVID-19 pandemic. 放慢速度还是恢复正常?与COVID-19大流行前的五个欧洲大国相比，英国的预期寿命有所改善。

IF 6.7 2区医学

British medical bulletin Pub Date : 2023-04-05 DOI: 10.1093/bmb/ldac036

Jon Minton, Lucinda Hiam, Martin McKee, Danny Dorling

{"title":"Slowing down or returning to normal? Life expectancy improvements in Britain compared to five large European countries before the COVID-19 pandemic.","authors":"Jon Minton, Lucinda Hiam, Martin McKee, Danny Dorling","doi":"10.1093/bmb/ldac036","DOIUrl":"https://doi.org/10.1093/bmb/ldac036","url":null,"abstract":"Introduction or background: Life expectancy is an important summary measure of population health. In the absence of a significant event like war or disease outbreak, trends should, and historically have, increase over time, albeit with some fluctuations.Sources of data: Data were extracted from the human mortality database for life expectancy at birth and age 65 years from 1980 to the latest available year for England & Wales, Scotland (Great Britain), France, Spain, Italy, the Netherlands and Germany.Areas of agreement: It is well established that life expectancy improvements in Great Britain have stalled in recent years, and that a similar stalling was seen in other high-income countries during the mid-2010s.Areas of controversy: The significance and causes of the slowdown in improvement in life expectancy in Britain are disputed. First, was Britain's slowdown in progress in life expectancy in the 2010s a deviation 'from' earlier sustained improvements or simply returning to normal (slower) improvement rates following faster gains in the 2000s? Second, did other European countries have slowdowns comparable to that in Britain?Growing points: Life expectancy, as a summary measure, conceals inequalities. Other measures, such as lifespan disparity, complement it in understanding changing trends. While annual fluctuations in life expectancy are expected, continued stalls should raise concern. The three British nations examined were the only ones among these European countries to experience stalling of life expectancy gains in both sexes.Areas timely for developing research: While it is clear that Britain is making less progress in health than similar countries, more research is needed to explain why.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"145 1","pages":"6-16"},"PeriodicalIF":6.7,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9260463","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}

引用次数: 1

Loneliness-a clinical primer. 孤独——临床入门。

IF 6.7 2区医学

British medical bulletin Pub Date : 2023-04-05 DOI: 10.1093/bmb/ldad003

Zohar Lederman

{"title":"Loneliness-a clinical primer.","authors":"Zohar Lederman","doi":"10.1093/bmb/ldad003","DOIUrl":"https://doi.org/10.1093/bmb/ldad003","url":null,"abstract":"Introduction: loneliness is prevalent worldwide. It is also associated with an increased risk for depression, high blood pressure, cardiovascular disease, stroke and early death. As such, loneliness is a major public health issue. This paper summarizes the salient points clinicians should know and encourages clinicians to assume an active part in the identification, mitigation and prevention of loneliness.Sources of data: white papers, academic publications.Areas of agreement: loneliness is a distressful subjective experience, which does not always correlate with social isolation. Both internal (personal) and external (contextual, societal) factors determine whether an individual would feel lonely in a given situation.Areas of controversy: identifying loneliness in the clinic may be time consuming and challenging. There is a scarce robust evidence to support interventions.Growing points: due to increased individualization and incidence of infectious diseases, loneliness is likely to become even more prevalent.Areas timely for developing research: more research is needed to further elucidate the health impacts of loneliness as well as to find evidence-based interventions to prevent and mitigate loneliness that could then be implemented by policy-makers and clinicians.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"145 1","pages":"132-140"},"PeriodicalIF":6.7,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9704506","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}

引用次数: 0

Return to sport or work following surgical management of scapholunate ligament injury: a systematic review. 舟月骨韧带损伤手术治疗后恢复运动或工作:系统回顾。

IF 6.7 2区医学

British medical bulletin Pub Date : 2023-04-05 DOI: 10.1093/bmb/ldac026

Mei Yen Liew, Lewis A Dingle, Abi Semple, Philippa A Rust

{"title":"Return to sport or work following surgical management of scapholunate ligament injury: a systematic review.","authors":"Mei Yen Liew, Lewis A Dingle, Abi Semple, Philippa A Rust","doi":"10.1093/bmb/ldac026","DOIUrl":"https://doi.org/10.1093/bmb/ldac026","url":null,"abstract":"Introduction: This systematic review aims to compare the rate and time to return to sport or work following surgical interventions for isolated scapholunate ligament (SLL) injury.Sources of data: A PRISMA-compliant systematic search of Medline, EMBASE, Cochrane, AMED, CINAHL Plus and SPORTDiscus was performed using keywords 'scapholunate', 'scapholunate ligament', 'scaphoid lunate', 'sport', 'sport injury', 'athlete', 'athletic performance', 'elite', 'return to sport', 'training', 'work', 'activity', 'return to activity'. Adult patients with isolated SLL injury, without osteoarthritis, were included.Areas of agreement: Fourteen papers, including six different surgical interventions, met the criteria for the final analysis. All surgical techniques demonstrated acceptable rates of return to work or sport (>80%).Areas of controversy: The optimal surgical intervention for isolated SLL injury remains undetermined due to heterogeneity and limited sample sizes of published studies.Growing points: This systematic review has provided clarification on the available literature on treatment modalities for isolated SLL injuries in the absence of osteoarthritis.Areas timely for developing research: Prospective, randomized, primary studies are needed to establish optimal treatment for acute isolated SLL injuries.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"145 1","pages":"30-44"},"PeriodicalIF":6.7,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9689526","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}

引用次数: 0

Cancer survivors and adverse work outcomes: associated factors and supportive interventions. 癌症幸存者和不良工作结果:相关因素和支持性干预。

IF 6.7 2区医学

British medical bulletin Pub Date : 2023-04-05 DOI: 10.1093/bmb/ldac028

Angela G E M de Boer, Astrid de Wind, Pieter Coenen, Fenna van Ommen, Michiel A Greidanus, Amber D Zegers, Saskia F A Duijts, Sietske J Tamminga

{"title":"Cancer survivors and adverse work outcomes: associated factors and supportive interventions.","authors":"Angela G E M de Boer, Astrid de Wind, Pieter Coenen, Fenna van Ommen, Michiel A Greidanus, Amber D Zegers, Saskia F A Duijts, Sietske J Tamminga","doi":"10.1093/bmb/ldac028","DOIUrl":"https://doi.org/10.1093/bmb/ldac028","url":null,"abstract":"Introduction: The number of cancer survivors in a working age is rising. An awareness of factors associated with adverse work outcomes, and of supportive interventions, is needed.Sources of data: A narrative review of research obtained via several databases, including Medline and PsycINFO, was conducted.Areas of agreement: A range of factors is associated with adverse work outcomes such as prolonged sick leave, delayed return to work, disability pension and unemployment in cancer survivors. They include the cancer type and treatment, fatigue, cognitive functioning, work factors and elements of health care systems. Effective supportive interventions encompass physical and multicomponent interventions.Areas of controversy: The role of behaviour determinants and legislative and insurance systems is unclear. It is furthermore uncertain what the optimal timing of delivering supportive interventions is.Growing points: Further focus on vulnerable groups, including specific cancer types and those with lower income, lower educational level and in precarious employment, is needed.Areas timely for developing research: Recent developments are tailored and timely interventions.","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"145 1","pages":"60-71"},"PeriodicalIF":6.7,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4f/15/ldac028.PMC10075241.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9327355","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}

引用次数: 5