Current dietary advice and challenges for adolescents
AbstractBackgroundThe major risk factors driving the global burden of disease are diet related. Adolescence presents a window of opportunity for establishing healthy dietary trajectories. Yet around the world, adolescents experience many barriers that prevent them from consuming diets that would give them the foundation for long, healthy and productive adult lives.Sources of dataA narrative literature search of most relevant original, review and meta-analyses, restricted to English was conducted in Medline, Web of Science and PubMed up to December 2019 together with published papers known to the author concerning the curre...
Source: British Medical Bulletin - June 3, 2020 Category: General Medicine Source Type: research
Health inequalities are worsening in the North East of England
AbstractBackgroundThe North of England, particularly the North East (NE), has worse health (e.g. 2 years lower life expectancy) and higher health inequalities compared to the rest of England.Sources of dataWe explore this over time drawing on publicly available data.Areas of agreement and controversyWhilst overall health is improving, within-regional health inequalities are getting worse and the gap between the NE and other regions (particularly the South of England) is worsening. The gap in life expectancy is widening with substantial variation between deprived and affluent areas within the NE. Those living in the NE ar...
Source: British Medical Bulletin - May 28, 2020 Category: General Medicine Source Type: research
Understanding and managing suicide risk
AbstractBackgroundSuicidal behaviours and non-suicidal self-harm (NSSH) are global public health concerns that affect millions of lives.Sources of dataThis review is a narrative synthesis of systematic reviews, meta-analyses of randomized control trials (RCTs) and landmark studies published in scientific journals.Areas of agreementRestricting access to lethal means reduces the likelihood of future suicide deaths.Areas of controversyOur ability to predict future suicidal behaviour is no better than chance. No individual risk prediction instrument offers sufficient sensitivity and specificity to inform clinically useful deci...
Source: British Medical Bulletin - May 21, 2020 Category: General Medicine Source Type: research
Posterior shoulder instability: a systematic review
AbstractIntroductionThis review aims to provide information on outcomes of surgical procedures for soft tissue or bony glenoid and/or humeral abnormalities in case of posterior shoulder instability.Source of dataA systematic review of the literature according to the PRISMA guidelines was performed. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, Ovid and Google Scholar databases using various combinations of the keywords ‘shoulder’, ‘posterior instability’, ‘dislocation’, ‘reversed bony bankart’, ‘reversed Hill Sachs’, and ‘capsulolabral’ was performed.Areas of agreementA total ...
Source: British Medical Bulletin - May 18, 2020 Category: General Medicine Source Type: research
The mental health status of asylum seekers in middle- to high-income countries: a synthesis of current global evidence
AbstractIntroductionThe last 5 years have witnessed a significant increase in the number of people fleeing their countries of origin and seeking refuge in host countries. By the end of 2018, there were 3.5 million asylum seekers awaiting outcomes on their applications, the majority of whom were hosted by middle- to high-income countries. This review aimed to identify and synthesize current knowledge regarding the mental health status of asylum seekers in middle- to high-income countries.Sources of dataA search was conducted across various databases for research literature published within the last 5 years (2014 –2019). T...
Source: British Medical Bulletin - May 14, 2020 Category: General Medicine Source Type: research
Non-insulin therapies in addition to insulin in Type 1 DM treatment
AbstractIntroductionComplications of Type 1 diabetes (T1DM) remain prevalent due to suboptimal glycaemic control despite advances in analogue insulin, its delivery and technological advances in glucose monitoring. Intensive insulin therapy is associated with hypoglycaemia and weight gain. Non –insulin-dependent glucose lowering strategies may provide a strategy in improving glycaemic control without hypoglycaemia and weight gain.Sources of dataResearch papers and reviews about adjunctive treatment with insulin in T1DM in the published literature.Areas of agreementNon –insulin-dependent strategies may be beneficial inT1...
Source: British Medical Bulletin - May 14, 2020 Category: General Medicine Source Type: research
The health impact of climate change in cities of middle-income countries and the global nursing shortages
These important subjects have full free online access. In addition, as usual, the Bulletin has a section to celebrate its amazing archive, (see end of ‘In this Issue’). The BMB has been further developing its website and now has a fascinating section on the five Nobel Prize winners who wrote for the Bulletin and went on to win the accolade. A cheering thought for our present and future authors. (Source: British Medical Bulletin)
Source: British Medical Bulletin - June 21, 2019 Category: General Medicine Source Type: research
Immunohistochemical features of rotator cuff tendinopathy
AbstractBackgroundRotator cuff tendinopathy is a common musculoskeletal ailment in sedentary and athletic individuals. Various mediators of inflammation have been detected in human tendons: they are thought to initiate or progress the course of tendinopathy.Sources of dataAn online search was conducted using AMED, CINAHL, Embase, The Cochrane Library, PEDro and Pubmed, using the terms tendinopathy, tendon, tendinitis, tendinosis, histology, histopathology, immunohistochemistry, immunohistochemical, rotator cuff and pain.Areas of agreementHistological examination of tendinopathic tendons shows degeneration of the collagen s...
Source: British Medical Bulletin - May 16, 2019 Category: General Medicine Source Type: research
Tremor
AbstractIntroduction or backgroundTremor is one of the commonest movement disorders and can be disabling. There are many causes and treatment options include medications, adaptations, botulinum toxin injections and functional neurosurgery.Sources of dataPubmed.gov peer-reviewed journal articles and reviews.Areas of agreementA new tremor classification has been published. Axis 1 of this classification highlights the clinical characteristics of tremor and axis 2 is dedicated to aetiology. The cerebello-thalamo-cortical network and connections to other brain areas is emerging as pivotal to many types of tremor.Areas of contro...
Source: British Medical Bulletin - May 16, 2019 Category: General Medicine Source Type: research
Global nurse shortages —the facts, the impact and action for change
AbstractIntroductionNurses comprise half the global health workforce. A nine million shortage estimated in 2014 is predicted to decrease
by two million by 2030 but disproportionality effect regions such as Africa. This scoping review investigated: what is
known about current nurse workforces and shortages and what can be done to forestall such shortages?Sources of dataPublished documents from international organisations with remits for nursing workforces, published reviews with forward citation and key author searches.Areas of agreementAddressing nurse shortages requires a data informed, country specific model of the route...
Source: British Medical Bulletin - May 13, 2019 Category: General Medicine Source Type: research
Health impact of climate change in cities of middle-income countries: the case of China
AbstractBackgroundThis review examines the human health impact of climate change in China. Through reviewing available research findings under four major climate change phenomena, namely extreme temperature, altered rainfall pattern, rise of sea level and extreme weather events, relevant implications for other middle-income population with similar contexts will be synthesized.Sources of dataSources of data included bilingual peer-reviewed articles published between 2000 and 2018 in PubMed, Google Scholar and China Academic Journals Full-text Database.Areas of agreementThe impact of temperature on mortality outcomes was the...
Source: British Medical Bulletin - May 9, 2019 Category: General Medicine Source Type: research
MicroRNA in osteoarthritis: physiopathology, diagnosis and therapeutic challenge
AbstractBackgroundOsteoarthritis (OA) is the most orthopedic condition. The pattern of gene expression and the transcription factors that exert control of chondrogenesis have been extensively studied.Sources of dataA systematic search (up to July 2018) of articles assessing the role of microRNA (miRNA) in physiopathology, diagnosis and therapy of OA was performed, with the purpose of giving a critical perspective of the possibilities for diagnostic and therapeutic use of miRNA in the management of OA.Areas of agreementmiRNAs are small noncoding RNAs that can regulate gene expression in human cells. miRNAs can be expressed ...
Source: British Medical Bulletin - May 8, 2019 Category: General Medicine Source Type: research
Neuroinflammation is a putative target for the prevention and treatment of perioperative neurocognitive disorders
AbstractIntroductionThe demographics of aging of the surgical population has increased the risk for perioperative neurocognitive disorders in which trauma-induced neuroinflammation plays a pivotal role.Sources of dataAfter determining the scope of the review, the authors used PubMed with select phrases encompassing the words in the scope. Both preclinical and clinical reports were considered.Areas of agreementNeuroinflammation is asine qua non for development of perioperative neurocognitive disorders.Areas of controversyWhat is the best method for ameliorating trauma-induced neuroinflammation while preserving inflammation-...
Source: British Medical Bulletin - May 3, 2019 Category: General Medicine Source Type: research
The presence of residents during orthopedic operation exerts no negative influence on outcome
AbstractBackgroundOperative procedural training is a key component of orthopedic surgery residency. It is unclear how and whether residents participation in orthopedic surgical procedures impacts on post-operative outcomes.Sources of dataA systematic search was performed to identify articles in which the presence of a resident in the operating room was certified, and was compared with interventions without the presence of residents.Areas of agreementThere is a likely beneficial role of residents in the operating room, and there is only a weak association between the presence of a resident and a worse outcome for orthopedic...
Source: British Medical Bulletin - May 3, 2019 Category: General Medicine Source Type: research
Hospices and palliative care for children: converging stories
AbstractIntroductionChildren ’s hospices offer support to children and their families according to a model that is quite different from adult hospices and has evolved in parallel with specialist paediatric palliative medicine services.Sources of dataPublished research, Together for Short Lives.Areas of agreementThe services hospices offer are highly valued by families.Areas of controversyIt is not always clear that hospices can be described as ‘specialist’, which can make it difficult for hospices to negotiate appropriate commissioning arrangements with the statutory sector.Growing pointsChildren ’s palliative care...
Source: British Medical Bulletin - April 10, 2019 Category: General Medicine Source Type: research
