British medical bulletin
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British medical bulletin · Jun 2021
ReviewProlotherapy for chronic low back pain: a review of literature.
Low back pain is common and imposes major societal burdens for patient suffering and costs. Prolotherapy injections are used for musculoskeletal conditions including tendinopathies, osteoarthritis and low back pain to enhance soft-tissue healing. This review aims to clarify the place of prolotherapy in chronic low back pain (CLBP). ⋯ The analysis of the studies included in the review, using appropriate tools, showed how their quality has decreased over the years, reflecting the need for appropriately powered well planned and performed randomized control trials.
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Vaccination decisions and policies present tensions between individual rights and the moral duty to contribute to harm prevention. This article focuses on ethical issues around vaccination behaviour and policies. It will not cover ethical issues around vaccination research. ⋯ The relationship between individual, collective and institutional responsibilities to contribute to the public good of herd immunity will be a major point of discussion, particularly with regard to the COVID-19 vaccine.
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Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality. To improve the health status and reduce symptom burden, it is important to identify a group of patients with similar characteristics and prognosis, called clinical phenotypes. Herein we shall review the different phenotypes of COPD. ⋯ Well-designed COPD trials with identification of phenotypes for more personalization of the treatment of COPD.
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British medical bulletin · Mar 2021
ReviewDesigning delivery models of traditional and complementary medicine services: a review of international experiences.
The World Health Organization advocates integration of traditional and complementary medicine (T&CM) into the conventional health services delivery system. Integrating quality services in a patient-centred manner faces substantial challenges when T&CM is delivered within a health system dominated by conventional medicine. This review has synthesized international experiences of integration strategies across different contexts. ⋯ Research is needed on the optimal methods for financing integrated care to ensure equitable access, as well as in remuneration of T&CM practitioners working in integrative healthcare.
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British medical bulletin · Mar 2021
ReviewSedentary behaviour in the workplace: prevalence, health implications and interventions.
This paper reviews the prevalence and health risks of excess sedentary behaviour in office workers, and the effectiveness of sedentary workplace interventions in a manner accessible to practitioners. ⋯ Determining the long-term health and cost-effectiveness of sedentary workplace interventions is a priority to encourage employer buy-in for their implementation.