British medical bulletin
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British medical bulletin · Dec 2014
ReviewCare of the dying: how do we replace the Liverpool Care Pathway?
Death is an inescapable certainty of life. Variability in care for dying persons, however, is present. The Liverpool Care Pathway (LCP) sought to guide care for the last days of life but was phased out after intense scrutiny. ⋯ Perceptions of relevant terminology; review of the definition of dying; improved recognition of the dying process and measuring the impact of communication skills training.
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Genomic science is developing rapidly, and engagement of public health professionals will be necessary to appraise new technologies and use them effectively. ⋯ Public health researchers should address how to accelerate the implementation of genomics for health benefit in developed and developing countries.
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British medical bulletin · Dec 2014
ReviewHigh-resolution imaging of bone and joint architecture in rheumatoid arthritis.
Rheumatoid arthritis (RA) is characterized by local and systemic bone loss caused by increased bone resorption. We describe the current utilization of high-resolution peripheral quantitative computed tomography (HR-pQCT) in the evaluation of bone and joint in RA. ⋯ Although HR-pQCT is currently a research tool, there is potential for its use in the clinical diagnosis and management in RA. Further research is required to evaluate the clinical relevance of imaging abnormalities identified in RA patients.
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British medical bulletin · Sep 2014
ReviewNon-communicable diseases in South Asia: contemporary perspectives.
Non-communicable diseases (NCDs) such as metabolic, cardiovascular, cancers, injuries and mental health disorders are increasingly contributing to the disease burden in South Asia, in light of demographic and epidemiologic transitions in the region. Home to one-quarter of the world's population, the region is also an important priority area for meeting global health targets. In this review, we describe the current burden of and trends in four common NCDs (cardiovascular disease, diabetes, cancer and chronic obstructive pulmonary disease) in South Asia. ⋯ Opportunities for innovative structural and behavioral interventions that promote maintenance of healthy lifestyles-such as moderate caloric intake, adequate physical activity and avoidance of tobacco-in the context of socioeconomic development are abundant. Testing of health care infrastructure and systems that best provide low-cost and effective detection and treatment of NCDs is a priority for policy researchers.
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British medical bulletin · Sep 2014
ReviewMortality as a measure of quality of care in infants with congenital cardiovascular malformations following surgery.
Mortality has traditionally been perceived as a straightforward measure of outcome and has been used to evaluate surgical performance. In the rapidly developing arena of paediatric cardiac surgery, the insightful analysis of mortality figures is challenging. ⋯ As the vast majority of children undergoing cardiac surgery now survive beyond 30 days, the focus for measures of quality is shifting towards morbidity.