Brit J Hosp Med
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Microbiologists are frequently consulted for guidance on the investigation and management of infection, including antimicrobial prescribing in hospital settings. There is a rising demand for timely microbiology advice in the context of increasing global travel and antibiotic resistance, which give rise to complex cases. However, junior doctors are seldom trained in making effective referrals. ⋯ This benefits patients who are more likely to receive appropriate treatment. This article presents guidance, developed in consultation with specialists, to improve the quality of referrals to microbiologists. This includes the information required for a high-quality referral, and signposts referring clinicians to existing resources which are suitable for simpler cases not requiring specialist input.
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The COVID-19 pandemic challenged the NHS to make rapid adjustments to practice to ensure that patients could continue to access vital treatments while reducing the risk of infection. A roundtable discussion was convened, including professionals from cancer care delivery and those working in patient involvement, to discuss experiences during the pandemic and to offer recommendations for the safe transition and implementation of cancer care in the community setting.
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This article considers the strong public health response to the COVID-19 pandemic, while recognising that the system must be strengthened moving forwards. It provides an overview of the challenges facing public health today including widening social inequalities, increasingly squeezed health and social care budgets, changes to the public health landscape, and recovery from COVID-19.
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The population of people living with human immunodeficiency virus (HIV) is ageing and has an increasing burden of non-acquired immune deficiency syndrome (AIDS)-related morbidity and mortality, including frailty. Frailty is prevalent at a younger age in this population and is associated with multimorbidity, disability and death. This article examines the key interventions to ameliorate the advancement of frailty in people living with HIV. ⋯ Addressing the social determinants of frailty, such as social isolation and loneliness, are beneficial, but are dependent on local charities and resources. More research is required to assess pharmacological and nutritional interventions in frailty. This requires a greater understanding of the exact pathophysiology of frailty, which remains poorly understood.
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The World Health Organization draft global action plan aims to strengthen health services for asylum seekers and refugees in host countries. Addressing the healthcare needs of this population can be daunting but healthcare professionals can have a hugely positive impact by providing high quality, trauma-informed care and understanding the barriers these people may face in accessing care. This editorial unpicks the complexities healthcare professionals face when working with this vulnerable group.