Brit J Hosp Med
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A considerable portion of the world's population practices fasting, for religious purposes like Ramadan or to adopt a healthier lifestyle such as intermittent fasting. During this period, individuals undergo metabolic changes that alter their internal environment. ⋯ However, remodelling of the gastric environment and increases in concentrations of H. pylori were recorded. There is no relationship between fasting and the risk of developing H. pylori-induced peptic ulcers, suggesting that individuals with uncomplicated ulcers are not at risk of developing further ulcers and can participate in fasts provided they take the recommended measures.
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As part of the NHS long-term strategy to meet the medical and non-medical needs of patients, there is growing acceptance that the traditional model of service delivery can no longer meet current challenges. This has led to the co-creation of services with patients and other stakeholders such as the voluntary and community sector to help deliver these. Social prescribing, which is now available through the NHS, is one such option that allows individual patients with a social need to access local health resources and social support outside the NHS.
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Editorial
Understanding and managing the long-term cognitive consequences of traumatic brain injuries.
This editorial critically evaluates the current data on traumatic brain injuries and their effects on cognitive function. It discusses management strategies and clinical considerations to improve patient outcomes in light of these findings.
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Plastic surgery trauma care services vary widely between hospitals in the UK. The authors evaluated their plastic surgery trauma service and illustrated the use of lean thinking to successfully implement small interventions to create positive change. The study findings demonstrated an increase in the proportion of patients with trauma being treated in the outpatient clinic rather than in the main theatres. This coincided with an increase in the proportion of patients being treated on the day of presentation to hospital.
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Clinicians spend a considerable part of their time while supervising trainees providing feedback. It is generally accepted that feedback can play a major role in subsequent academic performance. Traditionally it was thought that all feedback was good feedback, that inevitably improved learner outcomes. ⋯ A learner who is feedback literate can recognise when they are getting feedback and understand how it relates to their progress; they can process it effectively both cognitively and emotionally, and they can put it in to action in ways which benefit their learning. Modifiable and non-modifiable factors can influence feedback literacy, with modifiable factors including feedback standards and supervisor behaviours. Providing clear feedback expectations, ensuring accuracy of feedback messages and focusing on the relationship between the teacher and learner have the most evidence for their effect on facilitating feedback literacy.