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Mashup Score: 0
Objective To determine whether the combined use of glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT-2) inhibitors is associated with a decreased risk of major adverse cardiovascular events and serious renal events compared with either drug class alone among patients with type 2 diabetes, and to assess the effect of the combination on the individual components of major adverse cardiovascular events, heart failure, and all cause mortality. Design Population based cohort study using a prevalent new-user design, emulating a trial. Setting UK Clinical Practice Research Datalink linked to Hospital Episode Statistics Admitted Patient Care and Office for National Statistics databases. Participants Two prevalent new-user cohorts were assembled between January 2013 and December 2020, with follow-up until the end of March 2021. The first cohort included 6696 patients who started GLP-1 receptor agonists and added on SGLT-2 inhibitors, and the second includ
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Mashup Score: 2When will Canada have national pharmacare? - 5 hour(s) ago
Canadians support it, public health demands it, now policy makers must deliver it Canada’s universal healthcare system, often referred to as Medicare, provides universal, public insurance for medically necessary physicians’ services and hospital care, including inpatient prescription drugs.1 Prescriptions filled outside hospitals are not part of this system, forcing Canadians to rely on an incomplete and uncoordinated patchwork of public and private drug plans.2 That might soon change. Canada’s federal government is debating a bill that would take the first step towards universal, public coverage of prescription drugs, legislation that has been long called for and often promised by government.3 But implementation of a “national pharmacare” system will face formidable opposition. Presently, Canada’s federal government, 10 provincial governments, and three territorial governments offer more than 100 different public drug plans for population subgroups that vary across the country.4 Each
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Mashup Score: 7Medicine is designed for righthanded people - 6 hour(s) ago
Chloe Milton describes the challenges of being left handed in clinical environments that are designed for righthanded use The surgeon glared at me. When I asked what I’d done wrong they replied that they found it “scary” that I’d used the “wrong” hand to cut sutures when assisting in theatre. What’s scary to me is how easily the challenges faced by lefthanded trainees are dismissed—an experience I’ve had not only in surgery but across all medical specialties. Medicine needs to move away from the idea of “right” and “wrong” hands, so that lefthanded students learning examination and surgical skills are properly supported in caring for patients. From the beginning of my first year of medical school I noticed that the whole clinical environment was designed for righthanded use. Tradition dictates that you should stand on the right side of a patient when examining them, making it difficult—if not impossible—to use your left hand to do so. Moreover, the equipment used in clinical skills ses
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Mashup Score: 2Prenatal opioid exposure and subsequent risk of neuropsychiatric disorders in children: nationwide birth cohort study in South Korea - 6 hour(s) ago
Objective To investigate the potential association between prenatal opioid exposure and the risk of neuropsychiatric disorders in children. Design Nationwide birth cohort study. Setting From 1 January 2009 to 31 December 2020, birth cohort data of pregnant women in South Korea linked to their liveborn infants from the National Health Insurance Service of South Korea were collected. Participants All 3 251 594 infants (paired mothers, n=2 369 322; age 32.1 years (standard deviation 4.2)) in South Korea from the start of 2010 to the end of 2017, with follow-up from the date of birth until the date of death or 31 December 2020, were included. Main outcome measures Diagnosis of neuropsychiatric disorders in liveborn infants with mental and behaviour disorders (International Classification of Diseases 10th edition codes F00-99). Follow-up continued until the first diagnosis of neuropsychiatric disorder, 31 December 2020 (end of the study period), or the date of death, whichever occurred firs
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Mashup Score: 0Big alcohol: Universities and schools urged to throw out industry-funded public health advice - 7 hour(s) ago
The long term harms of alcohol are being minimised in industry funded education, find Madlen Davies and Hristio Boytchev Universities and schools are being urged to join a growing movement in Ireland and the UK that seeks to drive out the alcohol industry from any influence on public health advice on drinking. A campaign in Ireland has led to educational programmes funded by the alcohol industry being removed from schools.1 But industry backed groups still provide alcohol education in UK schools, including a theatre group funded by drinks giant Diageo. Universities are also targeted: Drinkaware, a charity funded by major alcohol producers and retailers, venues, and restaurant groups, funds freshers’ education materials, including a free cup to measure alcohol units. The public health community is calling for an Ireland-style ban on materials by industry associated charities because they normalise drinking, are poorly evaluated, and take up space that otherwise could be filled by truly
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Mashup Score: 1Helen Salisbury: Sick notes and a national illness service - 9 hour(s) ago
A common complaint about the NHS is that it’s not so much a health service as an illness service and that we’d be a healthier, happier, and richer society if we focused on prevention rather than leaping into action only when people fall ill. There are many analogies, such as not just fishing bodies out of the river but going upstream to find out who’s pushing people in, or building a fence at the top of the cliff rather than parking your ambulance at the bottom. Of course, the NHS has some effective prevention programmes, including immunisations and the screening programmes for bowel and cervical cancer. The NHS …
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Mashup Score: 0Minimum unit pricing for alcohol saves lives, so why is it not implemented more widely? - 9 hour(s) ago
Minimum unit pricing (MUP) saves lives, particularly among heavy drinkers, and should be widely rolled out for the benefit of all, say Peter Anderson and colleagues ### Key messages Minimum unit pricing (MUP) for alcohol sets a price below which alcohol cannot be legally sold based on alcohol content. In Scotland, the price was set in 2018 at 50p per unit (8 g of alcohol)1 and will increase to 65p in September 2024.2 A major justification for MUP is to target cheaper, high strength alcohol, which is disproportionately purchased by people who drink heavily.1 MUP is one of a suite of alcohol pricing policies, including excise taxes,3 endorsed for implementation by all member states of the World Health Organization.4 Minimum pricing for alcohol was introduced in Ontario, Canada, soon after prohibition was repealed in the 1920s.5 Minimum prices were used to stabilise alcohol markets that were operated by government alcohol monopolies, an important source of government revenue.5 Widespread
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Mashup Score: 0Commercially driven efforts to frame alcohol harms have no place in UK health policy development - 9 hour(s) ago
Including the alcohol industry and allied organisations in decision making around alcohol regulation and policy can promote industry commercial interests over the health of the public There is considerable evidence of the role of commercial actors, particularly harmful commodity producers, and the trade associations and third party organisations they fund, in shaping policy and public discourse to their own ends.12 These actors undermine the adoption of effective prevention policies3 while presenting themselves as health experts and self-regulators.4 The cross-industry use of such strategies, including by the alcohol industry, is well documented. The World Health Organization (WHO) thus recommends that alcohol producers should not be part of policy considerations, beyond policy implementation.56 Despite this, in the UK, the alcohol industry remains an active participant in alcohol policy development. A recent parliamentary oral evidence session7 focused on preventing alcohol harms serv
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Mashup Score: 0Big alcohol: Universities and schools urged to throw out industry-funded public health advice - 9 hour(s) ago
The long term harms of alcohol are being minimised in industry funded education, find Madlen Davies and Hristio Boytchev Universities and schools are being urged to join a growing movement in Ireland and the UK that seeks to drive out the alcohol industry from any influence on public health advice on drinking. A campaign in Ireland has led to educational programmes funded by the alcohol industry being removed from schools.1 But industry backed groups still provide alcohol education in UK schools, including a theatre group funded by drinks giant Diageo. Universities are also targeted: Drinkaware, a charity funded by major alcohol producers and retailers, venues, and restaurant groups, funds freshers’ education materials, including a free cup to measure alcohol units. The public health community is calling for an Ireland-style ban on materials by industry associated charities because they normalise drinking, are poorly evaluated, and take up space that otherwise could be filled by truly
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 33The case for reform of rotational training - 10 hour(s) ago
Supporters argue that it broadens trainee experience—while detractors say the burden of moving to a new placement every few months is too high. The clamour for change is growing, reports Jo Best Calls for reform of rotational training have been growing. Grassroots movements, junior doctors’ committees, and others have been calling for updates to a system that they say brings little benefit and much disadvantage to doctors in training. Under the current system (see box 1) trainees rotate to new jobs—often spread over a wide geographical area—every few months for anything up to a decade (or longer if working less than full time) before achieving their certificate of completion of training. Supporters of the system argue that doctors are thus exposed to different hospitals, patient populations, and ways of working, bringing a breadth of knowledge to their practice. Box 1 ### How does rotational training work? The current rotational training system requires doctors to move between jobs reg
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Effect of combo Rx w/ glucagon-like peptide-1 receptor agonists & sodium-glucose cotransporter-2 inhibitors on incidence of CVD and serious renal events: population based cohort study https://t.co/MUJaHatCHz via @profLAzoulay et al @hswapnil @ChristosArgyrop @SABOURETCardio https://t.co/huZ6GGPAlE