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Mashup Score: 66Deprescribing in older adults with polypharmacy - 1 hour(s) ago
Polypharmacy is common in older adults and is associated with adverse drug events, cognitive and functional impairment, increased healthcare costs, and increased risk of frailty, falls, hospitalizations, and mortality. Many barriers exist to deprescribing, but increased efforts have been made to develop and implement deprescribing interventions that overcome them. This narrative review describes intervention components and summarizes findings from published randomized controlled trials that have tested deprescribing interventions in older adults with polypharmacy, as well as reports on ongoing trials, guidelines, and resources that can be used to facilitate deprescribing. Most interventions were medication reviews in primary care settings, and many contained components such as shared decision making and/or a focus on patient care priorities, training for healthcare professionals, patient facing education materials, and involvement of family members, representing great heterogeneity in
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Mashup Score: 0Guidance on terminology, application, and reporting of citation searching: the TARCiS statement - 3 hour(s) ago
Evidence syntheses adhering to systematic literature searching techniques are a cornerstone of evidence based healthcare. Beyond term based searching in electronic databases, citation searching is a prevalent search technique to identify relevant sources of evidence. However, for decades, citation searching methodology and terminology has not been standardised. An evidence guided, four round Delphi consensus study was conducted with 27 international methodological experts in order to develop the Terminology, Application, and Reporting of Citation Searching (TARCiS) statement. TARCiS comprises 10 specific recommendations, each with a rationale and explanation on when and how to conduct and report citation searching in the context of systematic literature searches. The statement also presents four research priorities, and it is hoped that systematic review teams are encouraged to incorporate TARCiS into standardised workflows. Synthesising scientific evidence by looking at the citation r
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Mashup Score: 13Helen Salisbury: No jobs for GPs—we’ll be missed when we’re gone - 5 hour(s) ago
Only two years ago when we were looking to add to our team of doctors, we had just a handful of applicants. Other practices nearby had to do several rounds of recruitment before being able to appoint. Up and down the country the story was the same: there simply weren’t enough doctors. Now we’ve moved from a situation of not enough GP applicants for advertised posts to one of intense competition for jobs. It’s not that there’s been a sudden influx of qualified GPs—in fact their number hasn’t shifted, despite an increase in both population and need.1 What has happened is that the …
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Mashup Score: 0An uncommon common cold - 7 hour(s) ago
This is a magnetic resonance image of the head of a previously well teenager with a one month history of nasal congestion and coryzal symptoms who developed severe headache and recurrent high fever (fig 1). He had no history of surgery …
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Mashup Score: 2Revolving doors: board memberships, hedge funds, and the FDA chiefs responsible for regulating industry - 17 hour(s) ago
The US Food and Drug Administration says that it takes conflicts of interest seriously. But financial entanglements with the drug industry are common among its leaders. Peter Doshi reports At his public confirmation hearing in late 2021, Robert Califf, President Biden’s nominee to lead the US Food and Drug Administration (FDA), faced pointed questions about his financial relationships with industry. Bernie Sanders, the senator from Vermont, asked, “At a time when the American people are outraged by the high cost of prescription drugs, deeply disturbed about what happened with Purdue and Oxycontin, what kind of comfort can you give to the American people when you have been so closely tied to the pharmaceutical industry yourself?” He added, “How can the American people feel comfortable you’re going to stand up to this powerful special interest?” Califf responded: “Senator Sanders, I have a history of doing that. But I’d also point out that this administration has the most stringent ethic
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Mashup Score: 19Engaging men and boys in sexual and reproductive health and rights - 17 hour(s) ago
Men and boys are critical to meaningful progress in gender equality Two of the UN’s sustainable development goals (on good health and wellbeing and on gender equality) emphasise improving sexual and reproductive health and rights.1 Given the centrality of unequal gender and power relations to this issue, we need to work with men and boys, alongside women and girls, to make meaningful progress.23456 For example, when services deliver women’s family planning advice by mobile phone in countries where men often control women’s use of mobile phones as well as their birth spacing choices, we must ensure that male partners understand the importance of respecting women’s bodily autonomy and supporting their choices.78 And we cannot teach sex education in schools without adequately challenging boys about their norms, beliefs, and behaviours with respect to sexual consent and safe sex, given that boys are an important part of the solution for issues such as gender based sexual violence, teenage
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Mashup Score: 25Work and vocational rehabilitation for people living with long covid - 19 hour(s) ago
### What you need to know Long covid is a complex, highly variable, and sometimes relapsing-remitting condition that may have profound impacts on a patient’s wellbeing and ability to work.1 Many people living with long covid are attempting to return to work, or stay in work, while learning to manage an emerging long term condition.2 These challenges may be compounded by workplace burnout, fuelled by labour shortages, the psychological effects of the pandemic, widening inequalities, and global economic insecurity. For some people, disabling symptoms lead to complete inability to work.3 In less extreme cases, “work instability,” which is a mismatch between patients’ functional abilities and the demands of their work, can threaten employment if not addressed.45 This may manifest as difficulties in executive functioning and communication which adversely affect those in roles where they are expected to deliver at optimum performance in high pressure working environments. Numerically, howeve
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Mashup Score: 29The UK doesn’t have a “sick note culture,” but it does have a broken benefits system - 20 hour(s) ago
The government needs to stop demonising disabled people and tackle the barriers that prevent them from accessing work, says James Taylor The government claims it’s planning to tackle the rise in economic inactivity in the UK by cracking down on Britain’s “sick note culture.”1 But for charities like Scope, who support disabled people to find suitable jobs, this assessment is entirely and infuriatingly off the mark. A “sick note” culture simply doesn’t exist. Around a million disabled people in the UK want to work, but are unable to because of a number of barriers, such as discrimination from employers, difficulty getting the right support they need, and inflexible working practices.2 All that the government’s damaging rhetoric will achieve is to make life harder for the UK’s 16 million disabled people.3 An extremely worrying report from the United Nations Committee on the Rights of Persons with Disabilities recently found that the government’s welfare reforms are “premised on a notion t
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Mashup Score: 93Association of ultra-processed food consumption with all cause and cause specific mortality: population based cohort study - 21 hour(s) ago
Objective To examine the association of ultra-processed food consumption with all cause mortality and cause specific mortality. Design Population based cohort study. Setting Female registered nurses from 11 US states in the Nurses’ Health Study (1984-2018) and male health professionals from all 50 US states in the Health Professionals Follow-up Study (1986-2018). Participants 74 563 women and 39 501 men with no history of cancer, cardiovascular diseases, or diabetes at baseline. Main outcome measures Multivariable Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals for the association of ultra-processed food intake measured by semiquantitative food frequency questionnaire every four years with all cause mortality and cause specific mortality due to cancer, cardiovascular, and other causes (including respiratory and neurodegenerative causes). Results 30 188 deaths of women and 18 005 deaths of men were documented during a median of 34 and 31 y
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Mashup Score: 25
Giving greater attention to the specific challenges facing doctors in training is a necessary step towards improving working conditions and wellbeing, writes Alexander Mafi The working conditions of doctors in training have had a brief moment in the spotlight following a recent letter from NHS England (NHSE) to NHS trusts urging measures to improve our working lives.1 While it’s encouraging to hear a call for nationwide action to tackle the challenges facing doctors in training, this letter is only a small first step to achieving that goal. The letter, sent by NHSE’s chief executive Amanda Pritchard, lays out several action points for hospital boards. It includes welcome recommendations to reduce the time burden of statutory mandatory training, increase attention to payroll accuracy, and improve rota management and deployment. NHSE’s commitment to monitoring compliance with rota regulations and providing intensive support to payroll teams is also promising. Many trainees will have expe
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Polypharmacy is common in older adults and is associated with adverse drug events, cognitive and functional impairment, and increased healthcare costs. What do we know about the effectiveness of deprescribing interventions? https://t.co/zbuGtG48X5