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Therapeutic value of oncology products with a conditional approval from Health Canada: a cross-sectional study. 加拿大卫生部有条件批准的肿瘤产品的治疗价值:横断面研究。
Pub Date : 2025-03-19 eCollection Date: 2025-03-01 DOI: 10.1177/20542704251325314
Joel Lexchin

Objectives: Investigate the additional therapeutic value compared to existing medicines of new oncology drugs given a conditional approval (Notice of Compliance with conditions, NOC/c) by Health Canada using therapeutic ratings from four independent organisations.

Design: A list of all new oncology drugs with an NOC/c from the start of the programme in 1998 to the end of 2023 was constructed. First-in-class and orphan drug status was determined for all drugs. Therapeutic ratings were obtained from the Canadian Patented Medicine Prices Review Board, the French drug bulletin Prescrire International, the French agency Haute Autorité de Santé and the German Institute for Quality and Efficiency in Health Care. If more than one organisation rated the drug, the highest rating was used.

Setting: Canada.

Participants: Oncology drugs with a conditional approval.

Main outcome measures: Additional therapeutic gain compared to existing products.

Results: Fifty-four oncology drugs were approved. Conditions were fulfilled for 29, fulfilment was still pending for 22 and 3 drugs were either discontinued by the manufacturer or placed on restricted access. Eighteen drugs had both orphan drug and first-in-class status. Therapeutic evaluations were available for 50 drugs, and the distribution of additional therapeutic value was examined for the entire group of 50 drugs, for 29 drugs that had fulfilled their conditions and for 18 drugs with both orphan drug and first-in-class status. In the three groups, 8.0%, 10.3% and 11.7%, respectively, offered major therapeutic improvement.

Conclusions: Few new oncology drugs approved through the NOC/c pathway offer major therapeutic improvements over existing drugs.

目标:利用四家独立机构的治疗评级,调查加拿大卫生部有条件批准(符合条件通知,NOC/c)的新型肿瘤药物与现有药物相比的额外治疗价值:设计:建立了一份从 1998 年该计划开始到 2023 年底所有获得 NOC/c 批准的肿瘤新药清单。确定了所有药物的一类药和孤儿药地位。治疗评级来自加拿大专利药品价格审查委员会(Canadian Patented Medicine Prices Review Board)、法国药品公报《国际处方集》(Prescrire International)、法国卫生高级管理局(Haute Autorité de Santé)和德国医疗质量与效率研究所(German Institute for Quality and Efficiency in Health Care)。如果有多个机构对药物进行评级,则以最高评级为准:地点:加拿大:有条件批准的肿瘤药物:与现有产品相比的额外治疗收益:结果:54 种肿瘤药物获得批准。结果:54 种肿瘤药物获得批准,其中 29 种符合条件,22 种尚未符合条件,3 种药物被生产商停产或限制使用。有 18 种药物既是孤儿药,又是一类药物。对 50 种药物进行了治疗评价,并对整个 50 种药物组、29 种已满足条件的药物和 18 种既是孤儿药又是一类药的药物的额外治疗价值分布情况进行了研究。在这三组药物中,分别有 8.0%、10.3% 和 11.7%的药物具有重大治疗效果:结论:通过 NOC/c 途径获批的肿瘤新药与现有药物相比,在治疗方面几乎没有重大改进。
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引用次数: 0
The UK's Early Access to Medicines Scheme 10 years on: an evaluation using publicly available data.
Pub Date : 2025-02-24 eCollection Date: 2025-02-01 DOI: 10.1177/20542704251317916
Pandora Pound, Rebecca Ram, Kathy Archibald

Objectives: To investigate the drugs and indications that have passed through the UK's Early Access to Medicines Scheme (EAMS) to date, the type of evidence the regulator considers when accepting a drug into the EAMS, and potential risks to patients.

Design: Analysis of publicly available data: MHRA Public Assessment Reports; Electronic Medicines Compendium database; interactive Drug Analysis Profiles database; Eudravigilance database.

Setting: United Kingdom.

Participants: The 51 'scientific opinions' available on the MHRA website in June 2024.

Main outcome measures: Public Assessment Reports, pharmacovigilance data.

Results: After exclusions, there were 48 EAMS submissions, consisting of 48 indications and 32 drugs. 60% of indications were for cancer. Only 7% of EAMS submissions were based on double-blind, placebo-controlled randomised trials. The average sample size of studies conducted for the EAMS was 654. Most studies used surrogate (76%) and/or survival (57%) outcomes. Only 17% used subjective outcomes. For 17% of the indications, no ongoing studies were being conducted. Animal studies were conducted preclinically for all drugs and 35% also conducted in vitro studies. 47% of the drugs had elevated rates of suspected adverse reaction reports according to pharmacovigilance data.

Conclusions: We recommend that the EAMS drugs with elevated reporting rates are reviewed, that future studies of EAMS drugs use patient-centred outcomes, that preclinical studies make greater use of human biology-based approaches, that post-approval trials are conducted, and that future reviews of the EAMS centre the experience of patients.

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引用次数: 0
De novo thyroid eye disease following COVID vaccination several years after radioiodine therapy. 放射性碘治疗几年后接种COVID疫苗后出现甲状腺眼病。
Pub Date : 2025-01-09 eCollection Date: 2025-01-01 DOI: 10.1177/20542704241304220
Athira Mukunda, Jovito James, Rhea Jacob, George I Varughese, Ananth U Nayak

The delayed onset of thyroid eye disease is well recognised but less commonly perceived in routine clinical practice and this case report serves as a reminder for a high index of suspicion in at-risk patients.

甲状腺眼病的延迟发病是公认的,但在常规临床实践中很少被察觉,本病例报告提醒高危患者高度怀疑。
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引用次数: 0
Mr Bates and the post office: The implications of the UK post office scandal for the taxonomy of trauma. 贝茨先生和邮局:英国邮局丑闻对创伤分类的影响。
Pub Date : 2024-12-24 eCollection Date: 2024-12-01 DOI: 10.1177/20542704241304573
Martin Deahl, Paul Foster

Objective: To explore the psychopathology of the victims of the UK Post Office scandal and the extent to which this can be adequately described by current classification of traumatic stress symptoms.

Design: Standard clinical interviews for the purposes of preparing medico-legal reports.

Setting: Face to face and virtual interviews.

Participants: Victims of the Post Office Scandal, postmaster's and postmistress's wrongly accused of theft.

Main outcome measures: ICD-10 diagnostic criteria.

Results: All the subjects had experienced life changing traumatic reactions which were inadequately captured by current diagnostic criteria.

Conclusions: The current taxonomy of trauma fails to capture the diversity of symptoms experienced by the postmasters and we argue that a formulation based approach should be employed, especially in the court room. There remains inadequate research exploring the impact of wrongful conviction on the mental state of victims.

目的:探讨英国邮局丑闻受害者的精神病理学,并在多大程度上可以通过目前的创伤应激症状分类来充分描述。设计:为准备医学法律报告而进行的标准临床访谈。设置:面对面和虚拟面试。参与者:邮政丑闻的受害者,被错误指控为盗窃的邮政局长和女邮政局长。主要结局指标:ICD-10诊断标准。结果:所有受试者均经历过改变生活的创伤性反应,现行诊断标准未充分反映这些反应。结论:目前的创伤分类法未能捕捉到邮政局长所经历的症状的多样性,我们认为应该采用一种基于公式的方法,特别是在法庭上。关于错误定罪对受害者精神状态的影响的研究仍然不足。
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引用次数: 0
Quality of undifferentiated chest pain evaluation and diagnosis guidelines: a systematic review and critical appraisal.
Pub Date : 2024-11-20 eCollection Date: 2024-11-01 DOI: 10.1177/20542704241288955
Nicole Palmer, Tejanth Pasumarthi, Joe O'Connell, Brandon Lee, Tiffany Yu, Venkata Neelima Kothapudi, Shama Patel, Rebecca L Morgan

Chest pain is a symptom that is potentially life-threatening and requires quick and accurate evaluations. This article describes the quality of guidelines related to the evaluation and diagnosis of acute, undifferentiated chest pain. After systematically evaluating existing guidelines, we found that there exists a wide variety of quality in these documents. Future documents that provide recommendations should utilize guideline evaluation tools during the creation process to ensure a high-quality product, regardless of document type.

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引用次数: 0
Providing personalised care for people with tuberculosis: an evaluation of enhanced case management in a UK TB Network 2013 to 2021. 为肺结核患者提供个性化护理:2013 年至 2021 年英国肺结核网络强化病例管理评估。
Pub Date : 2024-11-18 eCollection Date: 2024-10-01 DOI: 10.1177/20542704241290486
Tim Crocker-Buque, Harry Hayden, Jacqui White, Jennifer Dekoningh, Moerida Belton, Narinder Boparai, James Brown, Mike Brown, Danielle Hawley, Stefan Lozewicz, Rob Miller, Rachel Moores, Karyn Moshal, Jessica Potter, Marc Lipman

Objectives: Evaluating the outcomes of enhanced case management (ECM) for patients with tuberculosis (TB) in the North Central London TB Service (NCLTBS).

Design: Retrospective cohort study.

Setting: The NCLTBS provides care for persons diagnosed with TB across north and central London. Management involves both medical and psychosocial support, leading to the implementation ECM to provide additional non-clinical assistance to patients at risk of treatment non-completion. However, there has been limited evaluation of its outcomes.

Participants: All adults with TB notified to NCLTBS between January 2013 and June 2021.

Main outcome measures: Descriptive socio-economic and clinical characteristics grouped by binary ECM status (yes/no) and level (0-3). Clinical outcomes at 12 months (completed treatment, death, lost-to-follow-up, continuing on treatment) were compared using multivariable logistic regression.

Results: Totally, 2437 patients were included (57.2% male, 79.1% born outside the UK). Overall, 82.3% completed treatment and 4.1% died. Factors associated with mortality included older age (over 70 years odds ratio (OR) 3.3), inpatient diagnosis (OR 4.4), and mental health issues (OR 2.2). 52.8% received ECM, with the proportion increasing over time, and 76% of this group successfully competed treatment.

Conclusions: This comprehensive evaluation of ECM in a diverse London population indicates high treatment completion rates even among those with multiple social risk factors. However, ECM needs of patients has increased over time, with a particular rise in patients requiring the highest support level. Given the small difference between standard care and ECM categories 1 and 2, there may be scope to simplify the system.

目标:评估伦敦中北部结核病服务机构对结核病患者实施强化病例管理(ECM)的效果:评估伦敦中北部结核病服务机构(NCLTBS)对结核病患者实施强化病例管理(ECM)的效果:设计:回顾性队列研究:NCLTBS 为伦敦北部和中部的结核病患者提供治疗。管理涉及医疗和社会心理支持,因此实施了 ECM,为有可能无法完成治疗的患者提供额外的非临床帮助。然而,对其结果的评估却很有限:主要结果测量:描述性社会经济和临床特征,按二元 ECM 状态(是/否)和水平(0-3)分组。使用多变量逻辑回归对 12 个月的临床结果(完成治疗、死亡、失去随访、继续治疗)进行比较:共纳入 2437 名患者(57.2% 为男性,79.1% 在英国以外出生)。总体而言,82.3%的患者完成了治疗,4.1%的患者死亡。与死亡率相关的因素包括年龄较大(70 岁以上的几率比(OR)为 3.3)、住院诊断(OR 4.4)和精神健康问题(OR 2.2)。52.8%的患者接受了 ECM 治疗,这一比例随着时间的推移而增加,其中 76% 的患者成功完成了治疗:这项针对伦敦不同人群的 ECM 综合评估表明,即使是具有多种社会风险因素的患者,其治疗完成率也很高。然而,随着时间的推移,患者对 ECM 的需求也在增加,尤其是需要最高级别支持的患者。鉴于标准护理与 ECM 1 类和 2 类之间的差异很小,可能还有简化系统的余地。
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引用次数: 0
Redeployment experiences of healthcare workers in the UK during COVID-19: a cross-sectional analysis from the nationwide UK-REACH study. 英国医护人员在 COVID-19 期间的重新部署经历:来自全国性 UK-REACH 研究的横断面分析。
Pub Date : 2024-10-30 eCollection Date: 2024-09-01 DOI: 10.1177/20542704241290721
Zainab Zuzer Lal, Christopher A Martin, Mayuri Gogoi, Irtiza Qureshi, Luke Bryant, Padmasayee Papineni, Susie Lagrata, Laura B Nellums, Amani Al-Oraibi, Jonathon Chaloner, Katherine Woolf, Manish Pareek

Objectives: To assess how ethnicity, migration status and occupation are associated with healthcare workers (HCW) redeployment experiences during COVID-19 in a nationwide ethnically diverse sample.

Design: A cross-sectional analysis using data from the nationwide United Kingdom Research Study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH) cohort study.

Setting: Healthcare settings.

Participants: Healthcare workers (HCW).

Main outcome measures: Outcome measures included redeployment, provision of training and supervision during redeployment, change in patient contact and interaction with COVID-19 patients.

Methods: We used logistic regression to examine associations of ethnicity, migration status, and occupation with redeployment experiences of HCWs.

Results: Of the 10,889 HCWs included, 20.4% reported being redeployed during the first UK national lockdown in March 2020. Those in nursing roles (Odds Ratio (OR) 1.22, 95% Confidence Interval (CI) 1.04-1.42, p = 0.009) (compared to medical roles) had higher likelihood of being redeployed as did migrants compared to those born in the UK (OR 1.26, 95% CI 1.06-1.49, p = 0.01) (in a subcohort of HCWs on the agenda for change (AfC) pay scales). Asian HCWs were less likely to report receiving training (OR 0.66, 95% CI 0.50-0.88, p = 0.005) and Black HCWs (OR 2.02, 95% CI 1.14-3.57, p = 0.02) were more likely to report receiving supervision, compared to White colleagues. Finally, redeployed Black (OR 1.33, 95% CI 1.07-1.66, p = 0.009) and Asian HCWs (OR 1.30, 95% CI 1.14-1.48, p < 0.001) were more likely to report face-to-face interaction with COVID-19 patients than White HCWs.

Conclusions: Our findings highlight disparities in HCWs' redeployment experiences by ethnicity, migration, and job role which are potentially related to structural inequalities in healthcare.

目的在全国不同种族的样本中,评估种族、移民身份和职业与医护人员(HCW)在 COVID-19 期间的重新部署经历有何关联:设计:利用英国全国范围内医护人员种族和 COVID-19 结果研究(UK-REACH)队列研究的数据进行横断面分析:医疗机构:主要结果测量:主要结果测量:结果测量包括重新部署、重新部署期间提供的培训和监督、与患者接触的变化以及与 COVID-19 患者的互动:我们使用逻辑回归法研究了种族、移民身份和职业与医护人员重新部署经历之间的关联:在纳入的 10889 名医护人员中,有 20.4% 的医护人员表示在 2020 年 3 月英国首次全国封锁期间被重新部署。与医务人员相比,从事护理工作的人员被重新部署的可能性更高(比值比 (OR) 1.22,95% 置信区间 (CI) 1.04-1.42,p = 0.009);与在英国出生的人员相比,从事移民工作的人员被重新部署的可能性更高(比值比 1.26,95% 置信区间 (CI) 1.06-1.49,p = 0.01)。与白人同事相比,亚裔医护人员接受培训的可能性较低(OR 0.66,95% CI 0.50-0.88,p = 0.005),黑人医护人员接受监督的可能性较高(OR 2.02,95% CI 1.14-3.57,p = 0.02)。最后,重新部署的黑人(OR 1.33,95% CI 1.07-1.66,p = 0.009)和亚裔医护人员(OR 1.30,95% CI 1.14-1.48,p 结论:与白人同事相比,黑人医护人员更有可能接受监督:我们的研究结果表明,不同种族、移民和工作角色的医护人员在被重新部署的经历上存在差异,这可能与医疗保健领域的结构性不平等有关。
{"title":"Redeployment experiences of healthcare workers in the UK during COVID-19: a cross-sectional analysis from the nationwide UK-REACH study<sup />.","authors":"Zainab Zuzer Lal, Christopher A Martin, Mayuri Gogoi, Irtiza Qureshi, Luke Bryant, Padmasayee Papineni, Susie Lagrata, Laura B Nellums, Amani Al-Oraibi, Jonathon Chaloner, Katherine Woolf, Manish Pareek","doi":"10.1177/20542704241290721","DOIUrl":"10.1177/20542704241290721","url":null,"abstract":"<p><strong>Objectives: </strong>To assess how ethnicity, migration status and occupation are associated with healthcare workers (HCW) redeployment experiences during COVID-19 in a nationwide ethnically diverse sample.</p><p><strong>Design: </strong>A cross-sectional analysis using data from the nationwide United Kingdom Research Study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH) cohort study.</p><p><strong>Setting: </strong>Healthcare settings.</p><p><strong>Participants: </strong>Healthcare workers (HCW).</p><p><strong>Main outcome measures: </strong>Outcome measures included redeployment, provision of training and supervision during redeployment, change in patient contact and interaction with COVID-19 patients.</p><p><strong>Methods: </strong>We used logistic regression to examine associations of ethnicity, migration status, and occupation with redeployment experiences of HCWs.</p><p><strong>Results: </strong>Of the 10,889 HCWs included, 20.4% reported being redeployed during the first UK national lockdown in March 2020. Those in nursing roles (Odds Ratio (OR) 1.22, 95% Confidence Interval (CI) 1.04-1.42, <i>p</i> = 0.009) (compared to medical roles) had higher likelihood of being redeployed as did migrants compared to those born in the UK (OR 1.26, 95% CI 1.06-1.49, <i>p</i> = 0.01) (in a subcohort of HCWs on the agenda for change (AfC) pay scales). Asian HCWs were less likely to report receiving training (OR 0.66, 95% CI 0.50-0.88, <i>p</i> = 0.005) and Black HCWs (OR 2.02, 95% CI 1.14-3.57, <i>p</i> = 0.02) were more likely to report receiving supervision, compared to White colleagues. Finally, redeployed Black (OR 1.33, 95% CI 1.07-1.66, <i>p</i> = 0.009) and Asian HCWs (OR 1.30, 95% CI 1.14-1.48, <i>p</i> < 0.001) were more likely to report face-to-face interaction with COVID-19 patients than White HCWs.</p><p><strong>Conclusions: </strong>Our findings highlight disparities in HCWs' redeployment experiences by ethnicity, migration, and job role which are potentially related to structural inequalities in healthcare.</p>","PeriodicalId":17674,"journal":{"name":"JRSM Open","volume":"15 9","pages":"20542704241290721"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical reconstruction for spasticity and contracture: An underutilised rehabilitative strategy of adult stroke. 手术重建治疗痉挛和挛缩:一种未被充分利用的成人中风康复策略。
Pub Date : 2024-09-15 eCollection Date: 2024-08-01 DOI: 10.1177/20542704241278544
Marvin Man Ting Chung, Wing Yuk Ip

Post-stroke spasticity and contracture remain prevalent and pose significant challenges in stroke rehabilitation. While non-surgical management is the mainstay, surgical reconstruction offers a valuable adjunct when conservative measures are exhausted. This clinical review article provides an overview of surgical reconstruction for limb spasticity and contracture following adult stroke, encompassing the rationale and specifics of these interventions. It highlights the underutilization of surgical reconstruction in rehabilitation of adult stroke patients with spasticity and contracture, and the importance of multidisciplinary collaboration including surgeons in stroke rehabilitation to optimize functional outcomes.

中风后痉挛和挛缩仍然普遍存在,给中风康复带来了巨大挑战。虽然非手术治疗是主要手段,但在保守治疗无效的情况下,手术重建是一种有价值的辅助手段。这篇临床综述文章概述了手术重建治疗成人中风后肢体痉挛和挛缩的方法,包括这些干预措施的原理和具体细节。文章强调了手术重建在痉挛和挛缩成人中风患者康复中的应用不足,以及包括外科医生在内的多学科合作在中风康复中优化功能预后的重要性。
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引用次数: 0
Long COVID symptoms and demographic associations: A retrospective case series study using healthcare application data. 长期 COVID 症状与人口统计学相关性:利用医疗应用数据进行的回顾性病例系列研究。
Pub Date : 2024-08-28 eCollection Date: 2024-07-01 DOI: 10.1177/20542704241274292
David Sunkersing, Henry Goodfellow, Yi Mu, Mel Ramasawmy, Mayur Murali, Lawrence Adams, Ted J FitzGerald, Ann Blandford, Fiona Stevenson, Julia Bindman, Chris Robson, Amitava Banerjee

Objectives: To investigate long COVID (LC) symptoms self-reported via a digital application. Explore associations between various demographic factors and intensity of LC symptoms.

Design: A retrospective case series study. We analysed self-reported symptoms from 1008 individuals with LC between November 30, 2020, and March 23, 2022.

Setting: England and Wales.

Participants: Individuals with LC using the healthcare application in 31 post-COVID-19 clinics and self-reporting LC symptoms.

Main outcome measures: Highest reported LC symptoms, associations with demographic factors and intensity of symptoms.

Results: 109 symptom categories were identified, with pain (26.5%), neuropsychological issues (18.4%), fatigue (14.3%) and dyspnoea (7.4%) the most prevalent. The intensity of reported symptoms increased by 3.3% per month since registration. Age groups 68-77 and 78-87 experienced higher symptom intensity (32.8% and 86% higher, respectively) compared to the 18-27 age group. Women reported 9.2% more intense symptoms than men, and non-white individuals with LC reported 23.5% more intense symptoms than white individuals with LC. Higher education levels (national vocational qualification (NVQ) 3 to NVQ 5) were associated with less symptom intensity (27.7%, 62.8% and 44.7% less, respectively) compared to the least educated (NVQ 1-2). People in less deprived areas had less intense symptoms than those in the most deprived area. No significant association was found between index of multiple deprivation (IMD) decile and number of symptoms.

Conclusion: Treatment plans must prioritise addressing prevalent LC symptoms; we recommend sustained support for LC clinics. Demographic factors significantly influence symptom severity, underlining the need for targeted interventions. These findings can inform healthcare policies to better manage LC.

目的调查通过数字应用程序自我报告的长COVID(LC)症状。探讨各种人口统计学因素与 LC 症状强度之间的关联:设计:回顾性病例系列研究。我们分析了 1008 名 LC 患者在 2020 年 11 月 30 日至 2022 年 3 月 23 日期间自我报告的症状:地点:英格兰和威尔士:在 31 个后 COVID-19 诊所使用医疗保健应用程序并自我报告 LC 症状的 LC 患者:最高报告的 LC 症状、与人口统计学因素和症状强度的关系:结果:共发现 109 种症状,其中疼痛(26.5%)、神经心理问题(18.4%)、疲劳(14.3%)和呼吸困难(7.4%)最为常见。自登记以来,报告症状的强度每月增加 3.3%。与 18-27 岁年龄组相比,68-77 岁年龄组和 78-87 岁年龄组的症状强度更高(分别高出 32.8% 和 86%)。女性报告的症状强度比男性高 9.2%,非白人 LC 患者报告的症状强度比白人 LC 患者高 23.5%。与受教育程度最低者(国家职业资格(NVQ)1-2 级)相比,受教育程度较高者(国家职业资格(NVQ)3-5 级)的症状强度较低(分别为 27.7%、62.8% 和 44.7%)。与最贫困地区的人相比,较贫困地区的人症状强度较低。多重贫困指数(IMD)十分位数与症状数量之间没有明显关联:结论:治疗计划必须优先解决普遍存在的慢性淋巴细胞白血病症状;我们建议为慢性淋巴细胞白血病诊所提供持续支持。人口统计学因素对症状严重程度有重大影响,因此需要采取有针对性的干预措施。这些研究结果可为医疗保健政策提供参考,以更好地管理慢性淋巴细胞白血病。
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引用次数: 0
Racial microaggressions within the UK Healthcare System: a narrative review. 英国医疗保健系统中的种族微冒犯:叙事性回顾。
Pub Date : 2024-08-02 eCollection Date: 2024-08-01 DOI: 10.1177/20542704241232861
Promise Firi, Kwaku Baryeh

Racial microaggressions are subtle and everyday actions that communicate derogatory messages or assumptions based on an individual's race. These seemingly minor acts, often unintended, can accumulate to undermine patient well-being and contribute to healthcare disparities. They are the unnoticed comments, gestures, or attitudes that carry significant impact. Through a systematic analysis of the literature, we highlight the insidious nature of racial microaggressions and their impact on healthcare outcomes. The objectives of this paper are to: • Present real-life instances from research to showcase the tangible effects of racial microaggressions. • Identify the everyday scenarios within healthcare interactions where racial microaggressions often occur. • Emphasise the need for recognition and understanding of these biases for fostering better patient-provider relationships. Also, by analysing the fundamental elements underpinning racial microaggressions such as systems, interactions, vulnerabilities and consequences, we explore the implications it has on healthcare policy and management. Most importantly, we address the importance of identifying and tackling racial microaggressions in order to create a more inclusive healthcare environment.

种族微词是一种微妙的日常行为,它传达了基于个人种族的贬损信息或假设。这些看似微小的行为往往是无意的,但日积月累就会损害患者的福祉,造成医疗差异。这些不被注意的评论、手势或态度会产生重大影响。通过对文献的系统分析,我们强调了种族微冒犯的隐蔽性及其对医疗结果的影响。本文的目的是- 介绍研究中的真实案例,以展示种族微小诽谤的实际影响。- 确定在医疗保健互动中经常出现种族微观诽谤的日常场景。- 强调认识和理解这些偏见的必要性,以促进更好的患者-医护人员关系。此外,通过分析种族微诽谤的基本要素,如系统、互动、脆弱性和后果,我们探讨了它对医疗政策和管理的影响。最重要的是,我们探讨了识别和解决种族微观诽谤的重要性,以创造一个更具包容性的医疗环境。
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引用次数: 0
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