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Improving endoscopy unit efficacy and retention through the provision of role-specific admin and clerical training 通过提供针对特定角色的行政和办事员培训,提高内窥镜检查室的效率和留用率
IF 2.6 Q2 Medicine Pub Date : 2024-05-03 DOI: 10.1136/flgastro-2024-102642
Michael Dawson, Melissa Rankin, Grahame Smith
The North West Endoscopy Academy is committed to ensuring endoscopy training is of a standardised high quality that is multidisciplinary. It seeks to address the historic lack of admin training by providing a core admin and clerical (A&C) skills in endoscopy course for all A&C staff. The competency framework used for this training is the first developed specifically for A&C staff in endoscopy and the early indications are that it has significantly contributed to the efficacy of a unit’s performance, highlighting that greater focus should be placed on providing these opportunities to A&C staff in the future. This article will explore the aims and methodology of the course and present evaluation data to discuss the successes and future recommendations. We have used a combination of teaching methods, such as small group work, case study analysis and traditional classroom teaching to provide an education programme which seeks to underline existing best practice and introduce new themes and ways of working. Our two-tiered evaluation has shown this approach to be effective, in the future, we intend to implement a further evaluation to establish the long-term added value of the training. In combination, we will begin work on advanced skills modules aimed at supervisory and management staff.
西北内镜学院致力于确保内镜培训的标准化、高质量和多学科性。该学院为所有内镜诊疗人员提供内镜诊疗核心行政和文秘(A&C)技能培训课程,以解决历史上缺乏行政管理培训的问题。该培训所使用的能力框架是首个专门为内镜检查中的行政和文秘人员开发的框架,早期迹象表明,该框架极大地促进了一个科室的工作效率,突出表明今后应更加注重为行政和文秘人员提供这些机会。本文将探讨课程的目的和方法,并提供评估数据,以讨论取得的成功和未来的建议。我们综合运用了小组合作、案例分析和传统课堂教学等教学方法,提供了一个旨在强调现有最佳实践并引入新主题和工作方法的教育课程。我们的双层评估表明这种方法是有效的,今后,我们打算开展进一步的评估,以确定培训的长期附加值。同时,我们将开始针对监督和管理人员的高级技能模块的工作。
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引用次数: 0
UpFront 前方
IF 2.6 Q2 Medicine Pub Date : 2024-05-01 DOI: 10.1136/flgastro-2024-102720
R Mark Beattie
Faecal immunochemical testing (FIT) is recommended by the National Institute for Health and Care Excellence to triage symptomatic primary care patients who have unexplained symptoms but do not meet the criteria for a suspected lower gastrointestinal cancer pathway. During the COVID pandemic FIT testing was used to triage patients referred to the cancer pathway. FIT-negative patients were assessed and safety netted in a FIT negative clinic. In this issue Nigam and colleagues report a case note review of 622 patients referred to a FIT negative clinic – 2020/21, median age 71.5 years, median follow-up 2.5 years. Patients were referred with a change in bowel habit (61%), iron deficiency (24%), anaemia (11%), weight loss (9%), blood per rectum (5%). Further investigation by endoscopy/radiology was only indicated in around a third. Malignancy rate was low (1.5%) including rectosigmoid neuroendocrine tumour, oesophageal cancer and lung adenocarcinoma. The authors rightly suggest that using FIT as a triage in patients referred to the 2 week wait cancer pathway can result in fewer patients requiring further investigation and so more effective and efficient use of healthcare resources. (See page 190) A faecal immunochemical test (FIT) result of ≥10 µg has high sensitivity and negative predictive value for colorectal cancer (CRC) detection. In this issue Bashir and colleagues report the impact of the local implementation of a FIT diagnostic pathway (figure one) on cancer detection rate. The authors use National Endoscopic Data to compare local diagnostic rates in 2019 (before pathway implantation) and 2021. There was a significant increase …
美国国家健康与护理优化研究所(National Institute for Health and Care Excellence)建议使用粪便免疫化学检验(FIT)来分流有不明症状但不符合疑似下消化道癌症路径标准的初级保健患者。在 COVID 大流行期间,FIT 检测被用于对转诊至癌症路径的患者进行分流。对 FIT 阴性患者进行评估,并在 FIT 阴性诊所进行安全防护。本期,Nigam 及其同事报告了转诊至 FIT 阴性诊所的 622 名患者的病例回顾(2020/21 年,中位年龄 71.5 岁,中位随访 2.5 年)。转诊患者的排便习惯改变(61%)、缺铁(24%)、贫血(11%)、体重下降(9%)、直肠带血(5%)。只有约三分之一的患者需要接受内窥镜/放射学进一步检查。恶性肿瘤发生率较低(1.5%),包括直肠乙状结肠神经内分泌瘤、食道癌和肺腺癌。作者正确地指出,将 FIT 作为癌症两周等待路径转诊患者的分流手段,可减少需要进一步检查的患者人数,从而更有效、高效地利用医疗资源。(见第 190 页)粪便免疫化学检验 (FIT) 结果≥10 µg 对于大肠癌 (CRC) 的检测具有很高的灵敏度和阴性预测值。本期,Bashir 及其同事报告了当地实施 FIT 诊断路径(图一)对癌症检出率的影响。作者利用国家内镜数据比较了 2019 年(路径植入前)和 2021 年的地方诊断率。结果显示,癌症检出率明显增加。
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引用次数: 0
Randomised trial of ‘hybrid’ water-assisted colonoscopy (modified water immersion) versus water exchange colonoscopy: WAVE study 混合 "水辅助结肠镜检查(改良水浸法)与水交换结肠镜检查的随机试验:WAVE 研究
IF 2.6 Q2 Medicine Pub Date : 2024-04-29 DOI: 10.1136/flgastro-2023-102606
Ahmir Ahmad, Anna Buenaventura, Belma Motes, Ravi Misra, Ripple Man, Angad Dhillon, Paul Bassett, Kowshika Thiruvilangam, Brian P Saunders
Background and aims Colonoscopy practice has evolved with a trend towards water-assisted insertion. A recent national survey suggests a hybrid approach to colonic distension during insertion, with water used predominately to the splenic flexure and carbon dioxide (CO2) with water used thereafter to the caecum, is commonly used. This contrasts with the water exchange technique where no CO2 is used. This study aimed to evaluate whether a hybrid or water exchange technique allows more efficient colonoscopy. Methods This prospective, randomised controlled trial was conducted between March 2021 and June 2022. Participants were randomised 1:1 to hybrid or water exchange colonoscopy, performed by four experienced colonoscopists. The primary outcome was total procedure time with secondary outcomes of caecal intubation time, caecal intubation rate, polyp detection, loop formation, number of ancillary manoeuvres, sedation use and patient comfort. Results 256 patients were invited, and 246 were randomised to either hybrid or water exchange colonoscopy. 122 patients were included in each arm of the primary analysis. Total procedure time was greater in the water exchange group compared with hybrid (29 vs 25 min, p=0.009). Patient reposition episodes occurred more frequently in the water exchange group vs hybrid group (5.5 vs 5, p=0.003) and left colon Boston Bowel Preparation Scale (BBPS) score was improved. No difference was seen in all other outcomes. Conclusion A hybrid technique, compared with water exchange, enabled faster colonoscopy without adversely impacting sedation requirement, caecal intubation, overall bowel cleansing and patient comfort. This technique appears to maximise the advantages of both water and CO2 to enable more efficient colonoscopy. Trial registration number [NCT04710706][1]. All data relevant to the study are included in the article or uploaded as supplementary information. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04710706&atom=%2Fflgastro%2Fearly%2F2024%2F04%2F29%2Fflgastro-2023-102606.atom
背景和目的 结肠镜检查的实践已朝着水辅助插入的趋势发展。最近的一项全国性调查表明,在插入过程中,通常采用混合方法进行结肠扩张,即主要在脾曲部位使用水,在盲肠部位使用二氧化碳 (CO2)。这与不使用二氧化碳的水交换技术形成鲜明对比。本研究旨在评估混合技术或水交换技术是否能提高结肠镜检查的效率。方法 这项前瞻性随机对照试验于 2021 年 3 月至 2022 年 6 月期间进行。参与者按 1:1 的比例随机接受混合式或水交换式结肠镜检查,由四名经验丰富的结肠镜医师进行操作。主要结果是手术总时间,次要结果是盲肠插管时间、盲肠插管率、息肉检测、襻形成、辅助操作次数、镇静剂使用和患者舒适度。结果 256 名患者受邀参加,246 名患者被随机分配到混合式或水交换式结肠镜检查。在主要分析中,两组各纳入了 122 名患者。水交换组的总手术时间比混合组长(29 分钟对 25 分钟,P=0.009)。换水组与混合组相比,患者重新定位的频率更高(5.5 对 5,P=0.003),左结肠波士顿肠道准备量表(BBPS)评分有所提高。其他结果无差异。结论 混合技术与换水技术相比,结肠镜检查速度更快,但不会对镇静要求、盲肠插管、整体肠道清洁和患者舒适度产生不利影响。该技术似乎最大限度地发挥了水和二氧化碳的优势,从而提高了结肠镜检查的效率。试验注册号[NCT04710706][1]。与该研究相关的所有数据均包含在文章中或作为补充信息上传。[1]:/lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04710706&atom=%2Fflgastro%2Fearly%2F2024%2F04%2F29%2Fflgastro-2023-102606.atom
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引用次数: 0
Climate change for gastroenterologists: understanding the basics 气候变化对消化内科医生的影响:了解基本知识
IF 2.6 Q2 Medicine Pub Date : 2024-04-26 DOI: 10.1136/flgastro-2023-102499
Judith Chantal Eling, Jennifer Barker, Stefi Barna
The healthcare sector is a significant producer of greenhouse gas emissions. Gases that contribute to climate change include carbon dioxide, methane, nitrous oxide and chlorofluorocarbons. Climate change will impact the types and prevalence of diseases seen in clinical practice. Practising preventive medicine in gastroenterology can protect population health and reduce the need for health services, thus reducing the carbon footprint of the health sector. Increasing patient empowerment, making care pathways leaner and minimising the environmental impact of treatments and interventions could also make healthcare more sustainable.
医疗保健行业是温室气体的重要排放源。导致气候变化的气体包括二氧化碳、甲烷、一氧化二氮和氟氯化碳。气候变化将影响临床实践中的疾病类型和发病率。在肠胃病学中开展预防医学可以保护人口健康,减少对医疗服务的需求,从而减少医疗部门的碳足迹。增强患者的能力、使医疗路径更加精简以及最大限度地减少治疗和干预措施对环境的影响,也可以使医疗保健更具可持续性。
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引用次数: 0
Anal lesions in a 50-year-old HIV-positive man 一名 50 岁艾滋病毒阳性男子的肛门病变
IF 2.6 Q2 Medicine Pub Date : 2024-04-24 DOI: 10.1136/flgastro-2024-102653
J. Chanal, Nicolas Boo, P. Sohier, Nicolas Dupin
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引用次数: 0
Real-world effectiveness of upadacitinib in Crohn’s disease: a UK multicentre retrospective cohort study 达帕替尼对克罗恩病的实际疗效:英国多中心回顾性队列研究
IF 2.6 Q2 Medicine Pub Date : 2024-04-03 DOI: 10.1136/flgastro-2024-102668
Alexander Thomas Elford, Maria Bishara, Nikolas Plevris, Beatriz Gros, Nathan Constantine-Cooke, James Goodhand, Nicholas A Kennedy, Tariq Ahmad, Charlie W Lees
Background Upadacitinib is a Janus kinase inhibitor, which has recently been approved for treating Crohn’s disease. There are limited real-world studies on the outcomes of upadacitinib in Crohn’s disease. Objective Our aim was to evaluate the outcomes of upadacitinib in a real-world Crohn’s disease cohort. Methods We conducted a retrospective, multicentre, cohort study over a 2-year period across National Health Service (NHS) Lothian and Royal Devon University Healthcare NHS Foundation Trust. The primary outcome was treatment persistence at week 24. Secondary endpoints were corticosteroid-free clinical remission (Harvey-Bradshaw Index (HBI)<5) and biomarker remission (C-reactive protein (CRP)≤5 mg/L and faecal calprotectin (FCAL)<250 µg/g) at 12, 24 and 52 weeks. We recorded adverse events. Results 135 patients commenced upadacitinib as of the 1 January 2024, of which 93 patients with active Crohn’s disease were included with a minimum of 12 weeks follow-up. The median follow-up time was 25 weeks (IQR 15–42 weeks). 82% of the cohort had exposure to at least two classes of advanced therapies, and 52% had exposure to at least three classes of advanced therapies. Treatment persistence was 87.1% at week 12, 81.7% at week 24 and 62.8% at week 52. Rates of clinical remission were 64% (42/66), 48% (22/46) and 38% (8/21) at weeks 12, 24 and 52, respectively. Significant reductions in HBI, CRP and FCAL were observed during follow-up. 14% (13/91) had a hospitalisation due to Crohn’s disease. Adverse events occurred in 40% (37/93) of the cohort, of which 12% (11/93) were serious. Conclusion Upadacitinib was effective in a real-world, highly refractory, Crohn’s disease cohort with good persistence. Data are available on reasonable request.
背景 乌达帕替尼是一种 Janus 激酶抑制剂,最近被批准用于治疗克罗恩病。有关乌达帕替尼治疗克罗恩病疗效的实际研究非常有限。目的 我们的目的是评估达达替尼在真实世界克罗恩病队列中的疗效。方法 我们在英国国家卫生服务系统 (NHS) 洛锡安医院和皇家德文大学医疗保健 NHS 基金会信托公司开展了一项为期两年的回顾性多中心队列研究。主要结果是第 24 周时的治疗持续性。次要终点是12周、24周和52周时的无皮质类固醇临床缓解(哈维-布拉德肖指数(HBI)<5)和生物标志物缓解(C反应蛋白(CRP)≤5 mg/L和粪钙蛋白(FCAL)<250 µg/g)。我们记录了不良事件。结果 截至2024年1月1日,135名患者开始服用达达替尼,其中93名活动性克罗恩病患者接受了至少12周的随访。随访时间中位数为 25 周(IQR 15-42 周)。82%的患者接受过至少两类先进疗法,52%的患者接受过至少三类先进疗法。治疗持续率在第12周为87.1%,第24周为81.7%,第52周为62.8%。临床缓解率在第12周、第24周和第52周分别为64%(42/66)、48%(22/46)和38%(8/21)。随访期间观察到 HBI、CRP 和 FCAL 显著下降。14%(13/91)的患者因克罗恩病住院治疗。40%的患者(37/93)发生了不良反应,其中12%(11/93)为严重不良反应。结论 Upadacitinib对现实世界中高度难治的克罗恩病患者有效,且具有良好的持续性。如有合理要求,可提供相关数据。
{"title":"Real-world effectiveness of upadacitinib in Crohn’s disease: a UK multicentre retrospective cohort study","authors":"Alexander Thomas Elford, Maria Bishara, Nikolas Plevris, Beatriz Gros, Nathan Constantine-Cooke, James Goodhand, Nicholas A Kennedy, Tariq Ahmad, Charlie W Lees","doi":"10.1136/flgastro-2024-102668","DOIUrl":"https://doi.org/10.1136/flgastro-2024-102668","url":null,"abstract":"Background Upadacitinib is a Janus kinase inhibitor, which has recently been approved for treating Crohn’s disease. There are limited real-world studies on the outcomes of upadacitinib in Crohn’s disease. Objective Our aim was to evaluate the outcomes of upadacitinib in a real-world Crohn’s disease cohort. Methods We conducted a retrospective, multicentre, cohort study over a 2-year period across National Health Service (NHS) Lothian and Royal Devon University Healthcare NHS Foundation Trust. The primary outcome was treatment persistence at week 24. Secondary endpoints were corticosteroid-free clinical remission (Harvey-Bradshaw Index (HBI)<5) and biomarker remission (C-reactive protein (CRP)≤5 mg/L and faecal calprotectin (FCAL)<250 µg/g) at 12, 24 and 52 weeks. We recorded adverse events. Results 135 patients commenced upadacitinib as of the 1 January 2024, of which 93 patients with active Crohn’s disease were included with a minimum of 12 weeks follow-up. The median follow-up time was 25 weeks (IQR 15–42 weeks). 82% of the cohort had exposure to at least two classes of advanced therapies, and 52% had exposure to at least three classes of advanced therapies. Treatment persistence was 87.1% at week 12, 81.7% at week 24 and 62.8% at week 52. Rates of clinical remission were 64% (42/66), 48% (22/46) and 38% (8/21) at weeks 12, 24 and 52, respectively. Significant reductions in HBI, CRP and FCAL were observed during follow-up. 14% (13/91) had a hospitalisation due to Crohn’s disease. Adverse events occurred in 40% (37/93) of the cohort, of which 12% (11/93) were serious. Conclusion Upadacitinib was effective in a real-world, highly refractory, Crohn’s disease cohort with good persistence. Data are available on reasonable request.","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140582467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
To biopsy or not to biopsy (for the diagnosis of coeliac disease): insights from the #FGDebate 活检还是不活检(用于诊断乳糜泻):#FGDebate 辩论的启示
IF 2.6 Q2 Medicine Pub Date : 2024-03-27 DOI: 10.1136/flgastro-2024-102640
Giovanna McGinty, S. Raju, D. S. Sanders, Peter Michael Gillett
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引用次数: 0
Oral manifestations of inflammatory bowel disease: a guide to examination 炎症性肠病的口腔表现:检查指南
IF 2.6 Q2 Medicine Pub Date : 2024-03-22 DOI: 10.1136/flgastro-2023-102619
Sandeep Joshi, Alice Moore, Joel Mawdsley, Barbara Carey
Orofacial symptoms are common in patients with inflammatory bowel disease (IBD). They may present as a primary manifestation of the disease in the oral cavity with oral Crohn’s disease, or as a secondary manifestation of the disease such as iron deficiency, or due to side effects to medications used in treatment. Orofacial manifestations of IBD may result in significant morbidity which can impact patients’ quality of life. Systematic examination and a timely diagnosis are fundamental in initiating appropriate management. This article provides a guide for gastroenterologists to systematically perform an extraoral and intraoral examination of the orofacial region. The extraoral examination includes evaluation of lymph nodes, lips and perioral skin. Common extraoral features of IBD include lip swelling, lip fissuring, angular cheilitis, perioral erythema and cervicofacial lymphadenopathy. The intraoral examination involves a systematic inspection of all areas of the oral cavity. Intraoral IBD features include ulceration, cobblestoning of the buccal mucosa, gingival erythema and mucosal tags. Examining the orofacial region is important in the complete assessment of patients with IBD, to diagnose orofacial conditions, to initiate tailored treatments and to identify those patients who would benefit from input from oral medicine specialists.
口腔症状在炎症性肠病(IBD)患者中很常见。口腔症状可能是口腔克罗恩病的原发表现,也可能是缺铁等疾病的继发表现,或者是治疗药物的副作用所致。IBD 的口腔表现可能会导致严重的发病率,影响患者的生活质量。系统检查和及时诊断是启动适当治疗的基础。本文为消化内科医生系统地进行口外和口内口腔检查提供了指南。口外检查包括评估淋巴结、嘴唇和口周皮肤。IBD 常见的口外特征包括嘴唇肿胀、嘴唇裂开、角颊炎、口周红斑和颈面部淋巴结病。口腔内部检查包括对口腔所有部位进行系统检查。口腔内 IBD 特征包括溃疡、颊粘膜鹅卵石样变、牙龈红斑和粘膜标签。检查口腔面部区域对于全面评估 IBD 患者、诊断口腔面部疾病、启动有针对性的治疗以及确定哪些患者可从口腔医学专家的意见中受益非常重要。
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引用次数: 0
Carbon footprinting for the gastroenterologist 消化内科医生的碳足迹
IF 2.6 Q2 Medicine Pub Date : 2024-03-20 DOI: 10.1136/flgastro-2023-102612
Sandeep Shivananda Siddhi, Mhairi Donnelly
We are in a climate emergency—this is anthropogenic, and we can do something about it. An awareness of carbon footprinting is essential to allow us to understand and address this issue, both in our personal and professional lives. The aim of this article is to demystify carbon footprinting and to make the concept relevant to the gastrointestinal healthcare professional.
我们正处于气候紧急状态--这是人为因素造成的,我们可以做些什么。无论是在个人生活还是工作中,对碳足迹的认识对于我们理解和解决这一问题都至关重要。本文旨在揭开碳足迹的神秘面纱,并使这一概念与胃肠道保健专业人员息息相关。
{"title":"Carbon footprinting for the gastroenterologist","authors":"Sandeep Shivananda Siddhi, Mhairi Donnelly","doi":"10.1136/flgastro-2023-102612","DOIUrl":"https://doi.org/10.1136/flgastro-2023-102612","url":null,"abstract":"We are in a climate emergency—this is anthropogenic, and we can do something about it. An awareness of carbon footprinting is essential to allow us to understand and address this issue, both in our personal and professional lives. The aim of this article is to demystify carbon footprinting and to make the concept relevant to the gastrointestinal healthcare professional.","PeriodicalId":46937,"journal":{"name":"Frontline Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140202171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Call for sustainable food systems including (medical) nutrition for hospitalised children and their families 呼吁建立可持续的食品系统,包括为住院儿童及其家人提供(医疗)营养
IF 2.6 Q2 Medicine Pub Date : 2024-03-20 DOI: 10.1136/flgastro-2023-102478
Sascha C A T Verbruggen, Suzan Cochius den Otter, Johanna Bakker, George Briassoulis, Ilia Stavoula, Lynne Latten, Koen Joosten, Shancy Rooze, Eva van Zanten, R Mark Beattie, Luise V Marino
The climate emergency presents a profound threat to global health, adversely affecting the health and well-being of children who are projected to bear a substantial disease burden, as well as impacting children’s right to food, water, healthcare and education. The healthcare sector strives to prioritise preventative healthcare policies improving the health of individuals across the life course. However, current healthcare practices significantly contribute to greenhouse gas (GHG) emissions and waste generation, in which (medical) nutrition plays an important role. Plant-based proteins offer sustainability benefits, and potential health advantages, and have a lower climate footprint, although there may also be unintended consequences of land-use change and deforestation for certain crops. However, to develop suitable plant-based alternatives to medical nutrition, it will be necessary to address regulatory obstacles as well as ensure nutritional profiles are suitable, particularly protein (amino acid) and micronutrient composition. Additionally, the development of heat-tolerant and water-efficient plant genotypes could bolster adaptation to changing climatic conditions. Effective waste management, including wasted food and medical nutrition, emerges as a key strategy in mitigating the climate impact of medical nutrition. While research on food waste in healthcare settings is limited, minimising waste spillage in medical nutrition is a crucial area to explore. Healthcare professionals must acknowledge their roles in curbing the climate footprint of medical nutrition as well as recommendations for food-based approaches. This review aims to investigate the sustainability of medical nutrition for paediatric care, focusing on factors contributing to GHG emissions, plant-based alternatives, waste management and plastic packaging. Such an exploration is vital for healthcare professionals to fulfil their responsibilities in addressing the climate crisis while advocating for change.
气候紧急情况对全球健康构成了深远的威胁,对儿童的健康和福祉产生了不利影响,预计他们将承受巨大的疾病负担,并影响儿童获得食物、水、医疗保健和教育的权利。医疗保健部门努力将预防性医疗保健政策作为优先事项,以改善个人一生的健康状况。然而,目前的医疗保健做法大大增加了温室气体(GHG)的排放和废物的产生,而(医疗)营养在其中发挥着重要作用。植物性蛋白质具有可持续发展的优势和潜在的健康优势,而且对气候的影响较小,不过某些作物也可能会带来土地使用变化和森林砍伐的意外后果。然而,要开发出适合医疗营养的植物替代品,就必须解决监管障碍,并确保营养成分适合,特别是蛋白质(氨基酸)和微量营养素成分。此外,开发耐热和节水的植物基因型可增强对不断变化的气候条件的适应性。有效的废物管理(包括浪费的食物和医疗营养品)是减轻医疗营养品对气候影响的关键战略。虽然对医疗环境中食物浪费的研究有限,但最大限度地减少医疗营养中的废物溢出是一个需要探索的重要领域。医疗保健专业人员必须认识到他们在遏制医疗营养的气候足迹方面的作用,以及对基于食物的方法的建议。本综述旨在研究儿科医疗营养的可持续性,重点关注导致温室气体排放的因素、植物替代品、废物管理和塑料包装。这种探索对于医疗保健专业人员在倡导变革的同时履行其应对气候危机的责任至关重要。
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引用次数: 0
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Frontline Gastroenterology
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