British Society Research Articles

Retrospective analysis of the construction of the national system of hospice and palliative care in Great Britain

Today, Great Britain has one of the best hospice care systems for palliative patients in the world, which leads to interest in the path of building a Hospice and Palliative Care (НPC) system in this country. The hospice care system is mainly financed by the volunteer sector, which indicates a significant development of the state-society partnership in the organization of НPC. The national НPC system consists of inpatient care, day palliative care, care in the community and emergency hospitals. 2004–2008 is considered the key moment in the formation of the country's НPC system, which will be the focus of this study. For specialist palliative care, the National Health Service of Great Britain allocated almost £50 million a year in those days until 2004. At the same time, volunteer support was about 4 times greater. More than 220 volunteer support groups for palliative patients operated in the country. The success of building a national НPC system is described in the Palliative Care White Paper. A number of interrelated national programs may be used as a standard of palliative care in 20 years by many other countries. The development of the НPC system has influenced the British homes for the elderly, the system of primary care, the attitude to the НPC problem of doctors, local communities and society as a whole, increased the quality and availability of palliative care. Palliative care since those years has been provided 24/7, managed by coordination centers located outside medical facilities and hospices. High national НPC standards and mechanisms for monitoring their compliance have been created. Narcotic analgesia for palliative patients with chronic pain, the necessary medical, psychological, social and spiritual care is mostly available. The public debates the question of a dignified death without restrictions. The value for money of НPC is recognized by British society as acceptable. Therefore, studying the British experience of НPC organization as one of the "best practices" is useful for other countries with less developed НPC systems. Keywords: "best practices", place of death, palliative care quality standards.

Abstracts Presented at the Winter Meeting of the British Association of Clinical Anatomists on 19th December 2023, at the Cardiff School of Biosciences, Cardiff University, Cardiff, United Kingdom.

Abstracts Presented at the Winter Meeting of the British Association of Clinical Anatomists on 19th December 2023, at the Cardiff School of Biosciences, Cardiff University, Cardiff, United Kingdom.

Distributive Epistemic Justice in Science

Previous articleNext article No AccessDistributive Epistemic Justice in ScienceGürol Irzik and Faik KurtulmusGürol Irzik Search for more articles by this author and Faik Kurtulmus Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by The British Journal for the Philosophy of Science Just Accepted Society: The British Society for the Philosophy of Science Views: 141Total views on this site Views: 141Total views on this site Article DOIhttps://doi.org/10.1086/715351 Views: 141Total views on this site HistoryAccepted May 04, 2021 PDF download Crossref reports no articles citing this article.

Scratching beneath the surface: An evaluation of the management of scabies 2017-2023.

Possible resistance to recommended treatments for scabies has emerged recently. In response to anecdotal reports of a recent increase in treatment failure with permethrin, the British Association for Sexual Health and HIV (BASHH) released a statement alerting members to this. To examine attendances and the treatment pathways for scabies cases seen at local sexual health clinics. A case note review of scabies attendances between January 2017 and December 2023 was conducted. Data collected included patient demographics, clinical information, and scabies treatment histories. Statistical analysis was performed. 143 patients attended with scabies. The number of scabies cases did not appear to increase significantly from 2017 to 2023 (p = .09). There was significant increase in median number of treatments per case per year over time (p = .013). The number of individuals needing second-line treatments increased significantly over time (p-trend < 0.001). Individuals with scabies are requiring more treatments to clear infection. Use of ivermectin has risen in the last year suggesting that second-line treatment is increasingly needed for eradication. Whilst treatment failure may be due to non-compliance with treatment and decontamination efforts for both index and contacts, the more recent change in findings could be attributed to a fall in permethrin efficacy.

A study on the interaction between civil business groups and the state from the perspective of public sphere theory—A comparison between the Shanghai branch of the China association and the Philippine Chinese charitable association Inc.

This article attempts to use public sphere theory as a starting point to compare the behavior of the British government in protecting the interests of British business in China in the 19th century with the Chinese government’s neglect of the interests of Chinese business in the Philippines. Mill’s method of finding identities will be used. This article uses the Shanghai Branch of the China Association and the Philippine Chinese Charitable Association Inc. as representatives of civil business groups in the UK and China. For the UK, due to the public sphere of competition with the central government within the UK, civil business groups must consult with relevant civil business groups when implementing any economic foreign policy. This process promotes consensus between the British government and society to promotes the British government’s determination to maintain British business in China. However, for China, due to the absence of a public sphere where the central government interacts with society, even though Chinese civil business groups have huge interests overseas, the state and society have always been unable to form a positive interaction. At the same time, this situation also results in Chinese business in the Philippines having to rely on their abilities to maintain their local interests.

Guideline for laboratory diagnosis and monitoring of von Willebrand disease: A joint guideline from the United Kingdom Haemophilia Centre Doctors' Organisation and the British Society for Haematology.

Guideline for laboratory diagnosis and monitoring of von Willebrand disease: A joint guideline from the United Kingdom Haemophilia Centre Doctors' Organisation and the British Society for Haematology.

Racial Discourses in Aegean Prehistory c. 1900: The Case of the Cupbearer Fresco at Knossos

This article traces characterizations of the Cupbearer fresco, named after the large vessel the figure holds and uncovered at the site of Knossos in 1900, in light of the research agendas about the ‘races’ of the prehistoric Aegean and traditions of racial science current in late Victorian Britain. The head of the Cupbearer was compared to Classical Greek art, modern Cretan populations, and cranial remains from prehistoric contexts. Drawing from academic publications, articles in the press, and reports of the British Association for the Advancement of Science, the author situates the discourse surrounding the Cupbearer in the context of scholars seeking the origins of ‘European’ civilization in prehistory, and the creation of racial typologies, especially using cranial measurements and photography. The Cupbearer gained a dual status as a racial portrait comparable to past and present human populations, but also as a work of art that prefigured the later achievements of Classical Greece.

Consensus on managing open ankle fractures in the frail patient.

Ankle fractures are common injuries and the third most common fragility fracture. In all, 40% of ankle fractures in the frail are open and represent a complex clinical scenario, with morbidity and mortality rates similar to hip fracture patients. They have a higher risk of complications, such as wound infections, malunion, hospital-acquired infections, pressure sores, veno-thromboembolic events, and significant sarcopaenia from prolonged bed rest. A modified Delphi method was used and a group of experts with a vested interest in best practice were invited from the British Foot and Ankle Society (BOFAS), British Orthopaedic Association (BOA), Orthopaedic Trauma Society (OTS), British Association of Plastic & Reconstructive Surgeons (BAPRAS), British Geriatric Society (BGS), and the British Limb Reconstruction Society (BLRS). In the first stage, there were 36 respondents to the survey, with over 70% stating their unit treats more than 20 such cases per year. There was a 50:50 split regarding if the timing of surgery should be within 36 hours, as per the hip fracture guidelines, or 72 hours, as per the open fracture guidelines. Overall, 75% would attempt primary wound closure and 25% would utilize a local flap. There was no orthopaedic agreement on fixation, and 75% would permit weightbearing immediately. In the second stage, performed at the BLRS meeting, experts discussed the survey results and agreed upon a consensus for the management of open elderly ankle fractures. A mutually agreed consensus from the expert panel was reached to enable the best practice for the management of patients with frailty with an open ankle fracture: 1) all units managing lower limb fragility fractures should do so through a cohorted multidisciplinary pathway. This pathway should follow the standards laid down in the "care of the older or frail orthopaedic trauma patient" British Orthopaedic Association Standards for Trauma and Orthopaedics (BOAST) guideline. These patients have low bone density, and we should recommend full falls and bone health assessment; 2) all open lower limb fragility fractures should be treated in a single stage within 24 hours of injury if possible; 3) all patients with fragility fractures of the lower limb should be considered for mobilisation on the day following surgery; 4) all patients with lower limb open fragility fractures should be considered for tissue sparing, with judicious debridement as a default; 5) all patients with open lower limb fragility fractures should be managed by a consultant plastic surgeon with primary closure wherever possible; and 6) the method of fixation must allow for immediate unrestricted weightbearing.

Abstract 4771: Assessment of Ki67 proliferation index in pre-malignant colonic adenomas: Implication for new biomarker testing to predict metachronous disease (The INCISE project)

Abstract Approximately 40% of patients are found to have polyps at bowel screening colonoscopy, which are associated with a higher risk of developing future polyps or colorectal cancer. The British Society of Gastroenterology 2020 (BSG20) guidelines stratify patients into high/low risk of metachronous disease, using the size, dysplasia, and number of polyps found at index colonoscopy. This study aims to explore the prognostic significance of Ki67 proliferation percentages in adenomatous polyps, with metachronous disease. Tissue microarray (TMA) was constructed from 1201 index adenomatous polyps with representative cores of basal and luminal adenomatous epithelia. 67% patients were identified as high risk at index colonoscopy. The median time to detect metachronous polyps was 55 months (range 6-72 months) with 56% of patients developing metachronous polyps by the end of follow-up. TMA was stained for Ki67 using immunohistochemistry. Ki67 proliferation percentages in adenomatous epithelia was quantified using QuPath. Data was split into training (n=830) and test (n=371) datasets. The Ki67 proliferation cutpoint was made using Survmine R package using the training dataset. X2 test was used to study associations with clinicopathological criteria and Kaplan survival analysis was used to assess Ki67 association with metachronous lesions. Ki67 percentages were higher in lumina than in basal adenomatous epithelium (median Ki67 were 63% &amp; 48%; respectively). Total Ki67 percentages were computed by averaging luminal and basal values. Thresholds of 70%, 64% and 59% were employed to classify patients into low/high categories based on luminal, basal or total percentages; respectively. In the training cohort, high luminal, basal or total Ki67 were associated with metachronous lesions (p values 0.032, &amp;lt;0.001 and 0.006; respectively). Other associations were significant between luminal or total Ki67 and location of index polyps (p=0.017 &amp; p=0.044; respectively), histology (p=0.019) and advanced future lesion status (p=0.002 &amp; p&amp;lt;0.001; respectively). In multivariate cox regression analysis, high Ki67 was an independent prognostic factor for metachronous polyps (luminal Ki67 HR=1.28, CI: 1.052-1.560, p=0.014; basal Ki67 HR=1.639, CI: 1.313-2.046, p&amp;lt;0.001; total Ki67 HR=1.344, CI: 1.105-1.635, p=0.003) when adjusted to number of index polyps and BSG20 risk score. BSG20 risk score stratification of patients in terms of metachronous disease was improved when combined with luminal, basal or total Ki67 in the training datasets (all p&amp;lt;0.05). Prediction of metachronous disease by the combined groups was validated in the test cohort for luminal, basal and total Ki67 (all p&amp;lt;0.05). High Ki67 proliferation rates in adenomatous polyps are independently associated with the development of metachronous polyps and may help improve the BSG20 criteria. Citation Format: Gerard P. Lynch, Aula Ammar, Christopher Bigley, Mark Johnstone, Jakub Jawny, Hannah Morgan, Jennifer Hay, Noori Maka, Stephen McSorley, Joanne Edwards. Assessment of Ki67 proliferation index in pre-malignant colonic adenomas: Implication for new biomarker testing to predict metachronous disease (The INCISE project) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4771.

A British Society for Haematology guideline on the assessment and management of bleeding risk prior to invasive procedures.

A British Society for Haematology guideline on the assessment and management of bleeding risk prior to invasive procedures.

Место Сэмюэля Джонсона в духовной жизни британского общества второй половины XVIII века

The review is devoted to the analysis of the monograph, which examines the place and role of the educator S. Johnson in the spiritual life of British society in the second half of the 18th century. The reviewer shows that the author of the monograph was able to convincingly prove that the intellectual heritage of the compiler of the “Dictionary of the English Language”, a moralist and literary critic, most fully reflected the trend towards self-identification that dominated contemporary English culture. The reviewer’s attention is focused on considering how this problem was solved.

Food insecurity and the dental team: a pilot study to explore opinions

PurposeIn total, 17% of UK households with children experience food insecurity, with evidence to suggest a direct correlation with the prevalence of oral disease. This study explores current perceptions of the dental team, when recognising and supporting families who may experience food insecurity.Materials and methodsAn online, anonymous cross-sectional survey was designed and sent to members of the British Society of Paediatric Dentistry (BSPD) in June 2023, examining confidence and understanding surrounding food insecurity and dental health. Quantitative data is presented descriptively and qualitative data using a thematic analysis.ResultsThe response rate was 9.6% (n = 76). A significant number recognise the link between poor oral health and food insecurity, 80.3% (n = 61). Although practitioners are confident in oral health counselling, 80.3% (n = 61) a smaller proportion are not as confident when approaching food insecurity 32.9% (n = 25). Dental team members recognise the need to improve identification of affected patients and that they have a professional duty to support. Intervention strategies, such as additional training to support team development and signposting of patients are indicated.ConclusionThis study suggests that whilst dental professionals understand the link between food insecurity and oral health, and their responsibilities to those affected; they lack confidence in identifying such patients and providing support. Additional conversations and training are fundamental to better understand their role, which must reflect the needs of the population that they serve.

Common pitfalls, and how to avoid them, in child and adolescent psychopharmacology: Part I.

As Faculty of the British Association for Psychopharmacology course on child and adolescent psychopharmacology, we present here what we deem are the most common pitfalls, and how to avoid them, in child and adolescent psychopharmacology. In this paper, we specifically addressed common pitfalls in the pharmacological treatment of attention-deficit/hyperactivity disorder, anxiety, bipolar disorder, depression, obsessive-compulsive disorder and related disorders, and tic disorder. Pitfalls in the treatment of other disorders are addressed in a separate paper (part II).

Supporting work participation for adults with hand and upper limb conditions: A survey of the British Association of hand therapists

Introduction Musculoskeletal disorders affect over a third of the UK adult population and are a common reason for sick leave from work. The aims of this study were to describe the reported provision of work participation support for adults with hand and upper limb conditions by UK hand therapists, and to identify potential training needs in this area. Methods A previous survey of the Australian Hand Therapy Association was adapted for the UK. The electronic questionnaire was distributed to members of the British Association of Hand Therapists. Eligible individuals were UK-based occupational therapists or physiotherapists whose role included the assessment and/or treatment of patients ≥18 years with hand or upper limb issues. Results There were 123 participants (17% response rate). The most frequently reported work participation interventions were discussing graded return to work and sign-posting patients to speak with their doctor. The Allied Health Professionals Health and Work Report and Fit Note were not regularly used, and respondents reported low levels of confidence in issuing these documents. Barriers to providing work recommendations included a perceived lack of time, skills, knowledge and training. Facilitators included the patient discussing work as a rehabilitation goal. Conclusion Development opportunities for UK hand therapists include increasing patient awareness that they can ask for work-related advice and documentation, promoting existing health and work training, developing hand therapy-specific resources, and ensuring access to electronic Fit Notes. International opportunities include the continuation of this survey with a focus on generating exemplar work participation strategies to inform further research.

Common pitfalls, and how to avoid them, in child and adolescent psychopharmacology: Part II.

As Faculty of the British Association for Psychopharmacology course on child and adolescent psychopharmacology, we present here what we deem are the most common pitfalls, and how to avoid them, in child and adolescent psychopharmacology. In this paper, we specifically addressed common pitfalls in the pharmacological treatment of autism and intellectual disability, eating disorders, neuropsychiatric correlates of epilepsy, and psychosis. Pitfalls in relation to the treatment of other disorders are addressed in a separate paper (Part I).

‘An elegant and able practitioner’. Marian Mason and the rise of women’s calisthenics in nineteenth century Britain

ABSTRACT In 1826 Marian Mason was introduced to British society as a callisthenic instructor. Trained by P.H. Clias, a gymnast who oversaw physical training in the military and navy, Mason is the first high profile female fitness coach in British history. Despite her importance as a landmark figure, Mason's contributions, and indeed life, remain relatively obscured from the historical record. Studying Mason's heyday in public life from 1826 to the early 1830s, this article provides the first substantive examination of Mason's life, her social networks and wealth and, critically, the monograph she published in 1826. While acknowledging Mason's role as an early female fitness coach, the article provides a deep reading of Mason's successes, focusing on her class and relationship advantages, her ability to court medical favour and shrewdness in addressing broader societal concerns. This article is less a biography and more an examination of the broader social and medical trends in early nineteenth century England, which created a space for people like Mason. The article presents a simple argument – Marian Mason was an early female fitness coach who, drawing on broader societal concerns about the body, created a niche for her career by leveraging her expertise and familial connections.

Practice guideline: Preparation for CAR T-cell therapy in children and young adults with B-acute lymphoblastic leukaemia.

The objective of this guideline, prepared by the ALL subgroup of the Advanced Cell Therapy Sub-Committee of BSBMTCT (British Society of Blood and Marrow Transplantation), is to provide healthcare professionals with practical guidance on the preparation of children and young adults with B-acute lymphoblastic leukaemia from the point of referral to that of admission for CAR T-cell treatment. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) nomenclature was used to evaluate the levels of evidence and to assess the strength of recommendations. The GRADE criteria can be found at http://www.gradeworkinggroup.org.

Medical Associate Professionals in the UK

Anyone who has any connection with the world of social media will be aware of the ‘storm in a teacup’ that has been brewing in the last few months with Medical Associate / Assistant Professionals (MAPs) in the UK as Parliament debated and swiftly passed legislation1 related to their regulation by the UK General Medical Council. In its supporting statement, the UK Minister for Health2 specified,&#x0D; &#x0D; ‘Physician associates work under the supervision of doctors taking medical histories, carrying out physical examinations, performing some medical procedures and analysing test results. Anaesthesia associates review patients before surgery, initiate and manage medications, administer fluids and blood therapy during surgery, and ensure there is a plan for patients following their operation. Both roles can work autonomously, but always under the supervision of a fully trained and experienced doctor.’&#x0D; The legislation was passed in the UK Parliament in Feb24 and will be in force from Dec’24.&#x0D; The British Association of Physicians of Indian Origin (BAPIO) is leading a survey 17and workshop designed to have a 360-degree review of the impact of MAPs on training and career progression for all doctors, including the missing voice of several thousands of doctors who are not in formal training, are locally employed on shorter-term contracts, are considered as speciality doctors by the GMC. A vast proportion of these doctors are international medical graduates, and a significant proportion belong to cohorts who are under-represented in leadership positions (including those that were previously considered from Black or minority ethnic groups). The workshops and focus groups will include representation from all under-represented groups of doctors across the spectrum, patient representatives, nursing, and allied healthcare professionals who form an integral part of the MDT, medical leaders, higher education institutions, NHS workforce Training and Education and NHS employers. The results of the independently facilitated focus groups and survey results will be published with recommendations for all stakeholders in May 2024, and aim to provide a framework for action, reflecting consultation and views of the whole healthcare profession.

The registers of pediatric patients with home artificial nutrition. The Spanish experience

the number of infants and children who receive artificial nutrition at home has been steadily increasing over the last decades, as better outcomes for children with chronic conditions have been achieved. In order to evaluate the need of resources to implement the technique it is necessary to know how many patients benefit from home artificial nutrition. This information can be estimated from the register of patients, when available. in this paper the characteristics of all registers were reviewed, especially those devoted to pediatric patients. only two pediatric registers are active in 2023: the Canadian register and the Spanish one. NADYA register from the Spanish Society for Clinical Nutrition and Metabolism (SENPE) and the recent REPAFI, form the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition. The most valuable register from the British Society, BANS, stopped providing information in 2018. despite the fact of acknowledging the importance of having gathered information on the prevalence and incidence of home artificial nutrition, to fit resources to necessities, the number of active registers is quite short.

Evaluation of the Progress of Coronavirus Disease-19 Pneumonia using the British Society of Thoracic Imaging Reporting Model: A Validation Study

Abstract: Background: SARS-COV-2 (also known as severe acute respiratory syndrome corona virus-2), emerged as a pandemic and became an overwhelming global concern, causing substantial morbidity and mortality worldwide. Reverse transcription polymerase chain reaction (RT-PCR) is considered a gold standard in detecting clinically symptomatic patients but can have false negative and false positive results. As chest X-Ray (CXR) is considered as a baseline investigation in many hospitals, BSTI reporting model during COVID-19 pandemic has been a useful tool in diagnosis of COVID-19 pneumonia. Objective: To validate the British Society Thoracic Imaging (BSTI) coding system in the evaluation of the progress of the disease severity in patients with coronavirus disease-2019 (COVID-19) pneumonia. Materials and Methods: This is a cross sectional observational study. Total 450 CXRs (which included both the baseline and serial CXRs) of 225 COVID positive patients (RT-PCR positive for COVID-19 on nasal swabs) were included. These were retrospectively reviewed and reported by two Radiologists (having experience of at least 5 years in Radiology Reporting) in Corona Ward in Dr. Ruth K M Pfau Civil Hospital Karachi, Pakistan, for the duration of 10 months from 1st March 2020 till 31st December 2020. BSTI coding system was used to classify and interpret the CXR imaging findings as normal, definitive, indeterminate and non-COVID for baseline (CXR on 1st day of admission) and follow up CXRs (done in between 3rd and 7th day of admission). Data was analyzed using SPSS version 25. Numeric data was assessed for distribution using Shapiro-Wilks test. Median and interquartile range (IQR) were reported for numeric variables. Frequencies and percentages were reported for categorical data. Kappa statistics was applied to assess the agreement between BSTI scoring at baseline and follow-up CXRs. A p-value ≤0.05 was considered as statistically significant. Result: CXRs (including 225 baseline and 225 follow up CXRs) of 225 RT-PCR COVID-19 positive patients were analyzed. Interval change in BSTI coding system was noted, increase in frequency of probable/definitive COVID-19 findings were diagnosed on serial CXRs. The BSTI scoring at baseline and follow-up showed moderate agreement with kappa statistics as 60.3% (p=0.001). Conclusion: BSTI coding system can be helpful to classify the COVID-19 disease on CXR and filter for the prognosis of disease severity in the serial radiographs. Utilization of BSTI reporting model for reporting CXRs, even before RT-PCR, in future COVID pandemic can be considered as a useful tool.