scholarly journals P136 Vegan orthopaedics

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Gwithyen Silk ◽  
Niraj Vetherajan ◽  
Alice Blohm ◽  
Katie Keen ◽  
Fiona Teeling ◽  
...  
Keyword(s):  
Ethnic Diversity ◽  
Informed Choice ◽  
Pharmaceutical Companies ◽  
Vitamin D2 ◽  
World Religions ◽  
Animal Products ◽  
Animal Source ◽  
Specific Manner ◽  
Prescribed Medicines ◽  
The Uk

Abstract Introduction Bristol is the vegan capital of the UK. The UK vegan index reveals that Bristol has 360,000 Google searches each month for Vegan content. However, do we think about the possible animal source of the medications we prescribe. Although all medications in the UK need to be tested on animals prior to being licensed and therefore cannot be truly “vegan”, there are alternatives available for some commonly used medications that do not contain animal products. Several world religions prohibit their followers from consuming certain foods, ranging from those not prepared in a specific manner to those derived from certain animals. Kosher and halal diet adherents share concerns with those on vegan diets. Vegan options are a solution when only non-conforming or uncertain products are available. Methods We conducted a review of commonly used medications in Orthopaedics and reviewed their source. The BNF, local pharmacy and online Summary of Product Characteristics (SPCs) for the medications were reviewed. Results Where possible we have compiled a list of those that contain animal derived components and suggest alternatives. Sometimes, pharmaceutical companies cannot guarantee or differentiate the specific sources of animal-derived ingredients, as various suppliers are used in the manufacturing process and the sources can change. All unfractionated or standard heparin is porcine in origin; Rivaroxaban and Fondaparinux are simple alternatives for example. Cholecalciferol (vitamin D3) – Manufacture also involves the use of lanolin from sheep’s wool. Vitamin D2 (ergocalciferol) is vegan. Conclusion Disclosure of animal content and excipients would help patients make an informed choice. With an increasingly informed population and ethnic diversity, we should all be aware of the drugs that may contain animal products so that we can offer alternatives. Patients are more likely to adhere to prescribed medicines if they have been actively involved in prescribing decisions.

Caesarean section as an informed choice in the UK: a systematic review

2021 ◽  
Vol 29 (10) ◽  
pp. 579-588
Author(s):  
Clementine Djatmika ◽  
Joanne Lusher ◽  
Jane Meyrick ◽  
James Byron-Daniel
Keyword(s):  
Decision Making ◽  
Caesarean Section ◽  
Psychological Impact ◽  
Healthcare Providers ◽  
Informed Choice ◽  
Steady Increase ◽  
Thematic Synthesis ◽  
Critical Appraisal Skills ◽  
Online Library ◽  
The Uk

Background Despite the steady increase in the number of women giving birth via caesarean section in the UK, little is understood about how shared decision making is implemented in obstetrics or what this means for women that have given birth via caesarean. The aim of this review is to assess narratives of women's experiences of caesarean birth as an informed choice and their involvement in this process. Methods A number of databases were searched, including MEDLINE via EBSCO, EMBASE via OVID, MIDIRS via OVID, Scopus, Wiley Online Library, Google Scholar and Ethos, as well as the reference sections of the included studies. Primary studies published between 1990–2020 were included and quality was assessed using the critical appraisal skills programme tool. Findings were analysed using a thematic synthesis framework to elicit higher order interpretations. Results A total of 11 studies were included in the final review. Quality assessment indicated the studies were generally of good quality, with the main limitations being in methodology quality indicators. Thematic synthesis identified eight subthemes within three main themes: ‘patient-doctor relationships’, ‘decision making as an emotional journey’ and ‘caesarean not really an informed “choice”’. The role of healthcare providers in promoting women's agency via patient-centred care was a prominent theme in women's narratives. Conclusions Women's decision making in consent to undergo caesarean births is a complex, emotionally driven process that can have a significant long-term psychological impact.

How screening started

Screening ◽  
2019 ◽  
pp. 1-26
Author(s):  
Angela E. Raffle ◽  
Anne Mackie ◽  
J. A. Muir Gray
Keyword(s):  
Cervical Screening ◽  
Informed Choice ◽  
Commercial Activity ◽  
Best Value ◽  
Randomised Control Trials ◽  
The Face ◽  
The Usa ◽  
Scientific Challenge ◽  
The 1960S ◽  
The Uk

This chapter explains how health screening began, how the aims have evolved, how evidence and organisation influenced matters, and how challenges in the future will give rise to continuing change. It begins with Gould’s address in 1900 to the American Medical Association and charts events that led, almost by accident, to the institution of comprehensive annual testing of healthy adults in the USA, and to 5 day hospital-based ‘Human Dry Dock’ screening for Japanese executives. Scientific challenge then came from two randomised control trials, which failed to find benefit, but by then screening had become an important commercial activity. Using the UK cervical screening programme as a case study, the chapter explores how the optimism of the 1960s led through disillusionment, then to programme organisation and, by the 1990s, an era of realism. Evolution of the Wilson and Jungner criteria as an aid for policy making is covered. A key challenge now is to ensure best value policy, high quality systematic programme delivery and informed choice in the face of commercial forces that lead to the glossing over of screening’s complexities and far reaching consequences.

scholarly journals Pharmaceutical sponsorship of educational events: what can we learn from healthcare ethics?

2006 ◽  
Vol 30 (5) ◽  
pp. 189-191
Author(s):  
Christopher A. Vassilas ◽  
Sarah Matthews
Keyword(s):  
Medical Education ◽  
Point Of View ◽  
Ethical Principles ◽  
Pharmaceutical Companies ◽  
Healthcare Ethics ◽  
Monetary Value ◽  
Ethical Point ◽  
The Uk

In the UK, postgraduate medical educational events are commonly sponsored by pharmaceutical companies, often with the provision of food and gifts with a small monetary value (e.g. pens and torches). The involvement of pharmaceutical companies with doctors has been discussed extensively (Abbasi & Smith, 2003; Shooter, 2005). We have chosen to consider sponsorship of educational events from an ethical point of view in order to see if this approach can provide guidance for a situation that is the norm in many hospitals, but of increasing concern to educationalists. We also hope to illustrate how the application of ethical principles can be applied to a medical education issue.

Pharmaceutical Companies and Managed Care in the UK

1997 ◽  
Vol 1 (3) ◽  
pp. 100-102 ◽  
Author(s):  
Tim Williams
Keyword(s):  
Managed Care ◽  
Pharmaceutical Companies ◽  
The Uk

scholarly journals Mortality of ethnic minority groups in the UK: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e034903
Author(s):  
Fiona Stanaway ◽  
Naomi Noguchi ◽  
Erin Mathieu ◽  
Saman Khalatbari-Soltani ◽  
Raj Bhopal
Keyword(s):  
Systematic Review ◽  
Ethnic Diversity ◽  
Minority Groups ◽  
Meta Analysis ◽  
Grey Literature ◽  
Primary Data ◽  
Majority Population ◽  
White Majority ◽  
Newcastle Ottawa Scale ◽  
The Uk

IntroductionGrowing ethnic diversity in the UK has made it increasingly important to determine the presence of ethnic health inequalities. There has been no systematic review that has drawn together research on ethnic differences in mortality in the UK.MethodsAll types of observational studies that compare all-cause mortality between major ethnic groups and the white majority population in the UK will be included. We will search Medline (OvidSP), Embase (OvidSP), Scopus and Web of Science and search the grey literature through conference proceedings and online thesis registries. Searches will be carried out from inception to 2 August 2019 with no language or other restrictions. Database searches will be repeated prior to publication to identify new articles published since the initial search. We will conduct forward and backward citation tracking of identified references and consult with experts in the field to identify further publications and ongoing or unpublished studies. Two reviewers will independently screen studies and extract data. Two reviewers will independently assess the quality of included studies using the Newcastle-Ottawa Scale. If at least two studies are located for each ethnic group and studies are sufficiently homogeneous, we will conduct a meta-analysis. If insufficient studies are located or if there is high heterogeneity we will produce a narrative summary of results.Ethics and disseminationAs no primary data will be collected, formal ethical approval is not required. The findings of this review will be disseminated through publication in peer reviewed journals and conference presentations.PROSPERO registration numberCRD42019146143.

scholarly journals Documenting entrepreneurial opportunism in action

2017 ◽  
Vol 119 (1) ◽  
pp. 105-121 ◽  
Author(s):  
Robert Smith
Keyword(s):  
Supply Chain ◽  
Design Methodology ◽  
Historical Research ◽  
Insurance Companies ◽  
Criminal Enterprise ◽  
Food Fraud ◽  
Animal Products ◽  
Content Type ◽  
Food Integrity ◽  
The Uk

Purpose The contemporary rustler is a shrewd businessman, or rogue farmer exploiting food supply chain anomalies. Indeed, the first conviction in the UK for 20 years was a farmer stealing from neighbouring farmers. The theft of sheep in the UK is an expanding criminal enterprise which remains under researched. The purpose of this paper is to examine what is known of the illegal trade and its links to food fraud from a supply chain perspective with an emphasis on food integrity issues. Design/methodology/approach There is a dearth of current viable literature on livestock theft in a western context making it necessary to turn to socio-historical research and to official documents such as those published by the NFU and other insurance companies to build up a picture of this illegal practice. This is supplemented by documentary research of articles published in the UK press. Findings From this raw data a typology of rustlers is developed. The findings point to insider “supply chain” knowledge being a key facet in the theft of livestock. Other examples in the typology relate to urban thieves wrestling live sheep into a car and to industry insiders associated with the abattoir sector. Research limitations/implications The obvious limitations is that as yet there are few detected cases of rustling in the UK so the developing typology of rustlers is sketchy. Another limitation is that much of the evidence upon which the typology is developed is anecdotal. Originality/value The typology should prove helpful to academics, insurance companies, investigators, industry insiders and farmers to help them understand this contemporary crime and how to prevent its spread. It also sheds light on food integrity in relation to the purchase and consumption of the end product in that customers expect to be purchasing legally and ethically reared animal products.

scholarly journals Does ethnic diversity explain intra-UK variation in mortality? A longitudinal cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024563
Author(s):  
Lauren Schofield ◽  
David Walsh ◽  
Zhiqiang Feng ◽  
Duncan Buchanan ◽  
Chris Dibben ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Ethnic Diversity ◽  
Policy Implications ◽  
Country Of Birth ◽  
England And Wales ◽  
All Cause Mortality ◽  
Mortality Incidence ◽  
And Migration ◽  
The Uk

ObjectivesIt has been proposed that part of the explanation for higher mortality in Scotland compared with England and Wales, and Glasgow compared with other UK cities, relates to greater ethnic diversity in England and Wales. We sought to assess the extent to which this excess was attenuated by adjusting for ethnicity. We additionally explored the role of country of birth in any observed differences.SettingScotland and England and Wales; Glasgow and Manchester.ParticipantsWe used the Scottish Longitudinal Study and the Office for National Statistics Longitudinal Study of England and Wales (2001–2010). Participants (362 491 in total) were aged 35–74 years at baseline.Primary outcome measuresRisk of all-cause mortality between 35 and 74 years old in Scotland and England and Wales, and in Glasgow and Manchester, adjusting for age, gender, socioeconomic position (SEP), ethnicity and country of birth.Results18% of the Manchester sample was non-White compared with 3% in Glasgow (England and Wales: 10.4%; Scotland: 1.2%). The mortality incidence rate ratio was 1.33 (95% CI 1.13 to 1.56) in Glasgow compared with Manchester. This reduced to 1.25 (1.07 to 1.47) adjusting for SEP, and to 1.20 (1.02 to 1.42) adjusting for ethnicity and country of birth. For Scotland versus England and Wales, the corresponding figures were 18% higher mortality, reducing to 10%, and then 7%. Non-Whites born outside the UK had lower mortality. In the Scottish samples only, non-Whites born in the UK had significantly higher mortality than Whites born in the UK.ConclusionsThe research supports the hypothesis that ethnic diversity and migration from outside UK play a role in explaining Scottish excess mortality. In Glasgow especially, however, a large excess remains: thus, previously articulated policy implications (addressing poverty, vulnerability and inequality) still apply.

scholarly journals A review of the use of biological mesh products in modern UK surgical practice: a religious and cultural perspective

2020 ◽  
Vol 102 (8) ◽  
pp. 566-570
Author(s):  
RM Koshy ◽  
EG Kane ◽  
C Grocock
Keyword(s):  
Surgical Planning ◽  
Religious Leaders ◽  
Manufacturing Companies ◽  
Cultural Perspective ◽  
Religious Groups ◽  
Animal Products ◽  
Religious Perspective ◽  
Ovid Medline ◽  
The Individual ◽  
The Uk

Introduction The UK is an increasingly multicultural society. This change coincides with an increasing use of animal products in medicine and surgery and a change in the UK law of consent. The refusal of Jehovah’s Witnesses to accept blood products is well known, but the use of animal products in surgery is a neglected topic. As society becomes more diverse and medicine becomes ever more advanced, there is increasing potential for a mismatch between what is medically possible and what is acceptable from a religious perspective. Methods Surgical products were identified by searching the literature and contacting manufacturing companies. Literature was identified by using PubMed and OVID (MEDLINE). Religious views were established by contacting national bodies for each group. Findings The views of common UK religious groups and the constituent parts of biological meshes are summarised in tables intended to be used as a reference during clinical practice. On an elective basis, the Islamic, Hindu. Sikh and Jain leaders contacted had strong views on avoiding animal derived products. The Christian and Jewish leaders contacted did not. All religious leaders contacted accepted the use of mesh derived from human tissue. All products, including those of porcine and bovine origin, were acceptable to all leaders contacted if the procedure was performed to save life. The highlighting of this issue should prompt earlier consideration and discussion in the surgical planning and the consenting process with all final decisions taken by both the surgeon and the individual patient.

Spectrum of causative mutations in patients with haemophilia A in Austria

2010 ◽  
Vol 104 (07) ◽  
pp. 78-85 ◽  
Author(s):  
Sylvia Reitter ◽  
Rümuth Sturn ◽  
Birgit Horvath ◽  
Renate Freitag ◽  
Christoph Male ◽  
...  
Keyword(s):  
Ethnic Diversity ◽  
Risk Estimation ◽  
Low Frequency ◽  
Clinical Information ◽  
Haemophilia A ◽  
Italian Population ◽  
Coding Region ◽  
Double Mutation ◽  
Sequencing Part ◽  
The Uk

SummaryIn patients with haemophilia A knowledge of the pathogenetic mutation is important i) as basis for carrier diagnosis and ii) for risk estimation of inhibitor formation. The pathogenetic mutations were identified by testing inversions in intron 1 and 22 (IVS22 and IVS1) and sequencing part of the promoter, the coding region and the exon/intron boundaries in a cohort of Austrian haemophilia A patients. A total of 239 patients from nine participating centres, who had consented to genetic testing and of whom clinical information was available were included in the study. First, IVS22 and IVS1 were tested; in case of absence of either inversion patients were subjected to sequencing. Mutations within the FVIII gene were identified in 234 patients. Notably, 53 mutations had not previously been described in HAMSTeRS. Of our patient cohort, 72.5 % had either an IVS22 or a missense mutation. Interestingly, in three brothers with severe haemophilia, we found a double mutation in exon 14 (missense + small deletion). The spectrum of mutations in Austrian haemophilia A patients was comparable to that found in the German and Italian population; however, it differed from the spectrum reported in the UK. In conclusion, 53 not previously published mutations were identified in Austrian haemophilia A patients. The occurrence of double mutations in the factor VIII gene could be confirmed and their low frequency was corroborated. We speculate that the differences between mutations in Austria and other European countries are due to ethnic diversity. Detailed investigations of the association of ethnicity and the mutation spectrum are planned.

Sign in / Sign up

Export Citation Format

Share Document