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Accountable care organisations in the United States and England

This briefing describes the different types of accountable care organisations emerging in the United States and discusses the implication of these developments for integrated care initiatives in England. The health system in England is facing a number of challenges including an ageing population, an increasing number of people with multiple, long-term conditions and a difficult financial climate. To meet these challenges, more integrated approaches to care delivery are needed to improve both the quality of care and patients' experience.  
kingsfund.org.uk
over 5 years ago
Www.bmj
1
15

In brief

Doctor denies charge of female genital mutilation: The first doctor in the United Kingdom to be charged with female genital mutilation will plead not guilty when he appears at Southwark Crown Court on 2 May, lawyers have said. Dhanuson Dharmasena, a registrar in obstetrics and gynaecology at the Whittington Hospital in north London, is alleged to have repaired the genital mutilation that had previously been carried out, and Hasan Mohamed, who is not a doctor, is charged with encouraging the doctor and aiding and abetting the offence.1  
bmj.com
over 5 years ago
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1
9

Examination bar for overseas doctors must rise, researchers say

Pass marks for the examination taken by overseas doctors seeking to work in the United Kingdom should rise to ensure that these doctors meet equivalent standards to UK trained doctors, two studies in The BMJ have concluded.  
bmj.com
over 5 years ago
Www.bmj
1
16

Lung cancer screening with low dose computed tomography

Lung cancer is a health problem that clearly merits a screening programme. Each year about 35 000 people in the United Kingdom die from lung cancer—more than the number for colorectal and breast cancer combined. In addition, about three quarters of people present with incurable disease, at a stage when treatment has little effect on overall survival; early stage disease is curable; risk factors for lung cancer are well understood; and a highly sensitive screening test is available.  
bmj.com
over 5 years ago
Www.bmj
1
21

Time to take periodontitis seriously

Periodontitis is the most common chronic inflammatory disease seen in humans, affecting nearly half of adults in the United Kingdom and 60% of those over 65 years.1 It is a major public health problem, causing tooth loss, disability, masticatory dysfunction, and poor nutritional status.2 Periodontitis also compromises speech, reduces quality of life,3 and is an escalating burden to the healthcare economy. In the UK alone it was estimated to cost £2.8bn (€3.4bn; $4.6bn) in 2008,4 not including raised all cause mortality, an association that has been noted in several populations.5 Worryingly, the disease is often silent, being present for decades before diagnosis and treatment. It can leave a substantial pathological footprint on multiple organ systems, as well as the oral cavity.  
bmj.com
over 5 years ago
Www.bmj
1
14

Time to take periodontitis seriously | The BMJ

Periodontitis is the most common chronic inflammatory disease seen in humans, affecting nearly half of adults in the United Kingdom and 60% of those over 65 years.1 It is a major public health problem, causing tooth loss, disability, masticatory dysfunction, and poor nutritional status.2 Periodontitis also compromises speech, reduces quality of life,3 and is an escalating burden to the healthcare economy. In the UK alone it was estimated to cost £2.8bn (€3.4bn; $4.6bn) in 2008,4 not including raised all cause mortality, an association that has been noted in several populations.5 Worryingly, the disease is often silent, being present for decades before diagnosis and treatment. It can leave a substantial pathological footprint on multiple organ systems, as well as the oral cavity. - currently located behind a paywall. Your institution may have access through Athens/Elservier or similar.  
bmj.com
over 5 years ago
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1
7

NHS England’s winter campaign: is earlier better?

This £3m campaign recommends earlier, self care for coughs and colds—but what evidence is there that such a message can improve health outcomes without causing harm, asks Margaret McCartney  
bmj.com
over 5 years ago
Preview
1
30

Should doctors prescribe cannabinoids?

The medical use of cannabis was advocated in the United States in the 1970s and 1980s when clinical trials of oral synthetic tetrahydrocannabinol (THC) and other oral synthetic cannabinoids reported efficacy in controlling nausea in patients with cancer who were undergoing chemotherapy.1 Dronabinol (an oral synthetic THC) was approved by the Food and Drug Administration in 1985 for this indication,1 but it was not widely used because patients were unable to titrate doses or disliked its psychoactive effects.1 It is still available in the US, United Kingdom, and the rest of Europe.  
www.bmj.com
over 5 years ago
Www.bmj
1
22

Should doctors prescribe cannabinoids?

The medical use of cannabis was advocated in the United States in the 1970s and 1980s when clinical trials of oral synthetic tetrahydrocannabinol (THC) and other oral synthetic cannabinoids reported efficacy in controlling nausea in patients with cancer who were undergoing chemotherapy.1 Dronabinol (an oral synthetic THC) was approved by the Food and Drug Administration in 1985 for this indication,1 but it was not widely used because patients were unable to titrate doses or disliked its psychoactive effects.1 It is still available in the US, United Kingdom, and the rest of Europe.  
bmj.com
over 5 years ago
Www.bmj
1
22

Removal of access to alemtuzumab for patients with aggressive multiple sclerosis

Although some treatments are now available for multiple sclerosis, better treatments are needed for people with aggressive disease. The need to find agents that can prevent or slow disease progression is particularly challenging and requires a concerted global effort that combines academic and pharmaceutical expertise. Although such partnerships are rare, the story of alemtuzumab has shown, inspirationally, that academic and pharmaceutical prowess can be combined to deliver an agent with real promise. Alemtuzumab, which has been used successfully off label to treat active relapsing-remitting multiple sclerosis, is a humanised monoclonal antibody that targets the CD52 antigen on leucocytes. Not surprisingly, there was therefore an outcry when Genzyme, now a Sanofi company, surrendered the licence for all currently licensed preparations of alemtuzumab, with effect from 8 August 2012, meaning that it will no longer be available as a licensed product in the United Kingdom once existing supplies run out.1 2  
bmj.com
over 5 years ago
Preview
1
16

Should doctors prescribe cannabinoids?

The medical use of cannabis was advocated in the United States in the 1970s and 1980s when clinical trials of oral synthetic tetrahydrocannabinol (THC) and other oral synthetic cannabinoids reported efficacy in controlling nausea in patients with cancer who were undergoing chemotherapy.1 Dronabinol (an oral synthetic THC) was approved by the Food and Drug Administration in 1985 for this indication,1 but it was not widely used because patients were unable to titrate doses or disliked its psychoactive effects.1 It is still available in the US, United Kingdom, and the rest of Europe.  
www.bmj.com
over 5 years ago
Www.bmj
1
10

Lung cancer screening with low dose computed tomography

Lung cancer is a health problem that clearly merits a screening programme. Each year about 35 000 people in the United Kingdom die from lung cancer—more than the number for colorectal and breast cancer combined. In addition, about three quarters of people present with incurable disease, at a stage when treatment has little effect on overall survival; early stage disease is curable; risk factors for lung cancer are well understood; and a highly sensitive screening test is available.  
bmj.com
over 5 years ago
Preview
1
7

NHS England’s winter campaign: is earlier better?

This £3m campaign recommends earlier, self care for coughs and colds—but what evidence is there that such a message can improve health outcomes without causing harm, asks Margaret McCartney  
bmj.com
over 5 years ago
Www.bmj
1
12

Lung cancer screening with low dose computed tomography

Lung cancer is a health problem that clearly merits a screening programme. Each year about 35 000 people in the United Kingdom die from lung cancer—more than the number for colorectal and breast cancer combined. In addition, about three quarters of people present with incurable disease, at a stage when treatment has little effect on overall survival; early stage disease is curable; risk factors for lung cancer are well understood; and a highly sensitive screening test is available.  
bmj.com
over 5 years ago
Www.bmj
1
14

Non-parametric statistical tests for two independent groups: numerical data

Researchers described the outcomes at one year for a national cohort of infants with gastroschisis. A prospective cohort study design was used. Participants were 301 liveborn infants with gastroschisis between October 2006 and March 2008 from all 28 paediatric surgical centres in the United Kingdom and Ireland. The aim of the study was to describe outcomes at one year, comparing infants with simple gastroschisis (intact, uncompromised, and continuous bowel) with those with complex gastroschisis (bowel perforation, necrosis, or atresia). The main outcome measures included duration of parenteral nutrition and length of stay in hospital.1  
bmj.com
over 5 years ago
Www.bmj
1
19

Should doctors prescribe cannabinoids?

The medical use of cannabis was advocated in the United States in the 1970s and 1980s when clinical trials of oral synthetic tetrahydrocannabinol (THC) and other oral synthetic cannabinoids reported efficacy in controlling nausea in patients with cancer who were undergoing chemotherapy.1 Dronabinol (an oral synthetic THC) was approved by the Food and Drug Administration in 1985 for this indication,1 but it was not widely used because patients were unable to titrate doses or disliked its psychoactive effects.1 It is still available in the US, United Kingdom, and the rest of Europe.  
bmj.com
over 5 years ago
Www.bmj
1
15

Time to take periodontitis seriously

Periodontitis is the most common chronic inflammatory disease seen in humans, affecting nearly half of adults in the United Kingdom and 60% of those over 65 years.1 It is a major public health problem, causing tooth loss, disability, masticatory dysfunction, and poor nutritional status.2 Periodontitis also compromises speech, reduces quality of life,3 and is an escalating burden to the healthcare economy. In the UK alone it was estimated to cost £2.8bn (€3.4bn; $4.6bn) in 2008,4 not including raised all cause mortality, an association that has been noted in several populations.5 Worryingly, the disease is often silent, being present for decades before diagnosis and treatment. It can leave a substantial pathological footprint on multiple organ systems, as well as the oral cavity.  
bmj.com
over 5 years ago
Static.www.bmj
1
36

Arthroscopy for degenerate meniscal tears of the knee

The NHS performs around 150 000 arthroscopic knee operations a year, with more than half involving resection of the meniscus. Therefore, close scrutiny of this intervention in the United Kingdom is entirely appropriate, particularly in the context of the ongoing drive towards providing evidence based and value based care.  
bmj.com
over 5 years ago
Www.bmj
1
15

Time to take periodontitis seriously

Periodontitis is the most common chronic inflammatory disease seen in humans, affecting nearly half of adults in the United Kingdom and 60% of those over 65 years.1 It is a major public health problem, causing tooth loss, disability, masticatory dysfunction, and poor nutritional status.2 Periodontitis also compromises speech, reduces quality of life,3 and is an escalating burden to the healthcare economy. In the UK alone it was estimated to cost £2.8bn (€3.4bn; $4.6bn) in 2008,4 not including raised all cause mortality, an association that has been noted in several populations.5 Worryingly, the disease is often silent, being present for decades before diagnosis and treatment. It can leave a substantial pathological footprint on multiple organ systems, as well as the oral cavity.  
www.bmj.com
over 5 years ago
Static.www.bmj
1
37

Arthroscopy for degenerate meniscal tears of the knee

The NHS performs around 150 000 arthroscopic knee operations a year, with more than half involving resection of the meniscus. Therefore, close scrutiny of this intervention in the United Kingdom is entirely appropriate, particularly in the context of the ongoing drive towards providing evidence based and value based care.  
bmj.com
over 5 years ago