Brit J Hosp Med
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A considerable portion of the world's population practices fasting, for religious purposes like Ramadan or to adopt a healthier lifestyle such as intermittent fasting. During this period, individuals undergo metabolic changes that alter their internal environment. ⋯ However, remodelling of the gastric environment and increases in concentrations of H. pylori were recorded. There is no relationship between fasting and the risk of developing H. pylori-induced peptic ulcers, suggesting that individuals with uncomplicated ulcers are not at risk of developing further ulcers and can participate in fasts provided they take the recommended measures.
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Inherited kidney disease accounts for a significant proportion of chronic kidney disease and end-stage renal failure. There is increasing evidence that genetic testing for inherited kidney disease should be integrated into clinical care pathways at the earliest opportunity so that patients and their families can maximally benefit from carefully tailored care. Despite increased availability of genetic testing, the proportion of patients with renal disease undergoing genetic investigations remains low. This article introduces key concepts of genetic and genomic testing to the renal physician and addresses some common barriers to the wider integration of genetic testing in routine clinical practice to fully capitalise on recent advances in genomic medicine and improve patient outcomes.
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As part of the NHS long-term strategy to meet the medical and non-medical needs of patients, there is growing acceptance that the traditional model of service delivery can no longer meet current challenges. This has led to the co-creation of services with patients and other stakeholders such as the voluntary and community sector to help deliver these. Social prescribing, which is now available through the NHS, is one such option that allows individual patients with a social need to access local health resources and social support outside the NHS.
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Clinicians spend a considerable part of their time while supervising trainees providing feedback. It is generally accepted that feedback can play a major role in subsequent academic performance. Traditionally it was thought that all feedback was good feedback, that inevitably improved learner outcomes. ⋯ A learner who is feedback literate can recognise when they are getting feedback and understand how it relates to their progress; they can process it effectively both cognitively and emotionally, and they can put it in to action in ways which benefit their learning. Modifiable and non-modifiable factors can influence feedback literacy, with modifiable factors including feedback standards and supervisor behaviours. Providing clear feedback expectations, ensuring accuracy of feedback messages and focusing on the relationship between the teacher and learner have the most evidence for their effect on facilitating feedback literacy.