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Johanna Hanefeld and Richard Smith: Charging for non-EEA migrants’ access to the NHS—who will follow?

25 Jul, 14 | by BMJ

Johanna HanefeldThe UK government has recently announced that it will in future charge migrants from outside the European Economic Area (EEA) and foreign visitors a 150% fee for service when using the NHS. This is to recoup estimated costs incurred where patients from abroad use services without entitlement. Justification for the additional surcharge is to incentivise hospitals to implement this type of cost recovery.[1] more…

The BMJ Today: Feet and fudge

25 Jul, 14 | by BMJ Group

davidpayneA calcaneal fracture can mean a two year recovery, with a stiff, painful, deformed foot that will not fit into a normal shoe.

How does operative and non-operative treatment for intra-articular fractures compare?

A research team led by Damian Griffin, professor of trauma and orthopaedic surgery at Warwick University Medical School, conclude in their randomised controlled trial that operative treatment by open reduction and internal fixation is not recommended. more…

Lavanya Malhotra: Tackling obesity with gold

24 Jul, 14 | by BMJ

Lavanya MalhotraThe Dubai municipality has come up with a novel way to promote a balanced diet and exercise in the city: slim down, and the reward will be worth your weight in gold. Or rather, you will receive 1 g of gold for every kg shed. Earlier this week it was estimated that more than 15 000 people had signed up, with the final numbers expected to be more since registration closed yesterday. Already this is more than the 9666 people who took part in a similar scheme last year.

An initiative like this is especially important in Dubai. The United Arab Emirates (UAE) has been ranked as the fifth most obese nation in the world, according to a 2012 report published in the BMC Public Health journal. More than 66% of men and 60% of women in the UAE are overweight or obese, according to the Lancet‘s Global Burden of Disease Study 2013. more…

The BMJ Today: More on transparency

24 Jul, 14 | by BMJ

BirteIn recent years, The BMJ has campaigned on transparency—the focus of our Open Data campaign, and an issue of vital importance if modern medicine is to retain the trust of doctors and the public, writes Trevor Jackson in this week’s Editor’s Choice.

Dabigatran was the first of the new oral anticoagulants licensed to prevent stroke in patients with non-valvular atrial fibrillation. It was approved by the US Food and Drug Administration in 2010 and by the European Medicines Agency for this use a year later. The drug’s unique selling point, said its manufacturer, Boehringer Ingelheim, was that it would need no monitoring, unlike warfarin. more…

Billy Boland: Life after the NHS Leadership Academy

23 Jul, 14 | by BMJ

billy_bolandIs it nearly over? Putting the final touches to my portfolio seems all wrong somehow. The outcome of my time at the NHS Leadership Academy depends on this submission, and while it’s now due, I feel I’ve only just started. Come to think of it, this experience has been one of the key features of my learning on the programme: the way I feel about something isn’t always the best guide to what is actually going on. And let me tell you, as someone who can tend to draw on emotions to help make decisions, that can be pretty confusing at times.

As I reflect on this latest stage in my leadership journey, it seems like a good time to share some of the highlights of my learning since my first blog in October last year: more…

The BMJ Today: Time to rethink your assumptions about sepsis, Minerva

23 Jul, 14 | by BMJ

When I first arrived at the University of Bath, to study history and philosophy of science, our first lecture was about Sulis-Minerva: the combination of Minerva, Roman goddess of wisdom, and Sulis, the Celtic goddess who lived in the hot springs that gave the city its name.Sulis_Minerva_head_Bath

Sulis-Minerva became the goddess of health in Roman Britain, so it it seemed appropriate when working at The BMJ to ritually read her summary of the big journals each week. The latest edition is called “The progression of rheumatoid arthritis and other stories . . . ” but it’s the note about Chickenpox that makes this worth a read. The virus used to kill 100 US residents of all ages every year, but that number’s dropped after concerted vaccination programmes. And, the fear that this may push the virus into older populations, where shingles is much more severe, hasn’t manifested. more…

Aser Garcia Rada: The resurgence of HIV/ AIDS in Europe—let’s focus on priorities

23 Jul, 14 | by BMJ

Aser García Rada_BMJI was recently invited to a meeting on HIV/AIDS that was hosted in Athens by the European Commission. Although the grass is greener on the EU side, the epidemic still poses relevant challenges. Contrary to the overall global decline in new HIV infections, 29 381 people were newly diagnosed across the EU in 2012, 1% more than in 2011. Late presenters represent 49% of new diagnoses. In the WHO European region—which includes Central Asia—131 202 new cases were reported (8% higher than in 2011). On the whole, 2.2m people live with HIV in the European region, with around half of those people unaware that they are infected. more…

The BMJ Today: A good idea gone wrong?

22 Jul, 14 | by BMJ

At the 2008 World Economic Forum in Davos, Bill Gates highlighted a new US Food and Drug Administration (FDA) law that rewarded sponsors of drugs for tropical diseases with a voucher that entitles the bearer to a “priority review” of another new drug application. It was intended to encourage for-profit companies to invest in treating diseases that affect the poor. Seven years on, the FDA has awarded just three vouchers, and two of the three drugs were developed and registered outside the US well before the voucher system was established. Peter Doshi looks at the controversy surrounding the voucher scheme, and asks if it is a good idea gone wrong. more…

Bijal Chheda-Varma: Bariatric surgery is unsustainable

22 Jul, 14 | by BMJ

Bijal Chheda-Varma2Obesity is widely recognised as one of the greatest health threats of the 21st century across the developed world, with about a third of the global population now obese or overweight.

While the evidence of the problem is undisputed, there is little agreement as to how to solve it. Many solutions are being brandished about in terms of both prevention and cure; in the UK, for example, a sugar tax has been suggested, and NICE has issued its headline grabbing draft recommendations that patients with a BMI of 30 or more should be given bariatric surgery. From my experience of treating overweight and obese patients, it seems clear that, as standalone solutions, these are not sustainable as they do not address the root causes of obesity. more…

Sarah Woznick: A nurse’s account of working in Gaza

21 Jul, 14 | by BMJ

msf_gazaSarah Woznick is a specialist intensive care nurse working with Médecins Sans Frontières (MSF/ Doctors Without Borders). She arrived in Gaza six months ago from Denver, Colorado. She was due to leave the mission the day after operation “Protective Edge” began, but decided to stay on to help provide medical care.

Image: Sarah in the intensive care unit of Nasser hospital, Gaza. Credit: MSF. 

I was scheduled to leave Gaza the day after the military operation “Protective Edge” started. That first day there were lots of air strikes in our area. It’s a strange feeling when you realise that one is falling not far from you. Now I am a little more accustomed, but it still makes me jump from time to time. All of us think about our Palestinian colleagues. The MSF compound is a safe place, but their homes might not be, and we worry about them and their families. more…

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