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Jeffrey Aronson: When I use a word . . . Breaking bad

3 Jul, 15 | by BMJ

jeffrey_aronsonMetanalysis is when you break a word badly. It’s defined in the Oxford English Dictionary as “the reinterpretation of the form of a word, resulting in the creation of a new word; esp. the changing of the boundaries between words or morphological units.” Pea and cherry fit the first part of this definition; they were derived by metanalysis from pease and cherise, original singular forms that sound plural. The second part describes how a word breaks up into smaller parts, a new word being formed. In about the 15th century the indefinite article, a or an, was commonly written in combination with the accompanying noun as a single word (aman, anague). When a century or so later they became separated again, there was often uncertainty about where the division should occur. In some cases this led to spurious metanalytic words (for example, a nague), a few of which persisted. Take a naedre, the Old English word for the viper: having been written “anaedre,” it became an aedre, the break occurring after the n. Netherfield in Sussex was a place where adders were found. Similarly, an ekename, having become anekename, then became a nekename or nickname, the break occurring before the n. more…

Tom Moberly: Showing patients what they are worth

3 Jul, 15 | by BMJ

tom_moberlyPrinting the cost of drugs on their packaging is one of Jeremy Hunt’s latest ideas for helping the health service save money.

Arguing that patients need to use NHS resources responsibly, the health secretary said that ministers “intend to publish the indicative medicine costs to the NHS on the packs of all medicines costing more than £20.” Alongside the price, the phrase “funded by the UK taxpayer” will be printed. “This will not just reduce waste by reminding people of the cost of medicine, but also improve patient care by boosting adherence to drug regimes,” he said. more…

The BMJ Today: The heat is on

3 Jul, 15 | by BMJ

climate_change_heat• Amid record breaking heat across the globe, including Europe and the UK, Fiona Godlee’s editor’s choice on climate change could not have been timed better.

Citing the Pope’s recent encyclical on the environment and the report from the Lancet Commission on Health and Climate Change, she calls upon the main funding bodies for research to join the BMA and 200 other institutions in their call for divestment from fossil fuel companies and re-investment in renewable energy. more…

Samir Dawlatly: When is a deal not a deal?

3 Jul, 15 | by BMJ

One of the questions I was taught to ask as a GP trainee when someone came to see me with symptoms that had been ongoing for a while was, “Why now?” What is it that has tipped the balance for the patient to make an appointment about something that has been bothering them for weeks and months?

The same question springs to mind with Jeremy Hunt’s latest “New Deal” for British general practice. Why now? Why make some big pronouncement weeks after the general election. I’m not sure I fully understand why he felt the need to make an announcement in the first place. After all the General Practitioners Committee of the British Medical Association negotiate the GP Contract with the Department of Health each year. Part of me wonders if this is the first sign that this is going to be more public than usual. more…

William Cayley: Planning for uncertainty

2 Jul, 15 | by BMJ

bill_cayley_2Martin Marshall could not have said it better in his recent blog—the idea of the 10 minute consultation is a travesty . . . except that sometimes it is not.

With the increasing demands on and increasingly complex expectations of GPs and family physicians, expecting everything to fit into a 10 minute visit is simply crazy. Yet there are times when that 10 minute visit (or less) is what the patient wants. In good generalist primary care or family medicine, when we present ourselves as comprehensive physicians there to stand with our patients in health and in sickness, in prevention and in treatment, it should be no surprise that many a visit goes beyond the stated “chief complaint” to a much longer agenda. On the other hand, sometimes our patients simply want treatment for one narrowly focused concern—a cold, a tick bite, a skin infection. more…

Nicola Bedlington: Patient involvement in medical devices—an opportunity we may be missing

2 Jul, 15 | by BMJ

nicola_bedlingtonPatient involvement in health and social care is a fundamental right, and an operating principle of European healthcare systems. In the area of medicines patients are recognised as experts and are participating in many aspects of access, innovation, safety, and transparency, thanks, not least, to the commitment to patient involvement of the European Medicines Agency. However, in the area of medical devices a change of mind-set is needed. more…

Marika Davies: Standing up to disrespectful doctors

2 Jul, 15 | by BMJ

marika_daviesMedia reports that chip away at the confidence the public has in doctors occur regrettably often. A recent case in Virginia, USA, in which a patient recorded offensive comments made about him by the medical team during a colonoscopy, will make depressing reading for all those who work hard to earn and maintain the trust of patients. more…

The BMJ Today: Too much of a good thing?

2 Jul, 15 | by BMJ

BMJ-Prolific-authors• A new research paper shows that 110 highly prolific authors contributed to one third of the evidence base for glucose lowering treatment; of these, 44% were company employees and 56% were academics who work closely with pharmaceutical companies. The authors urge that the burden of authorship be distributed more equitably in future, so that we can alleviate concerns about the independence and integrity of the evidence base for treatment of diabetes. more…

Rethinking human resources for health in post-earthquake Nepal

1 Jul, 15 | by BMJ

Attracting, distributing, and retaining health workers remain a challenge in Nepal. In 2011, Nepal had 0.04 doctors and 0.23 nurses per 1000 people, against a World Health Organization benchmark of 2.3 health workers per 1000 people. A survey conducted in 2013 revealed that only about 50% of sanctioned posts for doctors and nurses were filled in district hospitals. Overall, two thirds of sanctioned posts were filled in hospitals and lower level health facilities.

Nepal’s already crippled health system was further aggravated by the 7.8 Richter scale earthquake on 25 April and a strong aftershock of 7.2 on 12 May 2015. A total of 8841 deaths including 18 health workers, 22 309 injuries including 75 health workers, and 117 000 displacements have been reported as of 26 June 2015. more…

James Raftery: Ever higher cancer drug prices—driven by US policies and genetic sequencing

1 Jul, 15 | by BMJ

The high prices charged by companies for cancer drugs has led to lots of speculation, but very little explanation. The most interesting attempt to explain these high prices has been made by a US oncologist Scott Ramsey. As the article is paywalled, I summarise it below (with thanks to the author for a copy).
His identifies two major factors: US health policies and technology. more…

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