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Margaret Cooter: Colour me unusual—a MRSA quilt and a TB dress

24 Oct, 14 | by BMJ

Margaret_Coote2On learning about the source of the colour of Anna Dumitriu’s quilt, some people feel distinctly uncomfortable, and a few have even said, “But that’s irresponsible! That’s dangerous!”

The blue doesn’t come from indigo or from a new type of powder—and the way it’s used is definitely not irresponsible or dangerous. Although the colour comes from MRSA bacteria (“superbugs”), the colouring process was carried out in a laboratory, under optimal safety conditions. more…

Samir Dawlatly: A GP on why I still go to work

24 Oct, 14 | by BMJ

Recently Lord Howe warned GPs to stop complaining about their work conditions, so that they did not cause a workforce crisis. Similar noises were heard from NHS England at the recent Royal College of General Practitioners Annual Conference, where politicians and leaders were questioned about the state of primary care and, in particular, general practice, by delegates who seemed close to breaking point.

As a GP, I have every sympathy with those raising issues about excessive, unreasonable patient demand; arbitrary health and safety checks (including the state of paintwork in the cleaner’s cupboard); and the morale sapping nature of being the current political football of choice. And yet I still go to work. As do most GPs. more…

Gustav Nilsonne: Towards an ecosystem for open data

24 Oct, 14 | by BMJ

Gustav_Nilsonne_2Have you ever tried to get your hands on data from somebody else’s scientific paper? I have, for a meta-analysis. In my experience it is a discouraging task. If data still exist at all, they are too often kept under lock and key. Savage and Vickers tried to retrieve 10 datasets from papers published in PLoS journals. They received only one, even though the PLoS journal policies at the time required that data be shared on request. Vines et al tried to retrieve datasets from 516 papers in ecology from two to 22 years old. They received only 101 (19%).

This shows that in some areas, it is too often the case that our current practices for data archiving and sharing are no better than if we were to purge our records by fire from time to time. Since excellent technical solutions are now available for publishing open data of most kinds, there is no excuse for allowing this attrition to continue. more…

The BMJ Today: Swingers, surrogacy, and three parent families

24 Oct, 14 | by BMJ

tom_m_sepSexual health and parenthood feature prominently in The BMJ today, in news stories that highlight the need to ensure policies are based on evidence and not prejudice.

Jacqui Wise describes a study that finds that heterosexual couples who swap partners or have group sex have high rates of sexually transmitted infections, a finding that may not surprise many readers.  more…

William Cayley: Social history consultations and patient time vs patient time

23 Oct, 14 | by BMJ

bill_cayley_2Who are you, what do you need, and how do I figure out how to care for you?

Fundamentally, those are the questions that drive every encounter between a doctor and a patient. A recent article in the New England Journal of Medicine calls for us to expand the “social history” facet of this to include six domains: individual characteristics, life circumstances, emotional health, perceptions of healthcare, health related behaviors, and access to and utilization of health. more…

Sally Norton: Weight loss—help us to help ourselves

23 Oct, 14 | by BMJ

sally_nortonIf I hear one more time that keeping your weight down is all about personal responsibility—”just eat less and exercise more”—I will take a double chocolate, banana, and salted caramel, extra large, two for the price of one muffin and ram it into the mouth from whence this smug platitude came.

Of course weight control is about personal responsibility, but with two thirds of the English population classed as overweight, most of us are clearly unable to do the necessary on our own. So, do we just carry on, failing to manage our weight ourselves, or do we ask for help? more…

Richard Graham: Is technology changing the brain—how to interpret and advise on the evidence

23 Oct, 14 | by BMJ

Richard GrahamThe recent release of a study by the Sackler Centre for Consciousness Science, University of Sussex, which said that it had found changes in the structure of the brain caused by technology media multi-tasking, coincided with a panel discussion about just that at the Cheltenham Literary Festival. more…

The BMJ Today: Get your sums right

23 Oct, 14 | by BMJ

The big news today is the publication of the chief executive of NHS England Simon Stevens’s five year plan for the NHS.

As Gareth Iacobucci reports in The BMJ today, the report has a strong focus on public health and the prevention of illness. Unsurprisingly, this includes Stevens’s pet topic of tackling obesity.

Stevens claims the report marks a “crossroads” for the NHS. It calls for the historical boundaries between primary and secondary care to be broken down and for new models of care to be developed, such as NHS hospitals taking control of general practice services or GPs heading up multispecialty provider groups. more…

Neal Maskrey: How do we become an expert?

22 Oct, 14 | by BMJ

neal_maskreyWe humans often use analogies to help us solve problems. From our memory, we identify a problem similar to—but not exactly the same as—the one we are currently faced with, and apply the previous successful approach to the new problem. It’s called analogical reasoning. Sometimes we get great results, sometimes not so much.

I recently came across a great analogy from Brian Goldman, an accident and emergency doctor in Toronto. more…

James Raftery: NICE and value based pricing—is this the end?

22 Oct, 14 | by BMJ

Since Andrew Lansley announced in 2010 that the NHS would in future use “value based pricing” in its purchases of pharmaceuticals, civil servants and (more recently) the National Institute for Health and Care Excellence (NICE) have been struggling to develop an approach for how this could be implemented. For the twists and turns, see previous blogs on the topic.

At its September board meeting, NICE considered a document on “value based assessment.” This made recommendations based on the results of NICE’s recent consultation. The document provided greater detail than NICE’s press release of 18 September. more…

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