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Gado Napo-Koura: Togo joins the Family Planning 2020 Movement

6 Mar, 15 | by BMJ

As a former medical intern, I witnessed the devastating impact that lack of access to modern family planning had on the lives of women and young girls. I recall admitting a teenager who had an unsafe abortion that was done in secret. Her own mother was what we call an “avorteuse”—a traditional, unqualified practitioner who performs abortions, and she had performed this practice on her own daughter. Unfortunately, it went horribly wrong, and we had to perform a complete hysterectomy on this young girl, who has consequently never been able to dream of motherhood. more…

Jeffrey Aronson: When I use a word . . . Pah! Disgusting!

6 Mar, 15 | by BMJ

jeffrey_aronsonEmily Colas’s Just Checking is a riveting, often unsettling, account of obsessive-compulsive disorder (OCD). Reading it got my stream of consciousness ruminating about the link between disgust and stereotypy.

Neasden is a byword for ordinariness; Wigan for northernness; and East Cheam, at least since Tony Hancock, for supposed rundown provinciality. more…

Ian Franklin: Doctors, manslaughter, and avoidable harm

6 Mar, 15 | by BMJ

ian_franklinThe sudden surge in prosecutions of doctors in the criminal courts when patients die is alarming. There is a growing body of opinion that the charge of gross negligence manslaughter is being used inappropriately to prosecute doctors who, in their daily lives, work in an inherently high risk environment.

It is generally accepted that deaths and complications are best discussed in a transparent, no-blame environment, such as M&M (mortality and morbidity) meetings. This allows lessons to be learned and future care to be improved in much the same way that pilots analyse aviation incidents. more…

“Anything you get for free is not of good quality:” perceptions of generic medicines

6 Mar, 15 | by BMJ

Bhanu_prakashThe number of people with non-communicable diseases (NCDs) in India is increasing with each passing year. The World Health Organization estimates that NCDs could account for nearly 60% of total deaths in India.

Yet, despite an increased allocation of spending on healthcare by the government in the past few years, out of pocket expenditure by patients at the point of service delivery has shown little respite. In this context, India’s role as a leading manufacturer of generic drugs could offer great potential for decreasing healthcare expenditure—by both the people and the government. more…

The BMJ Today: Freezing to death, childhood asthma, and TB screening

6 Mar, 15 | by BMJ

Here’s your Friday roundup:

Cold homes and winter deaths
old_person_cold• GPs should identify people living in cold homes and visit them once a year to assess their heating needs, says the National Institute for Health and Care Excellence (NICE).

The guidance recommends that anyone whose health and wellbeing are at risk because of a cold home should be assessed and referred to local agencies, such as the health and housing service. The guidance isn’t just aimed at GPs, but anyone who has contact with vulnerable groups including social care staff, safety services staff, and workers from charities and voluntary organisations. more…

Alvin Chan: Chances are, you’re not sensitive to gluten

5 Mar, 15 | by BMJ

alvin_chanIn the medical community, there are certain conditions that fall under the fuzzy category of medically unexplained syndromes (MUS). These syndromes, like fibromyalgia, chronic fatigue syndrome, and somatoform disorder, present with odd constellations of symptoms that neither physical examination nor diagnostic tests can explain. [1] To some members of the medical community, these are not diseases in their own right, but rather, clinical manifestations of underlying depression or some other biological or psychological condition. Given all the attention gluten is getting these days, I’m beginning to wonder if gluten sensitivity belongs in this category of MUS or is simply a result of the gluten-free fad. more…

Tessa Richards: Big data—jam tomorrow

5 Mar, 15 | by BMJ

Tessa_richardsRest easy in your beds overworked doctors and ailing patients, for tomorrow, all will be well. Big data will revolutionise healthcare. Processes in creaky health systems will be streamlined, patients empowered, and outcomes improved. Upbeat messages permeated the air at the UK e-health meeting at Olympia in London this week (ukehealthweek.com). E-health is more a joined up state of mind than a technology, a tweeter observed, and a smorgasbord was on offer. It included workshops on service transformation and informatics priorities, best practice cafes, “future zones,” “digital plenaries,” and numerous tech company stands. The programme listed 501 in total. Some with enticing names, such as Clarity Informatics and Co–ordinate My Care. But frustration was in the air too…. more…

Jocalyn Clark: Where cancer is a neglected disease

5 Mar, 15 | by BMJ

Jocalyn_Clark1A great deal of attention is being paid to non-communicable diseases (NCDs) as an emerging source of illness, death, and healthcare costs—recognising that low and middle income countries (LMICs) in particular are faced with a growing threat.

The NCDs movement tends to coalesce around four priority conditions—heart disease, diabetes, lung disease, and common cancers—and has been effective at pressing for the inclusion and priority of these diseases in the “post 2015″ international development agenda. more…

The BMJ Today: Cannabis, childhood depression, and winter pressures

5 Mar, 15 | by BMJ

cannabis_leavesEditorial: High potency cannabis

In this editorial, Wayne Hall and Louise Degenhardt’s editorial discuss the recent research article published in Lancet Psychiatry that found daily use of “skunk” (a highly potent form of cannabis) is a contributory cause of schizophrenia. After exploring the key limitations of the research, they conclude that “the remarkable consistency of multiple types of individually fallible evidence makes it much more likely than not that regular cannabis use is a contributory cause of psychosis.” more…

David Pencheon: How health professionals, organisations, and systems can invest in a healthy future

4 Mar, 15 | by BMJ

david_pencheon_3Our behaviour is more influenced by our surroundings than we think—it is a response to what happens around us: physically, socially, and culturally. We are shaped by norms more than we shape them. Consequently, when an influential group of people have the chance to re-set norms in visible and newsworthy ways, and where results benefit almost everyone both immediately and long term, why wouldn’t we seize the opportunity?

Well, health professionals and health organisations have such a chance. The case for divesting from fossil fuel is now very strong. The British Medical Association (BMA) is committed to this journey of divestment and, since its 2014 Annual Representatives Meeting (ARM), has been actively investigating how best to send out a powerful message on health and social justice. more…

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