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Archive for February, 2012

Laura Woolfenden: Here comes good health

29 Feb, 12 | by BMJ Group

The 1920s and 1930s was an era of social and political revolution, and a switch of attitude on public health was indicative of the changing approach to public policy. The Wellcome Collection currently has an exhibition of cinematic work released by Bermondsey Borough Council’s public health department, which showcases the changed ideology on health provision in the 1920s. The borough created a number of short, silent, and informative films, screened for free in the open air on streets and other public domains, in an attempt to improve the health and wellbeing of the voting population. more…

Richard Vize on the commission on dignity in care for older people

29 Feb, 12 | by BMJ Group

Richard VizeThe consultation document published today by the Commission on Dignity in Care for Older People has powerful messages about the role of hospital doctors and the training of doctors and medical students.

The commission, a joint enterprise by the NHS Confederation, Age UK and Local Government Association, was established in the wake of investigations by Parliamentary and Health Service Ombudsman Ann Abraham into shocking failures in the care of older people. (I should declare an interest – I wrote the commission’s report.) It moves on from the increasingly frequent exposure of such failures by identifying the underlying causes for poor care of older people in hospitals and care homes and recommending reforms. It calls for “fundamental changes to culture, leadership, management, staff development, clinical practice and service delivery.” more…

Harriet Vickers: David Hockney’s crusade against tobacco regulation

29 Feb, 12 | by BMJ

Harriet VickersDavid Hockney’s one-man crusade against tobacco regulation has struck again. Fresh off the back of critical acclaim for his use of an iPad to capture the Yorkshire landscape, he’s used his new artistic tool to create an image protesting against the “anti-smoking fanatics,” and the Guardian have put it on their home page. more…

John Gabbay: “We’ll never re-elect you if you wreck our NHS”

28 Feb, 12 | by BMJ Group

So why would a retired professor of public health decide to write a protest song, get his kids to help him record it, his wife to help him with the graphics, and take his first plunge into the dangerous world of YouTube? Isn’t this the fellow that usually writes dusty academic works about evidence-based practice? The answer is that the song was indeed an attempt at evidence-based practice, just one more tool in the struggle to prevent a major threat to the people’s health, namely Andrew Lansley’s Health and Social Care Bill. more…

Peter Bailey: Hot frogs jump

28 Feb, 12 | by BMJ Group

Biology A level classes in the 1970s often involved frogs making the ultimate sacrifice for the benefit of their dissector’s knowledge of what lies beneath the amphibian skin. As far as I remember, it was not however common practice to test the widely-held belief that a frog in a water bath would tolerate a slowly rising temperature and die from heat exposure before attempting to escape. Dedicated scientists have proved that this is not the case. Hot frogs jump. more…

Richard Smith: Talking death with a CCG

27 Feb, 12 | by BMJ Group

Richard SmithRecently I had the privilege of talking with the members of an emerging clinical commissioning group (CCG). (For those who don’t know, CCGs are groups of GPs who will have responsibility for commissioning care for a whole population.) It was my job to try and lift the conversation above governance, finance, and the future of the local hospital. I laid out an agenda of carbon reduction, polypathology, disruptive innovation, and, my favourite, death. And it was death that got them going, so much so that eventually you had to shout to be heard. (This was over dinner, and alcohol was served.) more…

Richard Lehman’s journal review – 27 February 2012

27 Feb, 12 | by BMJ Group

Richard LehmanJAMA  22 Feb 2012  Vol 307
813    When an Italian team of physicists reported that they had detected neutrinos travelling faster than light, the televisual physicist Jim Al-Khalili promised to eat his boxer shorts if it proved to be true. It turns out to have been a measurement error due to faulty wiring. Unbelievable results either shatter the laws of the known universe, or else they are wrong. So if a study tells us that 42% of women and 31% of men presenting with myocardial infarction do not have chest pain (or even pain in the arm or jaw), this either overturns clinical medicine as we know it – from experience and from several other large cohort studies – or else it is due to lousy recording. Guess which. This retrospective study is based on a single tick in a box completed by busy physicians looking after over a million patients coming into American hospitals with heart attacks between 1994 and 2006. It could be that they had better things to do than record the obvious. If these figures are true, then I will eat my elegant black Marks & Spencer long johns. These thermal underpants have proved very effective at protecting my lower parts from the ravages of winter on the eastern seaboard of America, and I just wish journal editors were as effective at protecting us against the ravages of bad data.
more…

Marge Berer: In defence of abortion on a woman’s request, including on grounds of fetal sex

24 Feb, 12 | by BMJ Group

Ach, what a furore. The Daily Telegraph is in its element and having a ball printing nasty allegations about doctors doing abortions illegally on grounds of sex selection. Let’s look at the issues a bit more dispassionately. First, is it actually illegal? Yes and no. The 1967 Abortion Act does not permit abortion on grounds of sex selection per se, it is true, and the law is framed so that anything that cannot be defended as coming under one or more of the named legal grounds is technically illegal. However, the question remains whether abortion on grounds of sex selection can be defended under the existing legal ground for abortions. I believe the answer is yes. more…

Andrew Jones: Transforming patient care using technology

24 Feb, 12 | by BMJ Group

A search on one fantastic piece of technology, the internet, suggests that technology can be defined as “…the application of science, especially to industrial or commercial objectives.” When I think about it, other than talking to our patients, most of what we do in medicine involves some use of technology. In fact, increasingly communicating with patients is even beginning to rely on it as well. As clinicians we have become highly skilled in the selection, development, and implementation of a variety of different technologies. These combine biomedical sciences with chemistry, physics, and engineering to create medicines, devices and systems which change the way in which we manage disease and treat patients. more…

Peter Bailey: poisoned chalice

23 Feb, 12 | by BMJ Group

It is now just over three weeks since I saw my last patient, hung up my stethoscope, and retired. A GP with time to think! Just imagine what might happen. Among the first fruits of this contemplation was the personal view of the Health and Social Services Bill that I submitted to the BMJ which was published under the tag “Primary Care Duped.” The press release prior to publication alerted the media to my article and I had calls from the BBC, the Guardian, the Morning Star, and from Sky television. Just before a live TV interview with Rupert Murdoch’s lot, I had a call from Mr Lansley’s office, asking me to ring as soon as possible. Straightening my tie and pushing a copy of Gray’s Anatomy down my trousers in anticipation of a thrashing, I phoned. A very polite young man, clearly weary from the burden of dealing with waves of opposition to the bill, gently told me that I had misunderstood key elements of the bill. In particular, he assured me that PCTs were not really being abolished, that the managers who staffed them were not really leaving, and that the transfer of financial responsibility to Clinical Commissioning Groups and GPs was just an administrative device to ensure that PCTs became more responsive to clinical advice.  The managers who were previously PCT employees would transfer seamlessly to the Clinical Commissioning Groups and no one would really notice any difference.  And no, the private sector would not be providing all the commissioning support. more…

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