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Jane Morris: Making the glorification of anorexia a crime

23 Apr, 15 | by BMJ

jane_morrisI make a point of telling students that an eating disorder is an illness, not a crime. It’s a more controversial statement these days. Some of my patients continue to argue that anorexia is their lifestyle choice rather than an involuntary illness, and I’ve just learned that the lower house of the French Parliament has approved legislation that would make the “glorification of anorexia” a crime punishable by large fines and even imprisonment.

Olivier Véran, a rather dashing young socialist politician, who is also a neurologist at the University Hospital of Grenoble, has amended health minister Marisol Touraine’s wider health bill to include two key measures on anorexia. more…

Owen Bowden-Jones: New drugs, new harms, new clinical guidance

22 Apr, 15 | by BMJ

Owen-Bowden-JonesMindmelt, Annihilation, Black Mamba, and Kronic. Welcome to the world of novel psychoactive substances (NPS), or so called “legal highs.” The past five years has seen an unprecedented increase in the number of these psychoactive drugs. European figures reveal that over 100 new NPS were detected across EU drug markets during 2014 alone. That number has been increasing for the past seven years with no sign of slowing.

Many of the drugs are unregulated and available to buy over the internet or in so called “head shops.” Some clinicians have expressed concern that the legal status of NPS misleads users into believing that they are safer than more established drugs. more…

Jocalyn Clark: Rana Plaza survivors—let down by some, lifted up by others

22 Apr, 15 | by BMJ

Jocalyn_Clark1As the two year anniversary of the collapse of the Rana Plaza approaches—when over 1100 people were killed and 2500 injured, mostly women garment workers—the fight for compensation continues. The eight storey building outside Dhaka, which housed several clothing factories supplying major global brands, collapsed on 24 April 2013 in one of the world’s worst industrial disasters.

Last week the Italian Benetton Group announced a US$1.1 million contribution to the Rana Plaza compensation fund—but this has been met with disappointment by the two global unions representing victims who say it is too little too late, and has highlighted the dozen or so other European and North American companies still in arrears for their payments. more…

Engaging medical diasporas with their country of origin

20 Apr, 15 | by BMJ

While discussion about the contributions of the African diaspora to their countries of origin is often centred on their financial and business resources, less attention is afforded to their participation in healthcare. Despite an attempt by the Ugandan government to engage with its diaspora community through a diaspora desk, we still lack a comprehensive engagement plan for medical diasporas, even though these groups could be vital to addressing the migration of skilled healthcare workers and the consequent depleted workforce in low resource countries. more…

Rui Tato Marinho: Travelling, learning, and futuring in Mozambique

14 Apr, 15 | by BMJ

Rui Tato MarinhoLast September I was in Mozambique, trying to find my grandparents’ house in the city of Beira. The house is there, still alive. They left Mozambique 50 years ago. Mozambique is a Portuguese speaking country, in the southeast of Africa with 27 million inhabitants.

Besides the curiosity to know a little bit about my family history, I had finished reading the important book Turning the World Upside Down by Nigel Crisp, in which he talks several times about innovation in Mozambique’s healthcare. The “técnicos de cirurgia” are healthcare workers recruited from various rural settings, who undergo a two year course enabling them to carry out obstetric surgery. Mortality rates for obstetric surgery are very low in the country, for example, only 0.1% in elective surgery. more…

Bernard Merkel: Measuring the performance of health systems—a troubled history

9 Apr, 15 | by BMJ

bernard_merkelThe World Health Organization has never been the most radical or dynamic body, which—as an international, public, administrative organisation with a ferociously complex governance structure—is not entirely surprising. But in its annual World Health Report of 2000, it did something that was in its own way quite revolutionary: it produced a ranking of the performance of the health systems of countries around the world (nearly 200). This turned out to be a brave, if not foolhardy, venture. more…

Nasreen Jessani: The (conflicted) role of researchers as advocates

9 Mar, 15 | by BMJ

Nasreen Jessani“You must lobby the parliament for your research to be considered! Rigorous evidence needs to be coupled with intense lobbying in order for political parties, who are steered by interest groups, to be willing to listen.”

This was the advice of a Kenyan parliamentarian at the opening session of the ResUpMeetUp symposium in Nairobi, Kenya in February 2015 (ResUpMeetUp is a community of research uptake and communication professionals). Not surprisingly, the advice resulted in several nodding heads, numerous discontented murmurs, and a handful of quizzical expressions among the participants. This range of reactions reflects the perpetual dilemma researchers face about how their role in society is interpreted: as responsible citizens, as neutral knowledge brokers, or as biased advocates. more…

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…

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…

Janneke Hartvig Blomberg: Insights into infant feeding practices in Indonesia

3 Mar, 15 | by BMJ

unnamedExperts in nutrition, researchers, academics, and business leaders gathered in London last week for the Global Alliance for Improved Nutrition (GAIN)’s Symposium to progress thinking around infant and young child nutrition. When seeking to develop effective communications to bring about lasting change, understanding the motivations and cultural and societal beliefs that inform behaviours is essential.

Indonesia faces major nutritional challenges. Rates of childhood malnutrition are high and, according to the national nutrition survey Riskesdas (2013), 37.2% of children in the country are affected by stunting. more…

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