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The BMJ Today: Sex, babies, and future plans

21 Nov, 14 | by BMJ

sally_carterI don’t get out much, but with blogs like the one by Nigel Hawkes to read, I don’t feel I need to. It gave me a great picture of the latest exhibition at the Wellcome Collection in London, which is about sexuality and the scientists who studied it . He writes, “ . . . at the heart of the exhibition are the sexual explorers, from Magnus Hirschfeld to Masters and Johnson.” And they seem a strange bunch. more…

The BMJ Today: Tweet, share, and like

20 Nov, 14 | by BMJ

Emma-ParishOne of my personal goals this year was to become more tech savvy and engage with social media. I already had a Facebook account. I even had a Twitter account, but felt my interest was, well, quite shallow as I basically used it to hear the occasional ponderings of my old teenage heartthrobs.

So, imagine my delight when I read how much serious good can be done with this technology. In her feature, Meg Carter reports how Twitter may have helped Nigeria contain Ebola. Through the campaign @EbolaAlert, Lawal Bakare, a Nigerian dentist, shared information with 76 000 followers, connecting them with public health advice from the World Health Organization. more…

The BMJ Today: Safe self monitoring and patient treatments

19 Nov, 14 | by BMJ

Hypertensive disorders in pregnancy are a leading cause of maternal mortality worldwide, with associated problems of poor foetal growth, low birth weight, and preterm delivery. While there is a trend towards pregnant women monitoring their own blood pressure, a recent analysis article asks if this is safe and effective? Guidelines encourage it and research suggests that women prefer it, however, Hodgkinson and colleagues advise caution.

They list some of the disadvantages of self monitoring, including the lack of validation of some monitors, as well as no diagnostic thresholds from home monitoring to identify pre-eclampsia or gestational hypertension. The authors call for a strengthening of the evidence base before this is recommended as a formally accepted part of antenatal care. more…

The BMJ Today: Gender and health—are men and women so different?

18 Nov, 14 | by BMJ

navjoyt_ladherThere are differences in the way men and women experience healthcare. Sometimes this is because the sex of a person confers a particular risk for a disease. Sometimes societal norms and cultural values lead to inequalities between men and women, which in turn affect health. Several articles published on thebmj.com in the past couple of days illustrate these differences.

In India, 13 women have died after having laparascopic sterilisation as part of a government run mass sterilisation programme in the Indian state of Chhattisgarh. A further 14 women are described as “seriously ill.” As part of India’s attempts to control population growth, people are offered financial incentives to undergo sterilisation. These payments are offered for both vasectomy and female sterilisation; however, of the four million sterilisations that were carried out last year in India, 97% were in women. Given that vasectomy is considered a safer and less complex operation than tubal ligation, one wonders what is behind this particular difference? more…

The BMJ Today: How can doctors learn about research?

17 Nov, 14 | by BMJ

tiago_villanuevaIn my previous role at The BMJ, I had the chance to work on Endgames, whose educational content is aimed at helping junior doctors in the UK and around the world prepare for their postgraduate examinations. Apart from case reports and picture quizzes, Endgames also include a series of weekly quizzes called “Statistical question,” which cover concepts of statistics, clinical epidemiology, and research, and are written by London based statistician and professor of statistics Philip Sedgwick.

Primary care research has always lagged behind research carried out in hospitals for many reasons, but many countries—such as the UK, the Netherlands, Canada, or Australia, just to mention a few—now have world class research units and teams, and some of the resulting work ends up published in The BMJ. more…

The BMJ Today: More pay, better care?

14 Nov, 14 | by BMJ

debsDoes pay for performance improve health outcomes in certain chronic conditions? The UK has one of the largest schemes in the world—the Quality and Outcomes Framework—and, to date, evaluations have produced mixed results and uncertainties remain.

In a recently published research paper on thebmj.com, one international team carefully examine one aspect of pay for performance in healthcare—if QOF reduced emergency admissions for certain chronic conditions since the introduction of the scheme. Such ambulatory care sensitive conditions (ACSCs) are illnesses for which it is possible to prevent acute exacerbations and reduce the need for hospital admission through active management. more…

The BMJ Today: Happiness, money, and mental health

13 Nov, 14 | by BMJ

Opening your curtains to a stunning view of the Scottish Highlands may put a smile on your face, but is it enough to make you change your job? The NHS Highlands is hoping so with its new recruitment programme using picturesque images to recruit doctors to work in remote and rural areas.

But Nigel Hawkes has a more cynical view of what makes people happy—money. He points out that recent improvements in national wellbeing have coincided with rises in gross domestic product. And since international research has shown that gross domestic product correlates with happiness better than almost all indices of wellbeing, he questions whether it is worth measuring happiness at all. more…

The BMJ Today: Fat—the word that dare not speak its name in The BMJ?

12 Nov, 14 | by BMJ

One of The BMJ articles trending today is our outspoken weekly columnist Margaret McCartney’s latest piece, which takes to task recent critics of overweight NHS staff. Sally Davies and Simon Stevens, you know who you are.

The headline, “Fat doctors are patients too,” was queried by The BMJ duty editor yesterday. He questioned if “fat” was an appropriate word for a medical journal. We decided to keep the term in print, “lay” or not, because this is an opinion article; McCartney, a practising GP, had volunteered the phrase; and the piece, which had been online for days, has attracted no reader complaints. And yet, in our weekly online poll, we posed the question in more sober terms, “Can overweight doctors give credible lifestyle advice to their patients?” Which is best, does it matter, and do readers even care? Let us know. more…

The BMJ Today: Talking about the harms of IV fluids

11 Nov, 14 | by BMJ

helen_macI recall grillings about intravenous (IV) fluids and the compartments of the body as a very junior doctor. Confidence in prescribing the right fluid, at the right rate at the right time, with or without added potassium, seemed to be the mark of a registrar. Amid the anxiety provoked by on-call ward cover—a stack of dog eared fluid charts, obs charts, blood charts, and their corresponding patients—it felt difficult to see the wood for the trees when charting fluid prescriptions. Had I thought in a more rational manner, I might have asked for a clearer overview of the wood before I got lost in the detail and day to day of the trees. more…

The BMJ Today: A US unprepared for Ebola, fat doctors, and stiff upper lips

10 Nov, 14 | by BMJ

rich_hurley

“Misinformation and conflicting messages have led to panic about contagion among the public,” writes The BMJ’s US clinical research editor, José G Merino, in our latest editorial on Ebola, which considers the response to the outbreak in the United States.

Four cases in the country, he writes, have “led to overreaction and unjustified fear . . . driven by misinformation, lack of scientific evidence, and demagoguery.” more…

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