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The BMJ Today: How can you provide healthcare without healthcare staff?

27 Nov, 14 | by BMJ

tom_m_sepThe ultimate consequences of problems recruiting doctors and other healthcare workers have been highlighted this week.

A report into Scotland’s worst ever outbreak of Clostridium difficile infection describes how difficulties recruiting staff exacerbated problems at a “dysfunctional” hospital and undermined the quality of patient care. As Bryan Christie writes, the uncertain future of the Vale of Leven Hospital in the period preceding the outbreak in 2007-8 had led to problems recruiting and retaining staff, with a consequent impact on patients. “Basic standards of nursing and medical care were not met, and infection control systems and procedures were inadequate,” he says. more…

The BMJ Today: Tomorrow’s World for doctors, and how hospitals are evicting patients today

25 Nov, 14 | by BMJ

I used to love watching Tomorrow’s World as a child to see how scientists thought we might be living in 10 or 20 years. I remember being told that we would be talking to each other over video links, seeing prototype mobile phones, and being shown countless household appliances and robots to take on the more mundane chores of life. more…

The BMJ Today: Why are we bringing back smoking?

24 Nov, 14 | by BMJ

As an ex-smoker who gave up the habit with huge difficulty 30 years ago, I have been pleased at the way smoking has become increasingly invisible in my life. First it disappeared from advertisements on my television screen, then from colleagues in my office, and then from my pub.

But now it is reappearing. Last week a television advertisement for cigarettes was aired, and on Friday night I sat next to two smokers in my local. Admittedly, these people are “vaping” e-cigarettes, rather than “smoking” tobacco, but it is still thrusting the habit back in my face. And it is worth mentioning that the companies who make e-cigarettes are largely the same ones who make the real thing. more…

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…

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