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The BMJ Today: The best place in the world to die

16 Oct, 15 | by BMJ

assisted_dying2• The UK is still officially the best place in the world to die, having once again topped the rankings in the Economist Intelligence Unit’s latest Quality of Death Index. In an editorial, John Hughes, director of the UK charity Sue Ryder, discusses how the UK got to the top in palliative care, and what needs to happen to keep it there. He identifies plenty of threats to current services including a “flatlining NHS economy,” chronically underfunded social care, and a move away from hospices to community based services, which might reduce charitable donations. more…

The BMJ Today: China, philanthropy, statistics, Minerva, and what your patient is thinking

15 Oct, 15 | by BMJ

• In his acclaimed weekly blog, Richard Lehman highlights a cluster of articles on healthcare in China. Acute kidney injury seems to be an emerging problem in China as many traditional herbal products may contain nephrotoxic plant substances, with more than 70% of patients giving a history of possible toxic drug ingestion.

peter_sandercock• Peter Sandercock, featured in the latest BMJ Confidential, says that if he was given £1 million he would invest half in training doctors from low and middle income countries on stroke prevention and treatment, and give the other half to advocacy groups lobbying governments towards better control of the global tobacco and food industries. more…

The BMJ Today: Global health, socioeconomic differences, and other matters

14 Oct, 15 | by BMJ

primarycare_Nurse_training_uganda• To achieve universal health coverage by 2030, as required by UN Sustainable Development Goals, primary care must be strengthened in middle and low income countries. Educational resources and decision support tools for primary care workers in these settings are critically needed.

In an editorial, Fairall and Walsh argue that educational materials must be developed in partnership with local institutions and focus on multimorbidity rather than individual conditions. These educational materials must also address the challenges posed by limited availability of resources. more…

The BMJ Today: The diesel scandal and breast cancer

13 Oct, 15 | by BMJ

volkswagen• Paul Wilkinson and Andy Haines call for consequences to the Volkswagen diesel scandal in an editorial. Perhaps the lesson from the Volkswagen episode is not just whether manufacturers will comply with the legislation aimed at cleaning an inherently polluting fuel source. It may be time for society to commit to a decisive break with fossil fuel combustion. more…

The BMJ Today: The NHS, dietary guidelines, and diabetes drugs

12 Oct, 15 | by BMJ

money_nhs• The NHS keeps dominating headlines, with bad news and some good news. The bad news is the deficit of almost a billion pounds, which NHS hospital trusts in England have run up in the first three months of this year. This is already higher than the deficit for the whole of the previous financial year. Gareth Iacobucci asked a number of experts about the situation, who agreed on one thing: “that a decline in patient care is inevitable without emergency funding being made available” and all “urged the government to take urgent action to address the crisis.” more…

The BMJ Today: Hunt says BMA is being “irresponsible”

8 Oct, 15 | by BMJ

jeremy_hunt_oct2015• Yes, you read that headline correctly—Jeremy Hunt is accusing doctors of being irresponsible over their handling of the new contract for junior doctors. As Gareth Iacobucci reports, the health secretary told the Conservative Party conference that the BMA was being “utterly irresponsible” in the way it has handled changes to junior doctors’ contracts. He said the BMA was scaremongering by portraying the message that the government wanted to cut doctors’ pay. more…

The BMJ Today: Don’t call me Citler

7 Oct, 15 | by BMJ

pregnant_woman_wine• Advice on alcohol for pregnant women is the topic of this latest head to head debate. Mary Mather and Kate Wiles argue that current advice to pregnant women is contradictory and confusing, and they should know that “there is no threshold of alcohol consumption that is certain to be safe.”

On the opposing side, Patrick O’Brien says it is wrong to say to pregnant women, “We’ve confused you, so just abstain: it’s safer.” He adds, “We all deal with uncertainty in our lives on a daily basis; pregnant women are no less capable of doing so.” more…

BMJ Today: Warriors and worriers

6 Oct, 15 | by BMJ

nobel_prize_2015Nobel warriors: The story behind this year’s Nobel Prize for Physiology or Medicine is one of meticulous and methodical laboratory toil that led to the discovery of two important drug treatments for many millions of people in the developing world affected by roundworm parasites and malaria.
Avermectin (later ivermectin) has led to the near edradication of onchocerciasis (river blindness) and elephantiasis (lymphatic filariasis) while artemisinin has proved invaluable in areas of cholorquine resistant malaria. As Geoff Watt’s says in his news report the Nobel committee’s choice may surprise some, but hopefully inspire many more along the journey to drug discovery. more…

The BMJ Today: When is humane discretion in the NHS an offence?

5 Oct, 15 | by BMJ

jeremy_hunt_againWhile Jeremy Hunt prepares to tell the Tory party conference about his plans for a seven day NHS, one doctor suggests there are more immediate problems that he should address, namely overcrowding in today’s hospitals. David Oliver, consultant in geriatrics and acute general medicine, Berkshire, says: “I have a confession: I sometimes allow patients to stay an extra day or three in hospital, even when they’re technically stable enough to leave. Yes: I know that it’s bad. England has relatively few acute beds. We’ve lost them rapidly, while emergency admissions and delayed transfers have risen inexorably.”


The BMJ Today: The active role clinicians can play in tackling society’s inequalities

2 Oct, 15 | by BMJ

hiv_particlesMajor update to HIV treatment guidance
The World Health Organisation has released guidance which would dramatically affect the threshold at which patients with HIV are offered antiretroviral medication. At present, highly effective medications are routinely offered when the immune system shows signs of decline. The new guidance suggests that these medications should be offered from diagnosis. This could have major implications for the costs of treating the infection, but could also represent a fantastic opportunity to reduce onward transmission of HIV; individuals with a low HIV viral load are much less likely to pass the infection to others. more…

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