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The BMJ Today: How “political” should The BMJ be?

20 Oct, 14 | by BMJ

At the Royal College of Physicians’ Harveian Oration last week, a doctor told me The BMJ had become a “political” rag. And it was not the first time that the accusation has been made. So when are medical and healthcare issues purely scientific matters and when are they “political?”

Dr Michael O’Donnell, former editor of World Medicine, and the subject of our BMJ Confidential column this week, believes that the organisation of healthcare has always been a political matter. His current day job is writing an eyewitness account of the rise and fall of the NHS. He calls Aneurin Bevan “a shrewd political operator,” not least because of the time it has taken “for those who wished to destroy the NHS to make any progress.” more…

The BMJ Today: Aiming for a culture of safety not perfection

17 Oct, 14 | by BMJ

kate_adlington_picDo you believe in the “boundless capacity of medical science?”

In a philosophical podcast to accompany this week’s analysis article, Professor Jerome Hoffman and Dr Hemal Kanzaria, of the University of California, suggest that efforts to reduce overdiagnosis and overtreatment should focus on changing physician and public attitudes towards medical error and uncertainty. more…

The BMJ Today: Teenage pregnancy and sleepless nights

16 Oct, 14 | by BMJ

Teenage pregnancy (within the ages of 13-19) is a major public health concern. About 16 million females aged 15-19 and about 1 million girls aged less than 15 give birth. Complications during pregnancy and childbirth are the second cause of death in 15-19 year old females globally.

A clinical review by McCarthy and colleagues looks at the issues around teenage pregnancy and how to approach them. It discusses how common it is, who is most likely to become a teenage mother, and what can be done to prevent it. The medical and social impacts of teenage pregnancy on mothers and their children are neatly represented in an online infographic. more…

The BMJ Today: The pitfalls of migration

15 Oct, 14 | by BMJ

I’ve been taking lots of travel histories lately. As a GP who sees lots of patients with fever, patients are even starting to pre-empt me (” . . . and I’ve never been to Africa”). This heightened awareness is unsurprising, given news that some countries are introducing airport screening for Ebola. But will this actually make much difference? Probably not, say editorialists Mabey et al. By their calculations, “an entrance screening policy will have no meaningful effect on the risk of importing Ebola into the UK.” more…

The BMJ Today: The challenge of getting ready for autumn

14 Oct, 14 | by BMJ

Emma-ParishAs the seasons shift here in the UK to embrace autumn, more people will seek advice for coughs, sore throats, and hoarseness, but are you up to date on laryngitis? In their clinical review, an Australian ENT team present the diagnostic challenge of this condition, outlining the red flag symptoms to prompt investigation for malignancy—very timely for mouth cancer awareness month in November. more…

The BMJ Today: Ebola and the importance of taking a travel history

13 Oct, 14 | by BMJ

navjoyt_ladherThe new cases of Ebola virus disease reported in Spain and the United States in recent days have reminded healthcare workers around the world to be vigilant for the infection. Several weeks ago, we spoke to Nick Beeching, senior lecturer and consultant in infectious disease at the Liverpool School of Tropical Medicine, about the UK’s response to the outbreak.

In the video, he outlines when to suspect viral haemorrhagic fever and emphasises that cases in the UK are extremely rare in comparison to other imported diseases, such as malaria. more…

The BMJ Today: Antidepressants, FDA warnings, and suicide under the microscope . . . again

10 Oct, 14 | by BMJ

peter_doshiFor those who like “journalology,” today’s The BMJ has many of the ingredients for a rich case study.

The latest published letters to the editor are dominated by those taking issue with a previously published research paper.

The paper at issue—published this June and authored by Lu and colleagues—probed whether the Food and Drug Administration’s (FDA) 2003-04 warnings about the risk of suicidality in children and adolescents on antidepressants may have had “unintended consequences.” Their research found it did, and the authors concluded that after the FDA warnings, consumption of antidepressants decreased while suicide attempts increased. If true, it means the FDA warnings had the exact opposite of their intended effect. more…

The BMJ Today: Guidelines—comfort in a sea of uncertainty?

9 Oct, 14 | by BMJ

rich_hurleyWe’ve just published two more summaries of recommendations from the National Institute for Health and Care Excellence. We hope that these help our busy clinician readers get to grips fast with current best practice, especially where uncertainty or controversy exists.

Both these summaries cover the latest you should know on diagnosis and management; one concerns acute heart failure in adults and the other multiple sclerosis.

In synthesising its guidance, NICE does systematic reviews of the best available evidence and considers cost effectiveness. “When minimal evidence is available,” the summaries warn, “recommendations are based on the guideline development group’s experience and opinion of what constitutes good practice.” more…

The BMJ Today: Honey, I shrunk the health service

8 Oct, 14 | by BMJ Group

If the blistering analysis article posted today on thebmj.com is correct, then foundation trusts (FTs) need to prepare for a cut in the NHS funded services they are legally obliged to provide. This reduction in “mandatory” core services could come as soon as 2016 for some FTs. It matters, say the authors, because the fewer services NHS trusts are required to provide, the less comprehensive our health service becomes.  more…

The BMJ Today: Climate change and conflicts of interest: the sound and the fury

7 Oct, 14 | by BMJ

debs“Fury as top medical journal joins the green bandwagon” fumed the Daily Mail last week, which took exception to The BMJ’s publication of an article that, in the words of editor in chief Fiona Godlee, was not medicine or health but “pure climate science.”

“In this unequal battle with big business and political inertia we have a crucial card to play: the knowledge that much of what we need to do to tackle climate change will bring substantial benefits to health,” Godlee charged, adding that the World Health Organization should call a public health emergency.

And how prescient that comment was. Said fury came from Dr Benny Peiser of the Global Warming Policy Forum (GWPF), a think tank founded by former Chancellor Lord Lawson.

“The World Health Organization would become a global laughing stock if they were to follow the ridiculously over-the-top demands of a green alarmist editor. There is a real disconnect between what they are saying and the reality,” he was quoted as saying. more…

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