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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…

Jon Stamford: Patients must help design clinical trials

22 Apr, 15 | by BMJ

jon_stamfordIt is a truth universally acknowledged that clinical trials are the bedrock upon which all medical progress is based. Without successful trials new medicines are not introduced, new treatments are not developed, and new understanding is not gleaned. The furtherance of knowledge hinges upon the successful design, execution, and interpretation of clinical trials. more…

The BMJ Today: What are doctors around the world up to?

22 Apr, 15 | by BMJ

us_dollarsThe BMJ has reported a number of medical fraud cases in the US lately. An ophthalmologist in Florida who used to see 100 patients per day has been accused of making false diagnoses of serious eye disease and providing unnecessary treatments which he would then bill Medicare for. He is considered the top Medicare biller in the United States. Between 2004 and 2013 he billed Medicare for $190 million. more…

Richard Vize: Facing the NHS funding reality

21 Apr, 15 | by BMJ

richard_vizeThe intervention by former NHS England chief executive Sir David Nicholson in the election debate on the NHS exposes the chasm between manifesto rhetoric and funding reality.

Nicholson pointed out that the political parties are promising extra services while the Five Year Forward View from NHS England—on which the widely accepted additional funding need of £8 billion a year is based—makes hugely optimistic assumptions about efficiency savings simply to get the service repositioned for sustainability, without heroic promises about more and better care. more…

General election 2015: The health and care debate live blog

21 Apr, 15 | by BMJ

Head2head_final

The BMJ was live blogging from the Health and Care debate at the British Library.

Jeremy Hunt, Secretary of State for Health, Andy Burnham, Shadow Heath Secretary, Norman Lamb, Minister of State for Care and Support, and Julia Reid, UKIP Deputy Health Spokesman, answered questions at the debate chaired by Sarah Montague from the BBC. 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…

Matthew Honeyman: Reconfiguring NHS services: necessary but fraught with difficulties

20 Apr, 15 | by BMJ

matthew_honeymanWith the NHS facing growing pressures on all fronts, following the general election the next government is likely to begin a new round of NHS service reconfiguration planning. In addition, work will continue to implement the new care models—such as urgent and emergency care networks and modernised maternity services—set out in the NHS five year forward view. So what are the challenges around service reconfiguration? And what evidence is available to help guide this planning process? more…

Richard Lehman’s journal review—20 April 2015

20 Apr, 15 | by BMJ

richard_lehmanNEJM 16 April 2015 Vol 372
1489 Your learning task this week is to memorise “proprotein convertase subtilisin–kexin type 9 (PCSK9).” The next big lipid lowering debate will be all about inhibitors of PCSK9, and somebody should urgently invent a popular name for them. I suggest fatins (fat lowering injections), to rhyme with statins. There are two of them at the moment: alirocumab and evolocumab. In this trial, alirocumab was given as an injection every two weeks to two thirds of 2341 patients at high risk for cardiovascular events who had LDL cholesterol levels of 1.8 mmol per litre or more and were receiving treatment with statins at the maximum tolerated dose. The rest had a placebo injection. “At week 24, the difference between the alirocumab and placebo groups in the mean percentage change from baseline in calculated LDL cholesterol level was −62 percentage points (P<0.001); the treatment effect remained consistent over a period of 78 weeks.” The trial was not powered to detect a fall in actual cardiovascular events over this period, but as its name ODYSSEY LONG TERM implies, it means to go on:
To strive, to seek, to find, and not to yield. (Last line of Ulysses by Tennyson) more…

The BMJ Today: What is happening in US medicine?

20 Apr, 15 | by BMJ

9_11_emergency_workersEven though I was far away from New York City, I will always remember the 11 September 2001, as I was in medical school taking an exam that day. An article in research news reports that the emergency medical workers who arrived in the immediate aftermath of the World Trade Centre attacks were at greater risk for a number of chronic conditions compared with the workers who did not attend the aftermath of the attacks. For example, first responders were almost four times more likely to have reflux, seven times more likely to have post-traumatic stress disorder, and twice as likely to have depression. more…

Jeffrey Aronson: When I use a word . . . Conjugation

17 Apr, 15 | by BMJ

jeffrey_aronsonA case of Vernet’s syndrome, unilateral paralysis of the 9th, 10th, and 11th cranial nerves, caused me to read up about the jugular foramen and tumours therein.

The jugular foramen, a triangular structure at the base of the brain near the mastoid process, nearly long enough to be regarded as a canal, contains numerous important structures, including the internal jugular vein, the inferior petrosal sinus, and the posterior meningeal artery, the glossopharyngeal, vagus, and spinal accessory nerves, Arnold’s nerve, and Jacobsen’s nerve. more…

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