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Chris​ Simms: Global health and Brexit—choosing when anxious

21 Jun, 16 | by BMJ

Chris_simsRecent research shows that anxiety not only fails to produce good decisions but seems “exquisitely designed” to produce bad ones. In local and global health, where anxiety often thwarts good decision making, efforts to improve how choices are made have focused on collaboration and the use of scientific evidence. These efforts may have some relevance to an anxious public deciding this week whether the United Kingdom remains in the European Union.

Patient centered care envisions collaboration and shared decision making. One recommended way to improve medical decision making is through the application of prospect theory. This theory is rooted in economics and psychology, and addresses the behavioral underpinnings of choice in the face of uncertainty. more…

Hilary Burton: Get on board with genomics—a call to all clinicians

21 Jun, 16 | by BMJ

hilary_burtonPersonalised medicine has become the “holy grail” of modern medical research and has been embraced by policy makers and healthcare providers as a route to more satisfied patients, more effective and efficient health services, potentially even reducing demand through more effective prediction and prevention of disease. But what do today’s health professionals make of this, beyond their belief that they already provide personalised care—choosing the best treatment according to a patient’s particular medical and social circumstances and reaching agreement jointly with the patient about the best management strategy? more…

Kamal R Mahtani: Beware evidence “spin”: an important source of bias in the reporting of clinical research

21 Jun, 16 | by BMJ

Kamal R MahtaniDoes the name Malcolm Tucker ring a bell? The Malcolm Tucker I am referring to is the fictional character from the BBC political satire The Thick of it. Tucker (played by Peter Capaldi) was a government director of communications, skilled in propaganda, more specifically in the art of “spinning” unfavorable information into a more complimentary, approving (and sometimes even glowing) public facing message. Whether the show accurately reflects real life governmental politics, or whether real life politicians “copy the show, remains a topic of discussion. Either way, “spin” in the political arena feels like something we are increasingly getting used to, almost expect. more…

Jeffrey Aronson: When I use a word . . . Leave or remain

20 Jun, 16 | by BMJ

jeffrey_aronsonAmong all the misleading statements and frank untruths with which we’ve been bombarded by both sides in the debate on the forthcoming referendum, one form of argument has not, as far as I can tell, been mentioned—the etymological one.

As followers of this blog know, the English judge Sir William Jones observed, in 1786, that “No philologer could examine [Sanskrit, Greek, and Latin] without believing them to have sprung from some common source, which, perhaps, no longer exists.” That common linguistic source was later (1813) called “Indo-European”. more…

Richard Lehman’s journal reviews—20 June 2016

20 Jun, 16 | by BMJ

richard_lehmanNEJM  16 Jun 2016  Vol 374
Data about parasites
2335   I love it when it’s parasite time in the NEJM. Tenaciously clinging to the wall of the large bowel, tapeworms suck up the digested food that North Peruvians have carefully gathered and prepared, just like people who reanalyse or meta-analyse data that others have gone to the trouble of producing. Such tapeworms—I mean the Peruvian kind—can be eliminated by a number of strategies. The ones considered here involved screening of humans and pigs, antiparasitic treatment, prevention education, and pig replacement in 42 villages. A scaled up strategy of mass antiparasitic drugs for humans and Taenia solium vaccination for pigs eventually did the trick. At the end of the exercise hardly any village pigs were found to contain meta-analysts. I mean T solium cysts. more…

Richard Smith: On being misunderstood, exploited, and abused

20 Jun, 16 | by BMJ

richard_smith_2014A friend has pointed out to me that I am listed as an “exemplary professional” on the website of the Alliance for Human Research Protection. Others on the list include Florence Nightingale and the Nobel prize winner Sydney Brenner. I clearly don’t belong in such exalted company, but another on the list is Andrew Wakefield—yes, him of the fraudulent research that suggested that the MMR vaccine caused autism and created much suffering and confusion. It’s because of him—and the whole dubious nature of the website—that my friend wants me to protest.

I can see why I’m there. They have carefully and cleverly gathered together much that I have written over many years arguing that much of what appears in medical journals should not be believed. I am thus being used to advance their cause that research they don’t like should not be believed. I could be used in this way to advance almost any cause. more…

Emily Sena: Too many drugs, too few medicines—the translational failure of animal research

20 Jun, 16 | by BMJ

emily_sena374 interventions have been reported to be effective in experimental stroke; 97 were tested in clinical trials but only one of these was shown to be effective. The principle of drug development goes that if a therapy improves outcome in animals the next step is to test it in humans in a clinical trial, with the hope that important improvements in outcome will be seen. The reality is that there are huge amounts of animal data (too many drugs), from experiments that are not designed with sufficient rigour or adequately reported, and important improvements in outcomes are usually not seen in clinical trials (too few medicines). Many animal experiments are failing in their objective effectively to inform human health. more…

Goher Rahbour: In the Calais refugee “Jungle”

17 Jun, 16 | by BMJ

Goher_RahbourHaving read about and witnessed scenes on television of the humanitarian disaster affecting refugees across Europe, I developed a desire to help in some form.

In February 2016, the United Nations Refugee Agency stated that “It is concerned about some 4000 refugees and migrants currently reported to be living in the Calais ‘jungle’ and almost 2500 in Grande-Synthe, on the edges of Dunkerque, often in dire circumstances, aggravated by the winter conditions. Of particular concern are hundreds of children, many of them travelling by themselves, who arrive at the informal camps in northern France in need of both shelter and adequate protection.” more…

David McCoy: Antibiotic resistance is also a food and climate issue

17 Jun, 16 | by BMJ

david_mccoyWhen George Osborne spoke to the IMF in April about antibiotic resistance being a greater threat to mankind than cancer, one might assume that the current government had actually listened to some professional advice from the medical community. Sally Davies, the country’s Chief Medical Officer, has been raising the alarm that the growing emergence of antibiotic resistance is a ticking time bomb of potentially apocalyptic proportions.

This impending crisis has been in the making for decades during which time governments across the world have failed to implement the financing arrangements, laws and policies to ensure proper stewardship over the sale and use of antibiotics. Underlying this failure has been the broad trend towards the deregulation and marketization of health systems, and the effects of structural adjustment programmes and public budget cuts in many countries. more…

Lifebox and Medsin—making a difference to the future of safer surgery today

17 Jun, 16 | by BMJ

It’s wrong that surgery is up to a thousands times more dangerous in low resource settings. It’s wrong that 70,000 operating rooms worldwide don’t have access to a pulse oximeter. Most medics remember a time when they were more idealistic—but do they remember taking action?

Maybe they didn’t have a local branch of Medsin.

Medsin is a UK wide student network advocating for global health equality. It’s an organised campaign machine, sophisticated in message and messengers (and the age difference only means we have better music at our AGMs). As UK partners to the International Federation of Medical Student Associations (IFMSA), we’ve got a platform stretching from the student centre to the World Health Assembly—and we’re proud to partner with Lifebox Foundation as we expand our focus on global surgery. more…

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