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Michael Wilks: Climate change—action at a national and global level is essential

1 Jul, 15 | by BMJ

The 2015 Lancet Commission on Health and Climate Change was published on 23 June. A previous commission, established jointly by The Lancet and University College London, described climate change as “the biggest global health threat of the 21st century.” While the 2015 report recommends practical steps to be taken by national and international administrations, it also brings into sharper focus two components that cannot be ignored if a sustainable global solution is to be found to a so-far intractable global problem. more…

The BMJ Today: Healthcare in war

1 Jul, 15 | by BMJ

isisWho is taking care of civilians and fighters’ medical needs in parts of Iraq and Syria taken over by the Islamic state? Duncan Gardham reports that doctors have been forced to pledge allegiance or flee, aid workers have retreated, and the Islamic state is organising a workforce of medical jihadists from around the world. Hear from a British vascular surgeon who has been taking up to six weeks unpaid leave from the NHS to work in war zones, from Bosnia to Afghanistan, Iraq, Sierra Leone, Libya, Gaza, and Syria. He tells how the Islamic state is different, and why it may have become too dangerous to help. more…

Julian Sheather: Forty years of the Declaration of Tokyo

1 Jul, 15 | by BMJ

julian_sheatherMedical involvement in torture looks like a category error. Medicine has to do with the healing of bodies and minds; torture with their destruction. It is now forty years since the World Medical Association (WMA) adopted the Declaration of Tokyo on Guidelines for Physicians Concerning Torture. It was necessary then. The tragedy is how necessary it remains. more…

David Payne: Remembering 7/7 ten years on

1 Jul, 15 | by BMJ

IMG_1656Outside BMA House a solitary bunch of purple stocks hangs from the railings, alongside the memorial plaque to victims of the Tavistock Square suicide bomb attack on a London bus 10 years ago.

As passers-by stop to read the names of the dead, inside the building survivors of the blast, along with bereaved friends and family, join members of the emergency services for the annual 7/7 Tavistock Square Memorial Trust lecture. more…

Juliet Dobson: Cutting support services for new mothers is a false economy

1 Jul, 15 | by BMJ

juliet_dobsonI was sad to hear that support services for new mothers are going to be cut across England. The Guardian reports that breastfeeding classes, home visits from midwives, and “babyfeeding cafes”—where mothers can drop in and talk to feeding advisers as well as other parents—are increasingly being scaled back or cut owing to pressures on local authority and NHS budgets.  more…

Tom Jefferson: Are we ready for the EMA revolution?

30 Jun, 15 | by BMJ

After attending a webinar on the European Medicines Agency’s (EMA) new 0070 policy, which formalises the release of regulatory data held by the EMA, some of my earlier doubts have been addressed by what seems to be a general EMA commitment to openness (see my first blog on this webinar). For example, following a remark and a line in a webinar slide, I repeatedly questioned the EMA about the existence of “two data sets.” But I was told that the data sets (the one for scientific review by the EMA and the one to be published on the EMA website) are “mirrors” differing only in the redactions. The similarity will have to be certified by each manufacturer when submitting both versions. The EMA will not be carrying out a manual check of the content. more…

Tom Jefferson: The EMA revolution gathers pace

30 Jun, 15 | by BMJ

In October 2014, the European Medicines Agency (EMA) promulgated its policy 0070 on the release of regulatory data acquired and held in the course of its regulatory function. At the time, some of us advised caution in accepting the policy at face value, although we recognised the great contribution that the policy and the EMA’s attitude were making to a culture of openness in human experiments.

One of the undoubted difficulties that such a policy would entail was the sheer complexity of publishing huge amounts of very complicated documents on regulatory websites. There are no precedents for this.

A recent webinar held by those responsible for the implementation of the policy allowed a detailed glimpse of what is in store. I attended as a researcher, or more precisely as a systematic reviewer, and what follows is my take on the policy roll-out. more…

Doctors’ Day in India: Time for critical reflection for the medical profession

30 Jun, 15 | by BMJ

AnantBhanBhavnaDhingraIndia celebrates Doctors’ Day every year on 1 July, in memory of Bidhan Chandra Roy (1 July 1882-1 July 1962), a well respected physician who was also the second chief minister of the state of West Bengal. The day sees a fair bit of fanfare, with events held across the country, especially by bodies such as the Indian Medical Association. While the day serves to highlight the importance of medicine in society, it should also be an opportunity for medical professionals to reflect on their profession and the challenges facing it. more…

The BMJ Today: Sex workers in Bangladesh, welfare advice, and incentives for behavioural change

30 Jun, 15 | by BMJ

bangladesh_sexworkers• Female sex workers in Bangladesh
In a feature published on thebmj.com today, Jocalyn Clark provides a moving account of the plight of female sex workers in Bangladesh. With effectively no voice to demand basic rights and entitlements, these women suffer severe social stigma, poor health, and violence. Several non-governmental organisations have stepped in to offer health services, advocate on their behalf, and empower them to pursue alternative options for a living. Progress remains slow however, given the lack of political will to recognise this group and directly tackle factors such as poverty and social estrangement, which drive women and children into the sex trade. more…

Michael Soljak: Data access for research—Kafka writes again

29 Jun, 15 | by BMJ

Data are the lifeblood of health research, and the UK government is claiming that data collected in the course of NHS clinical care are available to reputable researchers for the purposes of improving health and healthcare. However, the reality is rather different, and it is becoming increasingly difficult to obtain research data.

Anonymised patient level Hospital Episode Statistics (HES) data on inpatient admissions have been available for research and other secondary uses for many years, and their use has led to major improvements in quality, from identifying higher mortality at weekends to sounding the alarm about institutional failures such as those at Mid Staffordshire Foundation Trust. This was achieved with reasonable information security standards and a proportionate approach to the risks and benefits by the Information Centre for Health and Social Care, as it was called then. more…

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