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Aeesha NJ Malik: Improving children’s eye health in Pakistan

2 Feb, 16 | by BMJ

aeesha_malik1.5 million children in Pakistan are blind. Many from eye diseases which are preventable and treatable. Often children don’t know they have a vision problem because they assume they see the way everyone around them sees. However childhood visual impairment or blindness has a huge impact—its effects last a lifetime and affect not just the individual, but their family and society. more…

Tim Lobstein: Community interventions for healthy bodyweight—can we make them work?

2 Feb, 16 | by BMJ

tim_lobsteinGroups like mine which advocate for market interventions to restrict advertising, raise taxes, control fast food outlets and the like, are having a tough time making progress. Governments prefer to change health behaviour at the individual level through education, through subtle nudges and social marketing campaigns, and, especially, by devolving responsibility to local, community-level interventions.

There is no denying that community interventions have potential: the Ottawa Charter for health promotion clearly recognised community empowerment as the key to better community health. Community interventions provide valuable opportunities, especially if we take care not to widen health inequities by failing to reach those who need them most, and not to increase victim-blaming or a sense of failure among participants who fail to lose weight, or a sense of failed community cohesion if a project suffers high drop-out. more…

Neville Goodman’s Metaphor Watch: Guns and needles

2 Feb, 16 | by BMJ

neville_goodmanSometimes research goes badly, and red herrings lead to a blind alley (qv), but sometimes there’s a smoking gun: conclusive evidence just a little bit short of being caught in the act. But note “just a little bit short.” This means that smoking gun shouldn’t be applied to properly conclusive evidence, and that it doesn’t make sense to ask if something is a smoking gun. A smoking gun is obvious, in-your-face evidence; the question is whether it’s valid, well illustrated by these opening sentences of a commentary article on the evidence that T cells cause rheumatoid arthritis. This article came to my attention some years ago for its title, “A fistful of T cells”, which, rather than metaphorical, is an allusive title. Of course, the important property of the smoking gun is the temporal one, and that is not so for most evidence in research, but the sentences capture the essence of the smoking gun. more…

Richard Lehman’s journal review—1 February 2016

1 Feb, 16 | by BMJ

richard_lehmanNEJM 28 Jan 2016 Vol 374
Venetoclax & CLL
311 Venetoclax is a wonderful name. I shall set up a burglar alarm company in Venice so that I can see it painted on the side of gondolas: “Protect your palazzo with VENETOCLAX.” Then, when the moony silence of the Venetian night is pierced with the affrighting wail of our klaxons, I will be able to mutter contentedly, “Another one caught. Another success for Venetoclax.” I don’t know how the name venetoclax came to be attached to a new drug for resistant chronic lymphocytic leukaemia (CLL). But here it is, attacking BCL2, a protein central to the survival of CLL cells, in a phase 1 trial. Almost every patient with relapsed or refractory CLL or small lymphocytic lymphoma showed a response. I would opine that it is much too early to predict its place in the overall management of CLL, though this is a subject which I know little more about than burglar alarm selling in Venice.

Et tu, Bruton
323 Things that I do know about CLL: it affects older people, it has hitherto been hard to treat, but the emerging standard of care seems to be ibrutinib, an irreversible inhibitor of Bruton’s tyrosine kinase (BTK), which is slightly better than chlorambucil and costs hundreds of times as much. more…

Patrice Baptiste: What is the future of the NHS?

1 Feb, 16 | by BMJ

patrice_baptisteDuring my foundation years I wasn’t completely sure about what specialty I wanted to pursue within medicine so I decided to take a year out of training. Although not my passion, I thought a lot about general practice as this encompasses a broad range of specialties, including the possibility of a “special interest,” as well as opportunities for teaching. I would actually get to see and know my patients over a longer period of time instead of one day in accident and emergency (A&E), or a week or two on the wards, not to mention being able to have a good work life balance in comparison to working in a hospital. more…

William Cayley: Out with the old (and practical) and in with the new (and techie)?

29 Jan, 16 | by BMJ

bill_cayley_2Out with the old and in with the new? Improvements in the quality and portability of electronic diagnostic equipment have led to increasing discussion of late over the possible demise of the stethoscope. News outlets for the general public and for medical professionals have noted the growing debate over whether portable and handheld ultrasound, as well as other electronic diagnostic devices, should replace the traditional tool and icon of the physician: the stethoscope.

I tend to be a bit of a skeptic about the alleged wonders of the latest and greatest technology, and admittedly have a bent towards sticking with what is proven to work. So, to further investigate the potential merits of the stethoscope and its competitors, I had a brief (and admittedly limited) look for quality studies addressing the question. more…

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

29 Jan, 16 | by BMJ

jeffrey_aronsonLast Saturday (23 January) I went to Sam Wanamaker’s Globe Theatre in Southwark (picture) for a meeting of the Oxford–Globe Forum for Medicine and Drama in Practice, as part of the commemorations of the 400th anniversary of Shakespeare’s death in 1616, expertly organised by Shakespearean scholar Professor Laurie Maguire and her colleagues.

I gave a talk about the historical development of medicines regulation, relying heavily on R G Penn’s paper in the British Journal of Clinical Pharmacology, “The state control of medicines: the first 3000 years”. Having only 15 minutes to cover the subject, I restricted myself to the past 2000 years. I finished with what were not perhaps wise saws but certainly modern instances, describing some recent work on drug withdrawals more…

David Kerr: A bump on the road to mHealth utopia?

28 Jan, 16 | by BMJ

david_kerr_2015picA recent clinical trial’s finding that digital health technology (also known as mHealth) failed to reduce healthcare costs is raising eyebrows on this side of the Atlantic. For naysayers the results will most certainly reinforce their belief that mHealth is a fad, which distracts from the real business of medicine, and that more investment in staff is preferable to wasting time on smart new shiny things. On the other side of the argument, however, the study had major flaws: it had a small number of participants (3998), had a very short duration, and was already out of date when it started—given the rapid pace of technology development.

Where I live on the west coast of the US, only a few hours’ drive down from Silicon Valley, there is indeed a widespread belief that technology will change the future and much sooner than for previous generations. more…

Jeanelle de Gruchy: Should David Bowie have spoken out about the cause of his cancer?

28 Jan, 16 | by BMJ

jeanelledegruchy2David Bowie has died. From cancer. So much outpouring of grief. And yes I participated, posting #RIPBowie tweets and reminiscing about seeing him in concert in Montreal as an 18 year old with all who would listen, shedding a tear listening to the day long radio tributes as I felt my youth slipping away with his passing. And yet everything I watched, on TV, on YouTube, on Facebook and in the many pictures, there it was, revelling in its strong silent presence and mocking us for our complicity, the killer that took him away from us aged only 69. The swell of adulation for one of the greatest musicians, pop stars, cultural icons, and boundary pushers was wonderful; the lack of comment on what killed him prematurely was pitifully duplicitous. more…

Enes Hajdarbegovic and Deepak Balak: Science, spam, and scam

27 Jan, 16 | by BMJ

Enes-Hajdarbegovic_2Deepak-Balak_2Hi there! Are you interested in making easy money? Go into scientific publishing with this easy three step programme:

The first step is to get yourself a website. Get some server space from any of the super cheap providers and get your HTML magic going. Create a biomedical journal with a name that sounds a lot like an existing top journal. Make sure to include words such as experimental or clinical or reviews. Finally, furnish the website so that it resembles that journal.

The second step is to find willing customers. Don’t worry, plenty of those! more…

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