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Jason Cone: There is no such a thing as “free” vaccines: Why MSF rejected Pfizer’s donation offer of pneumonia vaccines

19 Oct, 16 | by BMJ

jason_coneI recently had the difficult task of telling Ian Read, Pfizer’s CEO, that Médecins Sans Frontières (MSF) is rejecting the company’s offer to donate a significant number of pneumonia vaccine (PCV) doses for the children we serve. This is not a decision that we took lightly, since our medical teams working in the field witness the impact of pneumonia every day.

Pneumonia claims the lives of nearly one million kids each year, making it the world’s deadliest disease among children. Although there’s a vaccine to prevent this disease, it’s too expensive for many developing countries and humanitarian organizations, such as ours, to afford. As the only producers of the pneumonia vaccine, Pfizer and GlaxoSmithKline (GSK) are able to keep the price of the vaccine artificially high; since 2009, the two companies have earned $36 billion on this vaccine alone. For years, we have been trying to negotiate with the companies to lower the price of the vaccine, but they offered us donations instead. more…

Chris van Stolk and Joanna Hofman: Helping people with mental health problems to stay in work

19 Oct, 16 | by BMJ








Reducing mental ill health in the UK remains a significant policy challenge for government. Just over 6 million working age people have mental health problems, with 39 per cent of those seeking help and 24 per cent receiving treatment. However, a recent report from the National Audit Office (NAO) indicated that access to mental health services is limited with patients having little choice over the services they receive and often enduring long waiting times.

At the same time, these services can incur significant costs to governments. In 2016, the Mental Health Task Force valued the current costs of mental health support and services across government departments in England at £34 billion a year. However, even this high number was seen by the task force as being insufficient to meet current demand. more…

Jonny Martell: Opening a dialogue in mental health

18 Oct, 16 | by BMJ

jonathan-martellI was there the first time my father saw the psychiatrist. I think it was the only time, in his study at home. I remember I was seated behind him, a bit to the side. A little out of the way. Walking down the corridor afterwards, my father still seated by the fire, the psychiatrist asked me, “Is there a shotgun in the house?”

“Yes,” I replied—my father used to farm.

“Find a new home for it please.”

She prescribed some medication and requested a head scan. A community psychiatric nurse paid him visits—described by my father, not unkindly, as “a little bully.”

The scan results came through several months later. But my father never saw them. more…

Tim Lobstein: Can wearable technology help patients tackle obesity?

18 Oct, 16 | by BMJ

tim_lobsteinTechnology offers solutions to many health problems, but can the new generation of wearable sensors help patients manage their weight? Experience from an EU funded project suggests that there are challenges and opportunities.

One in eight British adults is now using wearable technology to support and change their health behaviour. Many products are aimed at encouraging more physical activity, and some are aimed at improving our diets. Do they also have a role in supporting clinical practice, especially for patients trying to manage their body weight? more…

Polly Moyer: On balance, we’re making progress

18 Oct, 16 | by BMJ

Balance Awareness Week (BAW) 2016 recently took place. Given that I have to co-exist with a rare condition that affects my balance I can’t say that I was an impartial observer to some of the relevant news that I read during this time. Some of it made me very happy, some of it depressed me, and much of it indicated that there is still a long way to go before all patients with balance problems receive the services they need. more…

Iain Chalmers: Should the Cochrane logo be accompanied by a health warning?

18 Oct, 16 | by BMJ

Iain-ChalmersThe birth of the Cochrane logo

Twenty four summers ago I asked David Mostyn to design a logo to illustrate the objectives of the soon-to-be-opened Cochrane Centre. He did a good job: the circle reflects global objectives and international collaboration; the mirror image “Cs” stood for the Cochrane Centre (and, a year later, the Cochrane Collaboration); the horizontal and vertical lines show the results of some early randomised trials assessing the effects of prenatal corticosteroids on the likelihood of early neonatal mortality; and the diamond is a statistical summary of the information derived from the individual studies above it. As prenatal corticosteroids were not in widespread use at the time, the logo illustrated the human costs that can result from failure to prepare systematic, up-to-date reviews of controlled trials of health care. more…

Richard Smith: Can the NHS ever manage to analyse data to improve patient care?

17 Oct, 16 | by BMJ

richard_smith_2014In order to improve patient outcomes the NHS badly needs to collect data on all that is happening, analyse it intelligently, and present the information to clinicians and managers in an understandable and actionable form. That was the central message from Keith McNeil, who recently became chief clinical information officer health and social care for the NHS, to the Cambridge Health Network last week.

Previously, he was a clinician for 30 years and chief executive of Addenbrooke’s. His message, as I cynically observed, was probably said 15 years ago (if not longer) but it hasn’t ever happened. more…

Neville Goodman’s Metaphor Watch: Not a raft unless it’s flat and keeps you afloat

17 Oct, 16 | by BMJ

neville_goodmanRaft has three primary meanings (COD): a flat buoyant structure or small boat; a floating mass of fallen trees, ice, etc.; foundation concrete for a building. From the second meaning it has come to mean a large amount of something. This makes it an attractive word.

There are 7000 rafts in PubMed. One thousand are there because it is an acronym: RAFT polymerization is reversible addition-fragmentation chain transfer polymerization. The poor old initial c of chain has been left out, presumably because RAFCT is unpronounceable, although without the chain nothing would happen at all. more…

Richard Lehman’s journal review—17 October 2016

17 Oct, 16 | by BMJ

richard_lehmanNEJM  13 Oct 2016  Vol 375
Outcomes and choices
This week’s print NEJM contains mostly papers I’ve already commented on—notably, Gilbert Welch’s important study of mammography and breast cancer outcomes and the landmark British trial comparing surgery, radiotherapy, and watchful waiting for PSA detected prostate cancer (ProtecT).

However, I hadn’t commented on the patient reported outcomes paper that went with this study. This is immensely important because the two papers together provide all the information that men with localised prostate cancer detected by PSA need to make a decision about treatment. If they opt for surgery, they run the highest risk for impotence and urinary incontinence, and this is unlikely to improve over time. If they opt for radical radiotherapy, they run similar risks but the effects tend to improve after six months. They are also likely to have bowel effects, which may resolve to a varying extent. more…

Sian M Griffiths: How to implement handwashing with soap in schools

14 Oct, 16 | by BMJ

sian_griffiths11 March 2016 was an important day for global public health. It was the day the UN adopted a hygiene indicator as part of Sustainable Development Goal (SDG) 6–the goal that covers the availability and sustainable management of water and sanitation for all, and which will guide funding and policy in this area for the next 15 years.

The adoption of the indicator is in part thanks to advocacy efforts of the water, sanitation, and hygiene (WASH) sector, especially the Global Public-Private Handwashing Partnership on Handwashing with Soap. Academics, influential NGOs including the Water Supply and Sanitation Collaborative Council and UNICEF, and private sector partners such as Unilever-Lifebuoy, have all played their part in raising the profile of handwashing with soap (HWWS). more…

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