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Kate Adlington: Should the UK move towards greater regulation of doctor-industry relations?

20 Oct, 14 | by BMJ

kate_adlington_picInternational interest in the interaction between physicians and industry has been mounting since the Physician Payment Sunshine Act (PPSA) was passed in the United States in 2012. The first data made available as a consequence of this act were published last week by the Centers for Medicare and Medicaid Services (CMS). The BMJ published their own rapid analysis of this information, which covers all payments made by US drug and device makers to US doctors in the last five months of 2013. more…

Surayya Johar: Open Access Week—the next generation

20 Oct, 14 | by BMJ

Surayya_JoharOpen Access Week, a global event now entering its eighth year and running from 20-6 October, is an opportunity for the academic and research community to continue to learn about the potential benefits of open access, to share what they’ve learned with colleagues, and to inspire wider participation in helping to make open access a new norm in scholarship and research.

BMJ Open takes a closer look at this year’s theme as announced by the Scholarly Publishing and Academic Resources Coalition (SPARC): “Generation Open.” As explained by SPARC, this theme represents the role of the next generation of open access advocates, and also what impact any changes within scholarly publishing may have upon the careers of scholars and researchers. more…

Richard Lehman’s journal review—20 October 2014

20 Oct, 14 | by BMJ

richard_lehmanNEJM 16 October 2014 Vol 371
1507  I hate military metaphors for cancer as much as anybody, but here is a study which describes hell in the leukaemia trenches. The 30 patients in the trial had acute lymphoblastic leukaemia. The youngest was 5 years old; most were under 20. All of them had relapsed after initial chemotherapy, which heaven knows is bad enough. Eighteen had then endured the horrors of allogeneic stem cell transplantation, and then relapsed again. Some had been through other experimental treatments. Now they were given an infusion of autologous T cells transduced with a CD19-directed chimeric antigen receptor (CTL019) lentiviral vector. In all of them, this caused a cytokine release syndrome, which was severe in over a quarter of cases and had to be treated with the anti–interleukin-6 receptor antibody tocilizumab. The complete remission rate at the end of all this was 90%. So victory at a high price: the challenge now is to operationalise this treatment in a way that is bearable to patients and affordable to health systems. more…

The BMJ Today: How “political” should The BMJ be?

20 Oct, 14 | by BMJ

At the Royal College of Physicians’ Harveian Oration last week, a doctor told me The BMJ had become a “political” rag. And it was not the first time that the accusation has been made. So when are medical and healthcare issues purely scientific matters and when are they “political?”

Dr Michael O’Donnell, former editor of World Medicine, and the subject of our BMJ Confidential column this week, believes that the organisation of healthcare has always been a political matter. His current day job is writing an eyewitness account of the rise and fall of the NHS. He calls Aneurin Bevan “a shrewd political operator,” not least because of the time it has taken “for those who wished to destroy the NHS to make any progress.” more…

Amy Price: Patients doing research for themselves

17 Oct, 14 | by BMJ

Amy_price_picPatient rights and empowerment movements have grown exponentially over the last decade. Shared data movements and clinical decision making may employ slogans like “having a voice,” “nothing about me, without me,” and “give me my damn data,” all these expressions share the language of loss and blame. Vision and partnership are not built by crying for what we do not have, but instead by realistically assessing the situation as it is and working to build collectively what we have. (Price, Biswas & Biswas, 2013)

Some patients have done just that. In a recent BBC programme, Vivienne Parry interviewed those who have dared to engage in patient led research, and who have subsequently challenged and enriched the medical establishment. more…

The BMJ Today: Aiming for a culture of safety not perfection

17 Oct, 14 | by BMJ

kate_adlington_picDo you believe in the “boundless capacity of medical science?”

In a philosophical podcast to accompany this week’s analysis article, Professor Jerome Hoffman and Dr Hemal Kanzaria, of the University of California, suggest that efforts to reduce overdiagnosis and overtreatment should focus on changing physician and public attitudes towards medical error and uncertainty. more…

Yvonne Obura: Female genital cutting—improving doctors’ awareness

17 Oct, 14 | by BMJ

UK PM David Cameron attends the 'Girl Summit 2014' in London.Female genital cutting (FGC) or mutilation (FGM) is the removal or injury of the external female genitalia for non-medical purposes. It is estimated that 125 million women and girls worldwide are currently living with the effects of FGC, and a further 30 million girls are at risk of being cut within the next decade.

According to a recent study, 137 000 women and girls living in England and Wales have undergone FGC. Since 2008, around 1.5% of all women giving birth in England and Wales had undergone FGC, of which 60% originated from the Horn of Africa. more…

Carolyn Thomas: My experience of patient peer review

16 Oct, 14 | by BMJ

carolyn_thomasI’ve finally hit the “Submit” button on my patient review of a research paper submitted to The BMJ—and in time for its deadline. Hurray!

This is the first project of this type I’ve ever been involved in, and at first blush I wondered if I would have anything at all meaningful to contribute—as a non-scientist who wouldn’t know a Hosmer-Lemeshow test from my left elbow at the best of times. more…

Ahmed Rashid: Junk food history taking

16 Oct, 14 | by BMJ

ahmed_rashid“Listen to the patient and they will tell you the diagnosis.”

Widely attributed to Sir William Osler, this quote is often shared with new medical students, and I often find myself repeating it to the undergraduate clinical students I currently supervise. Regardless of the specialty area or examination skills we cover, clinical history taking remains a recurring topic in our tutorials. more…

The BMJ Today: Teenage pregnancy and sleepless nights

16 Oct, 14 | by BMJ

Teenage pregnancy (within the ages of 13-19) is a major public health concern. About 16 million females aged 15-19 and about 1 million girls aged less than 15 give birth. Complications during pregnancy and childbirth are the second cause of death in 15-19 year old females globally.

A clinical review by McCarthy and colleagues looks at the issues around teenage pregnancy and how to approach them. It discusses how common it is, who is most likely to become a teenage mother, and what can be done to prevent it. The medical and social impacts of teenage pregnancy on mothers and their children are neatly represented in an online infographic. more…

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