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Tessa Richards: “Burnout shops” are bad for health

24 May, 16 | by BMJ

Tessa_richardsBurnout is a pervasive problem. Its high prevalence among health professionals is well recognised. But the extent of its impact on the quality, safety, and cost of patient care needs more scrutiny, agreed participants at the WELL-Med conference in Greece last week.

“Fixing toxic workplaces rather than fixing the people” who suffer from working in them should also be a priority, said the guru of burnout research, Christina Maslach, professor of psychology at the University of California. She went on to warn that “the number of organisations” whose policies seem designed to make them “burnout shops” is rising. more…

Anne Marie Rafferty: Whose responsibility is the workforce anyway?

24 May, 16 | by BMJ

anne_marie_raffertyIt’s the workforce stupid! That is the key message of the Nuffield Report, “Reshaping the workforce to deliver the care patients need.” Workforce solutions are rarely quick fixes so policy makers often find it is more appealing to introduce new types of workers rather than grind away at trying to make what we already have work better. So it is gratifying that the Nuffield Trust report takes such a measured view of what might help to make the system work better and rightly focusses on the largest part of what we’ve got in the system, the so-called non-medical workforce (though no one likes to be referred to as a “non” anything). more…

Soumyadeep Bhaumik’s review of South Asian medical papers—May 2016

24 May, 16 | by BMJ

soumyadeep bhaumikIt is summer in South Asia, and it seems to be getting hotter than ever before (though I have been spared this year). Climate change is expected to have major consequences in the region with Bangladesh at the top of the risk index for global climate change by the Intergovernmental Panel on Climate Change (IPCC) for nine consecutive years now. Recently the baseline results of a cohort study to see the health effects of climate change in Bangladesh were published. The future will unfold through the lens of this cohort and hopefully force the global leaders to act before the damage becomes irreversible.  more…

Neel Sharma: We need to understand the real life applications of technology in medical education

24 May, 16 | by BMJ

Technology as we all know has caused significant movement in medical education. In reality this was not a desire of our own as doctors, but was brought to us courtesy of the gaining popularity of technology use in everyday lives, from the rise of the internet, mobile devices, laptops, and social media. We then attempted to utilise this technology due to its abundance. And further attempted to enhance the academic validity of its use by linking its worth to educational theories. Interestingly many of these theories were developed at a time when technology did not exist. more…

Paul Hunter: Zika virus would be able to spread in Europe

23 May, 16 | by BMJ

paul_hunterZika virus is not new. Last year, when I was asked if I knew of an expert on the disease in the UK, I searched for papers written by an author giving a UK address. I found 11 papers, six of which were written before I had started primary school in 1961. Yet in the past six months the virus has risen to the top of the infectious disease news headlines with very good reason.

It is now widely accepted that the infection is responsible for the epidemic of microcephaly (a devastating disability) seen in South America in babies of mothers infected during pregnancy. Furthermore, other serious neurological sequelae have been described in both children and adults, including Guillain-Barré syndrome, acute myelitis, and meningo-encephalitis. more…

Rebecca Coombes: Beware the medicalisation of female genital cutting

23 May, 16 | by BMJ

rebecca_coombesI met two remarkable women this week. Actually, I met many such females at the vast Women Deliver conference in Copenhagen—obstetricians, lawyers, midwives, and former presidents (including a possible future one when Hillary Clinton made a live appearance on the big screen).

In a cast of thousands, activists Filzah Sumartono, from Singapore, and Mariya Taher, from India, made an impact with their plain speaking about female genital cutting (FGC). Sumartono confronted the growing problem of medicalisation of FGC. Indonesia and Malaysia have called for a standardisation of the procedure, essentially legitimising the practice. more…

Richard Lehman’s journal review—23 May 2016

23 May, 16 | by BMJ

richard_lehmanNEJM 19 May 2016 Vol 374
Danazol & the Norns
1922 In early European mythology, life was seen as a fragile string, which could be cut by an arbitrary force outside the power of the gods. In the Greek version, a child would be visited on the third day of life by the three Moirai. Clotho spun the thread of human fate, Lachesis dispensed it, and Atropos cut it at the appointed moment of death. In Norse mythology, these ladies took the form of Norns. Nowadays Clotho dispenses telomeres at the end of DNA strands. With each cell division, these shoelace ends become shorter, and eventually Atropos steps in with her abhorred shears and you die. Lachesis sometimes causes mischief by handing out telomeres that are too short, causing people to be highly susceptible to cancer or to die prematurely from bone marrow failure, liver cirrhosis, and pulmonary fibrosis. more…

Jeffrey Aronson: When I use a word . . . Political personification

20 May, 16 | by BMJ

jeffrey_aronsonHaving deconstructed part of the Conservative Party’s 2015 manifesto in last week’s blog, I thought that I ought to extend the favour this week to the Labour Party’s 2015 manifesto.

Reading it, I was immediately struck by a phenomenon that I previously described when discussing weasel words—the flexible use of the words “we” and “our”, covering the spectrum from the all exclusive variety (the editorial or royal we, i.e. “I”) to the all inclusive variety (i.e. all of us). Even single sentences illustrate this diversity more…

John Appleby: New NHS inflation figures underline funding pressures facing the NHS

20 May, 16 | by BMJ

john-applebyThe latest Quarterly Monitoring Report from the King’s Fund surveying NHS trust finance directors reveals deepening pessimism about local finances and concern about the outturn for the current financial year. New NHS inflation figures from NHS Improvement reveal the true extent of the financial pressures facing the NHS this year and up to 2020/21.

How much money the NHS has been allocated over the next few years is a somewhat contested fact. It shouldn’t be of course; how much the government has decided to spend on healthcare should be —in one sense at least—an uncontroversial figure. more…

Trish Groves and David Moher: How to get published

20 May, 16 | by BMJ

trish_groves1david_moher

In the run up to Evidence Live 2016, we are running a series of blogs by the conference speakers discussing what they will be talking about at the conference.

The highlight of last year’s excellent Evidence Live was, for me (Trish Groves), a short, private conversation. Two doctors from Pakistan (a husband and wife) sought me out to say they had taken part in my Evidence Live workshop two years earlier, on how to publish research. They went on to complete their research and, for the first time, to successfully publish two papers. “BMJ helped us broaden our vision, and changed our lives” they said.

Similar stories, and a growing realisation that we all need to tackle the huge challenge of waste in research, inspired BMJ to develop Research to Publication. This is a comprehensive eLearning programme for early career researchers. more…

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