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Marta Balinska: Psychological distress versus mental illness

19 Sep, 16 | by BMJ Group

marta“You will know very few happy moments in life, so make the most of them.” Those are words I often heard from my late mother, leading me to believe that life was going to be a painful affair. In retrospect, I wonder whether she was dealing with chronic depression or whether she was “merely” dogged by unhappiness. In fact, is unhappiness so different from depression? The World Health Organization defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease” from which it is logical to deduce that if you are unhappy, then you are ill. more…

Tessa Richards: WHO and the politics of health

16 Sep, 16 | by BMJ

Tessa_richardsGaining cross country consensus on joint European strategies to tackle politically and culturally sensitive public health issues is not easy. So it was not surprising perhaps that a decision to adopt an action plan on sexual and reproductive health at the World Health Organization’s 66th Regional Committee meeting in Copenhagen went to the wire.

It started calmly enough, with a detailed account of the wide and protracted prior consultation with the 53 member states, and most delegations expressed high praise for the plan. Suddenly, Turkey and Russia threw last minute googlys more…

Jeanne Lenzer: Donald Trump on Dr Oz—the greatest non-evidence based show on earth

16 Sep, 16 | by BMJ

jeanne_lenzerLate night comics will love Donald Trump’s latest act of showmanship: the neatly choreographed moment when he pulled out his “medical record” from his jacket pocket on The Dr Oz Show last night.

The show and this big reveal garnered plenty of headlines: now everyone knows that Mr Trump is overweight, verging on obese; that he thinks that waving his hands during his speeches is exercise; and that he asks his aides not to tell fast food servers that they are purchasing for Trump lest they doctor the food. And he takes low dose aspirin and a statin. more…

William Cayley: Systems wisdom

16 Sep, 16 | by BMJ

bill_cayley_2In a recent BMJ blog Steve Ruffenach made some excellent points on the importance of balancing “accept” and “except” in approaching “Tech” in medicine.

However, as we continue to feel the pressure of realizing “meaningful use” of electronic medical records (often with attendant requirements for documentation, reporting, and ad-nauseam clicks of different buttons in each patient’s chart), I’ve been intrigued by growing evidence suggesting we need rather to focus on “wise use.”

Some seem to feel that the more systems (usually supported by “tech”) that we implement in medicine more…

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

16 Sep, 16 | by BMJ

jeffrey_aronsonA lecture of the type that I am used to giving is defined in the Oxford English Dictionary as “a discourse given before an audience upon a given subject, usually for the purpose of instruction”, although I always keep in mind the BBC’s mission statement, originally formulated by John Reith, their first Director–General, “to inform, educate, and entertain”, particularly the last of these. This rubric is still to be found in the BBC’s latest draft charter.

The IndoEuropean root LEG meant to gather or set in order. Anything thus eclectically gathered was ready to be read or spoken more…

Neville Goodman’s Metaphor Watch: From cast iron to concrete

16 Sep, 16 | by BMJ

neville_goodmanIn the last blog, I looked at cast iron as a metaphor for strong. You could say that concrete was analogous as a metaphor for real: we want concrete evidence, not just something glimpsed in passing, or some vague speculation. I found over 300 papers in PubMed that presented concrete evidence: “…no concrete evidence demonstrating a role for endogenous APE1” ; “…concrete evidence of the essential contribution of non-starter lactic acid bacteria”; “…the most concrete evidence for cochlear power amplification to date.” more…

Soham D Bhaduri: How we can improve the specialty status of family medicine in India

15 Sep, 16 | by BMJ

Soham Dinabandhu BhaduriA few weeks ago I was interviewing Dr Ashoka Prasad, a psychiatrist and campaigner for improving the rights of those with mental illness, for a popular Indian medical news portal, and was grabbed by a point that he made. The interview was mainly about the state of mental healthcare in India, yet Prasad stressed the role of primary healthcare in providing a foundation for effective psychiatric care, and the criminal under-emphasis of the importance of primary care that we see in India today.

Dr Prasad also expressed his disappointment that only two institutions in the country have thus far expressed their interest in offering a postgraduate course in family medicine. more…

Steve Ruffenach on accepting technology in medicine

15 Sep, 16 | by BMJ

steve_ruffenachLike every other profession, medicine has been radically changed by our friend Tech. You of course know Tech; he is that associate that is always around, always snooping where he doesn’t belong. He’s the one who won’t leave you alone no matter where you are or what you are doing.

His virtues and failings have been discussed countless times for centuries. And our love-hate relationship with him has been present ever since he first showed up. Every time Tech comes out with a new ability, we seem to immediately embrace it and then condemn it. The classical Greek philosopher Socrates condemned one of Tech’s earliest tricks, the act of writing, (“It will produce forgetfulness in the minds of those who learn to use it”), although his student Plato wrote the Socratic dialogues to preserve his work. The Luddites hated and smashed the new-fangled factory machines that threatened their work (“We wish to live peaceably and honestly by our labour” 1), but used various appliances to make their point and meet their goals. And while many people love their horses more than their automobiles, (“One can get in a car and see what man has made. One must get on a horse to see what God has made” 2), those very cars and trailers are irreplaceable in the lives of nearly every horse lover. more…

David Zigmond: How and why do we retire? Ill omens for younger doctors

14 Sep, 16 | by BMJ

david_zigmond2The nature of our departures from our work often tells us much about what kind of problems are being left behind. The individual may escape, but what about the wider community?

The continuing troubles and discontents of junior doctors have evident newsworthiness; not so the equivalent problems in later careers. This is easy to understand: younger doctors have (we hope) a long future career ahead—that future is also our future healthcare, so we want them to be there, and in fine fettle. Older doctors will have retired from that picture: we are less concerned. more…

Amy Price: The evidence informed patient

14 Sep, 16 | by BMJ

amy_price2The journey
My work in international relief as a psychologist and cognitive rehabilitative consultant did not prepare me to be a trauma patient with brain damage. The injuries showed me we patients need to be full partners in our own healthcare and that we need a bridge. That bridge is evidence and the vehicle through which it travels is relationship and shared knowledge. To build this bridge I reinvented my destiny and trained in evidence based healthcare at the University of Oxford, where I am presently pursuing a doctorate. more…

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