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Richard Smith: Would you like to die at 75 or 150?

16 Jan, 15 | by BMJ

richard_smith_2014“Sex and death are the only things that can interest a serious mind,” said W B Yeats, so, although more of a flippant than a serious mind, I return to death after my last pondering on the subject that spread literally across the globe. I’m asking whether it would be better to live to 75 or to 150, and if you know me at all you will know my answer.

I’m asking the question because a friend sent from America two interesting articles that address the question. more…

The BMJ Today: Rabies, stroke, and screening

16 Jan, 15 | by BMJ Group

rabies_virus_particlesRabies is a neglected tropical disease that predominantly affects the most vulnerable humans—children living in the most disadvantaged areas of the poorest countries.

Many countries have successfully reduced the impact of the disease by tackling the gap between public and animal health through a concerted “one health” approach. more…

John Middleton and Jim Parle: Food crime—why should doctors care?

15 Jan, 15 | by BMJ

john_middletonJim-ParleFood crime is big business. It is everywhere. It is international. The same organised crime networks that profit from drugs, cigarettes, booze, people, or any other kind of international traffic also profit from food crime. You can call it food fraud if you wish. But we should not be tempted to think that the “horsegate” scandal was a novelty, a one off, a “fraud” with no health risks. It was a lucky accident if horsegate did not damage public health; in practice our surveillance systems and knowledge of the provenance of the meat are inadequate to tell us whether it did or not. These were the conclusions of Professor Chris Elliott of Queens University Belfast, presented last month at a meeting of the newly formed Birmingham Food Council, on which we sit. more…

Abhishek Bhartia: What can a hospital in India learn from a vineyard in Spain?

15 Jan, 15 | by BMJ

abhishek_bhartia

A lot, it turns out, about healthcare transformation.

A fifth generation wine producing family in Spain faced the challenge of transforming itself in the late 1990s. The family vineyard in the region of Priorat, south of Barcelona, had been losing money for many years and past attempts to turn it around had failed. One day in September 1998, when Ramon and Valenti Llagostera, two brothers from the family, were on the wine estate helping with harvesting, one of the brothers tasted some of the grapes and was struck by how good they were. He asked, “What if we only produced the best grapes and sold a high quality wine?” more…

Charlotte McIntyre: How to survive your surgical ARCP

15 Jan, 15 | by BMJ

charlotte_mcintyreThe Annual Review of Competence Progression (ARCP) was introduced in 2007, as part of the implementation of Modernising Medical Careers (MMC), and can be an especially daunting time for surgeons in training. Particularly, if it is your first surgical ARCP, trying to ensure that you will meet all of the expected requirements can seem like a Sisyphean task. more…

The BMJ Today: Raising funds for the fight against Ebola

15 Jan, 15 | by BMJ

BirteAfter a hiatus of more than 18 months, blogger Sandra Lako provides an update from Sierra Leone, where she has been working for the past nine years, improving access to and quality of healthcare for women and children. “A year ago I would not have believed anyone who told me that I would be in the middle of an Ebola outbreak in January 2015,” she writes. “A confirmed Ebola case in West Africa never crossed my mind. Even in May of last year, when the first positive case in Sierra Leone was announced, I could not imagine the extent to which this virus would spread throughout Sierra Leone. No one was ready for the battle we are up against.” Read more about her unique insight into the outbreak. more…

William Cayley: “Enjoy in struggling”

14 Jan, 15 | by BMJ

bill_cayley_2“Struggling is the meaning of life. Victory and defeat are in the hands of God, so one must enjoy in struggling.”

The saying above the doorway caught my attention as I settled in at my friend’s home for a weekend visit. I was a medical student, rotating at a mission hospital in rural Africa, and was visiting a friend in rural Kenya for the weekend. It was my first time away from the hospital for more than a day after arriving a few weeks prior, and it helped me frame my reflections on everything from treating patients with life stories far different from mine, working in far different conditions than my medical school in suburban Milwaukee, and even dealing with the same mundane challenges faced at home of call scheduling, prioritizing theatre time, and figuring out exactly what the supervising physician was expecting. more…

Sandra Lako: The impact of Ebola in Sierra Leone

14 Jan, 15 | by BMJ

sandra_lakoToday is the 228th day of the Ebola outbreak in Sierra Leone. A year ago I would not have believed anyone who told me that I would be in the middle of an Ebola outbreak in January 2015. A confirmed Ebola case in West Africa never crossed my mind. Even in May of last year, when the first positive case in Sierra Leone was announced, I could not imagine the extent to which this virus would spread throughout Sierra Leone. No one was ready for the battle we are up against.

To date there have been 7696 confirmed cases in the country, affecting people in every district. Still the virus is looming. It has been an incredibly challenging time for Sierra Leone. Life and work for many people has been consumed by this outbreak and sometimes it is hard to remember a time without Ebola. more…

The BMJ Today: Working all hours and alcohol use

14 Jan, 15 | by BMJ

juliet_dobsonYou would have thought that working long hours would leave people with little time left for an after work drink, but according to this meta-analysis by Virtanen and colleagues, people who have long working hours are at higher risk of alcohol use. Editorialist Cassandra A Okechukwu says that the findings of this study add impetus to further regulation of working hours as a public health intervention. She writes that the risks of working long hours cannot be ignored, especially in light of mounting pressure to exclude an increasing proportion of workers from current standards that limit working hours in Europe and other developed countries. more…

Sandesh Kotte: Reviving the public health system in Telangana, India

13 Jan, 15 | by BMJ

sandeshThe first budget for India’s newly formed state, Telangana, was presented amid a lot of hype and media attention. A cursory look at the budget shows that the allocations reflect the Telangana Rashtra Samiti (TRS) party’s promises made in their election manifesto. From the waiver of farm loans, to creating a drinking water grid, to making Telangana state the “seed bowl” of India by developing seed chains, all were part of the party manifesto. more…

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