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Neel Sharma: Reforms in medical education—are we missing something?

22 May, 15 | by BMJ

Medical education has seen significant change over the past decade and more. Advances in teaching, learning, and assessment strategies are vast. The didactic lecture form of teaching is no longer the flavour of the month it seems with more and more emphasis on problem and team based learning. Classrooms are seeing the use of mobile devices to allow for rapid learner access to information and instructors are now tasked with the need not to simply disseminate information but to ensure understanding and provide appropriate feedback. Classes are being “flipped” and the MOOC movement has meant that attending face to face teaching is slowly becoming a non-existing entity. more…

A gap in the evidence—what is the role of surgery in the patient with severe (secondary) Raynaud’s phenomenon?

21 May, 15 | by BMJ


This blog is part of a series of blogs linked with BMJ Clinical Evidence, a database of systematic overviews of the best available evidence on the effectiveness of commonly used interventions.

By Ariane Herrick and Lindsay Muir

People with Raynaud’s phenomenon secondary to an underlying disease or condition (the best researched one being systemic sclerosis) can progress to irreversible tissue injury with ulceration and/or critical ischaemia and gangrene. Although there has been increasing interest in recent years in identifying new drug therapies for severe Raynaud’s phenomenon with randomised controlled trials (RCTs) of, for example, phosphodiesterase inhibitors and endothelin receptor antagonists, the recent new BMJ Clinical Evidence overview identified no RCTs of any of the surgical procedures that have been advocated for advanced peripheral vascular disease. Specifically, there have been no RCTs of any of the following interventions: botulinum toxin injections, surgical debridement, peripheral (digital, digital plus ulnar and/or radial artery) sympathectomy, cervical/thoracic sympathectomy, arterial reconstruction, or amputation. more…

Tessa Richards: Fewer tablets, more self management support

21 May, 15 | by BMJ

Tessa_richardsIt’s easy to lose confidence and withdraw from life when you become ill and lose your job. “Anne” struggled for 20 years with multiple long term conditions and a drug regimen of 28 tablets a day before going on a six week self management course which “turned [her] life around.” She and other patients spoke eloquently at a recent meeting organised by The Health Foundation on how such courses gave them the motivation, knowledge, and skill to question what best management meant for them, change their behaviour, and reach self defined goals. Doctors should routinely “prescribe” self management courses for patients with long term conditions—and do so soon after diagnosis, not 20 years later, the meeting concluded. more…

The BMJ Today: Tobacco, tennis, and “unmitigated quackery”

21 May, 15 | by BMJ

cigarettes_darkAn investigation by The BMJ into attempts by big tobacco to prevent the introduction of plain packaging of cigarettes has revealed that MPs and peers accepted gifts from the tobacco industry, including tickets to the men’s final at Wimbledon and the opera at Glyndebourne. Jonathan Gornall’s article showed that 38 MPs received a total of £60,000 of industry hospitality between the time when changes were first mooted in 2010 and the vote this year. more…

Sue Hogston: “We only have one chance to get it right, so why are some still getting end of life care so wrong?”

20 May, 15 | by BMJ

Sue Hogston_Today’s report by the parliamentary and health service ombudsman demonstrates that end of life care could be improved for up to 355 000 people a year; highlighting tragic cases where people’s suffering could have been avoided or lessened with the right care and treatment.

Issues identified in the report as the most common within end of life care were: more…

David Oliver: Do bring me problems

20 May, 15 | by BMJ

david_oliver_2015In her book Smile or Die: How Positive Thinking Fooled America and the World, Barbara Ehrenreich brilliantly deconstructed this cult. Her starting point was her own diagnosis of breast cancer and the bullying attitude that if you don’t “fight” the cancer and stay “positive” in the face of distress and worry, then your demise is your own doing. She showed how these exhortations to think positively had permeated thinking in many aspects of policy, business, careers, and “self-actualisation.” Jenni Murray referred to this as seeing “the glass as half full even when it lies shattered on the floor.” On a recent day on call, I bonded with another physician over her irritation at this US business phenomenon entering UK healthcare, while also agreeing that some NHS staff have embraced the equally unhelpful cult of “negative thinking.” more…

Daniel Barrett: Will a seven day NHS push primary care recruitment from crisis to catastrophe?

20 May, 15 | by BMJ

I listened with personal interest as the new conservative government re-launched its grand plan to deliver a “seven day health service.” In a little over a year I will be beginning life as a junior doctor along with thousands of others, all starting to question where our careers are heading. The answer for many of us could well be tied up inextricably with the fate of the “seven day NHS.” more…

The BMJ Today: Patients let down by end of life care, seven day working, and a letter from Australia

20 May, 15 | by BMJ

palliative_care• A new report has found that terminally ill people are enduring painful and distressing deaths through failure by the NHS in England to properly manage care at the end of life. The concerning findings from the parliamentary and health service ombudsman are summarised here by The BMJ’s correspondent Clare Dyer. more…

David Payne at Health 2:0 Europe 2015

20 May, 15 | by BMJ Group

logo_conferencia_bcn_okIs the Uber minicab model fit for healthcare? Why are doctors terrible digital adopters? And can the medical workforce benefit from using applications which promise virtual doctors on demand?

These questions and others were debated at day 1 of technology conference Health 2:0, an annual event which profiles “international innovation in patient-provider communication, consumer health, data analytics, and more.” more…

Pallavi Bradshaw: Should employers have access to employees medical records?

19 May, 15 | by BMJ

pallavi_bradshawFlying has become an integral part of modern life, whether for pleasure or business. I have never been a nervous flyer although I would be lying if I said that I don’t get a little nervous, like most, when there is unexpected turbulence. For that split second, you worry about engine failure or a terrorist act, but never that the pilot is going to down the plane. The suicide and mass murder by Andreas Lubitz of the Germanwings plane shocked the world and ignited a debate about privacy and medical confidentiality. more…

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