You don't need to be signed in to read BMJ Blogs, but you can register here to receive updates about other BMJ products and services via our site.

Welcome to the BMJ Open blog. BMJ Open is an open access journal, dedicated to publishing medical research from all disciplines and therapeutic areas.

Find out more about the journal here.

We will be updating the blog with news about the journal, highly accessed papers, press coverage, events and matters of interest in the open access and publishing world, and anything else that catches our eye.

Top 10 Most Read in May: Coffee and liver cancer risk, vaginal breech delivery and perinatal death, and the association between area deprivation and generalised anxiety disorder in women versus men.

14 Jun, 17 | by Ed Sucksmith

7 new entries make it into May’s top 10 most read articles. Knocking Ravnskov et al.’s study off the top spot is a systematic review and meta-analysis of coffee and hepatocellular carcinoma (HCC) by Oliver Kennedy and colleagues. Their study suggests that increasing coffee consumption by two cups per day is associated with a 35% reduction in the risk of HCC. At number 3 is a national cohort study of over 520,000 term-born singletons by researchers from Norway who have found that vaginal breech delivery is associated with an excess risk for neonatal mortality compared with vaginal cephalic delivery, but not with an excess risk for cerebral palsy. Other new entries include a large population study of generalised anxiety disorder (GAD) in the UK by researchers from the University of Cambridge, who have found that area deprivation is significantly associated with an increased risk for GAD in women, but not in men.

 

Rank Author(s) Title
1 Kennedy et al. Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose-response meta-analysis
2 Ravnskov et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review
3 Bjellmo et al. Is vaginal breech delivery associated with higher risk for perinatal death and cerebral palsy compared with vaginal cephalic birth? Registry-based cohort study in Norway
4 Ferrando et al. The accuracy of postoperative, non-invasive Air-Test to diagnose atelectasis in healthy patients after surgery: a prospective, diagnostic pilot study
5 Brignardello-Petersen  et al. Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review
6 Fenton et al. Systematic review of the association between dietary acid load, alkaline water and cancer
7 Remes et al. Sex differences in the association between area deprivation and generalised anxiety disorder: British population study
8 May et al. Autism spectrum disorder: updated prevalence and comparison of two birth cohorts in a nationally representative Australian sample
9 Bickerdike et al. Social prescribing: less rhetoric and more reality. A systematic review of the evidence
10 Li et al. Randomised controlled trial of online continuing education for health professionals to improve the management of chronic fatigue syndrome: a study protocol

*Most read figures are based on pdf downloads and full text views. Abstract views are excluded.

Top 10 most read in April: low-density-lipoprotein cholesterol and mortality in the elderly, social prescribing and non-pharmacological interventions for behavioural disturbances in older patients with dementia

8 May, 17 | by Hemali Bedi

April sees five new entries in the top 10 most read articles. Reaching number one this month is a systematic review of cohort studies by Ravnskov et al, which investigates the association between low-density-lipoprotein cholesterol (LDL-C) and mortality in the elderly. Results indicate that high LDL-C is inversely associated with mortality in most people aged over 60, questioning the validity of the cholesterol hypothesis. In light of their results, Ravnskov et al suggest that a re-evaluation of the guidelines recommending pharmacological reduction of LDL-C in the elderly is needed.

Palser et al are in at number three with a qualitative study exploring the views of people with cystic fibrosis, and those close to them, of their first experience of respiratory infection from Pseudomonas aeruginosa. Reaching number five is a systematic review assessing the evidence for the effectiveness of social prescribing. Bickerdike at al were not able to measure success or cost effectiveness due to limited detail in the data collected, but found that social prescribing is widely implemented and encouraged.

Also making its way into the top ten is a systematic review and meta-analysis by Whiting et al evaluating the risks and benefits of temporarily discontinuing medications to prevent acute kidney injury. Finally, at number 10 this month is a systematic review of systematic reviews by Abraha et el, which provides an overview of non-pharmacological interventions for behavioural and psychological symptoms in dementia (BPSD). Abraha et el found great variation in how the same treatments are applied and assessed and that conclude that music therapy and behavioural management treatments were effective for reducing BPSD.

Rank Author(s) Title
1 Ravnskov et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review
2 Fenton et al. Systematic review of the association between dietary acid load, alkaline water and cancer
3 Palser et al. Perception of first respiratory infection with Pseudomonas aeruginosa by people with cystic fibrosis and those close to them: an online qualitative study
4  Loo et al. Association between neighbourhood walkability and metabolic risk factors influenced by physical activity: a cross-sectional study of adults in Toronto, Canada
5 Bickerdike et al. Social prescribing: less rhetoric and more reality. A systematic review of the evidence
6 Williams et al. Childhood academic ability in relation to cigarette, alcohol and cannabis use from adolescence into early adulthood: Longitudinal Study of Young People in England (LSYPE)
7 Nguyen et al. Fruit and vegetable consumption and psychological distress: cross-sectional and longitudinal analyses based on a large Australian sample
8 Whiting et al.  What are the risks and benefits of temporarily discontinuing medications to prevent acute kidney injury? A systematic review and meta-analysis
9 Hoxha et al. Caesarean sections and for-profit status of hospitals: systematic review and meta-analysis
10 Abraha et al. Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series

*Most read figures are based on pdf downloads and full text views. Abstract views are excluded.

Top 10 Most Read in March: Caesarean section and for-profit status of hospitals, mental health links to diet, and weight discrimination

10 Apr, 17 | by Emma Gray

Caesarean sections and for-profit status of hospitals, the link between diet and mental health, and the effect of weight discrimination on physical activity

File:Fruits and Vegetables at Pike Place Market.jpg

The Top 10 Most Read articles in March showed great variety in topics and study types. In the top spot this month is a systematic review and meta-analysis by Hoxha et al discussing the association of for-profit status of a hospital and the odds of a woman having a caesarean section. Nguyen et al, at number four, undertake a cross-sectional study to investigate the association between fruit and vegetable consumption and the prevalence of psychological distress in middle-ages and older Australians, finding that there is potential for increased fruit and vegetable consumption in helping to reduce psychological distress. Reaching number seven this month is a study looking at the association between perceived weight discrimination and physical activity, by Jackson and Steptoe of UCL. At number eight this month we see a clinical trial comparing flucloxacillin with clindamycin to flucloxacillin alone for the treatment of limb cellulitis, while at number ten we have a pilot study carried out to inform the design of a future trial to determine the effectiveness and cost-effectiveness of a pharmacist-delivered medicines reconciliation service.

Rank Author(s) Title
1 Hoxha et al. Caesarean sections and for-profit status of hospitals: systematic review and meta-analysis
2 Burt et al. Understanding negative feedback from South Asian patients: an experimental vignette study
3 Ravnskov et al.
4 Nguyen et al. Fruit and vegetable consumption and psychological distress: cross-sectional and longitudinal analyses based on a large Australian sample
5 Williams et al. Childhood academic ability in relation to cigarette, alcohol and cannabis use from adolescence into early adulthood: Longitudinal Study of Young People in England (LSYPE)
6 Fenton et al. Systematic review of the association between dietary acid load, alkaline water and cancer
7 Jackson et al. Association between perceived weight discrimination and physical activity: a population-based study among English middle-aged and older adults
8 Brindle et al. Adjunctive clindamycin for cellulitis: a clinical trial comparing flucloxacillin with or without clindamycin for the treatment of limb cellulitis
9 Abraha et al. Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series
10 Cadman et al. Pharmacist provided medicines reconciliation within 24 hours of admission and on discharge: a randomised controlled pilot study

Most read figures are based on pdf downloads and full text views. Abstract views are excluded.

Top 10 Most Read: Negative primary care feedback from minority ethnic patients, higher caesarean sections in for-profit hospitals, adolescents’ sex and drug habits, and biased psychology

13 Mar, 17 | by Yaiza del Pozo Martin

 

 

February sees five new entries in the top 10 most read articles. At number one this month is an experimental vignette study investigating why minority ethnic groups report poorer primary care experience in patient surveys. Burt and colleagues designed an experiment in the UK to determine whether South Asian people rate simulated GP consultations the same or differently from White British. The findings suggest that the lower scores reported by Pakistani patients in national surveys represent genuinely worse experiences of communication compared to the White British majority.

Making its way up to the top and catching significant online attention, is a systematic review exploring whether researchers’ conflicts of interest are adequately reported in publications related to psychological therapies. The authors show that non-financial conflicts of interests, especially the inclusion of own primary studies and researcher allegiance, are frequently seen in systematic reviews in the field of psychology.

At number five, another systematic review and meta-analysis exploring the connections between caesarean sections and for-profit status of hospitals. Hoxha and colleagues establish that regardless of women’s risk and contextual factors, private for-profit hospitals are more likely to perform caesarean interventions to women as compared with non for profit hospitals. The authors recommend examining the incentive structures of for-profit hospitals to set strategies that encourage appropriate provision of caesarean sections.

Other new entries on February include two research papers looking at adolescent’s behaviours. The first one is an interesting epidemiological study concluding that brainy adolescents are at a reduced risk of cigarette smoking, but are more likely to drink alcohol regularly and use cannabis. The second on is a qualitative study exploring the views and experiences of young people about their school-based sex and relationship education.

The two most read articles the previous month, systematic reviews by Ravnskov et al. and Fenton et al., stay up in the ranking at the second and third positions respectively. January’s highlight article, a cohort study by Anick Bérard and colleagues indicating that antidepressants increase the risk of a wide range of organ-specific malformations, continues halfway through the ranking. Also, an enlightening survey by Boulton and colleagues reporting the unacceptably high amount of sugars hidden in drinks marketed to children continues to be highly read.

Finally, the cross-sectional study by Murdoch and colleagues investigating the lack of evidence and efficacy, and potential harmful effects, of a clinic website in Canada offering naturopathy, homeopathy, chiropractic and acupuncture to treat serious conditions such as allergy and asthma, continues to grow in popularity online. In light of the results, the authors call for a policy response to safeguard the public interest. We would like to take this opportunity to direct you to: Should doctors recommend homeopathy?

 

Rank Author(s) Title
1 Burt et al. Understanding negative feedback from South Asian patients: an experimental vignette study
2 Ravnskov et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review
3  Fenton et al. Systematic review of the association between dietary acid load, alkaline water and cancer
4  Lieb et al. Conflicts of interest and spin in reviews of psychological therapies: a systematic review
5 Hoxha et al. Caesarean sections and for-profit status of hospitals: systematic review and meta-analysis
6 Bérard et al. Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort
7 Murdoch et al. Selling falsehoods? A cross-sectional study of Canadian naturopathy, homeopathy, chiropractic and acupuncture clinic website claims relating to allergy and asthma
8 Pound et al.  What do young people think about their school-based sex and relationship education? A qualitative synthesis of young people’s views and experiences
9 Boulton et al. How much sugar is hidden in drinks marketed to children? A survey of fruit juices, juice drinks and smoothies
10 Williams et al. Childhood academic ability in relation to cigarette, alcohol and cannabis use from adolescence into early adulthood: Longitudinal Study of Young People in England (LSYPE)

*Most read figures are based on pdf downloads and full text views. Abstract views are excluded.

Identifying individuals at high risk of developing Alzheimer’s disease

7 Mar, 17 | by Yaiza del Pozo Martin

As we age, we can appreciate how our body changes in our hair, skin, and joints, letting us know that we are getting older. Alongside these obvious changes, our brain starts its own aging process too, although the symptoms might not be as noticeable. This perception mismatch is one of the key challenges in the prevention of neurodegenerative disorders.

In recent decades, thanks to the development of advanced imaging techniques, the changes occurring in our brain as we age have been observed permitting early diagnosis of neurodegenerative processes such as Alzheimer’s disease.  However, making a confident diagnosis relying on few symptoms and brain images remains challenging because some of the Alzheimer’s indicators are also an inevitable part of normal ageing.

Now, a new study published this month in BMJ Open, brings the prevention of Alzheimer’s disease a step forward.  Combining the current diagnostic imaging tests used by doctors with powerful statistical analyses, researchers propose a model that could not only help accurate early diagnosis, but also the identification of healthy people at high risk of developing Alzheimer’s disease.

Normal ageing or Alzheimer’s disease?

Alzheimer’s disease is a progressive disorder that affects between 10 and 30% of the population over 65 years of age according to the best estimates to date. The main brain areas damaged during disease progression are the cerebral cortex, responsible for our motor coordination and perception of sensory information, and the hippocampus, responsible for much of our memory. Using Magnetic Resonance Imaging (MRI) images of the brain, which reveal the anatomic structure of the brain, doctors can in most cases diagnose Alzheimer’s disease in contrast to healthy ageing. However, prevention – the identification of healthy individuals at risk of Alzheimer’s disease before brain damage occurs – is yet to be achieved. This is what this timely study by Cespedes and colleagues set out to answer: How can individuals at high risk of developing Alzheimer’s disease be identified?

 

The researchers obtained the brain images from patients from the Australian Imaging Biomarker and Lifestyle Study of Ageing (AIBL), an ongoing study which aims to discover factors potentially influencing the development of Alzheimer’s disease. A group of healthy adults, subjects having mild cognitive impairments, and Alzheimer’s disease patients had a MRI scan done every 18 months from the age of 65. The authors analysed the images obtained using an authoritative statistical technique and observed marked differences between the three groups. Comparing the volume of the hippocampus, one of the main areas affected by neuron loss during Alzheimer’s disease, allowed the identification of high-risk individuals who progressed from being healthy to having cognitive impairment over time (graphical representation below). Additionally, the researchers could detect specific time points when major degenerative events were likely to occur.

Image: graphical results representing the average volume of hippocampus in the brain against the age of the participants in healthy ageing adults (BLUE), subjects with minor cognitive impairments (GREEN) and diagnosed Alzheimer’s disease patients (RED). Note the marked differences in the hippocampus volume between the 3 groups in patients over 80 years of age. 

Clinical implications

To date, treatments that fight brain damage are used to ameliorate Alzheimer’s disease progression, but the future and ultimate goal of the research community is prevention; if individuals at high risk of Alzheimer’s disease could be confidently identified, active treatments beginning at around 50 years of age could prevent disease onset in the future. That is why using analyses such as the one described in this study could become crucial in preventing disease onset in still healthy individuals before clinically evident symptoms emerge, eradicating Alzheimer’s disease.

To learn more about the study, share it, or comment on it, please click here.

Collaboration in qualitative research: The Qualitative Health Research Symposium 2017

13 Feb, 17 | by Hemali Bedi

Hemali Bedi

I was very pleased to attend the 3rd Qualitative Health Research Symposium that was held in London, UK, on Tuesday 7th February 2017. Hosted by the UCL Qualitative Health Research Network, the focus of the symposium was enhancing engagement, co-production and collaborative meaning-making in qualitative health research. Abstracts from the symposium will be published by BMJ Open in early March.

After opening remarks from the UCL President & Provost Professor, Michael Arthur, this year’s symposium began with a number of insightful presentations that explored interdisciplinary collaboration within qualitative research. Case studies were presented by researchers from all over the world, including Argentina, Denmark and Tanzania.

Following this, a number of breakout sessions focused on new developments in qualitative research, such as the use of novel visual methods to support participant engagement, multi-sectoral collaborations in research on human-environmental health and the changing nature of healthcare organisations and how we study them.

The potential benefits of using novel visual methods to support participant engagement in qualitative research

One of the many highlights of the day was the keynote address from Professor Jonathon Tritter. He spoke about the various tensions, challenges and opportunities of patient and public involvement in qualitative research. Professor Tritter highlighted the significant differences between patient and public involvement and concluded that collaboration should be based on the recognition of these differences.

Professor Jonathan Tritter’s concluding thoughts: Who should be involved in research and what gets in the way?

Next, the poster presentations were delivered. There were a great number of interesting and thought provoking posters on display throughout the symposium. The key research themes were: culture, creativity and innovation in research, health services and systems, making research accessible to marginalised and vulnerable groups and theorising and reflecting on collaboration. Roman Kislov and Fiona Fox were voted the winners for their research titled “Enabling collaborative health research: a qualitative longitudinal study of a large-scale co-production programme” and “Insiders and Outsiders: the experience of co-researchers exploring autism in a Somali community” respectively.

The afternoon session further reaffirmed the need for interdisciplinary research teams to consist of both qualitative and quantitative researchers, as well as other health care professionals, stakeholders and policy makers. The audience was captivated by the panel discussion which followed.

Roberto Abadie spoke about the role of the broker in mixed-methods collaboration

We would like to thank all of the speakers and participants for sharing their insights and we look forward to attending the next symposium.

BMJ Open trials Penelope

6 Feb, 17 | by Yaiza del Pozo Martin

We are pleased to announce that, beginning today, BMJ Open will be providing authors with the option to trial Penelope.

Penelope is an automated online tool that checks scientific manuscripts for completeness and gives immediate feedback to authors. It has been customised to BMJ Open guidelines to help authors prepare for submission. Penelope was developed by Penelope Research in collaboration with the EQUATOR Network.

Authors have the ability to access Penelope via a link that we have included on the login page of the BMJ Open submission system. Authors provide the tool with a Word file and within minutes will receive feedback regarding aspects of a manuscript that require improvement, linking to additional resources when necessary. It is our hope that Penelope makes the submission process easier while also improving the reporting quality of submitted manuscripts.

Regarding the collaboration, James Harwood, Founder and CEO of Penelope Research, says, “Our goal at Penelope is to make publishing easier and faster, whilst also improving research integrity. BMJ staff are big contributors to the research integrity community, and I am delighted they have decided to invite their authors to use our tool”.We hope you find Penelope useful and welcome any feedback regarding your experience.

Top 10 Most Read: Antidepressant use during pregnancy, medical graduates’ preparedness for practice and E-therapies for stress, anxiety and depression

3 Feb, 17 | by Ed Sucksmith

January sees 5 new entries into the top 10 most read articles. At number 4 is a cohort study by Anick Bérard and colleagues investigating the association between first-trimester exposure to antidepressants and the risk of major congenital malformations in 18,487 depressed/anxious women from Quebec, Canada. Results indicate that antidepressants increase the risk of a wide range of organ-specific malformations. At number 6 is a systematic review and meta-analysis by Tea Reljic and colleagues suggesting that, in terminally ill patients, active treatment targeted at underlying disease does not have a demonstrable impact on overall survival compared to palliative care.

Also making its way into the top ten is a rapid review of the literature examining the preparedness of UK graduates for practice as junior doctors. Whilst the review indicates that junior doctors are well prepared in a number of different areas of practice, some problem areas are identified including safe and legal prescribing, multidisciplinary team-working, handovers, breaking bad news to patients, learning needs and reflective practice.

Other new entries this month include a systematic review of life expectancy among individuals with non-cancer chronic disease and a survey of web and smartphone apps used and recommended for stress, anxiety or depression by the National Health Service in England. Fenton et al.’s systematic review of dietary acid load, alkaline water and cancer moves up four positions to become January’s most read article.

 

Rank Author(s) Title
1 Fenton et al. Systematic review of the association between dietary acid load, alkaline water and cancer
2 Ravnskov et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review
3 Boulton et al. How much sugar is hidden in drinks marketed to children? A survey of fruit juices, juice drinks and smoothies
4 Bérard et al. Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort
5 Murdoch  et al. Selling falsehoods? A cross-sectional study of Canadian naturopathy, homeopathy, chiropractic and acupuncture clinic website claims relating to allergy and asthma
6 Reljic et al. Treatment targeted at underlying disease versus palliative care in terminally ill patients: a systematic review
7 Hole et al. How long do patients with chronic disease expect to live? A systematic review of the literature
8 Bennion et al. E-therapies in England for stress, anxiety or depression: what is being used in the NHS? A survey of mental health services
9 Monrouxe et al. How prepared are UK medical graduates for practice? A rapid review of the literature 2009–2014
10 Steele et al. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study

Most read figures are based on pdf downloads and full text views. Abstract views are excluded.

BMJ Open: highlights from 2016 in review

19 Jan, 17 | by Yaiza del Pozo Martin

In 2011 BMJ Open appeared on the medical publishing scene becoming, in only five years, the world’s largest general medical journal (2015 – Five years old and growing). Another year has passed since then, and thanks to defining our distinctive identity, and being rigorous, open and transparent, we have continued to grow consistently and steadily, publishing over 2000 articles last year.

To celebrate this new milestone in our ongoing journey, we are highlighting a selection of articles that gained significant attention in 2016 and exemplify BMJ Open’s unique approach.

 

Alcohol use: closure of the male-female gap

Systematic review – Addiction

The article that received the highest Altmetric score (1618) last year is a systematic review and meta-regression analysis confirming the closing male-female gap in alcohol use and its related harms. According to the latest Global report on alcohol and health of the WHO, in 2012, about 3.3 million deaths, 5.9% of all global deaths, were attributable to alcohol consumption. As explained in the article by Slade and colleagues from the National Drug and Alcohol Research Centre in Australia, historically, the prevalence of alcohol use and related harms has been between 2 and 12 times higher in men than women. However, the emerging evidence collected in recent decades suggests that alcohol use has changed in younger generations towards closing the male-female gap, and this is indeed what this systematic review of published literature shows.  Beyond confirming the premise, this analysis highlights the importance of working on reducing the harmful use of alcohol in both male and female youngsters as they age to prevent further deleterious effects.

Along the same lines reads this noteworthy article published last week in our Communications section. The authors explored how the UK media and online news represent women’s and men’s drinking habits to identify ways of better aligning news reporting of harmful drinking with the current evidence drawn by studies such as the one above, and the latest UK alcohol guidelines, which are gender-neutral in their recommendations. Patterson and colleagues show that the image the UK media presents of women’s ‘binge’ drinking is at odds with the existing epidemiological evidence, and may reinforce unrealistic gender stereotypes and hinder public compliance of the neutral-gender weekly alcohol consumption limits. The report emphasizes the need to engage with the media to shift its framing of ‘binge’ drinking away from specific groups and contexts, and focus it instead on the health risks of specific drinking behaviours.

Slade et al. updated Altmetrics

Patterson et al. updated Altmetrics

 

 

Confident fathers have happier children

Longitudinal observational study – Paediatrics

The third most disseminated article of last year with an Altmetric score of 1076 set out to explore the influence of paternal involvement in early child-rearing and its potential impact on the children’s pre-adolescent behavioural outcomes.

The study included more than 10,000 children that lived with both parents during the first year of age. The researchers evaluated paternal involvement during this year through fathers’ emotional response to the child; the frequency of fathers’ involvement in domestic and childcare activities; and fathers’ feelings of security in their role as parent and partner. The outcome of early paternal involvement was measured assessing the behaviour of the children as they reached 9 and 11 years of age. This long term analysis allowed Opondo and colleagues to establish that rather than the quantity of direct involvement in childcare, it is the psychological and emotional paternal involvement in children’s early upbringing, that associates with positive behavioural outcomes in children. Particularly, how new fathers see themselves as parents and adjust to the role seems to be a key factor for successful parenting.

Opondo et al. updated Altmetrics

 

 

Sweet end: ultra-processed foods and drinks

Observational studies – Nutrition and metabolism

Two enlightening observational studies published in BMJ Open last year revealed two of the main dietary sources of added sugar and emphasized the need to reduce their consumption to control weight gain, caries, and the risk of diabetes and cardiovascular disease.

The first study by Martinez-Steele and colleagues showed that ultra-processed foods, containing five times the content of added sugars than minimally processed foods, make up almost 60% of the calories and 90% of the added sugars consumed in the US. The second study, conducted in the UK, investigated the amount of sugars in fruit juices, juice drinks and smoothies marketed to children. The researchers determined that the mean sugars content in drinks marketed to children was 7 g/100 ml, which is ‘unacceptably high’ as expressed by the authors.

Source: Pixabay – Licensed under Creative Commons CC0 1.0.

The new updated WHO guideline on Sugars intake for adults and children calls for a further reduction of free sugars intake to less than 5% of total energy intake, and as demonstrated by these studies, avoiding ultra-processed foods and drinks is crucial to attain this goal.

Martinez-Steele et al. updated Altmetrics

Boulton et al. updated Altmetrics

 

 

How many failed attempts it takes to quit smoking?

Longitudinal cohort study – Addiction

Tobacco use is one of the main risk factors for a number of chronic conditions, including cancer, lung diseases, and cardiovascular disorders, and the number one cause of preventable mortality (WHO report on the global tobacco epidemic 2015). Despite the extensive awareness of the negative effects of tobacco in our health, millions worldwide continue to smoke. This is partly explained by the difficulty it takes to quit this habit, which is clearly illustrated in this quote of Mark Twain, ‘Quitting smoking is easy: I’ve done it thousands of times’.

This popular study published in BMJ Open aimed to provide a realistic approximation of the estimate number of quit attempts prior to quitting successfully, including in the analyses both successful and unsuccessful quitters. Applying different analyses to the data collected by the Ontario Tobacco Survey, the authors concluded that before quitting successfully, 30 attempts are made on average. This study helps assisting the clinical expectations of doctors and smokers alike, and establishes for the first time that for many smokers it may take 30 or more quit attempts before being successful. These striking results suggest that further increasing the frequency of these attempts could be decisive in reducing smoking prevalence.

Chaiton et al. updated Altmetrics

 

 

‘You can’t be a person and a doctor’

Qualitative research article – Medical education and training

BMJ Open has carved out a niche in qualitative research, and one of the recent highlights in this type of study design investigated the work-life balance of doctors undertaking postgraduate medical training in the UK. Generally, medical trainees spend long hours at work typically supplemented with revision and completion of other training duties. In this timely qualitative analysis published at the end of the year, researchers conducted focus groups and interviews with medical trainees and trainers exposing a lack of work-life balance that negatively impacts on the learning and well-being of medical students. Particularly, this work-life imbalance affected those with children and especially women who faced a lack of less-than-full-time positions and discriminatory attitudes.

Credit: Dr. Farouk – Licensed under Creative Commons 2.0.

 

The study revealed that to buffer some pressure of the demanding training, the profession should be looking at structural factors, such as developing a strong social support network, both fostering positive relationships at work and those with family and friends outside work, in order to reduce burnout and improve the well-being of medical trainees.

Rich et al. updated Altmetrics

 

Top 10 most read: Work-life balance of doctors in training, ultra-processed foods and added sugars in the US diet, and quality of life and visual function in patients with age-related macular degeneration

4 Jan, 17 | by Hemali Bedi

December’s top 10 most read list sees eight new entries. At number one this month is a qualitative study by Rich et al, which investigates the work-life balance of doctors undertaking post graduate mTired Docedical training in the UK. The authors conducted semistructured focus groups and interviews with medical trainees and trainers and found a lack of work life balance that negatively impacts on learning and well-being. In particular, women with children were the most affected.

Other new entries include a cross sectional study by Steele et al, which found that ultra-processed foods make up over half of all calories consumed in the US diet, and contribute to almost 90% of all added sugar intake. This study also received a press release.

Fenton et al’s systematic review on the associations between dietary acid, alkaline water and cancer incidence and treatment outcomes has dropped to fifth place in this month’s list. Jonas et al reached number six with a systematic review and meta-analysis examining the efficacy of surgery and invasive procedures for various conditions. The study concludes that the effects of surgery and other invasive procedures are uncertain, particularly in pain-related conditions.

Finally, at number 10 this month is a systematic review by Taylor et al, which looks into the affect of age-related macular degeneration (AMD) on visual function and quality of life (QoL) in patients living with the condition.

Rank Author(s) Title
1 Rich et al. “You can’t be a person and a doctor”: the work-life balance of doctors in training – a qualitative study
2 Ravnskov et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review
3 Steele et al. Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study
4 Murdoch et al. Selling falsehoods? A cross-sectional study of Canadian naturopathy, homeopathy, chiropractic and acupuncture clinic website claims relating to allergy and asthma
5 Fenton et al. Systematic review of the association between dietary acid load, alkaline water and cancer
6 Leary et al. Mining routinely collected acute data to reveal non-linear relationships between nurse staffing levels and outcomes
7 Jonas et al. To what extent are surgery and invasive procedures effective beyond a placebo response? A systematic review with meta-analysis of randomised, sham controlled trials
8 Opondo et al.  Father involvement in early child-rearing and behavioural outcomes in their pre-adolescent children: evidence from the ALSPAC UK birth cohort
9 Oliva et al. Gut feelings in the diagnostic process of Spanish GPs: a focus group study
10 Taylor et al. How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review

Most read figures are based on pdf downloads and full text views. Abstract views are excluded.