Another evidence booster for the quadrivalent vaccine today. Controlled clinical studies have shown it almost completely prevents high grade cervical abnormalities, and now a BMJ paper has confirmed that even in the messy, real world it confers a risk reduction of 46% for these, and also of 34% for other cervical abnormalities. Whilst this is obviously great news for women, the authors stress we need to rapidly review cervical screening in this new era of prevention.

The benefit of pursuing chemotherapy at the end of life is less clear cut, as Michael Rabow argues it’s a difficult decision with potentially unexpected consequences. Commenting on a linked paper led by Alexi Wright, he reflects on the finding that choosing palliative chemotherapy was associated with a whole set of outcomes that may not have been known, expected, or discussed by patients, their family caregivers, and their oncologists.

What’s in a name? The difference between paternalism and pragmatism, say Bruce Summers and Caroline Dover today, as they mull over a tide of -itides and syndromes they conclude are spurious labels.

And finally, a farewell to Eyad Rajab el-Sarraj, the first psychiatrist to practice in the Gaza strip. In the most violent weeks of the areas history, and in a culture where mental illness was kept quiet, he established a programme which now has 40 specialists tackling problems from post traumatic stress disorder and suicide bombing, to depression, domestic violence, and alcoholism.

Harriet Vickers is assistant multimedia editor, BMJ.