20 March

Br Med J (BMJ) http://www.bmj.com/

• 12:36
  First hepatitis D medicine is given restricted approval in Scotland after US rejection - Elisabeth Mahase Br Med J (BMJ)
  Scotland has become the first country in the UK to approve a specific treatment for the hepatitis delta virus (HDV), after it granted bulevirtide (Hepcludex) “restricted use” approval for patients with chronic infection and compensated liver disease.1The drug (2 mg powder for injection) will be (...) -- Infectious diseases, UK
• 12:31
  US state legislators propose death penalty for women who have an abortion - Janice Hopkins Tanne Br Med J (BMJ)
  Republican legislators in South Carolina have proposed a bill to change the state’s laws, making a fertilised egg or embryo a person and charging a woman who has an abortion with murder, which carries a 30 year prison sentence or the death penalty.1 Henry McMaster, the state’s Republican (...)
• 12:30
  Junior doctor strike led to 175 000 postponements, data show - Gareth Iacobucci Br Med J (BMJ)
  More than 175 000 planned hospital appointments and procedures were postponed during last week’s 72 hour strike by junior doctors, show official data from NHS England.1The release of the figures came as BMA leaders agreed to meet England’s health and social care secretary, Steve Barclay, this (...)
• 12:21
  Covid-19: US maternal mortality rose during pandemic - Janice Hopkins Tanne Br Med J (BMJ)
  Two studies show that maternal mortality in the US dramatically increased during the covid-19 pandemic and was especially severe among racial and ethnic minorities and in rural areas and small cities.12The US already has the worst maternal mortality rate among industrialised countries. The (...) -- COVID-19
• 12:06
  Gene editing: China’s new regulations contain concerning loopholes, experts warn - Elisabeth Mahase Br Med J (BMJ)
  China’s new ethics regulations are a step in the right direction in terms of overseeing gene editing research, but there are concerns that private ventures may not be covered.Joy Zhang, founding director of the Centre for Global Science and Epistemic Justice at the University of Kent, said that (...)
• 10:31
  GP training overhaul aims to boost flexibility, breadth, and quality of training - Adrian O’Dowd Br Med J (BMJ)
  GP trainees should be offered better and broader training alongside enhancements to their knowledge of technology, health inequalities, and areas of care such as mental health, says a report from Health Education England (HEE).1The report on HEE’s vision for the future of general practice (...)
• 09:06
  Trust and transformation: an agenda for creating resilient and sustainable health systems - Hans Kluge, Natasha Azzopardi-Muscat, Josep Figueras, Martin McKee Br Med J (BMJ)
  Health systems are facing unprecedented challenges as they emerge from the covid-19 pandemic. How they have responded has varied greatly. Just as with SARS in 2003, when some Asian health systems redesigned facilities to be better prepared for a future pandemic,1 we have seen new ways of (...)

17 March

Br Med J (BMJ) http://www.bmj.com/

• 19:55
  Why I wish they had composted the Pope - Richard Smith Br Med J (BMJ)
  As I wrote this piece, Pope Benedict XVI was being buried, but I wish he had been composted. Nature would have been respected, greenhouse gas emissions would have been reduced, and in little more than a month the Vatican would have had a bag of rich soil that could be used to grow something in (...)
• 18:16
  Falling employment and worsening health in the UK: connected or distinct trends? - Jonathan Cribb Br Med J (BMJ)
  Two concerning economic and social trends in the UK emerging from the covid-19 pandemic are the fall in employment of people aged 50 and over and the increase in sickness levels in the population. The drop in employment has not been caused by rising unemployment (when people are generally (...)
• 17:26
  Babies should be given peanut products between 4 and 6 months to reduce allergy, say researchers - Jacqui Wise Br Med J (BMJ)
  Researchers have called on the government to change official weaning advice, saying that peanut products should be introduced into babies’ diets during a “window of opportunity” of between 4 and 6 months of age to reduce the risk of allergy.The incidence of peanut allergy has tripled in recent (...) -- Paediatrics
• 17:00
  Birmingham trust is taking a defensive approach to patient safety matters, claims ombudsman - Clare Dyer Br Med J (BMJ)
  The Parliamentary and Health Service Ombudsman has accused one of the UK’s largest hospital trusts of taking a defensive approach to patient safety matters and refusing “to accept accountability or learn from past failings.”1The ombudsman, whose office takes final decisions on complaints that have (...)
• 16:36
  Semaglutide: should the media slim down its enthusiasm? - Margaret McCartney Br Med J (BMJ)
  “Hollywood’s favourite skinny jab is coming to the NHS,” read BBC Science Focus magazine, calling it a “weight loss game changer.”1 The Times said its arrival “could trim benefits bill.”2 The Economist’s cover story was enthusiastic: “Eat, inject, repeat—curing obesity, worldwide: The long term effects (...)
• 13:51
  Mouldy homes are damaging my patient’s health - Tamara Joffe Br Med J (BMJ)
  We must remember 2 year old Awaab Ishak. His death, the coroner concluded, was caused by exposure to mould in his home.1 We must talk about the health impacts of patients living in mouldy, damp housing.In 2000, my experienced GP trainer told me that she had only ever written one housing medical (...)
• 13:50
  Male footballers are 50% more likely to develop neurodegenerative disease, finds Swedish study - Elisabeth Mahase Br Med J (BMJ)
  Elite male footballers were 1.5 times as likely to develop neurodegenerative disease as population controls, found a study of men who played in Sweden’s top division from 1924 to 2019.1The observational study, published in Lancet Public Health, found that 8.9% of players (537 of 6007) and 6.2% (...) -- Neurology
• 13:36
  The UK’s Illegal Migration Bill will have grave consequences for health and human welfare - Sophie McCann Br Med J (BMJ)
  The UK’s Illegal Migration Bill, announced by the home secretary on 7 March 2023, will have devastating humanitarian and medical consequences for people seeking sanctuary in the UK. On a daily basis, we at MSF witness the grave impact worldwide of violent policies that focus on deterrence and (...)
• 11:17
  TikTok surgery reignites worries over doctors and social media - Shefali Malhotra Br Med J (BMJ)
  In October 2022, a Thai surgeon live streamed an operation on the social media app TikTok. The recording made its way to Twitter, causing an intense backlash. Some people complained that the doctor had violated his patient’s privacy and should be severely disciplined. But others pointed out that (...)
• 11:12
  What is the role of clinically assisted hydration in the last days of life? - Andrew Davies, Caroline Barry, Stephen Barclay Br Med J (BMJ)
  What you need to knowDecisions about the provision of clinically assisted hydration to patients in their last days of life are complex and should always be individualisedEvidence is lacking about the potential benefits and harms of clinically assisted hydration in the last days of lifeClinical (...) -- Uncertainties page

16 March

Br Med J (BMJ) http://www.bmj.com/

• 14:16
  Cancer plans are essential owing to the complexity of care - Robert A Haward Br Med J (BMJ)
  Sullivan and Aggarwal’s editorial sets out the case for, and reasons for retaining, a specific plan for cancer.1 The issues are not new, and previous experience remains relevant today.The first national cancer policy in the UK was published in 1995 by the chief medical officers of England and (...)
• 14:15
  Public health grants in England are “far too little, far too late,” says president of directors - Matthew Limb Br Med J (BMJ)
  Experts have said that the £3.53bn public health grant to English local authorities for 2023-24, just announced by the government, won’t properly fund services.Ministers said the grant allocations will give each local authority a 3.3% cash terms increase.1 Jim McManus, president of the (...)
• 13:46
  Budget fails to tackle workforce shortages and NHS funding, say critics - Matthew Limb Br Med J (BMJ)
  Leading doctors, patients’ groups, and health analysts have rounded on the UK chancellor of the exchequer, Jeremy Hunt, for ignoring critical pressures on NHS staffing and funding in his spring budget. They said that Hunt’s failure to publish an NHS workforce plan on 15 March, alongside a (...)
• 12:51
  Patient safety and strikes: aspects of love - Kamran Abbasi Br Med J (BMJ)
  Ten years on from Robert Francis’s inquiry into events at the UK’s Mid Staffordshire NHS Foundation Trust, is the NHS any safer? A recurring theme of investigations into avoidable harm, say Graham Martin and colleagues, is a failure to heed the concerns of patients and carers (...)
• 11:55
  Pensions: Doctors welcome government’s decision to abolish lifetime allowance - Gareth Iacobucci Br Med J (BMJ)
  In his spring budget for 20231 the UK chancellor Jeremy Hunt unveiled a major policy for tackling the number of senior NHS doctors reducing their hours or taking early retirement because of high taxation charges on their pensions.In a surprise move, Hunt announced a package of measures, (...)
• 11:26
  A teenager with auricular infection secondary to piercing - Xiaoting Cheng, Kevin A Peng, Bing Chen, Yilai Shu Br Med J (BMJ)
  A teenage girl presented with persistent ear pain after an uneventful piercing of her right auricle to place an earring. Five days after the piercing, she noticed otalgia adjacent to the piercing, and pain in the right side of her neck. She had no other medical conditions. Before presentation (...) -- Case Review
• 11:21
  The cost of bearing witness: watching and sharing videos of police brutality online - Michelle A Williams Br Med J (BMJ)
  In recent weeks we’ve seen an uproar ring out after police killed an unarmed Black man in the United States. I’m speaking of Tyre Nichols, who died in January 2023 after being punched, kicked, and beaten by five Memphis officers from an “elite” unit. But I could be speaking about Eric Garner, or (...)
• 11:16
  Spindle cell sarcoma on the scalp - Fang Li, Daguang Wang Br Med J (BMJ)
  This is a painless, red, nodular mass with overlying crusting on the scalp of a woman in her 50s (fig 1). The mass had been growing slowly over three years, with rapid growth in the six months before presentation. The woman had undergone hysterectomy and chemotherapy for uterine leiomyosarcoma (...)
• 11:11
  Oral anticoagulants, dementia . . . and other stories Br Med J (BMJ)
  Oral anticoagulants and dementia in people with atrial fibrillationOral anticoagulation helps to prevent stroke in people with atrial fibrillation and may also protect against cognitive decline. Atrial fibrillation puts people at increased risk of dementia because of ischaemic stroke, (...)
• 10:10
  Ann Robinson’s research reviews—16 March 2023 - Ann Robinson Br Med J (BMJ)
  AML: markers on the road to cure?Acute myeloid leukaemia (AML) is a cruel disease: 85% of those diagnosed will be dead within five years. Treatment usually consists of chemotherapy to achieve remission, often followed by stem cell transplant for those at highest risk of relapse. Stem cell (...)

15 March

Br Med J (BMJ) http://www.bmj.com/

• 10:35
  Voices from the picket lines: junior doctors speak out - Chris Stokel-Walker, Gareth Iacobucci, Elisabeth Mahase, Melina Zachariou, Charlotte Rose Br Med J (BMJ)
  Martin Whyte, Royal Victoria Infirmary, Newcastle upon Tyne“I’ve been a doctor for eight years, and all I’ve seen in that time is that workloads have become more intense. We’re not worth 26% less than we were 15 years ago. It’s a complete unwillingness to make pay appropriate for the level of (...)
• 10:41
  Psychological first aid training could help manage acute stress in junior doctors - Daniel J Chivers Br Med J (BMJ)
  Greenberg and colleagues offer valuable insights on the immediate management of acute psychological trauma—psychological first aid—in conflict zones.1 They explain that the use of peer delivered interventions can alleviate acute distress. Military personnel with supportive supervisors are less (...)
• 10:05
  Bold action is needed to strengthen primary prevention - Petra Meier, Srinivasa Vittal Katikireddi, Katherine Smith Br Med J (BMJ)
  Primary prevention tackles the underlying causes of ill health, preventing or substantially delaying onset, reducing the burden of disease in populations, and helping individuals live longer, healthier lives. In turn, this reduces pressure on health and social care systems. Primary prevention (...)
• 09:51
  What’s happened to NHS spending and staffing in the past 25 years? - John Appleby Br Med J (BMJ)
  Twenty five years ago, in the financial year 1998-99, the Department of Health in England spent £36.6bn in total, equivalent to £59bn in 2021-22 prices. The bulk of this covered the NHS but also included public health, arm’s length health bodies, and other health services. Today, in 2022-23, the (...)
• 09:46
  Comparative effectiveness of BNT162b2 versus mRNA-1273 covid-19 vaccine boosting in England: matched cohort study in OpenSAFELY-TPP - William J Hulme, Elsie M F Horne, Edward P K Parker, Ruth H Keogh, Elizabeth J Williamson, Venexia Walker, Tom M Palmer, Helen J Curtis, Alex J Walker, Colm D Andrews, Amir Mehrkar, Jessica Morley, Brian MacKenna, Sebastian C J Bacon, Ben Goldacre, Miguel A Hernan, Jonathan A C Sterne Br Med J (BMJ)
  AbstractObjectiveTo compare the effectiveness of the BNT162b2 mRNA (Pfizer-BioNTech) and mRNA-1273 (Moderna) covid-19 vaccines during the booster programme in England.DesignMatched cohort study, emulating a comparative effectiveness trial.SettingLinked primary care, hospital, and covid-19 (...) -- COVID-19

14 March

Br Med J (BMJ) http://www.bmj.com/

• 14:41
  James Duncan Donnelly - Peter Donnelly, Rob Donnelly, Katie Donnelly Br Med J (BMJ)
  After house jobs in medicine and surgery, and senior house officer posts in casualty, paediatrics, and obstetrics, James Duncan Donnelly (“Jimmy”) worked in general practice and community paediatrics before going to the Birmingham hospital board and joining the then newly emerging specialty of (...)
• 14:40
  Lawrence Guy Gardner - William Hinton Br Med J (BMJ)
  Lawrence Guy Gardner (“Lawrie”) did his elective in Bay Roberts, Newfoundland. After qualifying he moved to Elkhorn, Manitoba, Canada, with his wife, Jean, in 1965. While there he spent two years in general practice before returning to the UK in 1968. Lawrie then trained in anaesthesia at Jessop (...)
• 14:36
  Rajeev Gopal Banhatti - Ravindra Gokhale Br Med J (BMJ)
  bmj;380/mar14_8/p494/FAF1faRajeev Gopal Banhatti was born to two parents who were professors in English literature and freelance writers. He grew up in rural Maharashtra state in India. We met at Byramjee Jeejeebhoy Medical College in Pune as a freshers and became lifelong friends. Rajeev was (...)
• 14:35
  Melvin Ross - Melvin Ross Br Med J (BMJ)
  After national service as medical officer at the Guards Depot, Caterham, Melvin Ross started a new practice from scratch as a singlehanded general practitioner in Islington, north London. After a few years, and now with a partner, he joined up with another two partner practice, which soon (...)
• 14:06
  The NHS workforce crisis is a retention crisis - Malinga Ratwatte Br Med J (BMJ)
  The NHS is in the grip of chronic workforce shortages. This fact is plain to see for people working in the service and makes the daily working lives of staff increasingly difficult.Data from NHS England show that more than 9000 medical posts in secondary care were vacant in September 2022.1 In (...) -- UK
• 12:51
  Citizens should have a strong and informed voice in discussion of drug development - Cinzia Colombo, Rita Banzi Br Med J (BMJ)
  Angelis and colleagues debunk the argument that high prices are needed to sustain drug development.1 Their analysis refers to a large body of evidence showing that most drug industries invest more in selling, administrative activities—including marketing—and share buybacks than research and (...)
• 11:56
  Junior doctor strikes: Leaders urge government to drop preconditions and negotiate - Gareth Iacobucci Br Med J (BMJ)
  Junior doctors in England began a 72 hour walkout on 13 March in their ongoing dispute over pay and conditions. The strike action went ahead after the government’s 11th hour offer of talks, just before 10 pm on Friday 10 March, led to nothing after ministers agreed to talk only on the condition (...)
• 11:11
  Helen Salisbury: The new contract doesn’t deliver for GPs - Helen Salisbury Br Med J (BMJ)
  “We are drowning, and you throw bricks at us.” This was just one of the despairing responses to the latest general practice contract, published in outline by NHS England on 6 March.12With a growing population and record numbers waiting for hospital treatment, demand for GP appointments has (...) -- General practice / family medicine, UK
• 11:10
  Controlling avian influenza - Kathy Leung, Tommy T Y Lam, Joseph T Wu Br Med J (BMJ)
  Global reports of highly pathogenic avian influenza A(H5N1) in birds are increasing, with cases reported from every region except Australasia and Antarctica since 2020.1 The global spread of these avian influenza outbreaks is unprecedented, exacting large economic losses to poultry industries (...)
• 11:10
  Healthcare leadership: the medical education chief executive - Kathy Oxtoby Br Med J (BMJ)
  Johann Malawana will be recognisable to many as the former chair of the BMA’s junior doctors committee, leading negotiations during their dispute in 2015.“Throughout that time, I drew on the negotiating skills I’d developed over a decade of involvement with the BMA. I learnt about resilience, (...)

13 March

Br Med J (BMJ) http://www.bmj.com/

• 17:01
  Intercalation helps to develop doctors with a more holistic approach to medicine - Reagan Lee, Oscar Han Br Med J (BMJ)
  Intercalation gives UK medical students the chance to take a year out of their medical programme to obtain another degree in a discipline of interest. These degrees can range from medicine adjacent subjects like anatomy or pharmacology to those outside the scope of the usual medical curriculum, (...)
• 16:00
  Why COP28 must be a health COP - Emma L Lawrance, Mala Rao Br Med J (BMJ)
  The start of the year is a time of reflection, of looking forward to the future and resolving to make life changes with positive improvements. Making resolutions is important and worthwhile; it signals the optimism that a better future is possible and can inspire others to join shared goals.Our (...)
• 11:36
  Five US medical associations form coalition against gun violence - Janice Hopkins Tanne Br Med J (BMJ)
  Five major US medical associations have formed a coalition to work towards ending the nation’s epidemic of gun violence, which it has called “a public health crisis.”1Gun related injury is now the leading cause of death for US children and adolescents aged 1 to 19, replacing automobile accident (...)
• 11:26
  Girls’ education and the future of healthcare in Afghanistan - Ahmad Neyazi, Bijaya Padhi, Ranjit Sah, members of the Global Centre for Public Health Collaborators Br Med J (BMJ)
  On 15 August 2021, after the US government’s decision to withdraw its troops from Afghanistan, the Taliban invaded Kabul and took control of the country. Under Taliban control, government workers, minority groups, and supporters of the coalition forces are particularly vulnerable. Women and (...)
• 11:20
  Doctors have a role in tackling air pollution: here’s how some are rising to the challenge - Sally Howard Br Med J (BMJ)
  The case for a greater role for doctors in the UK’s air pollution problem has been growing over the past two years. Public officials, parents, and doctors themselves are calling for increased education for medical professionals about the link between air quality and health (box 1)—and for them to (...)
• 10:01
  Prepared health systems provide quality care at all times - Blerta Maliqi, Rachael Hinton, Minara Chowdury, Sanam Roder-DeWan, Achama Eluwa, Munir Kassa Br Med J (BMJ)
  The provision of good quality healthcare is fundamental to population health, preventing avoidable deaths and building population trust in services.1234 Every year, an estimated eight million people in low and middle income countries die from conditions that would have been treatable with (...)
• 10:00
  Networks of care to strengthen primary healthcare in resource constrained settings - Enoch Oti Agyekum, Katherine Kalaris, Blerta Maliqi, Allisyn C Moran, Andrews Ayim, Sanam Roder-DeWan Br Med J (BMJ)
  High quality primary healthcare is a cornerstone of country strategies to achieve universal health coverage but has been difficult to implement and scale. Systemic challenges such as lack of coordination and an inadequate health workforce limit the reach and impact of primary healthcare, which (...)
• 10:00
  Service delivery redesign is a process, not a model of care - Sanam Roder-DeWan, Supriya Madhavan, Savitha Subramanian, Kojo Nimako, Talib Lashari, Amith Nagaraj Bathula, Ramkumar Sathurappan, Sampath Kumar, Mickey Chopra Br Med J (BMJ)
  Achievements in expanding access to care will not result in better health outcomes without wider measures to improve quality of care. In 2018, the Lancet Global Health Commission on High Quality Health Systems proposed a fundamental shift from small scale quality improvement interventions (...)

12 March

Br Med J (BMJ) http://www.bmj.com/

• 18:06
  Strikes are a grim prospect, but a broken NHS is worse - Jennifer Darlow Br Med J (BMJ)
  At a time of constant news reports in the UK of different professional groups taking industrial action, a doctors’ walkout could easily be lost in the clamour to be heard. Yet the decision, as with any health professional choosing to strike, is multifaceted and never simple.When it comes to the (...)

10 March

Br Med J (BMJ) http://www.bmj.com/

• 19:50
  When I use a word . . . . Data—usage and ownership - Jeffrey K Aronson Br Med J (BMJ)
  Data—singular or plural?Having used etymology and grammar to settle the question of the singularity or plurality of the word “data” (it appears to swing both ways, although it’s usually plural1), we can add to the evidence by determining how people use the word in practice. In doing so we have in (...)
• 18:26
  What we learnt from the Matt Hancock WhatsApp revelations - Andy Cowper Br Med J (BMJ)
  Most of the time, the health sector doesn't have to think too much about its former secretaries of state for health.Occasionally, they have enlightened second lives as chairs of the House of Commons Health and Social Care Select Committee—as both Stephen Dorrell and Jeremy Hunt did. Their deep (...)
• 17:26
  Sixty seconds on . . . petrol pumps - Mun-Keat Looi Br Med J (BMJ)
  Mmm, benzene . . .You may like the aroma of petrol, but visits to the pumps could become rarer in Hawaii if the state government gets its way. It’s just passed a bill requiring climate change warnings to be displayed on all pumps in a bid to reduce consumption. If signed into law it would be the (...)
• 14:06
  Covid-19: Latin America must reduce its reliance on medical imports - Luke Taylor Br Med J (BMJ)
  Countries across the Americas and the Caribbean must bolster their surveillance of covid-19 and continue to vaccinate against the disease if they are to leave the pandemic behind, senior officials at the Pan American Health Organization (PAHO) said at a press conference on 10 March.The PAHO (...) -- COVID-19
• 13:56
  Cardiologists in Romania illegally reused cardiac devices taken from dead patients, prosecutors allege - Owen Dyer Br Med J (BMJ)
  Seven doctors formed a network in Romania that harvested implantable cardiac defibrillators from recently deceased patients and transplanted them into 238 other patients who believed they were receiving new devices, charges filed at the country’s highest court have said.“A large proportion of the (...) -- Cardiovascular medicine
• 12:31
  Strikes, patient outcomes, and the cost of failing to act - Ryan Essex, Sorcha A Brophy, Veena Sriram Br Med J (BMJ)
  Growing demands on healthcare workers have seen them become more vocal about their dissatisfaction with the conditions of the health systems in which they work. In the first year of the covid-19 pandemic, there were at least 6500 protests by healthcare workers globally, a 62% increase from (...)
• 11:11
  Retention of ethnic minority staff is critical to resolving the NHS workforce crisis - Katherine Woolf, Padmasayee Papineni, Susie Lagrata, Manish Pareek Br Med J (BMJ)
  The English NHS is facing the biggest workforce crisis in its history with nearly 1 in 10 positions vacant.1 A 2022 report from the World Health Organization European region identified the UK as having the lowest number of medical doctors, nurses, midwives, and dentists per 10 000 population in (...)
• 09:46
  Pay satisfaction among junior doctors plummeted in 2022, shows staff survey - Gareth Iacobucci Br Med J (BMJ)
  Satisfaction with pay among NHS staff has fallen sharply in the past 12 months, particularly among junior doctors, results1 from the annual NHS staff survey show.Findings for 2022 show that the number of junior doctors satisfied with their pay has halved in a single year—from 34.5% to 17.1%. (...)
• 09:25
  WHO regional director is fired for abusive conduct - Mun-Keat Looi Br Med J (BMJ)
  The World Health Organization has dismissed Takeshi Kasai, the regional director for its Western Pacific region, for abusive conduct.The move follows accusations of racism and abuse, which led to Kasai being placed on leave in August 2022.1 It is the first known instance of a regional director (...)

9 March

Br Med J (BMJ) http://www.bmj.com/

• 15:16
  Caring for young people with gender dysphoria - Kamran Abbasi Br Med J (BMJ)
  The debate on gender dysphoria perfectly captures all that is unsavoury about the intersection of science, medicine, and social media. Entrenched, even aggressively argued views are nothing new in science and medicine. But when it comes to gender dysphoria, just as with covid-19, there is (...)
• 14:56
  Gender equal leadership makes all kinds of sense - Helen Clark, Phumzile Mlambo–Ngcuka, Maria Fernanda Espinosa Garces, Gabriela Cuevas Barron Br Med J (BMJ)
  Gender equality is off track—according to a recent report by the United Nations, 300 years off track.1In a world of multiple crises, we find it surprising that gender equality is not a priority for most political leaders. Mounting evidence shows that the health and resilience of our communities (...)
• 13:31
  Data privacy: a decade of confusion - Alison Stone, Chris Carrigan Br Med J (BMJ)
  Iacobucci’s article on a general practice withdrawing from a kidney screening pilot after patients voiced concerns emphasises the urgent need for clear guidance for practices and patients about the ways that patient data are used, including the purposes of direct care and secondary purposes.1We (...)
• 13:01
  Nitrous oxide: Advisory panel rejects calls for ban on recreational use - Jacqui Wise Br Med J (BMJ)
  A government commissioned review has concluded that the possession of nitrous oxide should not be banned, but that additional measures are needed to tackle non-legitimate supply.1The decision by the Advisory Council on the Misuse of Drugs (ACMD) comes despite reports of an increase in (...)
• 12:56
  Salt intake: 97% of the world is failing to cut consumption, warns WHO - Mun-Keat Looi Br Med J (BMJ)
  Just 3% of the world’s population is protected by mandatory policies that would reduce the level of salt to healthy levels, according to a report from the World Health Organization.1Only nine countries—Brazil, Chile, Czech Republic, Lithuania, Malaysia, Mexico, Saudi Arabia, Spain, and (...)
• 12:26
  Tom Nolan’s research reviews—9 March 2023 - Tom Nolan Br Med J (BMJ)
  The eight survival secretsEat better, be more active, quit tobacco, get healthy sleep, manage weight, control cholesterol, manage blood pressure, and manage blood sugar: the American Heart Association’s “Life’s Essential 8” sounds a lot like my long abandoned list of New Year’s resolutions. A (...)
• 12:06
  Type 1 objections should not impede direct care - Paul Affleck Br Med J (BMJ)
  The case of a general practice withdrawing from an NHS commissioned pilot with a private company to provide kidney screening at home after patients raised data privacy concerns is fascinating.1 Had type 1 objections been applied, other patients who had registered such an objection could have (...)
• 11:16
  Hibiscus-like retinal haemorrhages - Qiang Wang, Ying Lin Br Med J (BMJ)
  This image of the fundus gives the appearance of a hibiscus in full bloom (fig 1), and is caused by subretinal and intraretinal haemorrhages seen on funduscopy around the left optic disc. The patient, a woman in her 20s, presented with 10 days of painless vision loss in her left eye, with no (...)
• 11:11
  A decade after Francis: is the NHS safer and more open? - Graham Martin, Susanna Stanford, Mary Dixon-Woods Br Med J (BMJ)
  It is 10 years since Robert Francis published the three volume report of the public inquiry into failings at Mid Staffordshire NHS Foundation Trust.1 Few will need reminding of the harrowing accounts of care at Stafford Hospital or the inquiry’s damning verdict—covering not just the trust but (...) -- Patient authored
• 11:10
  Sport for older adults . . . and other stories Br Med J (BMJ)
  Cardiac arrest in older adultsSports activity in older adults benefits both mental and physical health. But might there also be risks? A study from the west coast of the USA quantified the chances of sport related sudden cardiac arrest in people 65 years and older. Fortunately, the probability (...)
• 00:30
  A patient’s perspective on mental health and the pandemic - Sarah Markham Br Med J (BMJ)
  It is disappointing that countless critically important questions in mental health remain unanswered. Money has been wasted funding poor quality research that will be of little value to the many people who have mental health conditions. As a patient with a mental health disorder, I was sad to (...)

8 March

Br Med J (BMJ) http://www.bmj.com/

• 11:01
  How the Taliban are destroying female doctors in Afghanistan - Sally Howard, Geetanjali Krishna Br Med J (BMJ)
  Maria Zubair, a third year female medical student in Jalalabad who aspires to general practice, has been unable to attend classes since 18 December 2022 when the Taliban suspended university education for women.1 “The day after the ban we found that the door to the hospital was blocked for women (...)
• 10:56
  Swollen gums in a young adult - Adeline Hillan, Michael F Leahy Br Med J (BMJ)
  A woman in her 20s presented to the emergency department with a three week history of gingival swelling (fig 1), purulent exudate from the gums, and pain. At a previous dental review in the weeks before presentation the patient had been prescribed two courses of oral antibiotics for presumed (...) -- General practice, Haematology, Oncology, Case Review
• 10:41
  Inequities in managing and representing mpox - Alexandra Cardoso Pinto Br Med J (BMJ)
  An important, and often neglected, area of inequity is the choice of images promoting understanding of diseases such as mpox. The article by Mansour and colleagues recommends the use of “credible and diverse images.”1Imagery used in the field of infectious disease has repeatedly demonstrated (...)
• 10:40
  Ensuring equitable access in lessons learnt from mpox - Ayolola O Eni-Olotu Br Med J (BMJ)
  Mansour and colleagues discuss management of mpox;1 it is crucial to remember that, before this multi-country outbreak, mpox was endemic in several African countries—and also to ensure that responses to this outbreak reach endemic countries.23 Indeed, lessons learnt from decades of recurrent (...)
• 10:10
  The health workforce crisis in Europe is also a gender equality crisis - Hans Kluge, Natasha Azzopardi-Muscat Br Med J (BMJ)
  Europe’s health workforce is facing an unprecedented crisis. Shortages, long term sick leave, burnout, salary gaps, poor career prospects—these are but some of the troubles plaguing the healthcare sector in the WHO European Region, covering 53 countries across Europe and Central Asia. The fact (...)

7 March

Br Med J (BMJ) http://www.bmj.com/

• 16:16
  Wellcome displays art that shares the pain of migraine - Alison Shepherd Br Med J (BMJ)
  bmj;380/mar07_9/p544/FAF1faWellcome CollectionBetween 1980 and 1987 the British Migraine Association ran four art competitions to share impressions from across the world of people’s experience of migraine.Competitors were asked to express the pain created by the condition, using any material and (...)
• 14:41
  Industrial action: ask the government questions and wait for the answers - Hannah Walker Br Med J (BMJ)
  Limb discusses whether and why doctors are considering strike action.1 It is crucial to ask the government specific questions and to wait for the answer; silence is an extremely powerful bargaining tool. When will the workforce plan be published, for example?Which other public safety profession (...)
• 11:46
  Burnout: NHS staff haven’t recovered from pandemic’s effects, says leading doctor - Gareth Iacobucci Br Med J (BMJ)
  The NHS should be systematically measuring the mental health of its workforce and making wellbeing a “strategic priority” in response to the high levels of burnout since the covid-19 pandemic, a leading anaesthetist has urged.Kevin Fong, a consultant anaesthetist and chair of public engagement (...) -- COVID-19
• 12:31
  GPs to consider industrial action after NHS England imposes contract - Gareth Iacobucci Br Med J (BMJ)
  NHS England has imposed a contract on GPs that will start in April, prompting GPs’ leaders to renew their promise to discuss the possibility of industrial action.In a letter sent to GPs on 6 March,1 NHS England outlined changes to the contract for 2023-24 that had not been agreed with the BMA’s (...) -- General practice / family medicine, UK
• 11:16
  Molnupiravir and risk of hospital admission or death in adults with covid-19: emulation of a randomized target trial using electronic health records - Yan Xie, Benjamin Bowe, Ziyad Al-Aly Br Med J (BMJ)
  AbstractObjectiveTo emulate a randomized target trial to estimate the association between the antiviral drug molnupiravir and hospital admission or death in adults with SARS-CoV-2 infection in the community during the omicron predominant era who were at high risk of progression to severe (...) -- COVID-19
• 11:11
  Helen Salisbury: Benchmarking and unrealistic guidelines - Helen Salisbury Br Med J (BMJ)
  In their personal statements, medical school candidates often wax lyrical about embarking on a journey of lifelong learning in the ever changing worlds of science and medicine. These days I have to admit that my journal reading is scant, and the blessed internet provides most of the information (...) -- General practice / family medicine, UK
• 11:06
  Why I . . . run half marathons - Kathy Oxtoby Br Med J (BMJ)
  “It’s important to do something outside medicine that brings a sense of joy and personal accomplishment,” says Nicole Nation, a second year GP trainee.Currently on the Torbay vocational training scheme in Devon, she also believes it’s important to find an outside interest to boost your mental (...)

6 March

Br Med J (BMJ) http://www.bmj.com/

• 13:11
  An interprofessional strategy can strengthen secondary prevention - Arnaud Chiolero, Valerie Santschi Br Med J (BMJ)
  Clinical intervention for the secondary prevention of cardiovascular diseases is efficient and needs strengthening, as advocated by Whitty and colleagues.1 But how to make that happen with the shortage of healthcare providers and ageing populations? One path is the implementation of an (...)
• 12:46
  Insulin: Eli Lilly cuts price to $35 a month in US after pleas from patients and president - Janice Hopkins Tanne Br Med J (BMJ)
  The giant drug company Eli Lilly has reduced the price of its insulins to $35 (£27; €31) a month for the US’s eight million insulin dependent patients with diabetes, after campaigns by patients’ advocates and President Joe Biden.1Eli Lilly’s insulin prices in the US have risen by 1000% over the past (...) -- Diabetes
• 12:11
  Covid-19: US studies show racial and ethnic disparities in long covid - Janice Hopkins Tanne Br Med J (BMJ)
  Black and Hispanic Americans are more likely than white Americans to have symptoms of long covid and some people who had covid early in the epidemic may have long covid but not be diagnosed as such because of coding changes, show studies funded by the National Institutes of Health.123Long covid (...) -- COVID-19
• 11:41
  BMA pledges to end sexism in medicine and tackle gender discrimination in healthcare - Adele Waters Br Med J (BMJ)
  The BMA is appealing to organisations across the healthcare sector to stamp out sexism in the medical profession.Among the 10 goal pledge (box 1) is a call for senior doctors to “call out sexism” and be responsible and accountable for tackling their own bias.Box 1The NHS’s 10 goalsEliminate sexism (...)
• 11:31
  WHO keeps covid-19 a public health emergency of international concern - Jodie McVernon, Jonathan Liberman Br Med J (BMJ)
  On 30 January 2023 the director general of the World Health Organization, Tedros Adhanom Ghebreyesus, announced his decision that covid-19 remains a public health emergency of international concern (PHEIC),1 three years after the emergency was first declared.2 In doing so, Tedros acknowledged (...) -- COVID-19
• 11:26
  Sharp Scratch episode 88: Nothing like Grey’s Anatomy - Charlotte Rose Br Med J (BMJ)
  In this very fun episode of Sharp Scratch, we talk about our favourite medical TV shows. We play some of our favourite clips from popular medical TV programmes and discuss whether our experiences as medical students and new doctors compare. In this episode, I was joined once again by panellists (...)
• 11:21
  A front row seat for the exodus—is the NHS crisis scaring medical students away? - Alice Barber Br Med J (BMJ)
  Over the past year, I and many other medical students have witnessed a growing number of doctors and other healthcare professionals leaving the NHS. This is supported by wider data. A survey of 4553 junior doctors by the British Medical Association found that four in 10 junior doctors plan to (...)
• 11:10
  Secondary prevention must include treating tobacco dependence - Nicholas S Hopkinson Br Med J (BMJ)
  The call to ensure a comprehensive approach to secondary prevention—defined by Whitty and colleagues as “evidence based, preventive measures to help stop or delay disease, taken during an interaction between an individual patient and a clinician”—is welcome.1I was surprised, though, to see no (...)

3 March

Br Med J (BMJ) http://www.bmj.com/

• 16:21
  Sixty seconds on . . . fishbone doctors - Mun-Keat Looi Br Med J (BMJ)
  Oh my cod, what’s this?According to the Wall Street Journal1 doctors in China are adept at getting diners off the hook—or removing fish bones lodged in their throats. And there is a growing network of at least 11 specialised fishbone clinics, many located south of the Yangtze river that runs (...)
• 15:16
  Canada’s promise to reform drug prices left in doubt as regulator is hit by wave of resignations - Owen Dyer Br Med J (BMJ)
  An ambitious promise by Canada’s Liberal government to radically cut drug prices in one of the world’s most expensive markets seems to be in tatters after a flurry of resignations from its independent regulator.Last week saw the surprise departure of Douglas Clark, the executive director of the (...)
• 14:46
  Global cost of overweight and obesity will hit $4.32tn a year by 2035, report warns - Elisabeth Mahase Br Med J (BMJ)
  More than half (51%) of the global population will be living with overweight or obesity within 12 years unless prevention, treatment, and support improve, the World Obesity Federation has said.1In its World Obesity Atlas 2023, the federation said the economic impact of overweight and obesity on (...)
• 14:26
  Scrutiny of Hancock’s handling of the pandemic is far from over - Gareth Iacobucci Br Med J (BMJ)
  The erstwhile health secretary turned reality TV “star” Matt Hancock is back in the headlines.On Sunday 26 February, Hancock was asked to explain why he appeared to be wearing a signed Newcastle United shirt that he had previously auctioned off to raise money for charity. A Magpies fan since his (...)
• 12:41
  Abortion: UN is urged to intervene in “human rights crisis” in US after ending of rights - Mun-Keat Looi Br Med J (BMJ)
  Five international charities have called on the United Nations to act over what they have described as the “human rights crisis” in the United States in the wake of the Supreme Court’s 2022 abortion ruling to restrict access to services for millions of women.In an open letter the charities plead (...) -- Obstetrics and gynaecology
• 11:16
  Continuous glucose monitoring - Dana M Lewis, Tamara K Oser, Benjamin J Wheeler Br Med J (BMJ)
  What you need to knowContinuous glucose monitoring (CGM) is the preferred glucose monitoring method in most recent guidelines (ADA/EASD/ISPAD) for people with insulin-requiring diabetes, but it is also suitable for all people with diabetesAccuracy of CGM is close to that of finger stick blood (...) -- Therapeutics
• 11:06
  So you want to be a writer? An introduction to BMJ Student - Charlotte Rose, Pat Lok, Nikki Nabavi, Anna Harvey Bluemel, Laura Nunez-Mulder Br Med J (BMJ)
  Correspondence to: C Rose croseⓐbmj.com (or ⓐCharl_Rose24 on Twitter)What is BMJ Student?BMJ Studentis a section of The BMJ, a general medical journal that publishes content aimed at a diverse audience—from doctors and researchers to patients and the public. Student content is published online (...)
• 09:31
  Leadership diversity and equality in the medical workforce - Wahyu Wulaningsih Br Med J (BMJ)
  Being a female international medical graduate (IMG) doctor from a minority ethnic background, I can attest to the diversity in the junior NHS workforce. Such diversity is less apparent in many leadership roles, however, as highlighted by Reynolds and L’Esperance in their editorial.1I welcome the (...)
• 09:26
  Reducing commercial influence over guidelines won’t fix poverty but is still worth striving for - Lisa Parker, Lisa Bero Br Med J (BMJ)
  We agree with Braillon that the health of the public is well served by attending to the social determinants of health,1 but diet is an important plank in the public’s health and promoting healthy eating is a global matter.23We welcome suggestions for removing healthcare providers from a market (...)
• 09:16
  Stalled improvements in mortality and life expectancy predate the pandemic - Gerry McCartney, David Walsh Br Med J (BMJ)
  The UK chief medical officers are right to be concerned about recent high mortality.1 They focus on the lower-than-expected uptake of important cardiovascular interventions, and how increasing uptake might help. The framing of the causes of high mortality is, however, medicalised and (...)

2 March

Br Med J (BMJ) http://www.bmj.com/

• 14:46
  For integrated care systems to succeed private providers of clinical care must be removed from boards - Richard L Symonds Br Med J (BMJ)
  MPs on the House of Commons Public Accounts Committee have warned that the introduction of integrated care systems (ICSs) will not succeed unless government tackles longstanding problems in the NHS.1ICSs are a welcome, radical change to the ludicrous purchaser-provider system imposed on the NHS (...)
• 14:40
  H5N1: Has there been human-to-human transmission, and do we have a vaccine? - Elisabeth Mahase Br Med J (BMJ)
  What’s happening in Cambodia?Much of the spotlight has been on Cambodia in the past week, where an 11 year old girl died after being infected with an H5N1 virus. The girl, from Prey Veng province in the south of the country, was admitted to the National Paediatric Hospital on 21 February with (...) -- Infectious diseases
• 14:31
  Negotiating a pandemic accord: a promising start - Precious Matsoso, Roland Driece, Tovar da Silva Nunes, Ahmed Soliman, Kazuho Taguchi, Viroj Tangcharoensathien Br Med J (BMJ)
  The World Health Assembly took a historic decision at its special session in December 20211 to establish an Intergovernmental Negotiating Body (INB) to draft and negotiate an international instrument on pandemic prevention, preparedness, and response. At its first meeting,2 the INB elected (...)
• 14:30
  Reinventing surgical careers for parents and carers - Kamran Abbasi Br Med J (BMJ)
  Women want to work in surgery, but it’s a career ambition many struggle to achieve (doi:10.1136/bmj.p449).1 Those that do start often leave. Surgery is notoriously inhospitable to women (https://www.nuffieldtrust.org.uk/research/future-proof-the-impact-of-parental-and-caring-responsibilities-on-surgi
• 12:41
  Locum surgeon is struck off for failing to call for help during botched appendectomies - Clare Dyer Br Med J (BMJ)
  A former locum consultant general surgeon has been struck off the UK medical register after he twice failed to call for help during botched emergency laparoscopic appendectomies, prompting theatre staff to take emergency measures.On one occasion a theatre scrub nurse refused to give Luigi (...)
• 11:31
  An unexpected ECG finding - Qinghua Chang, Zhaolong Xu, Ningning Fu, Renguang Liu Br Med J (BMJ)
  A woman in her 60s presented to hospital for a second cycle of postoperative adjuvant chemotherapy with docetaxel and cyclophosphamide, having received her first cycle 19 days previously. She had received a diagnosis of left breast cancer six weeks earlier, for which she had undergone modified (...) -- Case Review
• 11:26
  Replacing RCTs with real world data for regulatory decision making: a self-fulfilling prophecy? - Beate Wieseler, Mattias Neyt, Thomas Kaiser, Frank Hulstaert, Jurgen Windeler Br Med J (BMJ)
  Key messagesEnthusiasm is growing for the use of observational real world data as a basis for regulatory, clinical, and health policy decision makingBut such study designs are ill suited to measure the treatment effects of new drugsPromoting the use of observational studies from routine (...)
• 11:21
  A stone in a balloon - Catherine Smith, Rabi Nambi Br Med J (BMJ)
  This appearance of a firm calcified nodule within a fluid filled sac (fig 1) is characteristic of a bullous pilomatricoma. It is a bullous variant of a pilomatricoma, a benign tumour arising from hair matrix cells that frequently occurs in children and young adults.1 This woman in her late (...)
• 11:11
  Hyponatraemia . . . and other stories Br Med J (BMJ)
  Low serum sodiumChronic hyponatraemia (serum sodium < 136 mmol/L) is common in older people and is usually caused by an increase in vasopressin mediated water reabsorption. A study of more than 8000 people finds that, although acute hyponatraemia can lead to neurological complications, (...)
• 10:01
  Tom Nolan’s research reviews—2 March 2023 - Tom Nolan Br Med J (BMJ)
  Disseminated and necrotising mpox as an AIDS-defining conditionA landmark case series in the Lancet shows the deadly effects of mpox (monkeypox) and establishes the necrotising form of illness as an AIDS-defining condition. The collaboration between clinicians in 19 countries gathered data on (...)
• 00:31
  Financing covid-19 mRNA vaccines - Victor Roy Br Med J (BMJ)
  Since the launch of their covid-19 vaccines, Moderna and Pfizer have accumulated more than $100bn (£83; €94) in global revenues from sales—more than 20 times the World Health Organization’s biennial budget in 2020-21.123 Yet for a vaccine that is estimated to cost $1-3 per dose to manufacture, both (...) -- COVID-19
• 00:30
  Inequities in surgical outcomes by race and sex in the United States: retrospective cohort study - Dan P Ly, Mariah B Blegen, Melinda M Gibbons, Keith C Norris, Yusuke Tsugawa Br Med J (BMJ)
  AbstractObjectiveTo assess inequities in mortality by race and sex for eight common surgical procedures (elective and non-elective) across specialties in the United States.DesignRetrospective cohort study.SettingUS, 2016-18.Participants1 868 036 Black and White Medicare beneficiaries aged 65-99 (...)
• 00:30
  US public investment in development of mRNA covid-19 vaccines: retrospective cohort study - Hussain S Lalani, Sarosh Nagar, Ameet Sarpatwari, Rachel E Barenie, Jerry Avorn, Benjamin N Rome, Aaron S Kesselheim Br Med J (BMJ)
  AbstractObjectiveTo estimate US public investment in the development of mRNA covid-19 vaccines.DesignRetrospective cohort study.SettingPublicly funded science from January 1985 to March 2022.Data sourcesNational Institutes of Health (NIH) Report Portfolio Online Reporting Tool Expenditures and (...) -- COVID-19

1 March

Br Med J (BMJ) http://www.bmj.com/

• 13:36
  NICE recommends online therapies to treat depression and anxiety in adults - Gareth Iacobucci Br Med J (BMJ)
  The National Institute for Health and Care Excellence (NICE) has conditionally recommended eight digital therapies to treat depression1 and anxiety2 disorders in adults.Draft guidance proposes rolling out the technologies as treatment options for disorders including post-traumatic stress (...)
• 11:56
  As well as improving outcomes and efficiency, integrated clinical academic training can be a tool for retention - Anna Harvey Bluemel Br Med J (BMJ)
  Recent appeals to the health secretary to protect and expand the clinical academic workforce in the UK have pointed out that doctors who are trained in both a clinical specialty and research are crucial to the continued efficient functioning of the NHS and good outcomes for patients.1 The (...)
• 11:41
  UK’s fertility law is inflexible and does not reflect modern practice, says regulator - Elisabeth Mahase Br Med J (BMJ)
  The Human Fertilisation and Embryology Authority (HFEA) has proposed changes to the UK’s 30 year old fertility law, saying that it does not reflect modern fertility practice and is inflexible in responding to scientific innovation.1The proposed changes, which are under consultation, include (...) -- Obstetrics and gynaecology, General practice / family medicine, UK
• 11:01
  Cholera: World Health Organization warns of rising cases in Africa - Columbus Mavhunga Br Med J (BMJ)
  The World Health Organization has warned that Africa is seeing an exponential rise in cholera and diarrhoea cases amid a global surge.This year alone, the continent has recorded cholera cases in Burundi, Cameroon, Democratic Republic of the Congo, Ethiopia, Kenya, Malawi, Mozambique, Nigeria, (...)
• 10:36
  Advertising for blood test ruled misleading by the Advertising Standards Authority - Jacqui Wise Br Med J (BMJ)
  A multiple blood testing panel marketed to the public as “FREE if we don’t find anything” has been found to breach advertising standards codes.Numan, a company providing treatment for men’s health problems, advertised on its website a “fear nothing blood test” checking 17 or 21 biomarkers.The (...)
• 10:31
  David Oliver: Delayed discharges harm patients, staff, and health systems alike - David Oliver Br Med J (BMJ)
  In the 1965 Hollywood film The Agony and the Ecstasy Rex Harrison’s Pope Julius II repeatedly asks Charlton Heston’s Michelangelo, who is painting the Sistine Chapel ceiling, “When will you make an end of it?” only to be answered, “When it is finished.”1Similar scenes play out daily on NHS adult (...) -- Emergency medicine, UK
• 10:26
  MPs call for reassessment of NHS recovery plans after lack of progress - Adrian O’Dowd Br Med J (BMJ)
  Plans for the NHS in England to get cancer and elective care targets back on track after the impact of covid-19 are failing and should be re-examined, according to MPs.The backlog on cancer and elective care waiting times is not being dealt with quickly enough and in some cases is getting worse (...)

28 February

Br Med J (BMJ) http://www.bmj.com/

• 12:36
  Antoni Naczk - Johnny McDonagh, Gregor Campbell Hewson Br Med J (BMJ)
  bmj;380/feb28_10/p419/FAF1faAntoni Naczk came to Edinburgh from St Mungo’s RC High School, Alloa, in 1980. He had all the enthusiasm of a boy going to the city for the first time, which may have been his own personal circumstances. With his gregarious nature, he was soon known to everyone simply (...)
• 12:35
  John Robson Owen - Michael J Owen, David K Owen Br Med J (BMJ)
  bmj;380/feb28_8/p418/FAF1faJohn Robson Owen was the only child of Norah and Jimmy Owen, born in Gravelly Hill, near Birmingham, in the last month of the 1920s. He was the first person in his family to attend university. After house jobs in Dudley, national service in the Royal Army Medical (...)
• 12:35
  David Beckitt - Sarah Wild Br Med J (BMJ)
  bmj;380/feb28_9/p424/FAF1faMy maternal uncle, David Beckitt, had an unusual start to his medical career. After A levels in Latin, Greek, and History he joined the civil service and worked in the Inland Revenue until he was called up for national service. As a conscientious objector he was told (...)
• 12:31
  Government’s handling of strikes is “dysfunctional and bizarre,” say experts - Elisabeth Mahase Br Med J (BMJ)
  The UK is experiencing a wave of strikes across the public sector, from doctors and nurses to railway workers, teachers, and civil servants. These account for hundreds of thousands of workers, who are mostly taking industrial action over pay.But despite unions sending warning signals to the (...)
• 12:16
  Long NHS waits and rising living costs are harming people’s health, show ONS data - Matthew Limb Br Med J (BMJ)
  People’s health and wellbeing are continuing to be affected by rising living costs and difficulties accessing NHS services this winter, new Office for National Statistics (ONS) data show.ONS’s latest winter survey, published on 27 February, found 70% of adults in Great Britain who were waiting (...)

27 February

Br Med J (BMJ) http://www.bmj.com/

• 19:56
  Can the new major conditions strategy deliver on its aims? - Layla McCay Br Med J (BMJ)
  Ever since the UK government’s health disparities white paper receded into the long grass last year, NHS leaders have been perturbed. Various other mooted plans for specific challenges like mental health, have also been scrapped. Given the government’s levelling up health mission to narrow the (...)
• 17:06
  Sharp Scratch episode 87: It’s not ?ust you, medicine is weird - Charlotte Rose Br Med J (BMJ)
  In this light-hearted episode of Sharp Scratch, we talk about how strange medicine can be. We discuss what happens when we start medical school and have to start doing things that conflict with how we would usually act. To talk more about this, I was joined by regular panellist and foundation (...)
• 17:01
  Covid-19 in Australia: How did a country that fought so hard for extra time end up so ill prepared? - Catherine M Bennett Br Med J (BMJ)
  When the covid-19 pandemic began, Australia was in a global subgroup of countries that, as island nations, could close their international borders to buy time to prepare for community transmission of SARS-CoV-2. Australia only fully opened its borders to international visitors in February 2022, (...) -- COVID-19
• 16:11
  Joginder Kumar Anand: a frequent and insightful rapid responder - Azeem Majeed Br Med J (BMJ)
  I was very sorry to hear about the death of J K Anand.1 Although we never met, he was a frequent poster of online rapid responses to BMJ articles including many of my own. He sometimes also emailed me about my articles in The BMJ. He was always very polite in his communications with me. (...)
• 15:01
  Joginder Kumar Anand’s support and generosity eased our transition to the NHS - Annette de la Court, Bea Hemmen, Fabienne Michielsen, Ineke Ruting, Isabelle Streng Br Med J (BMJ)
  We were very sad to learn of the death of J K Anand—Jog to his friends.1 In the late 1980s, we, a group of recent EU graduates, were tempted by Anand, who was medical director, to come and work in East Anglia at Peterborough District Hospital and later the Edith Cavell Hospital. At the time (...)
• 14:46
  Former GP and paediatrician is jailed for amassing a million indecent images of children - Clare Dyer Br Med J (BMJ)
  A former GP who was caught with one of the largest hauls of child sexual abuse images ever seen by the National Crime Agency has been sentenced to two years and two months in prison.David Shaw, 48, who was arrested four years ago at his former home in Maidstone, Kent, pleaded guilty last (...) -- Paediatrics, General practice / family medicine, UK
• 12:11
  Antiphospholipid syndrome: advances in diagnosis, pathogenesis, and management - Jason S Knight, D Ware Branch, Thomas L Ortel Br Med J (BMJ)
  AbstractAntiphospholipid syndrome (APS) is a thrombo-inflammatory disease propelled by circulating autoantibodies that recognize cell surface phospholipids and phospholipid binding proteins. The result is an increased risk of thrombotic events, pregnancy morbidity, and various other autoimmune (...) -- US, State of the Art
• 11:23
  Continued use of the situational judgment test raises many questions - Ikenna I Ogbu Br Med J (BMJ)
  For as long as the situational judgment test (SJT) has been used in selecting foundation doctors, there have been questions regarding its suitability for purpose and its contribution to trainee attrition.1234The statistically significant (...)
• 11:10
  The tale of snakebite’s fleeting spotlight—and why it encapsulates all that’s wrong with global health - Robert Fortner Br Med J (BMJ)
  Snakebites may kill as many as 120 000 people a year. As the most recently recognised neglected tropical disease (NTD), declared in 2017, snakebite received a surge of funding and momentum in 2019 when the World Health Organization announced a goal to halve deaths from snakebite by 2030.1And (...) -- Emergency medicine
• 10:36
  Junior doctors in England to strike for 72 hours from 13 March - Elisabeth Mahase Br Med J (BMJ)
  Junior doctors in England will take strike action for three days next month in a 72 hour walkout from Monday 13 March, the BMA has announced.The union’s representatives said that the health and social care secretary for England, Steve Barclay, had left them with no choice but to act after the (...)

24 February

Br Med J (BMJ) http://www.bmj.com/

• 19:31
  Responding to the crisis of care - Iona Heath, Victor M Montori Br Med J (BMJ)
  Healthcare is in crisis across most of the globe, and perhaps particularly in our two countries of the United States and the United Kingdom, both of which appear more disunited than ever by the greed and carelessness that drive socioeconomic and political polarisation, and the systematic (...)
• 17:56
  Transparency about emergency department waits should improve patient care - Katherine Henderson Br Med J (BMJ)
  Will NHS England’s new Delivery Plan for Recovering Urgent and Emergency Care Services1 stop deaths resulting from delays in emergency care? That must surely be its highest priority. Emergency department performance and ambulance response times are at an all time low, and data describe failures (...)
• 14:36
  E-cigarettes: FDA issues fines to four companies for selling unapproved vapes - Janice Hopkins Tanne Br Med J (BMJ)
  The US Food and Drug Administration has fined four companies that made and sold e-liquids (vapes) used in e-cigarettes. It is the first time the FDA has filed complaints seeking financial damages against tobacco product manufacturers because they violated its requirements for premarket review (...) -- Smoking and tobacco
• 13:56
  Care home residents already benefit from a full digital workflow from prescription to administration - Clive E Bowman Br Med J (BMJ)
  Patel and colleagues enthusiastically champion shared medication records through a digital “single version of the truth” but miss the opportunity to recognise that for one population this is already in effect.1 Care home residents are benefiting from increasingly capable electronic medicines (...)
• 13:41
  Sixty seconds on . . . milk alternatives - Mun-Keat Looi Br Med J (BMJ)
  Soy what’s the story?After much deliberation, the US Food and Drug Administration has ruled that oat and soy milk can be called milk.No wey . . .Yes way. According to new draft guidance,1 these products don’t pretend to be real dairy, so it’s not a problem in the eyes of the regulator. Fortified (...)
• 11:16
  Orthostatic tachycardia after covid-19 - Ana B Espinosa-Gonzalez, Harsha Master, Nicholas Gall, Stephen Halpin, Natalie Rogers, Trisha Greenhalgh Br Med J (BMJ)
  What you need to knowTachycardia on standing or minimal exertion may occur after covid-19 and may cause substantial functional impairmentWhen assessing a patient with tachycardia, consider potential causes including autonomic dysfunctionMeasures to reduce tachycardia can greatly improve (...) -- COVID-19
• 11:06
  A diverse public health workforce is more important than ever - Kazim Beebeejaun, Kerry Littleford Br Med J (BMJ)
  The covid-19 pandemic provided an opportunity to learn and rethink what a well equipped public health workforce looks like. To tackle health inequalities meaningfully and build long term trust with deprived communities in the UK, we must first confront inequities and biases in our own (...)
• 11:01
  In 1938 the Beano introduced satire to children’s literature - Stewart Forsyth Br Med J (BMJ)
  The uniqueness of the Beano is that the characters not only are rebellious and play pranks on each other but also challenge aspects of society that impact their freedom. Adults are generally overbearing, self-righteous, and flawed. Teachers, police, politicians, Hitler, royalty, and celebrities (...)
• 11:00
  Maternal health is now deteriorating in much of the world, UN report shows - Luke Taylor Br Med J (BMJ)
  The World Health Organization has warned that maternal health has been declining in many parts of the world since 2016, halting 15 years of progress.A report1 by WHO on behalf of UN agencies, published on 23 February, said that while maternal deaths are largely preventable with quality (...) -- Obstetrics and gynaecology
• 10:55
  Christopher Teik-Kooi Khoo: plastic and reconstructive surgeon with an interest in the regulation of cosmetic surgery - Rebecca Wallersteiner Br Med J (BMJ)
  bmj;380/feb24_1/p452/FAF1faChristopher Teik-Kooi Khoo was born in Singapore. His mother, Adeline Phoa, was a veteran of the anti-Japanese resistance, and his father, Khoo Oon Teik, was a distinguished nephrologist who established the first renal dialysis unit at the Singapore General Hospital (...)

23 February

Br Med J (BMJ) http://www.bmj.com/

• 13:01
  The NHS paid private hospitals pound2bn in the pandemic: did taxpayers get value for money? Br Med J (BMJ)
  This article (BMJ 2023;380:p329, doi:10.1136/bmj.p329, published 15 February 2023) has been updated to clarify that the name of the organisation is Nuffield Health rather than Nuffield.
• 12:36
  Covid-19: Death rate gap for ethnic minorities closes, ONS data show - Jacqui Wise Br Med J (BMJ)
  There is no longer evidence of higher covid-19 mortality among ethnic minority groups compared with white people in England, latest data1 from the Office for National Statistics (ONS) show.The news was welcomed, but a small increase in covid-19 mortality in the white British group during 2022 (...) -- COVID-19
• 12:06
  Scotland making poor progress on covid recovery plan, auditors find - Bryan Christie Br Med J (BMJ)
  The NHS in Scotland is struggling to recover from the covid-19 pandemic and an honest and open public discussion is needed about the challenges facing the service, a public spending watchdog has warned.In its latest annual review1 of the service, Audit Scotland said growing financial pressures, (...) -- COVID-19
• 11:56
  Evaluation of effectiveness and safety of pharmacist independent prescribers in care homes: cluster randomised controlled trial Br Med J (BMJ)
  An error was introduced into this paper by Holland and colleagues (BMJ 2023;380:e071883, doi:10.1136/bmj-2022-071883, published 14 February 2023) during the editing process. In the results section, the falls rate should be 1.55 per resident in the intervention arm and 1.26 per resident in the (...)
• 11:31
  Ann Robinson’s research reviews—23 February 2023 - Ann Robinson Br Med J (BMJ)
  Tackling global myopiaMyopia is a growing global problem, especially in Asia. By 2050, half of the world’s population is likely to be myopic. The earlier in life it develops, the greater the risk of high myopia and poor vision in later life. Getting children to spend more time outdoors helps (...)
• 11:30
  Ten thousand steps . . . and other stories Br Med J (BMJ)
  How many steps a day?Ten thousand steps a day is widely promoted as a target for healthy living. Fortunately, a meta-analysis of eight prospective studies with a total of more than 20 000 participants confirms that this is good advice. Among older adults—the mean age of the participants was 63 (...)
• 11:26
  Help! My trusted doctor is retiring - Wim JR Rietdijk Br Med J (BMJ)
  In 2011, I received a diagnosis of Hodgkin’s lymphoma. It was a period that has affected me ever since. I received nine months of chemotherapy—and in retrospect this seems a little bump along the way—but I was admitted to hospital several times with severe side effects. I also had months of (...) -- What your patient is thinking
• 11:21
  A traumatic elbow injury - Jiahao Meng, Weijie Liu, Shuguang Gao Br Med J (BMJ)
  A man in his 30s attended the emergency department after falling on his left arm while playing basketball. He was unable to move his forearm and experienced persistent dull pain. Examination showed an obvious elbow deformity with a depression, dark red ecchymosis, and left elbow swelling. There (...) -- Spot Diagnosis
• 11:11
  Healthy masculinities and the wellbeing of young men and boys - Ravi K Verma, Nalini V Khurana Br Med J (BMJ)
  Andrew Tate, the British-American social media personality and self-proclaimed misogynist, recently made headlines for his arrest on charges of rape and human trafficking. Alongside much global condemnation, Tate has received a massive wave of support—millions of young men and boys look up to (...)

22 February

Br Med J (BMJ) http://www.bmj.com/

• 15:01
  Transplant centres should match patients by suitability rather than location, says report - Elisabeth Mahase Br Med J (BMJ)
  Centres for the assessment and repair of organs before transplantation should be set up in England to enable better use of donations, a report by the Organ Utilisation Group said.1 The report, commissioned by the government, reviewed how the organ transplant system operates and potential (...)
• 13:01
  Cannabis consumption by UK teens is a ticking time bomb, warns president elect - Adele Waters Br Med J (BMJ)
  The incoming president of the Royal College of Psychiatrists has called for a public information campaign to be launched about the consequences to British teenagers of regularly smoking cannabis.Shubulade Smith, who takes up the post in July, warned that high consumption was associated with a (...) -- Psychiatry
• 12:31
  Consultant suspended for clinical failings is struck off after new charges - Clare Dyer Br Med J (BMJ)
  A locum consultant gynaecologist who was suspended for clinical failings has been struck off the UK medical register after a High Court judge sent his case back to the same tribunal to hear new charges against him.The Professional Standards Authority appealed to the court against the suspension (...) -- Obstetrics and gynaecology
• 12:01
  Politicians should back more radical action on primary prevention, says England’s CMO - Gareth Iacobucci Br Med J (BMJ)
  Elected leaders should support more radical action to tackle major problems such as air pollution, smoking, and obesity, England’s chief medical officer has told MPs.Giving evidence1 to the Health and Social Care Committee on 21 February to kick off its inquiry into prevention,2 Chris Whitty (...)
• 10:31
  Mpox: Clinicians identify severe form with high mortality in advanced HIV patients - Elisabeth Mahase Br Med J (BMJ)
  An international collaboration of clinicians has identified a severe, necrotising form of mpox which carries a high mortality in immunosuppressed people with HIV.1Clinicians from 19 countries provided data on 382 confirmed cases of mpox in people with HIV infection between 11 May 2022 and 18 (...)
• 10:21
  To improve mental healthcare we first need to build respect for psychiatry - Adele Waters Br Med J (BMJ)
  When Shubulade (Lade) Smith takes up the presidency of the Royal College of Psychiatrists (RCPsych) in July, she will be following her late father’s advice.She didn’t have the role in her sights when the election campaign kicked off last year, because she was focused on making the regular journey (...)
• 10:10
  Interpreting an estimated glomerular filtration rate (eGFR) in people of black ethnicities in the UK - Kathryn Griffiths, Rouvick Mariano Gama, June Fabian, Mariam Molokhia Br Med J (BMJ)
  What you need to knowMore people of black African or black Caribbean ethnicity will meet criteria for chronic kidney disease (CKD) diagnosis when ethnicity adjustment for estimated glomerular filtration rate (eGFR) calculation is not usedClassification and clinical coding of early CKD (...) -- Practice pointer
• 10:10
  Banning conversion therapy for trans people - Joz Motmans, Pieter Cannoot, Guy T’S?oen Br Med J (BMJ)
  Michelle Donelan, now the UK secretary of state for science, innovation, and technology, recently announced the government’s intention to propose a bill prohibiting conversion therapies that aim to change a person’s sexual orientation or gender identity.1 Contrary to earlier announcements,2 the (...)
• 10:05
  Effect of a multifaceted antibiotic stewardship intervention to improve antibiotic prescribing for suspected urinary tract infections in frail older adults (ImpresU): pragmatic cluster randomised controlled trial in four European countries - Esther A R Hartman, Alma C van de Pol, Sil?e Rebekka Heltveit–Olsen, Morten Lindbak, Sigurd Hoye, Sara Sofia Lithen, Par–Daniel Sundvall, Sofia Sundvall, Egill Snaeb?ornsson Arnl?ots, Ronny Gunnarsson, Anna Kowalczyk, Maciek Godycki–Cwirko, Tamara N Platteel, Wim G Groen, Annelie A Monnier, Nicolaas P Zuithoff, Theo J M Verhei?, Cees M P M Hertogh Br Med J (BMJ)
  AbstractObjectiveTo evaluate whether antibiotic prescribing for suspected urinary tract infections in frail older adults can be reduced through a multifaceted antibiotic stewardship intervention.DesignPragmatic, parallel, cluster randomised controlled trial, with a five month baseline period (...)

21 February

Br Med J (BMJ) http://www.bmj.com/

• 17:56
  Colombia divides over new health plan - Alison Shepherd Br Med J (BMJ)
  bmj;380/feb21_8/p411/FAF1faDaniel Romero/Long Visual Press/AlamyThousands of people in Colombia have taken to the streets to rally in favour of proposed health reforms put forward by President Gustavo Petro. Petro, who became the South American country’s first left wing president when he was (...)
• 14:11
  Ken Bagshawe: physician, scientist, and innovator in medical oncology - Michael J Seckl, Richard Begent, Surinder Sharma Br Med J (BMJ)
  bmj;380/feb21_7/p365/FAF1fabagshawe150223.f1Ken Bagshawe was a senior registrar in cardiology at St Mary’s in the mid-1950s when two unusual cases of pulmonary hypertension caused him to change his specialty to medical oncology. The first, a young woman who died from unexplained pulmonary (...)
• 13:36
  Managing opioid withdrawal in hospital starts in the community - Wahyu Wulaningsih Br Med J (BMJ)
  Having worked in a few of the busiest London hospitals as a junior doctor, I can vouch for the NIHR study’s finding on the difficulty in clarifying substitute opioids required out of hours.1 The Improving Hospital Opioid Substitution Therapy project is a promising avenue to help junior staff (...)
• 12:41
  A lucky man: the country GP - Kathy Oxtoby Br Med J (BMJ)
  General practitioner John Rees feels he is a fortunate man. A GP partner at Llanfair surgery, situated in a small rural community in Llandovery, Carmarthenshire, he says, “I feel lucky to have known and been the GP for five generations of local families.“Many of our patients’ families have lived (...)
• 12:36
  Matt Morgan: Hand over your invisible patients - Matt Morgan Br Med J (BMJ)
  My colleague in intensive care looked tired. Numerous patient stickers were stuck at skewed angles on the computer screen. Paperwork covered the desk like patchwork, including death certificates and transfer letters. Yet the intensive care unit (ICU) behind them was serene.“Not much to hand over (...) -- Intensive care
• 11:41
  Junior doctors in England set to strike next month after 98% back action - Gareth Iacobucci Br Med J (BMJ)
  Junior doctors in England have voted overwhelmingly to take strike action over pay and will stage a 72 hour walkout next month, the BMA has announced. The vast majority (98%) of junior doctors who voted backed strike action, with a turnout in excess of 77%.More than 47 600 junior doctors in (...)
• 11:06
  Helen Salisbury: Unfit fit note proposals - Helen Salisbury Br Med J (BMJ)
  Last week, we heard that GPs are to be encouraged to sign fewer fit notes as this will boost Britain’s flagging economy by getting people back to work.1 This particular kite has, according to the Telegraph, been flown jointly by the Treasury and the Department of Work and Pensions—and it is (...) -- General practice / family medicine, UK
• 10:06
  A competent and compassionate approach to opioid withdrawal in hospital - Joss Bray Br Med J (BMJ)
  The NIHR review of hospital policies on the management of opioid withdrawal is probably overdue.1 People who need opioid substitution therapy often have a difficult time in hospitals. Addiction is a strong driver to behave in certain ways, but I have found that using a competent and (...)

20 February

Br Med J (BMJ) http://www.bmj.com/

• 17:36
  Four tests for WHO leadership on sexual exploitation, abuse, and harassment - Sophie Harman Br Med J (BMJ)
  The World Health Organization wants you to know it is cleaning up its act on sexual exploitation, abuse, and harassment (SEAH). This follows a long history of women being diminished and abused by men associated with WHO, and a recent exposé published in the Telegraph.1 WHO says it has been busy (...)
• 17:16
  The NHS paid private hospitals pound2bn in the pandemic: did taxpayers get value for money? Br Med J (BMJ)
  This article (BMJ 2023;380:p329, doi:10.1136/bmj.p329, published 15 February 2023) originally stated that Rishi Sunak and Wes Streeting were holding discussions with the private sector about how it might help reduce NHS waiting times. It has been corrected to clarify that Sunak is holding such (...)
• 17:11
  Doctors back move to offer free school meals to every primary pupil in London - Gareth Iacobucci Br Med J (BMJ)
  Paediatricians have welcomed the decision to offer every primary school pupil in London free school meals, hailing the move as a major boost to tackling child health inequalities during the cost of living crisis.The scheme, announced by the mayor of London Sadiq Khan on 20 February, will be (...)
• 13:56
  #NoTrainingToday #NoSurgeonsTomorrow - Deborah M Eastwood Br Med J (BMJ)
  When undertaking trauma and orthopaedic surgery, we work as a team, and we rely on the presence of a “whole team.” And therein lies the key issue for us at present: the workforce crisis. Our recent survey indicated that 60% of our consultant staff intend to retire from the NHS within eight years (...)
• 11:11
  The WHO Foundation and conflicts of interest - Agnes Binagwaho, Kedest Mathewos Br Med J (BMJ)
  In 2021, the World Health Organization Foundation accepted a $2.2m donation from the multinational food and drink company Nestlé to support WHO’s Covid-19 Solidarity Response Fund.1 This caused controversy, given Nestlé’s non-compliance with the International Code of Marketing of Breastmilk (...)
• 11:10
  Rigid opiate agonist treatment programmes risk denying people their agency - Judy Chang Br Med J (BMJ)
  Opportunities to deliver opioid agonist treatment (OAT) for drug dependency more flexibly emerged during the covid-19 pandemic, as lockdowns and social distancing restrictions led to the suspension of strict treatment policies in many settings across the world. The daily supervision of (...)
• 11:06
  Using elective theatre capacity at the weekend could improve NHS surgery - Coonoor Chandrasekar Br Med J (BMJ)
  The single most important measure to fix the “inefficiency” of NHS surgery is the use of elective theatre capacity during weekends.1 This requires motivated staff with appropriate remuneration and incentives to take on the additional workload. Having the whole team on board can help. Not taking (...)
• 10:38
  Change in the NHS should be moulded to local needs - Steven Ford Br Med J (BMJ)
  Coombes says that we need innovative solutions to repair the NHS.1 Change is the only certainty. Change instituted by all the professions in healthcare will be of much greater value to patients than change that is politically driven. Change that is wrought at the front line and moulded to local (...)