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Mashup Score: 6Matt Morgan: Don’t lose the “why” - 2 hour(s) ago
A ward round in the intensive care unit ended with more questions than answers for the team. Only after seeing 10 critically ill patients did the hard work start: it was clear what was needed to help patients survive, but working out the “why” was more difficult. We knew that we needed to start steroids in a patient with septic shock—but why? We quickly decided that a patient recovering from a brain injury, who was weak, needed a tracheotomy—but why? And we’d already booked a brain scan for a patient after a cardiac arrest—but why? These were the questions I set the team to work on, to find the reasons behind our decisions. Ultimately, these decisions didn’t need me to make them: they were based on established international guidelines. Anyone who can follow a flowchart or use Google would have come to the same conclusions. But …
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
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Mashup Score: 4David Oliver: We should welcome Labour’s proposed 10 year NHS plan with healthy scepticism - 4 hour(s) ago
When Labour came to power in July the new health and social care secretary, Wes Streeting, promised a frank report on the current NHS. The report, led by Ara Darzi, pulled no punches about the state of the service and its challenges,12 which led Streeting to say that the NHS was “broken.”3 He also promised a working group to report back next spring on a 10 year plan.4 I want the Labour government to succeed in stabilising and improving England’s NHS, and I was glad to see an extra £22.6bn for the NHS promised in the autumn budget.5 However, any welcome for this “plan to have a plan” must be tempered with a healthy “wait and see” scepticism, for …
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet-
Any welcome for Labour’s proposed 10 year NHS plan must be tempered with a healthy “wait and see” scepticism, writes @mancunianmedic https://t.co/NC4kVzTRB2
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Mashup Score: 8The boom in fruit flavour cigarettes is driving youth smoking in Latin America—despite the tobacco industry’s promises - 5 hour(s) ago
Fruit flavour “click” or “capsule” cigarettes are an expanding market for big tobacco companies despite their promises to cut smoking and protect young people. The Examination , Salud Con Lupa , and LaBot investigate While much of the world wrestles with regulations around vapes and their many flavours, Philip Morris International (PMI) and British American Tobacco (BAT) have been pumping flavours into conventional cigarettes and fighting efforts to ban the products throughout Latin America, shows a joint investigation by The Examination and the media outlets Salud Con Lupa (Peru), and LaBot (Chile). Featuring splashy packaging, breezy names, and flavours that taste like blueberry, apple, or menthol, new varieties of cigarettes—known as click, capsule, or crush ball cigarettes (a capsule is crushed to use them, making a clicking sound)—are soaring in popularity in Latin America (fig 1). Both PMI and BAT have released dozens of new flavour capsule brands in the region in recent years—de
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet-
Fruit flavour “click” or “capsule” cigarettes are soaring in popularity in Latin America. @examinationnews, @saludconlupa, & @robotlabot investigate how these are an expanding market for big tobacco companies despite their promises to protect young people https://t.co/LNyxQwAAyO
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Mashup Score: 9Endometriosis and uterine fibroids and risk of premature mortality: prospective cohort study - 6 hour(s) ago
Objective To prospectively assess the effect of endometriosis and uterine fibroids on the long term risk of premature mortality (younger than 70 years). Design Prospective cohort study Setting The Nurses’ Health Study II, United States (1989-2019). Participants 110 091 women aged 25-42 years in 1989 without a history of hysterectomy before endometriosis or fibroids diagnosis, cardiovascular diseases, or cancer. Main outcome measures Hazard ratios (estimated by Cox proportional hazards models) for total and cause specific premature mortality according to laparoscopically confirmed endometriosis or ultrasound or hysterectomy confirmed uterine fibroids reported in biennial questionnaires. Results 4356 premature deaths were recorded during 2 994 354 person years of follow-up (27.2 years per person), including 1459 from cancer, 304 from cardiovascular diseases, and 90 from respiratory diseases. The crude incidence of all cause premature mortality for women with and without laparoscopically
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet-
Women with visually confirmed endometriosis and uterine fibroids might have a greater long term risk of premature mortality extending beyond their reproductive lifespan, suggests new study @jason19890203 https://t.co/fcfI4JuWIM
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Mashup Score: 5Road safety in Africa: a preventable public health crisis - 8 hour(s) ago
Health, economic, and social progress will stall without urgent global collaborative action Road traffic injuries are the leading killer of children and adults aged 5-29 years globally.1 Low and middle income countries are disproportionately represented in this statistic; Africa has the highest road crash mortality of all global regions. Increasing urbanisation and motorisation in many African countries are not yet matched by safer road infrastructure, safer vehicles, and public education on safer road use. Road traffic injuries rob these nations of their workforce and their future. The World Health Organization status report on road safety in the African region for 2023 highlights the urgent need for concerted global action.1 Whereas recorded road deaths have decreased by 5% globally in the past decade, in Africa they have increased by 17%. The demographics of deaths also differ. In high income countries road deaths are mostly among vehicle drivers and passengers; in Africa, half of t
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet-
"A long term plan to ramp up road safety, leading to healthier communities, would pay dividends to ensure the continent’s continued economic and social progress." A look at road safety in Africa https://t.co/JXg0DkigRV
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Mashup Score: 15What’s it like to be a patient as a doctor? - 8 hour(s) ago
Being a patient can feel alien to many doctors and can bring unique challenges. Jo Best reports For many doctors who start their medical careers as young, fit, healthy people, it can feel as though there’s an abyss between them and their patients. Doctors are the well; patients are the unwell. For most doctors, however, there will come a moment of crossing the Rubicon, from being a medical professional to being a patient. But the nature of doctors’ work can make them reluctant patients—medical knowledge can predispose doctors to self-treat, for example—while long hours make it hard for them to attend medical appointments, and understaffing of health services can put pressure on doctors not to call in sick.1 “Doctors often delay seeking treatment. They will try to diagnose themselves, and they treat themselves,” says Robert Klitzman, psychiatrist and author of When Doctors Become Patients .2 As doctors progress through their careers there’s a change in their attitude towards seeking hea
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet-
For most doctors, there will come a moment of crossing from being a medical professional to being a patient. What unique challenges can it bring? @forthebest reports https://t.co/C6UKWgkdel
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Mashup Score: 47Nurse and doctor turnover and patient outcomes in NHS acute trusts in England: retrospective longitudinal study - 9 hour(s) ago
Objective To investigate the association between monthly turnover rates of hospital nurses and senior doctors and patient health outcomes (mortality and unplanned hospital readmissions). Design Retrospective longitudinal study. Setting All 148 NHS acute trusts in England (1 April 2010 to 30 March 2019), excluding specialist and community NHS hospital trusts. Participants Yearly records on 236 000 nurses, 41 800 senior doctors (specialist, associate specialist and specialty doctors, and consultants), and 8.1 million patients admitted to hospital. Main outcome measures The panel data regression analysis used nine years of monthly observations from administrative datasets at healthcare worker and patient levels. Associations using linear and unconditional quantile regressions were estimated, including controls for seasonality and NHS hospital trust. Four hospital quality indicators (risk adjusted by patient age, sex, and Charlson index comorbidities) were used and measured at a monthly fr
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet-
High monthly turnover rates of nurses and senior doctors are associated with higher deaths for emergency patients admitted to NHS hospitals in England, finds new study @JoeMoscelli https://t.co/pHqfPhRPod
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Mashup Score: 11Extension of the PRISMA 2020 statement for living systematic reviews (PRISMA-LSR): checklist and explanation - 19 hour(s) ago
Publications of living systematic reviews (LSRs) are increasing rapidly. Guidance facilitating transparent, complete, and accurate reporting of LSRs is needed. This paper reports the development of an extension of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement for LSRs (PRISMA-LSR). The PRISMA-LSR extension includes the PRISMA-LSR checklist, the PRISMA-LSR flow diagram, reporting recommendations for the LSR status, and an explanation and elaboration document. This extension has been developed as an “add-on” to the PRISMA 2020 statement, meaning it should be used in addition to the PRISMA 2020 statement. The PRISMA-LSR extension is expected to benefit authors, editors, peer reviewers, and users of LSRs through transparent, complete, and accurate reporting of LSRs. Living systematic reviews (LSRs) are attracting attention from researchers and medical journals.12 Between 2014 (when the LSR approach first emerged3) and 2019, the rate of publi
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet-
Publications of living systematic reviews are increasing rapidly. This paper reports the extension of the PRISMA 2020 statement for living systematic reviews, with a checklist and explanations https://t.co/6G14TnjKYV
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Mashup Score: 8Coroner questions policy of waiving reporting requirements for certain medicines after deaths of three babies - 21 hour(s) ago
A UK coroner has warned of possible future deaths unless providers of unlicensed medicines face stricter requirements to report problems.1 Julian Morris, senior coroner for London inner south, delivered the warning after an inquest into the deaths of three babies who died in hospital after consuming contaminated feed. Each baby was one of a set of twins. In each case the babies were receiving total parenteral nutrition (TPN), and Bacillus cereus was recorded as one of the causes of death. Aviva Otte died aged 2 months in January 2014. She had received TPN compounded by the St Thomas’ Hospital pharmacy under an exemption from licensing requirements in section 10 of the Medicines Act 1968. Under the exemption a pharmacist may prepare a limited quantity …
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet-
A UK coroner has warned of possible future deaths unless providers of unlicensed medicines face stricter requirements to report problems. The coroner delivered the warning after an inquest into the deaths of three babies who died in hospital https://t.co/2TufyOeELt
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Mashup Score: 16Fragile promise of psychedelics in psychiatry - 22 hour(s) ago
Cédric Lemarchand and colleagues highlight weaknesses in the evidence on efficacy and safety of hallucinogens and question the use of expedited regulatory pathways The US clinical market for ketamine, estimated at $3.1bn in 2022 and expected to expand at 10.6% a year until 2030,1 is just one of many signs of renewed interest in the use of psychedelics to treat psychiatric conditions.2 Various mind altering drugs have already entered the market, including esketamine nasal spray, which the US Food and Drug Administration approved in 2019. And in 2022 the Australian Therapeutic Goods Administration (TGA) allowed psilocybin and 3,4-methylenedioxymethamphetamine (MDMA) to be prescribed by authorised physicians for psychiatric conditions such as depression and post-traumatic stress disorder. The decision was taken despite an independent scientific report commissioned by the TGA advising against authorisation because the certainty of evidence for benefits was low or very low.3 Psychedelics, t
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet-
There has been renewed interest in the use of #psychedelics for treating mental health problems. Cédric Lemarchand & colleagues highlight weaknesses in the evidence on efficacy and safety of hallucinogens and question use of expedited regulatory pathways https://t.co/UXWTqZVaK0
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"It’s important to distinguish healthcare workers’ ability to answer what to do from why we do it." We must retain the ability to ask and answer why, writes @dr_mattmorgan https://t.co/DVGVZfi5RN