World Malaria Day 2016 Since the early 2000s the world has seen considerable success in the fight against malaria, with a significant decrease in overall numbers of cases and deaths. But this success is uneven: there are still contexts where the toll of malaria is worsening and seasonal spikes in patient numbers are getting higher. Teams […]
Steve Ruffenach: Footprints old and new
A recent discovery of ancient footprints on the beach in Happisburgh, UK has set the archeological world aflutter. Scientists working at the scene have discovered pre-historic footprints left by our ancestors some 850,000 years ago. As reported by PLOS One, the details of the findings have challenged some long-standing beliefs regarding ancient human behavior and […]
Anne Gulland: Who wants to live forever?
Would you like to live to be 10,000? Or how about a more reasonable sounding 120? These were questions posed at an event organised by Intelligence Squared under the heading: the future of health, when death becomes optional. João Pedro de Magalhães, a senior lecturer at the University of Liverpool, offered some intriguing insights into […]
Natalie Blencowe and Jane Blazeby: Beyond Buxton—establishing when the time’s right for a surgical trial
In 1987 Martin Buxton observed that “it’s always too early [to evaluate] until suddenly, unfortunately, it’s too late.” This is particularly true in surgery. In most countries, there is rapid diffusion of new surgical techniques. This usually occurs without evaluation, perhaps reflecting a combination of surgeons’ enthusiasm for innovating and a misunderstanding of evidence based […]
Claire McDaniel and Daniel Marchalik: Haruki Murakami’s The Colorless Tsuluru Tazaki and the Complexity of Grief
The Doctors’ Book Club Haruki Murakami’s The Colorless Tsukuru Tazaki and His Years of Pilgrimage Invoking the ubiquity of sadness, Emily Dickinson writes: “I measure every Grief I meet With narrow, probing, eyes – I wonder if It weighs like Mine – Or has an Easier size.” Universal and elusive, everyone’s grief is both familiar and […]
Richard Smith: What are medical journals for and how well do they fulfil those functions?
Last week I gave a talk to the International Society of Medical Publication Professionals entitled “Medical journals: time for something different.” My core argument was that “Medical journals have played an important role in spreading medical knowledge, but they are now beset with problems. Some will transform, most will disappear. New forms of disseminating medical […]
Chris Ham: Statesmanship among medical leaders could help resolve the junior doctors’ dispute
Whatever the rights and wrongs of the standoff between the government and junior doctors, failure to reach agreement on a new contract is bad for patients and for staff. The all out strike planned for the end of the month will cause disruption and delay for patients, and add to the pressures on staff who […]
Paul Hodgkin: The dogs that don’t bark are the most difficult to hear
For at least the last 70 years patients have been regularly gathered in crowded outpatient clinics and left to sit in silence. Decade after decade, country after country, health systems around the world have ignored the massive potential for patients to learn from each other. Forget the rhetoric about listening and engaging patients. Just look […]
Richard Lehman’s journal review—18 April 2016
NEJM 14 April 2016 Vol 374 Fixing spinal stenosis 1413 Magnetic resonance imaging was like magic when it first appeared. Suddenly structures in the back that could only be guessed at on x-rays or even CT scans could be seen in lavish detail. It became clear that there was no such thing as a normal […]
Jeffrey Aronson: When I use a word . . . Mechanisms and evidence
To recap: my definition of a pharmacological mechanism, slightly expanded from before, is “one or more entities and activities organised spatially and temporally to interact in such a way as to be associated, depending on the milieu, with a phenomenon or phenomena”. In what ways can pharmacological mechanisms, so defined, be used as evidence? The […]