Sparing developing countries the fate of obesity associated diseases that plague the developed world is currently one of the most pressing global public health issues. Before we export wholesale the “follow the food pyramid, exercise, and eat no more calories than you burn” approach, it may be time to review how effective it actually is. […]
William Cayley: Continuity—in and out of hospital in the US
We’re seeing a resurgence in primary care in the US—or are we? In a recent post, Domhnall MacAuley comments on the way primary care seems to have “emerged from the shadows as central to the development of universal and sustainable healthcare in the US.” While the resurgence of primary care seems to get much press, […]
Mary E Black: Do we really need to have so many meetings?
It’s my fourth month working for public health in the local authority and I’ve had yet another request to join a stakeholder meeting. This time it’s from NHS England to hear about a new immunisation pilot … and the meeting will be held in Wimbledon. Wimbledon? We work 30 miles away in Havering… I have […]
Jen Gunter: The great Kate wait is a lesson for maternal health providers and pregnant women alike
The press and much of the world, or so it seems, has been on edge waiting for the Duchess of Cambridge to go into labor and finally that day has arrived. The historic event spawned a flurry of articles, some very concerned that the Duchess was post dates. Reporters have been camped out for weeks […]
From the BMJ archive: Medical implications of the Taser
On 8 July it was reported that a man died in Manchester after police hit him with a Taser shot. According to the BBC, this death is “the tenth to have occurred in England and Wales after police used a stun gun. In eight cases the Taser had not caused death, and in the other […]
Richard Lehman’s journal review—22 July 2013
JAMA 17 July 2013 Vol 310 270 There are three papers in this week’s JAMA which would make good teaching material for a course on critical reading. The first is a randomised, double-blind trial of an intervention for in-hospital cardiac arrest, carried out in three large Greek hospitals. The “placebo” was epinephrine (adrenaline) in saline, […]
Paul Glasziou: Beware the hyperactive therapeutic reflex
Nearly 15 years ago when I first presented the results of our systematic review on antibiotics for acute otitis media, one paediatrician snarled, “You’re making it too complicated. It’s simple: otitis media is an infection; the treatment of infection is antibiotics.” So that was that. The art of therapeutics could be boiled down to a […]
Richard Smith: Doctors and the “three body problem”
Paul Valéry, the French poet and polymath, believed that we all have three bodies and suffer because we cannot bring them together. The best doctors, I suggest, pay attention to all three bodies, but most doctors, I fear, restrict themselves to one of the three. The first body, argued Valéry, is the one we live […]
Leslie Shanks: To err is humanitarian
I remember that day as if it were yesterday. It was in the middle of the chaos of the cholera outbreak that followed the refugee influx into Zaire in 1994 at the end of the Rwandan genocide. I was asked to see a young man who was critically ill with congestive heart failure. Kneeling on […]
David Kerr on Google Glass and big brother medicine
Recently in the UK, the General Medical Council (GMC) faced a barrage of criticism following the publication of new guidance on the use of social media by doctors. The main point of contention was the recommendation by the GMC that doctors should avoid anonymity on line. This was perceived by critics as an infringement of […]