-
Mashup Score: 2Polio vaccines: hope, hype, and history repeating? - 57 minute(s) ago
Announcement of new polio vaccines has once again raised hopes of eradicating polio. But the ongoing difficulties of their predecessors provide a cautionary tale, writes Robert Fortner In June 2023, a research article in Nature heralded new, “more stable” versions of the vaccines against two of the three types of poliovirus (types 1 and 3).1 “Super-engineered polio vaccines created to help end polio,” read a BBC headline.2 “Polio endgame finish is in sight,”3 added a Nature news article.3 The backdrop, however, is a little muddier. A similar fanfare had greeted the first of this new generation of oral polio vaccines in 2021. Novel oral polio vaccine type 2 (nOPV2) targets type 2 polio and went straight into widespread use. But it remains far from clear how well nOPV2 works. Before it was approved for emergency use, scientists warned that nOPV2 would not solve the problem set for it: to stamp out vaccine-derived polio. So far, it has not done so. Instead there are unanswered questions a
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
-
Mashup Score: 26
Five infants died after developing whooping cough in England in the first three months of 2024, the UK Health Security Agency has reported.1 Altogether there were 1319 confirmed cases of whooping cough in the UK in March, up from 918 in February and 556 in January, bringing the total number of cases up to the end …
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
-
Mashup Score: 3
Objective To compare the effectiveness of three commonly prescribed oral antidiabetic drugs added to metformin for people with type 2 diabetes mellitus requiring second line treatment in routine clinical practice. Design Cohort study emulating a comparative effectiveness trial (target trial). Setting Linked primary care, hospital, and death data in England, 2015-21. Participants 75 739 adults with type 2 diabetes mellitus who initiated second line oral antidiabetic treatment with a sulfonylurea, DPP-4 inhibitor, or SGLT-2 inhibitor added to metformin. Main outcome measures Primary outcome was absolute change in glycated haemoglobin A1c (HbA1c) between baseline and one year follow-up. Secondary outcomes were change in body mass index (BMI), systolic blood pressure, and estimated glomerular filtration rate (eGFR) at one year and two years, change in HbA1c at two years, and time to ≥40% decline in eGFR, major adverse kidney event, hospital admission for heart failure, major adverse cardio
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
-
Mashup Score: 12China’s declining fertility rate - 4 hour(s) ago
A long term trend with serious implications for population health and healthcare China had the largest population in the world for many decades. Its total fertility rate (the average number of children a woman is expected to have in her lifetime) was as high as 6.0 before 1970, then decreased to 1.5-1.7 by the late 1990s. The rate remained stable until the early 2010s and then fell again.1 In an attempt to increase birth rates, China replaced its one child policy—introduced in 1979— with a universal two child policy from 2015. However, the total fertility rate continued to fall, reaching 1.3 by 2020.2 Additional pronatalist measures followed in 2021 but did not reverse the trend. In 2023, just 9.02 million babies were born in China, half the number born in 2016. As societies become more prosperous and women achieve greater equality in education and employment, a falling birth rate seems unavoidable. In addition to rapid socioeconomic development and urbanisation, China’s family plannin
Source: www.bmj.comCategories: General Medicine News, General Journals & SocietTweet
-
Mashup Score: 11Ultra-processed foods linked to higher mortality - 6 hour(s) ago
Debate about the “ultra-processed” concept must not delay food policies that improve health As research into ultra-processed food gains momentum,1 so too does the debate.234 Foods that fall into the ultra-processed category according to the Nova classification are heterogeneous and include carbonated soft drinks, confectionary, extruded snack foods, distilled alcohol (spirits), and mass produced packaged wholegrain bread.5 Ultra-processed foods are typically high in energy, added sugar, saturated fat, and salt, and a major criticism of previous studies is that they have not disentangled the effects of processing, per se, from the nutrient profile of food products. The linked paper by Fang and colleagues (doi:10.1136/bmj-2023-078476) addresses this concern and others, in their evaluation of the relation between ultra-processed food consumption and mortality in two large US cohort studies.6 Fang and colleagues found a modest increase in the risk of total mortality with higher ultra-proce
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
-
Mashup Score: 9Where to even begin with the challenges we face? - 7 hour(s) ago
From the climate emergency to declining population health, the challenges facing humanity can seem insurmountable. As a result, many people hesitate on how best to influence others to deliver change or believe they themselves can’t make any discernible difference at all. And yet The BMJ has many recent examples of practical actions that individuals can take to have an impact on these big issues. There is advice on how the climate emergency can be incorporated into patient consultations, the evidence base for the effects this can have, and the barriers that might face those seeking change (doi:10.1136/bmj-2024-079831).1 We also have an interview with …
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
-
Mashup Score: 6Surgery is better than nasal sprays for people with severely blocked airways caused by septal deviation - 10 hour(s) ago
Carrie S, O’Hara J, Fouweather T, et al. Clinical effectiveness of septoplasty versus medical management for nasal airways obstruction: multicentre, open label, randomised controlled trial. BMJ 2023;383:e075445. To read the full NIHR Alert, go to:
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
-
Mashup Score: 13“I’m not asking to be let off”—suspended climate activist GP Sarah Benn continues to stand her ground - 10 hour(s) ago
Sarah Benn—the first doctor to face disciplinary action after being convicted and jailed for actions relating to climate activism—tells Adele Waters why suspension from the medical register will not stop her protesting “I don’t feel guilty. I don’t feel I’ve dishonoured the profession, and I think I could explain myself very well to anybody who thought that I had,” says Sarah Benn, climate activist and former general practitioner. Fresh from the decision by the UK’s Medical Practitioners Tribunal Service (MPTS) on 23 April to suspend her from the professional register for five months,1 she finds the situation clear: the activism that led to her suspension was necessary to raise the alarm over the climate crisis and was also in keeping with a doctor’s mission to promote health and save lives. “The world is facing an unprecedented crisis due to the danger of climate and ecological collapse, and I believe that my actions are a justified and proportionate effort to raise an alarm about the
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
-
Mashup Score: 32Association of ultra-processed food consumption with all cause and cause specific mortality: population based cohort study - 11 hour(s) ago
Objective To examine the association of ultra-processed food consumption with all cause mortality and cause specific mortality. Design Population based cohort study. Setting Female registered nurses from 11 US states in the Nurses’ Health Study (1984-2018) and male health professionals from all 50 US states in the Health Professionals Follow-up Study (1986-2018). Participants 74 563 women and 39 501 men with no history of cancer, cardiovascular diseases, or diabetes at baseline. Main outcome measures Multivariable Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals for the association of ultra-processed food intake measured by semiquantitative food frequency questionnaire every four years with all cause mortality and cause specific mortality due to cancer, cardiovascular, and other causes (including respiratory and neurodegenerative causes). Results 30 188 deaths of women and 18 005 deaths of men were documented during a median of 34 and 31 y
Source: www.bmj.comCategories: General Medicine News, General HCPsTweet
-
Mashup Score: 32David Oliver: How well is the duty of candour enforced in the NHS? - 12 hour(s) ago
Readers of The BMJ who are registered clinicians working in the UK will be well aware of the professional duty of candour and transparency over incidents that put patients at risk or harm them. It was strongly reinforced in 2015 (updated in 2022) in joint guidance by the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC),12 as well as in updated professional codes of practice.34 This duty, which can also feature in our employment contracts, comes with a “must” and not a “should”: it applies equally to registered doctors, nurses, and midwives in management and professional leadership roles, who are expected to create a culture where staff can raise concerns without fear and can have them listened to and acted on. Aside from the professional duty of candour, some readers may be less aware of the statutory duty of candour for healthcare organisations and their executives. It’s still fairly rare to see the “duty of candour” referred …
Source: www.bmj.comCategories: General Medicine News, General Journals & SocietTweet
A new report by the Global Polio Eradication Initiative calls the 2016 decision to switch oral polio vaccines “an unqualified failure.” This BMJ Feature looks at how these ongoing difficulties provide a cautionary tale https://t.co/WbHEbPirHC