The BMJ最新文献 - Book学术

US public health would be in danger under Robert F Kennedy Jr

The BMJ Pub Date : 2024-12-24 DOI: 10.1136/bmj.q2860

British Medical Journal Publishing Group

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NHS provider league table: reward everybody, not just managers

The BMJ Pub Date : 2024-12-24 DOI: 10.1136/bmj.q2863

Judith M Neaves

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Facing death differently: revolutionising our approach to death and grief

The BMJ Pub Date : 2024-12-23 DOI: 10.1136/bmj.q2815

Lucy Selman

{"title":"Facing death differently: revolutionising our approach to death and grief","authors":"Lucy Selman","doi":"10.1136/bmj.q2815","DOIUrl":"https://doi.org/10.1136/bmj.q2815","url":null,"abstract":"Despite growing public interest in death, support for end-of-life care and bereavement remains inadequate. We urgently need a community centred, public health approach to the social processes of dying and grieving, backed by properly funded palliative care, writes Lucy Selman Over 600 000 people die each year in the UK,1 leaving more than six million grieving.2 On the surface, attitudes to death seem to be shifting: witness the rise of death and grief cafés,3 festivals and annual awareness events,4567891011 and the formation, in 2018, of a national association of end-of-life doulas.12 Television shows, films, and books about dying and grieving proliferate. A BBC video by the palliative care doctor, author, and activist Kathryn Mannix, “Dying is Not as Bad as You Think,” has had 145 000 views.13 But beneath the surface are major gaps in public knowledge and confidence around death, meaning that the practical, emotional, and spiritual wishes of dying people often remain unexpressed and unfulfilled. Meanwhile, futile medical interventions at the end of life persist as a global failure.14 Death is as natural a process as birth, yet much of society refuses to see it that way. This discomfort shows in our behaviour: we avoid seriously ill or bereaved people, and we shy away from discussing our own end-of-life wishes with family, friends, and health professionals. These attitudes are deeply intertwined with cultural and systemic issues, from harmful misconceptions about grief to the medicalisation of dying. Recent debates on assisted dying have put an intense spotlight on the failures of our attitudes towards, and systems for, end-of-life care and bereavement support, and the MP Rachael Maskell has announced a commission to improve palliative care. It’s a timely and vital move, but the commission must tackle the …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142874331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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The rapid rise of the UK’s cancer vaccine trials

The BMJ Pub Date : 2024-12-23 DOI: 10.1136/bmj.q2835

British Medical Journal Publishing Group

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Food industry has infiltrated UK children’s education: stealth marketing exposed

The BMJ Pub Date : 2024-12-23 DOI: 10.1136/bmj.q2875

British Medical Journal Publishing Group

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Death, love, and taxes: tales of resilience and humanity

The BMJ Pub Date : 2024-12-23 DOI: 10.1136/bmj.q2846

Tasnime Osama, Richard Hurley

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Death doulas could lead end-of-life care

The BMJ Pub Date : 2024-12-23 DOI: 10.1136/bmj.q2853

Marian Krawczyk

{"title":"Death doulas could lead end-of-life care","authors":"Marian Krawczyk","doi":"10.1136/bmj.q2853","DOIUrl":"https://doi.org/10.1136/bmj.q2853","url":null,"abstract":"Hospice and palliative care can only do so much. Doulas—non-medical, community based practitioners—could have a central role in demedicalising and deinstitutionalising dying to help people navigate the holistic care they need at the end of life, writes Marian Krawczyk More people are ageing and dying than ever before. Hospice and palliative care services alone cannot meet the increasing complexities of ageing and dying in the global north.12 We need new ways to support people who are approaching death. End-of-life doulas could have a key role in creating community-led supports, including cooperative end-of-life care networks. End-of-life doulas, or death doulas or death midwives, offer non-medical, holistic support to people with serious or terminal illness and their loved ones, including education, guidance, and practical, emotional, and sometimes spiritual assistance.3 Support might include after-death care of the body and funeral planning education or services, along with bereavement follow-up. The end-of-life doula role has emerged as an independent lay practice, rooted in a grassroots movement that echoes historical traditions of community members supporting dying individuals and their families. Opinions vary widely about its nature and scope. Although the role remains unregulated, many doulas advocate for professionalisation by establishing core competencies, practice guidelines, and accreditation. The end-of-life doula movement has sparked public interest and has begun to integrate into healthcare systems in countries such as Australia, Canada, the UK, and the US. Simultaneously, the movement is expanding in countries such as Brazil, Portugal, and Sweden, accompanied by a growing number of training programmes provided by entrepreneurial individuals, non-profit organisations, and higher education institutions. Cicely Saunders gave legitimacy to end-of-life care and laid the foundation for hospice and palliative care. She framed this work as both a science and an art, emphasising a dual foundation in rigorous medical knowledge and compassionate, individualised care …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142874329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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How do we create a sense of team?

The BMJ Pub Date : 2024-12-23 DOI: 10.1136/bmj.q2826

Abi Rimmer

{"title":"How do we create a sense of team?","authors":"Abi Rimmer","doi":"10.1136/bmj.q2826","DOIUrl":"https://doi.org/10.1136/bmj.q2826","url":null,"abstract":"Creating a sense of team among those who work together can make a big difference and often starts with small actions, Abi Rimmer hears Amrita Sen Mukherjee, positive psychology practitioner, European Mentoring and Coaching Council senior practitioner coach, and portfolio GP, says, “Creating a strong sense of team at work is essential for nurturing connection, trust, and shared purpose. Strong relationships are the foundation of a successful team, so making regular opportunities for the team to connect can make a big difference. “Shared experiences strengthen bonds and create lasting connections. These moments don’t need to be extravagant—even small interactions, such as regular informal coffee chats, contribute to a deeper sense of being a unit. Simple things like asking a colleague how they are—and genuinely listening to their response—can also make a huge impact. “Leadership is a behaviour that any team member can exhibit. Modelling trust, respect, and transparency fosters an environment where everyone feels safe to contribute and everyone has collective ownership of their goals. Encourage the team to step up, share ideas, and take initiative. “A sense of team thrives when there’s a shared understanding of purpose. Take time to articulate the team’s mission, values, and collective goals. Acknowledging team and individual accomplishments can also foster a positive culture. Highlighting strengths and achievements reinforces a sense of belonging, motivates the team, …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142874335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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The BMJ Appeal 2024-25: Starvation and malnutrition escalating the threat of Sudan’s civil war

The BMJ Pub Date : 2024-12-23 DOI: 10.1136/bmj.q2580

Jane Feinmann

{"title":"The BMJ Appeal 2024-25: Starvation and malnutrition escalating the threat of Sudan’s civil war","authors":"Jane Feinmann","doi":"10.1136/bmj.q2580","DOIUrl":"https://doi.org/10.1136/bmj.q2580","url":null,"abstract":"Getting aid to the millions facing “mass starvation” in Sudan’s brutal and escalating civil war is a top priority for the International Rescue Committee (IRC), the subject of this year’s BMJ appeal. Jane Feinmann reports “We are witnessing the world’s largest displacement crisis playing out in Sudan, with 12 million people being forced to flee for their lives, many of them multiple times, and more than 750 000 facing catastrophic food insecurity,” warns Shashwat Saraf, regional emergency director for East Africa at the International Rescue Committee (IRC). Intense fighting between the Sudanese Armed Forces and the paramilitary Rapid Support Force began in the country’s capital city, Khartoum, 19 months ago in April 2023, rapidly wiping out the country’s healthcare system along with its financial and political infrastructure. Since then, both sides have engaged in actions that have disproportionately affected civilian populations along ethnic lines, says Saraf, with the war “set to continue apparently indefinitely and largely ignored by the world’s media.” “There’s a perfect storm of displacement, low food production, and restricted humanitarian access that is leading to horrific levels of hunger and death,” says Eatizaz Yousif, the IRC’s Sudan director, speaking to the media in June.1 Amid the chaos, “malnutrition is being used as a weapon of war by both factions,” Saraf says. More than 750 000 people in Sudan are known to be facing catastrophic food insecurity. In some parts of the country, nearly one in three children (30%) are at risk of dying …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142874241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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End-of-life care needs decolonising

The BMJ Pub Date : 2024-12-23 DOI: 10.1136/bmj.q2810

Christian R Ntizimira, Mary Dunne, Smriti Rana, Pascal Birindabagabo

{"title":"End-of-life care needs decolonising","authors":"Christian R Ntizimira, Mary Dunne, Smriti Rana, Pascal Birindabagabo","doi":"10.1136/bmj.q2810","DOIUrl":"https://doi.org/10.1136/bmj.q2810","url":null,"abstract":"Rich knowledge and practices of community and family based care for dying people in formerly colonised countries should inform a reimagination of palliative care globally, say Christian R Ntizimira and colleagues End-of-life care existed long before modern medical practice. The perspectives of formerly colonised countries can help to create more inclusive and culturally sensitive end-of-life care worldwide that respects diverse attitudes to death and dying. Traditional end-of-life approaches in many communities include practices for spiritual, emotional, and physical healing—in South Africa, for example, traditional healers with a deep understanding of local customs and beliefs provide psychological, cultural, and spiritual care.1 From the mid-20th century, however, Cecily Saunders’s approach to palliative care quickly came to dominate international discourse.23 The imposition of Eurocentric models of palliative care in formerly colonised countries has marginalised local cultural values and practices related to dying, death, grieving, and community, with adverse results: international standards in palliative care fail to incorporate the values and needs of patients and families in diverse cultural settings, perpetuating social injustice.4 Pain management guidelines, for example, often prioritise pharmacological solutions over traditional …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142874332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0