The BMJ最新文献 - Book学术

“It was easier to retrain as a teacher than return to work as a doctor”: the struggle of doctors returning to work “接受再培训成为一名教师比重返工作岗位成为一名医生更容易”：医生重返工作岗位的斗争

The BMJ Pub Date : 2025-09-15 DOI: 10.1136/bmj.r857

Adele Waters

{"title":"“It was easier to retrain as a teacher than return to work as a doctor”: the struggle of doctors returning to work","authors":"Adele Waters","doi":"10.1136/bmj.r857","DOIUrl":"https://doi.org/10.1136/bmj.r857","url":null,"abstract":"Many doctors face huge difficulties when trying to return after a career break. Adele Waters explores the support available Leaving medicine for the second time was devastating for former GP trainee Vicky Tate. “Deciding to resign was such a hard decision to make. Part of me still regrets it,” admits the mum of three from Oxfordshire. After taking 10 years out of practice to raise a family, Tate says she was delighted when in 2020 she got the opportunity to work as a supernumerary second year foundation trainee at her local hospital three days a week. But after a couple of months in the role she was forced to quit. “I was having to get my head around a new job, trying to remember how to do all these practical things after not having done them for so long, with three children at home and my husband struggling to balance work and some homeschooling (it was during the pandemic). I just wasn’t able to balance everything. It wasn’t the right time so I decided to stop.” Tate says a more formalised return to work pathway could have made all the difference for her. “I didn’t feel clinically confident and I was nervous doing the practical things, so I would have found a structured programme where I could go over some of the basic clinical tasks, like taking bloods and inserting cannulas, as well as things like learning the new IT system, helpful. It would have made a big difference in building my confidence. “And it would have been helpful to be networked with other people in a similar situation,” Tate adds. “I just think I needed a bit more hand holding.” The BMJ has spoken to several doctors who have faced difficulties in returning to practice after extended periods away. …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"695 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059498","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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There’s no shame in stepping off the conveyor belt of medicine 从医学的传送带上走下来没什么可耻的

The BMJ Pub Date : 2025-09-15 DOI: 10.1136/bmj.r1924

Stephanie Santos Paulo

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My colleague humiliated me—what should I do? 我的同事羞辱了我——我该怎么办？

The BMJ Pub Date : 2025-09-15 DOI: 10.1136/bmj.r1869

Elisabeth Mahase

{"title":"My colleague humiliated me—what should I do?","authors":"Elisabeth Mahase","doi":"10.1136/bmj.r1869","DOIUrl":"https://doi.org/10.1136/bmj.r1869","url":null,"abstract":"Humiliation is often dismissed as banter, but doctors don’t have to put up with it, Elisabeth Mahase hears Cathy Finnegan, General Medical Council assistant director, standards and guidance, says, “Humiliation at work can take many forms. Sometimes it’s part of a pattern—a sustained campaign of undermining or belittling someone in front of others. It can also be a single offhand comment, a joke at a colleague’s expense, or a dismissive remark. “Humiliation at work can erode your confidence, make you question your worth, and have a lasting impact on how you see yourself. It’s also a patient safety risk. Being subject to this behaviour can make you less confident speaking up and being visible, which undermines teamwork and the delivery of care. “You have every right to expect support from your colleagues. When we updated our Good Medical Practice guidance in 2024 and strengthened the focus on behaviour between colleagues, we made clear that witnesses to poor behaviour should take action. They should consider how they can support you, challenge the behaviour, and report it. We also strengthened expectations of doctors with leadership and management responsibilities. You can expect to be heard and for your concerns to be tackled promptly. “Too often, attempts to humiliate colleagues—even when they cross into sexual harassment or other forms of discriminatory behaviour—are dismissed as banter or the result of a personality or generational clash. These aren’t acceptable excuses, and explaining something away—for example, a response to stressful working conditions—doesn’t lessen the impact. Work and training environments that tolerate …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059497","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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Patrick Vaughan: epidemiologist, WHO public health expert, and model for Piggy from Lord of the Flies 帕特里克·沃恩：流行病学家，世卫组织公共卫生专家，《蝇王》中小猪的原型

The BMJ Pub Date : 2025-09-15 DOI: 10.1136/bmj.r1919

Rebecca Wallersteiner

{"title":"Patrick Vaughan: epidemiologist, WHO public health expert, and model for Piggy from Lord of the Flies","authors":"Rebecca Wallersteiner","doi":"10.1136/bmj.r1919","DOIUrl":"https://doi.org/10.1136/bmj.r1919","url":null,"abstract":"Patrick Vaughan overcame a delayed education and dysfunctional childhood to make a major contribution to international health through his work at the London School of Hygiene and Tropical Medicine (LSHTM). Much of his career in epidemiology was spent working in low and middle income countries. He served with government health services in Papua New Guinea (PNG); helped start a medical school at the University of Dar es Salaam, Tanzania; and spent three years researching diarrhoea in Bangladesh. In 1985 he was among those consulted by the organisers of Live Aid on how best to spend the estimated £150m raised by the UK and US concerts. He authored more than 120 academic papers and 22 books over his career. As a lockdown project he co-edited Practical Epidemiology: Using Epidemiology to Support Primary Health Care (2021) with Cesar Victora and Mushtaque Chowdhury, both of whom he had mentored when they were doctoral students. John Patrick Vaughan was born in Penzance, Cornwall, in 1937, the only child of Ellaline (née Norwood) and Thomas Gerald Vaughan, an erratic investor and conscientious objector in the second world war. After the early death of his brother, Gerald spent all his inheritance, leading to bankruptcy. A few months after Patrick’s birth, the family left Cornwall and joined an Anabaptist Cotswold …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059394","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

Preventing gestational diabetes 预防妊娠糖尿病

The BMJ Pub Date : 2025-09-12 DOI: 10.1136/bmj.r1900

Ania Lucewicz Samarawickrama, Dharmintra Pasupathy

{"title":"Preventing gestational diabetes","authors":"Ania Lucewicz Samarawickrama, Dharmintra Pasupathy","doi":"10.1136/bmj.r1900","DOIUrl":"https://doi.org/10.1136/bmj.r1900","url":null,"abstract":"A challenge that tests the prevailing frame of reference > “ just as men who are sketching the landscape put themselves down in the plain to study the nature of the mountains and the highlands, and to study the low-lying land they put themselves high on the mountains, so, to comprehend fully the nature of people one must be a prince, and to comprehend fully the nature of princes one must be in ordinary citizen.”\u0000> > Letter from Niccolò Machiavelli to the Magnificent Lorenza dé Medici1\u0000Centuries ago, Machiavelli urged us to take an alternative perspective, to step outside our existing frame of reference, to make sense of complex problems. Currently, the challenge of preventing gestational diabetes presents an unresolved problem that tests the limits of our current frame of reference. Gestational diabetes, or hyperglycaemia first detected during pregnancy, is a globally high prevalence condition with immediate and lifelong cardiometabolic consequences for mother and offspring.23 Gestational diabetes is a challenge across the reproductive life course—with risk factors occurring before conception, at conception, throughout pregnancy, during the inter-conception period, and lifelong. Academic clinicians have trialled various interventions to try and reduce gestational diabetes risk with disappointingly mixed results. These results have raised important questions about the setting, timing, duration, …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035312","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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Prostate cancer: MRI shakeup could be cheaper and faster, study finds-but experts warn of potential overdiagnosis. 前列腺癌：研究发现，核磁共振检查可能更便宜、更快捷，但专家警告可能会出现过度诊断。

The BMJ Pub Date : 2025-09-12 DOI: 10.1136/bmj.r1926

Kate Bowie

引用次数: 0

More than half of births in Great Britain now have medical intervention, report finds. 报告发现，英国现在有一半以上的新生儿接受了医疗干预。

The BMJ Pub Date : 2025-09-12 DOI: 10.1136/bmj.r1923

Emma Wilkinson

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What MAHA's new Making Children Healthy Again report says-and what it doesn't. 马哈新发布的《让儿童再次健康》报告说了什么，没有说什么。

The BMJ Pub Date : 2025-09-12 DOI: 10.1136/bmj.r1922

Simon Williams

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Tobacco kills: stronger excise taxes would save lives 烟草致命：提高消费税可以挽救生命

The BMJ Pub Date : 2025-09-12 DOI: 10.1136/bmj-2025-085608

Guillermo Paraje, Mauricio Flores Muñoz, Daphne Wu, Prabhat Jha

{"title":"Tobacco kills: stronger excise taxes would save lives","authors":"Guillermo Paraje, Mauricio Flores Muñoz, Daphne Wu, Prabhat Jha","doi":"10.1136/bmj-2025-085608","DOIUrl":"https://doi.org/10.1136/bmj-2025-085608","url":null,"abstract":"Guillermo Paraje and colleagues argue that excise taxes are the most effective yet least implemented measure for tobacco control and that overcoming tobacco industry opposition could prevent millions of premature deaths The World Health Organization’s Framework Convention on Tobacco Control (FCTC) was enacted in 2005 with the objective of accelerating evidence based interventions to reduce global smoking. Currently, 183 countries with 90% of the world’s population have ratified the convention.1 WHO subsequently issued guidance, informed by work from the World Bank and the Curbing the Epidemic report,2 to help countries with tobacco control policy. This outlines six cost effective strategies countries should implement to reduce tobacco consumption using the acronym MPOWER: monitoring tobacco use; protecting people from tobacco smoke, primarily through smoke-free policies; offering cessation therapies to quit tobacco; warning about the use of tobacco; enforcing tobacco advertising, promotion, and sponsorship bans; and raising tobacco taxes. Smoking still causes over seven million deaths annually,1 and the effectiveness of the FCTC and individual MPOWER measures in reducing smoking has been questioned, particularly by conservative and libertarian media outlets and think tanks.34 However, extensive quantitative research shows a strong association between FCTC ratification and improvements in smoking related outcomes, including reductions in smoking prevalence among adults and youth, declines in the number of smokers, and increased cessation rates.56789 Improvements in these outcomes are closely linked to the extent and vigour with which measures are implemented, especially the design and substantial increases of tobacco taxes.5 Despite this evidence, taxation remains substantially underused as a tool in tobacco control. Most quantitative assessments of the effect of FCTC ratification or MPOWER show both to be effective.56710 An interrupted time series analysis of current smokers across 171 countries that ratified the …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035314","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

When I use a word . . . Academic and other sleuths—a taxonomy 当我用一个词…学术侦探和其他侦探——一种分类

The BMJ Pub Date : 2025-09-12 DOI: 10.1136/bmj.r1929

Jeffrey K Aronson

{"title":"When I use a word . . . Academic and other sleuths—a taxonomy","authors":"Jeffrey K Aronson","doi":"10.1136/bmj.r1929","DOIUrl":"https://doi.org/10.1136/bmj.r1929","url":null,"abstract":"In my survey of various types of sleuths I have identified four categories: investigative sleuths, who investigate crimes: diagnostic sleuths, clinicians and pathologists who pursue medical diagnoses; research sleuths, clinicians and epidemiologists who search for the causes of diseases and academics in any discipline who undertake research of any kind; and integrity sleuths, who scrutinize the publications of others, looking for evidence of misconduct. The earliest instances that I have found of the use of the term “sleuth” to describe the last of these categories date from the 1980s, but earlier instances might be found by further sleuthing. In my search for the earliest instances of the word “sleuth” and its derivatives in relation to observers of academic misconduct, I have found that there is a wide range of different types of sleuths, together calling out for a taxonomy. The origin of the word has so far been traced back only to a Norwegian word, slōð, meaning a track or a trail. However, that word must itself have had an antecedent form with a corresponding theoretical IndoEuropean forerunner. IndoEuropean roots starting with consonants such as K, L, M, P, T, or W sometimes have an S prefixed to them. For example, the root LEU, meaning to loosen or unbind, gives us words such as loose and …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043099","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