{"title":"Jillian Ann Jellicoe","authors":"Jenny Baxendale","doi":"10.1136/bmj.r512","DOIUrl":"https://doi.org/10.1136/bmj.r512","url":null,"abstract":"Jill, who was diminutive in stature with a large personality, was born in Liverpool. She studied medicine at Kings College London before house jobs in Hereford. She moved north and began training in anaesthesia at Whiston Hospital in Merseyside. Jill married Alan Fitzgerald in …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640542","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}
{"title":"Trends in UK mortality reflect a public health failure","authors":"Lucinda Hiam, David Walsh, Gerry McCartney","doi":"10.1136/bmj.r525","DOIUrl":"https://doi.org/10.1136/bmj.r525","url":null,"abstract":"Austerity harms health and must be reversed The headline of a recent BBC article, “UK death rate ‘reaches record low,’” puts a positive spin on mortality data, suggesting the UK has emerged from a period of poor health.1 Based on unpublished analysis from the Continuous Mortality Investigation (CMI) at the Institute and Faculty of Actuaries, the article reports that standardised death rates in 2024 returned to pre-pandemic levels, below those in 2019, which had the previous lowest reported mortality. However, as the CMI data highlight, mortality improvements remain stagnant. Between 1974 and 2010 mortality improvements averaged 26 per 100 000 population a year, before dropping steeply to around 7 per 100 000 population for the past 15 years. Moreover, mortality has consistently increased for people living in the most disadvantaged areas2 and for working age adults during this period.3 The BBC article focuses on the contributions of specific conditions, such as cardiovascular disease and obesity, as explanations of the mortality trends, with only passing comment of the established leading cause—austerity. This misleading coverage of the causes of Britain’s poor health is not unique. For example, reporting …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640546","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}
{"title":"Abolition of NHS England seeks to put ministers in control of the NHS","authors":"Chris Ham","doi":"10.1136/bmj.r554","DOIUrl":"https://doi.org/10.1136/bmj.r554","url":null,"abstract":"Reorganisation threatens to distract managers and staff from work to improve patient care In the end, enough was enough. Having promised not to undertake a top-down reorganisation of the NHS, that is exactly what Wes Streeting and Keir Starmer decided to do.1 NHS England is being abolished. The government’s decision was prompted by growing frustrations on the part of ministers at the duplication of responsibilities between NHS England and the Department of Health and Social Care and the need to find savings. Pressures on public finances have increased since last autumn’s budget, in part because of the government’s commitment to spend more on defence. With the Office for Budgetary Responsibility warning of the need to plan for increases in NHS spending to meet changing population needs, and the resources to do so shrinking, the government is acting to control NHS finances.2 A new leadership team in NHS England, led by Jim Mackey, has been …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653473","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}
The BMJPub Date : 2025-03-18DOI: 10.1136/bmj-2024-082639
Sudeep Adhikari, Sangeeta Bhusal, Md. Shabab Hossain, Buddha Basnyat
{"title":"Assessment and management of dengue","authors":"Sudeep Adhikari, Sangeeta Bhusal, Md. Shabab Hossain, Buddha Basnyat","doi":"10.1136/bmj-2024-082639","DOIUrl":"https://doi.org/10.1136/bmj-2024-082639","url":null,"abstract":"### What you need to know Dengue (dengue fever, breakbone fever), an arboviral infection transmitted by Aedes mosquitos, is endemic in more than 100 countries in the World Health Organisation (WHO) regions of Africa, the Americas, the Eastern Mediterranean, South-East Asia, and the Western Pacific.1 Although most patients are asymptomatic or recover after a febrile phase, 2-5% develop severe disease and may require intensive care.2 Mortality is 5% among severe dengue.2 Distribution of the four dengue virus serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) varies geographically and over time.3 Previously limited to tropical regions, outbreaks now occur in subtropical and temperate regions, including high altitude areas (such as Kathmandu, Nepal).245 In North America and Europe, where dengue is a common cause of fever in travellers returning from endemic areas,67 autochthonous (locally acquired) cases have also been reported.8910 …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640459","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}
{"title":"David Ian Marshall","authors":"Michael Millar-Craig","doi":"10.1136/bmj.r515","DOIUrl":"https://doi.org/10.1136/bmj.r515","url":null,"abstract":"David was born in Broadstairs, Kent, and educated at Glenalmond school in Scotland. His father Gordon was a proud Scotsman who believed strongly in the importance of a Scottish boarding school education, despite the distance involved. Gordon was a single handed GP in Broadstairs, and it was always David’s intention to join his father in general practice. David qualified from St Bartholomew’s Hospital, like his father, but while doing senior house officer posts at Southend General Hospital in 1973, Gordon sustained an acute myocardial infarction and David took over his practice. At that time no formal training was required to enter general practice, but David became well established as a successful and popular GP. His …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"197 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640541","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}
The BMJPub Date : 2025-03-18DOI: 10.1136/bmj.q2829
Roshni Shastri, Crispin Wiles, Oliver Sweeney, Lucy Easton, Steven Jacques
{"title":"Is the dissection of cadavers a necessary part of medical education?","authors":"Roshni Shastri, Crispin Wiles, Oliver Sweeney, Lucy Easton, Steven Jacques","doi":"10.1136/bmj.q2829","DOIUrl":"https://doi.org/10.1136/bmj.q2829","url":null,"abstract":"Dissecting cadavers is a mainstay of medical education, but it relies on donors and poses ethical and other challenges. Roshni Shastri and Crispin Wiles argue that modern teaching has moved on, but Oliver Sweeney, Lucy Easton, and Steven Jacques say that it would be foolish to dispense with the practice entirely Traditionally, cadaveric dissection has been central to anatomy, and its historical significance in medical education is undeniable. But as curriculums evolve, its role, particularly in undergraduate education, can be increasingly questioned. We believe that high quality anatomy education depends not on any single type of approach to learning (such as dissection) but on thoughtful and educationally principled curricular design. This requires meaningful learning outcomes that are supported by a range of educational resources that will support learners in achieving them. Prosected or plastinated specimens, 3D models, surface anatomy training, and interactive tools can all be used effectively to provide inclusive, time- and cost-efficient alternatives to dissection. Cadaveric dissection poses three main challenges. First, cadaveric dissection is resource heavy, requiring specialised laboratories, embalming chemicals such as formaldehyde, and rigorous safety protocols.1 Institutions often lack the financial and spatial resources to maintain dissection labs, leading many to shift to prosection, where students observe pre-dissected specimens.2 Second, dissection (as opposed to prosection) is also time intensive, detracting from other aspects of increasingly packed medical curriculums. Although dissection is often romanticised for its perceived “hands-on” value, studies have shown that students spend disproportionate time identifying structures hidden under fat or connective tissue rather …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640543","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}
The BMJPub Date : 2025-03-18DOI: 10.1136/bmj-2024-079839
Carole Lunny, J P T Higgins, Ian R White, Sofia Dias, B Hutton, J M Wright, Areti-Angeliki Veroniki, P F Whiting, A C Tricco
{"title":"Risk of Bias in Network Meta-Analysis (RoB NMA) tool","authors":"Carole Lunny, J P T Higgins, Ian R White, Sofia Dias, B Hutton, J M Wright, Areti-Angeliki Veroniki, P F Whiting, A C Tricco","doi":"10.1136/bmj-2024-079839","DOIUrl":"https://doi.org/10.1136/bmj-2024-079839","url":null,"abstract":"Systematic reviews with network meta-analysis (NMA) have potential biases in their conduct, analysis, and interpretation. If the results or conclusions of an NMA are integrated into policy or practice without any consideration of risks of bias, decisions could unknowingly be based on incorrect results, which could translate to poor patient outcomes. The RoB NMA (Risk of Bias in Network Meta-Analysis) tool answers a clearly defined need for a rigorously developed tool to assess risk of bias in NMAs of healthcare interventions. In this guidance article, we describe and provide a justification for the tool’s 17 items, their mechanism of bias, pertinent examples, and how to assess an NMA based on each response option. A network meta-analysis (NMA) is a type of quantitative analysis that can be performed as part of a systematic review.1234 An NMA is an extension of a pairwise meta-analysis that compares the effects of multiple interventions simultaneously on one clinical, public health, or policy question.1 NMAs provide coherent estimates of comparative effectiveness for all pairs of interventions in the network, including interventions that have never been previously compared in a head-to-head study. Furthermore, NMAs allow for the ranking of all interventions in a network of studies.5 Systematic reviews with NMA have potential biases in their conduct, analysis, and interpretation.67 Quality assessment of the evidence is integral to the practice of evidence based medicine. If the results or conclusions of an NMA are integrated into policy or practice without any consideration of the risks of bias, decisions could unknowingly be based on incorrect results, with the potential for these to translate to poor patient outcomes. Therefore, NMAs should be assessed in terms of potential for bias. The Risk of Bias in Network Meta-Analysis (RoB NMA) tool was developed because no …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"183 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640647","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}
{"title":"Body cameras and panic alarms for doctors could help deter violence and harassment","authors":"Caroline Kamau-Mitchell","doi":"10.1136/bmj.r529","DOIUrl":"https://doi.org/10.1136/bmj.r529","url":null,"abstract":"Body cameras and panic alarms in healthcare settings could act as deterrents and reactive solutions to abusive incidents, writes Caroline Kamau-Mitchell Doctors and healthcare staff need better protection from violence and harassment—many have lost their lives or been injured around the world. For example, in 2022, a patient murdered a doctor in Italy with an axe.1 In 2024, doctors and nurses in Italy barricaded themselves in a room after a mob of about 50 people connected with a patient attacked them.1 In August 2024, a female doctor in India was raped and murdered in hospital, and thousands of doctors went on strike in protest.2 These are only a few examples of the widespread violence that healthcare staff face globally. Body cameras and panic alarms could deter potential offenders34 and provide valuable evidence in cases of abuse.5 Global meta-analyses report that 15% of doctors have experienced physical violence from patients or visitors,6 and 45% have experienced sexual harassment.7 An investigation by The BMJ and the Guardian revealed that, in a five year period, there were over 20 000 cases of healthcare staff being abused by …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640539","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}
{"title":"Rammya Mathew: Abolishing NHS England is a reckless gamble with uncertain returns","authors":"Rammya Mathew","doi":"10.1136/bmj.r536","DOIUrl":"https://doi.org/10.1136/bmj.r536","url":null,"abstract":"The sudden and unexpected announcement that NHS England is being abolished has left many of us in NHS leadership roles feeling deeply unsettled. The language used by the prime minister, Keir Starmer, and the health and social care secretary, Wes Streeting—referring to NHS England as “the world’s largest quango”1—was not only offensive but also dismissive of the vast and essential work carried out by people in the organisation. These are the same individuals who orchestrated the most significant vaccination campaign of our lifetime during the covid pandemic, yet they now find their work reduced to mere “needless bureaucracy” while simultaneously learning that their jobs are on the line. Even more concerning is …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640534","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}
{"title":"Julia Ruth Hamilton","authors":"Sara Smith","doi":"10.1136/bmj.r514","DOIUrl":"https://doi.org/10.1136/bmj.r514","url":null,"abstract":"Julia was born and raised in Northern Ireland and studied medicine at Queens University, Belfast. Having decided on a career in general practice, she undertook her registrar year at the Whitefriars Green Practice surgery in Perth and became a partner on qualifying. She remained with the practice for the duration of her career, eventually becoming senior partner. Julia was …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640463","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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