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Transitions of care are often traumatic for patients and must be improved 护理过渡往往给患者造成创伤，必须加以改进
The BMJ Pub Date : 2025-04-02 DOI: 10.1136/bmj.r650
Helen Cowan
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引用次数: 0
UK welfare reforms threaten health of the most vulnerable 英国福利改革威胁最弱势群体的健康
The BMJ Pub Date : 2025-04-02 DOI: 10.1136/bmj.r660
British Medical Journal Publishing Group
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引用次数: 0
David Oliver: What functions should remain within NHS central government agencies? 大卫-奥利弗哪些职能应保留在国家医疗服务体系中央政府机构内？
The BMJ Pub Date : 2025-04-02 DOI: 10.1136/bmj.r630
David Oliver
{"title":"David Oliver: What functions should remain within NHS central government agencies?","authors":"David Oliver","doi":"10.1136/bmj.r630","DOIUrl":"https://doi.org/10.1136/bmj.r630","url":null,"abstract":"The latest major reorganisation of the NHS’s government departments and central agencies1 begs the hypothetical question of which functions can best or only be served by central bodies operating at national level. Hypothetical or not, I do have to give the question some empirical constraints. First, data from the British Social Attitudes survey2 and other big datasets such as the Health Foundation/Ipsos rolling polls3 on public perceptions of the NHS show little support for a wholesale shift away from a tax funded, universal, free-at-point-of-care health service and continuing support for the NHS’s founding principles, even though public satisfaction with the current service is at a record low.4 Second, even within universal healthcare systems in high income nations with publicly funded services rather than insurance or copayment models, the NHS is arguably the industrialised world’s most centralised.56 Several others have more devolution of power and accountability to regional administration, …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758008","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
Improving gynaecology with trauma informed care
The BMJ Pub Date : 2025-04-02 DOI: 10.1136/bmj.r632
Valerie E Humphreys
{"title":"Improving gynaecology with trauma informed care","authors":"Valerie E Humphreys","doi":"10.1136/bmj.r632","DOIUrl":"https://doi.org/10.1136/bmj.r632","url":null,"abstract":"The need for shared decision making and informed consent in gynaecology is not new.1 When the Supreme Court enshrined it in law in Montgomery v Lanarkshire Health Board,2 it was not doing anything revolutionary; these concepts were already part of General Medical Council guidance.3 But practical implementation was, and is, problematic. Good communication with a sympathetic and empathic listener is crucial for …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758012","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
Finding the right treatment for severe depression
The BMJ Pub Date : 2025-04-02 DOI: 10.1136/bmj.r478
Tony Frais
{"title":"Finding the right treatment for severe depression","authors":"Tony Frais","doi":"10.1136/bmj.r478","DOIUrl":"https://doi.org/10.1136/bmj.r478","url":null,"abstract":"Tony Frais found himself unprepared for the diagnosis of severe depression, and for the challenge of trying different treatments Waking in the middle of a dream, I felt a palpable click in my brain. Suddenly I felt very unwell. It was the same uncomfortable feeling you get when you are on the downhill part of a roller coaster. I got out of bed very scared of what was happening to me. I decided to book an appointment with my GP. My expectation was that I would be prescribed a pill and that would be the end of my discomfort. It never crossed my mind that any of this would be related to my mental health. I had no symptoms or concerns before this. My GP referred …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758159","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
John Launer: Watch out for that indulgent smile 约翰-劳纳：小心那纵容的微笑
The BMJ Pub Date : 2025-04-02 DOI: 10.1136/bmj.r629
John Launer
{"title":"John Launer: Watch out for that indulgent smile","authors":"John Launer","doi":"10.1136/bmj.r629","DOIUrl":"https://doi.org/10.1136/bmj.r629","url":null,"abstract":"I spend a lot of time teaching communication skills, although I prefer to call them interactional skills, which suggests more of a two way street. Much of what I cover relates to speaking and listening, although you can’t ignore body language too: eye contact, sitting position, and so on. One experience I mention quite often is seeing a video of my own consultations for the first time. I was horrified to see how much I fidgeted, played with my pen, and looked at the computer—and how much more distracting this was for the patient than stillness. Since then, I’ve always …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"216 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758075","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
Effective public health requires “deep prevention”
The BMJ Pub Date : 2025-04-01 DOI: 10.1136/bmj.r646
Nick Hopkinson
{"title":"Effective public health requires “deep prevention”","authors":"Nick Hopkinson","doi":"10.1136/bmj.r646","DOIUrl":"https://doi.org/10.1136/bmj.r646","url":null,"abstract":"The philosopher Derek Parfit, introducing his 1984 book Reasons and Persons, sets out a few basic concepts—that we have reasons for acting, that some ways of acting are morally wrong, and that some outcomes are good or bad in a sense that has moral relevance.1 Reaching for what he presumably judged to be an uncontroversial example of a poor outcome, he notes that “it is bad, for example, if people become paralysed.” Whatever hopes one might have about the arc of the moral universe bending towards justice, the US elections have placed enormous power in the hands of a Republican Party intent on sabotaging vaccination programmes and medical research, while withdrawing support from international programmes funded by USAID.2 This threatens the health and wellbeing of millions of people risking the resurgence of polio (and thus paralysis) as well as other existing and novel infectious diseases. While basic human decency calls for action to try to ensure that such policies, which will shorten the lives of many of the most vulnerable people, can be stopped, mitigated, and ultimately reversed, it is easy to feel right now that this is too hard or perhaps impossible. Bobbie Jacobson’s …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143745081","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
Northern Ireland needs a practitioner health service
The BMJ Pub Date : 2025-04-01 DOI: 10.1136/bmj.r599
Emma Murtagh, Ursula Mason
{"title":"Northern Ireland needs a practitioner health service","authors":"Emma Murtagh, Ursula Mason","doi":"10.1136/bmj.r599","DOIUrl":"https://doi.org/10.1136/bmj.r599","url":null,"abstract":"Wilkinson brings the challenges of burnout and mental ill health faced by doctors into sharp focus.1 In Northern Ireland, we look with envy at the provision of NHS Practitioner Health in England, and the corresponding services in Wales, Scotland, and the Republic of Ireland. We are the only nation on these islands without a commissioned, confidential mental health service for clinicians. In the 2024 Royal …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143745084","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
HIV in primary care: further considerations
The BMJ Pub Date : 2025-04-01 DOI: 10.1136/bmj.r639
Daniel Bradshaw
{"title":"HIV in primary care: further considerations","authors":"Daniel Bradshaw","doi":"10.1136/bmj.r639","DOIUrl":"https://doi.org/10.1136/bmj.r639","url":null,"abstract":"Singh and colleagues answer questions on managing HIV in primary care.1 Several other aspects are relevant to primary care clinicians caring for people with HIV. Many people with HIV, such as men who have sex with men, are at higher risk of mpox infection and are therefore recommended to receive mpox vaccination by the …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143745085","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
Stephen Andrew Cairns
The BMJ Pub Date : 2025-04-01 DOI: 10.1136/bmj.r614
Bill Stephens, Alastair Campbell
{"title":"Stephen Andrew Cairns","authors":"Bill Stephens, Alastair Campbell","doi":"10.1136/bmj.r614","DOIUrl":"https://doi.org/10.1136/bmj.r614","url":null,"abstract":"Steve was born in Preston, only two miles from where he would later practice as a consultant physician for 28 years. The maternity ward was hit by an outbreak of neonatal diarrhoea and there were several tragic deaths. Steve teetered on the brink but survived, according to his mother’s account, as a result of copious amounts of Lourdes holy water sprinkled daily on his forehead. Some 60 years later, by complete coincidence, he attended a domiciliary consultation with a lady with a similar birth date—and discovered that she also was one of the Preston outbreak survivors. Steve was the middle of three boys. His father was an engineer, his mother a teacher. Secondary education was at the …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"216 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143745082","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
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