The BMJ最新文献

{"title":"Scarlett McNally: Small changes make a big difference in helping women doctors thrive","authors":"Scarlett McNally","doi":"10.1136/bmj.r1067","DOIUrl":"https://doi.org/10.1136/bmj.r1067","url":null,"abstract":"I led sessions at the recent flagship conference of the Medical Women’s Federation with the theme “Redefining health—with women doctors.” A panel of representatives from 18 medical advocacy groups discussed barriers to progress and looked at effective solutions to ensure that women can thrive as doctors. It’s sobering that so many groups exist to advocate for this. Their testimony shows the huge need for change, but their work gives hope for a better future. Data from published and presented studies are overwhelming. A BMA survey reported that 91% of women doctors had experienced sexism, 70% believed that their clinical ability had been doubted by colleagues or patients, and 82% had been assumed to be more junior because of their gender.1 Intersectionality means that women doctors face a double whammy if they have other protected …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154015","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":"Michael Hession: psychiatrist, music lover, and “red rebel from Barts” who organised a protest against poor pay and working conditions","authors":"Rebecca Wallersteiner","doi":"10.1136/bmj.r1037","DOIUrl":"https://doi.org/10.1136/bmj.r1037","url":null,"abstract":"In his 2023 memoir Michael Hession wrote that he had been an individual of many parts: doctor, medical and political activist, publisher, photographer, pilot, skier, cellist, farmer, concert promoter, and more. After qualifying as a junior hospital doctor in 1964, Hession was paid £28 a month for working more than 120 hours a week, and he struggled to make ends meet. One weekend he donned his theatre gown at 8 am on a Friday and did not take it off until 4 30 pm three days later. His contract required him to be on-call around the clock and for six months he could not leave the hospital. Hession found this unacceptable: he was grossly exploited and was risking his health as well as the health of his patients. He and a few others formed the Junior Hospital Doctors Action Committee and organised the first NHS protest against pay and working conditions, lobbying the government, lodging a complaint with the BMA, and getting their message out to a largely supportive press. Although support from junior doctors was almost unanimous, consultants were unsympathetic. Their attitude was that they had suffered, so why …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154020","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":"Stephen James Collighan","authors":"Neil Collighan","doi":"10.1136/bmj.r1045","DOIUrl":"https://doi.org/10.1136/bmj.r1045","url":null,"abstract":"Stephen was born in Audenshaw, Manchester, in 1940. After attending Hulme Grammar School for Boys in Oldham he attained a place at Edinburgh University School of Medicine, qualifying in 1965. After graduation he did house jobs at the Deaconess Hospital in surgery and City Hospital in chest medicine. This was followed by a casualty job at Bangour Hospital and a position at the radiotherapy centre at the Western General. He then took a one year senior house officer job in obstetrics and gynaecology at the Western General. In 1967 Stephen married …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154019","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":"Helen Salisbury: Waiting for the 10 year plan","authors":"Helen Salisbury","doi":"10.1136/bmj.r1090","DOIUrl":"https://doi.org/10.1136/bmj.r1090","url":null,"abstract":"A fresh 10 year plan to put the NHS on the road to recovery was promised for this spring, but we’re at the tail end of May and there’s no sign of it. The main themes have been widely trailed, with a focus on three shifts: from treatment to prevention, hospital to community, and analogue to digital. Great soundbites, but they’re beginning to wear a bit thin as we wait for some practical details to flesh out these ambitions. The transfer of activity from hospital to community has been a policy aim for successive governments for at least 20 years, but despite …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154013","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":"John Launer: Botox, lifestyle medicine, and future general practice","authors":"John Launer","doi":"10.1136/bmj.r1078","DOIUrl":"https://doi.org/10.1136/bmj.r1078","url":null,"abstract":"Some years ago I taught an exceptionally bright young GP on a course. She seemed to grasp the values of the specialty intuitively. I hadn’t heard news of her for a while, but I discovered recently that she runs a private aesthetics clinic, offering botox, fillers, and so forth to people who want to look younger and are happy to pay for this. Forgive me, but my heart sank. It wasn’t the kind of career I’d hoped she might pursue. At the same time, I recognised that she may have made the choice for her own good. We hear a lot …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154014","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":"The UK is going its own way on AI regulation in health, but problems lie ahead","authors":"Mark Dayan, Cyril Lobont","doi":"10.1136/bmj.r1103","DOIUrl":"https://doi.org/10.1136/bmj.r1103","url":null,"abstract":"It is a frenzied time for UK health policy. NHS England is set to be abolished, amid an emerging 10 year plan, and every UK country faces difficult financial situations. This is set against two historic global shifts that bring deeper, slower change. Firstly, a “reset” in UK-EU relations brings the promise of deeper cooperation on security, agriculture, trade and travel. Secondly, the ever-faster emergence of artificial intelligence (AI) and governments’ scramble to respond. But as the UK draws closer to the EU in crucial areas, it is going the other way on AI.1 While the EU has passed an AI Act for comprehensive regulation, on AI the Labour government is so far sticking to the same approach as its Brexit-oriented predecessor—claiming the UK’s “pro-innovation approach” is “a source of strength that should be preserved.”23 These differences and the pace of technological change mean difficulties ahead, with no easy answers. #### The divergence dilemma The technical standards for AI as a medical device are similar in the UK and the EU. However, the EU requires a Fundamental Rights Impact Assessment to be conducted, unlike the UK, and those technical standards may diverge further in future. The EU applies a single framework to every use of AI, while the UK asks each individual …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154016","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":"Self-regulation of UK’s pharmaceutical industry","authors":"Piotr Ozieranski, Shai Mulinari, Cinzia Colombo, Barbara Mintzes","doi":"10.1136/bmj.r1065","DOIUrl":"https://doi.org/10.1136/bmj.r1065","url":null,"abstract":"Industry body’s decision to accept Novo Nordisk back reflects systemic failures The Association of the British Pharmaceutical Industry (ABPI) is one of the UK’s most powerful lobby groups, representing more than 150 companies. In addition to shaping pharmaceutical, science, and trade policy,1 it oversees industry standards for promoting prescription medicines and interacting with patients, healthcare professionals, and the NHS.2 The ABPI sets a code of practice that is administered by Prescription Medicines Code Practice Authority (PMCPA), and companies are expected to uphold the standards. If a company is found to breach the code, it must detail planned corrective actions3 and in severe cases may receive a public reprimand or an audit of company procedures; the ABPI board may also suspend or expel a member.3 The ABPI’s code of practice often surpasses standards adopted by comparable European trade groups,4 and its signatories attract more complaints about ethical breaches.5 For example, in 2023 the PMCPA received 149 complaints6 compared with 103, 59, and 22, respectively, for its counterparts in Switzerland, Sweden, and Germany.7 The ABPI regards the high volume of …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154299","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":"Stepping back from the brink: time for reason and rapprochement between India and Pakistan","authors":"Zulfiqar A Bhutta, Sanjay Nagral, Srinath Reddy, Tayyaba Butt, Iqbal A Memon, Huma Cheema, Neelam Mohan, Rajeev Seth, Monica Thomas, Jamal Raza, Samiran Nundy","doi":"10.1136/bmj.r1102","DOIUrl":"https://doi.org/10.1136/bmj.r1102","url":null,"abstract":"Paediatricians from all over the world—including many from India and Pakistan—assembled in Mexico City last week at the biennial International Congress of Pediatrics. They convened just as India and Pakistan once again stepped closer to an open conflict, and we watched and listened with extreme concern and dismay as military exchanges with missiles and drones escalated the situation and inflicted death and destruction in both countries. Just as the region appeared to slide down the slippery slope of war and potential nuclear conflagration, a temporary ceasefire was hurriedly agreed. The region once again teeters at the brink of conflict, reflecting deep rooted mistrust. Relations have sunk to an all-time low, and there is an absence of civil society and track two diplomacy. As medical professionals we are dismayed at this turn of events and its potential consequences, which will affect many generations. We do not dwell on the genesis of the recent conflict, nor the longstanding problems that underlie this mistrust and animosity. We recognise though that the trigger for the current exacerbation was the deplorable act of killing innocent tourists in Pahalgam, Kashmir on 22 April 2025.1 These despicable acts of terrorism against innocent civilians are now commonplace in the region and must be condemned in the strongest terms. Such acts include the hijacking of a passenger train in Balochistan in March …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154017","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":"A village doctor-led mobile health intervention for cardiovascular risk reduction in rural China: cluster randomised controlled trial","authors":"Xingyi Zhang, Siming Wang, Xingyu Zhou, Yajie Tang, Liying Xing, Shaoning Ma, Yan Xu, Chaoqun Wu, Jianlan Cui, Yang Yang, Chunying Lin, Yi Wu, Haibo Zhang, Lei Fan, Chunxiao Xu, Xi Li","doi":"10.1136/bmj-2024-082765","DOIUrl":"https://doi.org/10.1136/bmj-2024-082765","url":null,"abstract":"Objective To assess the effectiveness of a village doctor-led mobile health intervention on cardiovascular risk reduction among residents in rural China. Design Cluster randomised controlled trial. Setting 127 villages from five provinces and autonomous regions in China. Participants 4533 participants from 127 villages: 2297 (64 villages) were randomly assigned to the intervention group and 2236 (63 villages) to the control group. Participants were aged ≥35 years, had no established atherosclerotic cardiovascular disease (ASCVD) but a predicted 10 year risk of ≥10%, had contracted a family doctor service with the local village doctor, and owned a smart phone. Interventions In addition to usual clinical care and basic public health services provided for the control group, the intervention led by village doctors included five components: assessing risk factors to identify individualised intervention targets, setting gradual goals based on doctor-participant communication, providing targeted short videos on health education, conducting health monitoring with periodic feedback, and providing motivation to reduce risk based on gamification. Main outcome measure Mean change in predicted 10 year risk of ASCVD from baseline to 12 months. Results Enrolment took place between March 2023 and May 2023. During the 12 month follow-up (completion rate 99.4%), the 10 year risk of ASCVD decreased from 18.0% to 11.7% in the intervention group and from 17.8% to 13.6% in the control group (absolute difference −1.88% (95% confidence interval (CI) −2.57% to −1.19%; P<0.001). Compared with the control group, the intervention group showed larger reductions in lifetime ASCVD risk (−15.9% v −11.0%; difference −4.59%; P<0.001), systolic blood pressure (−23.2 mm Hg v −15.2 mm Hg; difference −7.64 mm Hg; P<0.001), diastolic blood pressure (−10.9 mm Hg v −6.9 mm Hg; difference: −3.59 mm Hg; P<0.001), fasting blood glucose (−0.9 mmol/L v −0.5 mmol/L; difference −0.30 mmol/L; P=0.008), proportion of daily smokers (−3.1% v −0.6%; odds ratio 0.60, 95% CI 0.43 to 0.84; P=0.003), and insufficient physical activity (−3.0% v 1.3%; odds ratio 0.63, 0.42 to 0.95; P=0.03). No significant differences were observed for change in non-high density lipoprotein cholesterol or proportion of participants with obesity. Conclusions The village doctor-led mobile health intervention was effective at reducing cardiovascular risk and improving control of behavioural and metabolic risk factors. This feasible approach could be scaled up in rural China and other under-resourced settings to improve health management based on the local primary healthcare system. Trial registration ClinicalTrials.gov [NCT05645640][1]. The supplementary files include the code used to analyse the data in the study. The data underlying the study findings are openly and publicly available (<https://doi.org/10.5061/dryad.tmpg4f58w>). [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT05645640&atom=%2Fbmj%2F389%2Fbmj","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"146 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145639","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":"Social prescribing or community referral? Either way, let’s do it","authors":"Allison R Dunne","doi":"10.1136/bmj.r1062","DOIUrl":"https://doi.org/10.1136/bmj.r1062","url":null,"abstract":"McCartney says that doctors shouldn’t be “prescribing” parkrun.1 Let’s not get caught up in the terminology, although perhaps the expression “community referral” might be more appropriate in some cases.2 As a clinical pharmacist who has studied and researched health promotion, including community initiatives such as parkrun, …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145643","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}