The BMJPub Date : 2025-01-28DOI: 10.1136/bmj-2023-077515
Marni Sommer, Julie Hennegan, Arundati Muralidharan, Caroline W Kabiru, Therese Mahon, Penelope A Phillips-Howard
{"title":"Adolescent menstrual health must go beyond pads","authors":"Marni Sommer, Julie Hennegan, Arundati Muralidharan, Caroline W Kabiru, Therese Mahon, Penelope A Phillips-Howard","doi":"10.1136/bmj-2023-077515","DOIUrl":"https://doi.org/10.1136/bmj-2023-077515","url":null,"abstract":"Marni Sommer and colleagues argue that lack of data on adolescent menstrual health is hindering investment in broader measures to improve long term wellbeing and gender equality Menstruation and the menstrual cycle affect female health and wellbeing from menarche, the first menstrual period, to menopause.123 Adolescent girls and women worldwide consistently report negative experiences with menstruation, including missed or delayed diagnosis of menstrual disorders. These issues have far reaching consequences for their wellbeing, education, livelihood opportunities, empowerment, and overall health.456 Investment in menstrual health (box 1) during adolescence is increasingly recognised as a pathway to mitigate these consequences and address gender inequality. This was emphasised in 2022 when the World Health Organization declared menstrual health as a health and human rights issue and not solely a hygiene issue.8 The emerging concept of menstrual justice highlights how harmful power structures and social norms result in menstrual related discrimination in many spheres of life that impede menstrual health.9 Box 1 ### Main components of menstrual health7 Menstrual health is a state of complete physical, mental, and social wellbeing, not merely the absence of disease or infirmity, in relation to the menstrual cycle. Achieving menstrual health implies that women, girls, and all other people who experience a menstrual cycle canRETURN TO TEXT Despite increased attention, insufficient data are available on adolescent girls’ menstrual health across countries. The absence of data on girls’ multidimensional requirements for menstrual health renders the challenges they experience invisible. Partly because of this, …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049814","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":"Trump’s global gag rule on abortion care will damage women’s health, rights, and futures","authors":"Carole Sekimpi","doi":"10.1136/bmj.r173","DOIUrl":"https://doi.org/10.1136/bmj.r173","url":null,"abstract":"We must act to safeguard reproductive healthcare and forge a path less reliant on US assistance, says Carole Sekimpi As president of the United States, Donald Trump has the power to affect lives and healthcare well beyond his country’s borders. Since Trump returned to power this month, his reinstatement of the “global gag rule”12 has triggered the end of funding for any non-US based global health and development organisation that provides or advocates abortion care. As the single largest funder of international aid, the US plays a powerful role in shaping the global health landscape—and women’s and girls’ lives are being used as pawns in this political game. My work overseeing reproductive health programmes in Africa for MSI Reproductive Choices gives me an understanding of the profound consequences that this will have on communities that Trump will never set foot in. It’s prudent to first understand that the US government never funds abortions.3 …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049810","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":"Storytelling as a tool for teaching paediatric concepts","authors":"Rhea Sibal","doi":"10.1136/bmj.r146","DOIUrl":"https://doi.org/10.1136/bmj.r146","url":null,"abstract":"Thomas and colleagues’ creative exploration of fairy tales to promote healthy sleep is an innovative and engaging approach to tackling a critical yet under-represented area in paediatric medicine.1 Paediatric sleep disorders, despite their grave effects, are often overlooked in both public health discourse and medical education. Disorders such as obstructive sleep apnoea …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044143","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 : 2025-01-27DOI: 10.1136/bmj-2023-077292
Stephanie L Hiser, Kelly Casey, Peter Nydahl, Carol L Hodgson, Dale M Needham
{"title":"Intensive care unit acquired weakness and physical rehabilitation in the ICU","authors":"Stephanie L Hiser, Kelly Casey, Peter Nydahl, Carol L Hodgson, Dale M Needham","doi":"10.1136/bmj-2023-077292","DOIUrl":"https://doi.org/10.1136/bmj-2023-077292","url":null,"abstract":"Approximately half of critically ill adults experience intensive care unit acquired weakness (ICUAW). Patients who develop ICUAW may have negative outcomes, including longer duration of mechanical ventilation, greater length of stay, and worse mobility, physical functioning, quality of life, and mortality. Early physical rehabilitation interventions have potential for improving ICUAW; however, randomized trials show inconsistent findings on the efficacy of these interventions. This review summarizes the latest evidence on the definition, diagnosis, epidemiology, pathophysiology, risks factors, implications, and management of ICUAW. It specifically highlights research gaps and challenges, with considerations for future research for physical rehabilitation interventions.","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044144","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":"Ending gambling adverts could prevent harm to millions of adults and children in the UK","authors":"Kevin Fenton, Will Prochaska","doi":"10.1136/bmj.r158","DOIUrl":"https://doi.org/10.1136/bmj.r158","url":null,"abstract":"A phased approach to ending gambling advertising could reduce the damage caused by this health harming industry, write Kevin Fenton and Will Prochaska The harm caused by gambling in the UK is alarming. Official figures released in 2024 showed that 2.5% of the adult population has a gambling problem, with a further 12% gambling at increased risk and showing signs of harm.1 The UK government must respond to the new evidence on the scale of harm and take urgent action to end all gambling advertising. Each person with a gambling problem has family and friends who are being harmed indirectly. Behind the numbers are human stories of damaged people and families. The harms include depression, strain on relationships, financial harms, prison, homelessness, and many suicides. The Department of Health and Social Care estimates that each year, in England, 117-496 people die by suicide that is related to gambling.2 It’s …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044142","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":"Why I . . . paint","authors":"Kathy Oxtoby","doi":"10.1136/bmj.r102","DOIUrl":"https://doi.org/10.1136/bmj.r102","url":null,"abstract":"GP Katherine Tully talks to Kathy Oxtoby about how painting helps her process the more difficult aspects of her clinical work, remain compassionate, and avoid burnout Katherine Tully’s interest in the care of older people is not only part of her practice, but also the subject of many of her paintings. The GP’s artworks include a series of portraits of older people. “Sometimes older people feel like they aren’t seen,” Tully says. “Conversely, painting their portraits meant really studying their faces for hours. I’ve had lovely feedback from the sitters about the experience.” Tully, a GP working with a virtual ward service in Devon, spends time outside of work at her studio creating “large scale, semi-figurative, expressive work in oils.” “My paintings are about bodies falling apart and we doctors trying to hold them together using whatever means possible, even when it’s clearly futile. And the absurdity of this at …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044145","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":"Tipu Zahed Aziz: resurrected functional neurosurgery in the UK in the face of a sceptical medical establishment","authors":"Erlick Pereira, Alex Green, Anne Gulland","doi":"10.1136/bmj.r121","DOIUrl":"https://doi.org/10.1136/bmj.r121","url":null,"abstract":"As a young physiology student Tipu Aziz was inspired by watching grainy videos from the 1970s showing patients undergoing brain surgery for movement disorders such as Parkinson’s disease. The films depicted medical miracles: before surgery patients had debilitating tremors, making the performance of everyday tasks almost impossible; afterwards, the tremors had disappeared. In the UK neurosurgery to treat movement disorders had fallen out of fashion, largely because of the introduction of levodopa. While the medication can be transformational, its long term use can lead to crippling side effects. Aziz realised functional neurosurgery still had a place and, in the face of a largely sceptical and indifferent surgical establishment, managed to resurrect it single handedly in the UK. Aziz’s quest began soon after he qualified and completed house jobs. He sought out Alan Crossman, a neuro-anatomist, with whom he worked as a research fellow, and obtained his doctorate in medicine. His work on monkeys demonstrated the subthalamic nucleus as a new surgical target for Parkinson’s disease—two decades later this would become the main target for deep brain stimulation (DBS). This discovery was soon translated into clinical practice and doctors in France were the first to report the efficacy of surgery in this part of the brain.1 In the UK, Aziz’s breakthrough was largely ignored. His …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027233","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":"Direct-to-consumer genetic tests also need to be regulated","authors":"Frances A Flinter","doi":"10.1136/bmj.r144","DOIUrl":"https://doi.org/10.1136/bmj.r144","url":null,"abstract":"Gram and colleagues describe valid concerns arising from the growing market for medical direct-to-consumer (DTC) tests but do not mention genetic tests.1 Most genetic tests are not regulated. They go to market (often over the internet) without any independent analysis to verify the claims of the company marketing them. Finding a “health risk” on DTC genetic testing often does …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027235","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":"When I use a word . . . Lexicographic anniversaries in 2025","authors":"Jeffrey K Aronson","doi":"10.1136/bmj.r164","DOIUrl":"https://doi.org/10.1136/bmj.r164","url":null,"abstract":"Like people, words have birthdays. My definition of the birthday of a word is the year in which it first appeared in a written text, as, for example, documented in the Oxford English Dictionary ( OED ). Of course, many words have had a spoken life before their written one, but I count that as the fetal stage in their development. Their appearance in the world is marked by their first appearance in print, their birthday or anniversary. In some cases the date on the birth certificate, i.e. the earliest recorded date in the dictionary, can be antedated by finding earlier examples of the use of the word in print; in my experience, this happens to about 10% of biomedical words. Counting anniversaries as having occurred in multiples of 50 years, I have searched for biomedical words whose birthdays fell in years ending in ’25 and ’75 and have found 655 of them, about 46 per 1000 new words of all kinds in those years. Among these, I discuss: “body sin,” dating from 1175 and largely obsolete since then, only once, more recently, being used to describe obesity; “licorice,” which dates from at least 1275, but perhaps earlier; and “spittle-evil” a synonym for leprosy, which dates from 1225. The last of these occurs in a 13th century manual of instruction for anchoresses, The Ancrene Riwle , in which God’s grace and the Devil’s work are both likened to the use of medicinal compounds, respectively beneficial and harmful. Indeed, the words medicine, remedy, and remission all occur for the first time in writing in this text. My last example is “pharmacological,” which celebrates its 200th anniversary this year. I have been listing medical anniversaries annually since 2016, and have recently done so for 2025.1 For this purpose I have counted an anniversary …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030996","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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