The BMJ最新文献

{"title":"Matt Morgan: The death of the traditional medical career","authors":"Matt Morgan","doi":"10.1136/bmj.r1969","DOIUrl":"https://doi.org/10.1136/bmj.r1969","url":null,"abstract":"Two hours into the beautiful drive through mid-Wales to the Machynlleth Comedy Festival, my friend James and I got onto a serious topic of conversation—diaries. While James has stuck to his faithful “week to view” leatherbound journal, my life is coordinated with multiple coloured events and recurring reminders in an ever more complex digital diary. Like a Swiss army knife with wi-fi, it reads my emails, slices meetings to size, decides on scheduling, and even uncorks my forgotten anniversaries. I need this level of integration because I’m one of those annoying people with a “portfolio career”: I teach, I write, and I sometimes even work as a full time doctor. Medicine has never really been a straight line. Even the Victorian physician John Snow embraced this. He was not only an anaesthetist—famously administering chloroform to Queen Victoria …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235949","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":"US protectionism makes it tougher for Europe to tackle health challenges, officials warn.","authors":"Kate Bowie","doi":"10.1136/bmj.r2102","DOIUrl":"https://doi.org/10.1136/bmj.r2102","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"97 5 1","pages":"r2102"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241032","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 . . . play football","authors":"Kathy Oxtoby","doi":"10.1136/bmj.r1930","DOIUrl":"https://doi.org/10.1136/bmj.r1930","url":null,"abstract":"GP trainee Asif Khapedi tells Kathy Oxtoby how playing football helps him stay connected with his community Asif Khapedi, a GP trainee in London, is a fan of the “beautiful game.” He watches and plays football with former school friends and doctor colleagues, finding the twice weekly games “a release” from the pressures of training. “Being able to switch off, even temporarily, helps me to get my energy back up for when I need to go back into work,” he says. “The day after a really hard shift or a block of on-calls, knowing I can just do something for me, without having to take responsibility, helps settle my nerves and the adrenalin I’m feeling after working a large number of hours. Football gets rid of all that stress and tension.” Khapedi has loved football for as long as he can remember. Growing up in east London he became a supporter of his …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"1143 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228968","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":"Sexual misconduct of doctors: New tribunal guidance welcomed but experts say inconsistencies will remain.","authors":"Adele Waters","doi":"10.1136/bmj.r2105","DOIUrl":"https://doi.org/10.1136/bmj.r2105","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"18 1","pages":"r2105"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241031","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":"Non-invasive high frequency oscillatory ventilation for primary respiratory support in extremely preterm infants: multicentre randomised controlled trial","authors":"Yang Li, Xingwang Zhu, Ling-Jun Li, Long Chen, Qian Yang, Liping Xu, Wuhua Liang, Xinzhu Lin, Chuanfeng Li, Jiang Xue, Ling Liu, Xinnian Pan, Rong Ju, Xianglian Peng, Wenyan Tang, Yuan Shi","doi":"10.1136/bmj-2025-085569","DOIUrl":"https://doi.org/10.1136/bmj-2025-085569","url":null,"abstract":"Objective To test the hypothesis that non-invasive high frequency oscillatory ventilation (NHFOV) is more efficacious than nasal continuous positive airway pressure (NCPAP) in reducing invasive mechanical ventilation as primary respiratory support for extremely preterm infants with respiratory distress syndrome. Design A multicentre, randomised controlled trial. Setting Twenty tertiary neonatal intensive care units in China. Participants 342 extremely preterm infants (gestational age between 24 weeks +0 day and 28 weeks +6 days) with respiratory distress syndrome were enrolled in the study between August 2022 and August 2024. Interventions Participants were randomly allocated to receive NCPAP or NHFOV as primary respiratory support for respiratory distress syndrome. Main outcome measures The primary outcome was treatment failure, defined as the need for invasive mechanical ventilation within 72 hours after birth. Results Treatment failure within 72 hours occurred in 27 of` 170 infants (15.9%) in the NHFOV group and 48 of 172 infants (27.9%) in the NCPAP group (risk difference −12.0 percentage points, 95% confidence interval −20.7 to −3.4; P=0.007). Treatment failure within seven days was also lower in the NHFOV group (−12.5 percentage points, 95% confidence interval −21.9 to −3.2; P=0.008) compared with the NCPAP group. All observed associations remained significant after sensitivity analysis including study sites and antenatal steroid use. No significant differences were found in any other secondary outcomes between the two groups. Conclusions NHFOV appeared superior to NCPAP in reducing the need for intubation when used as a primary respiratory support strategy in extremely preterm infants. Both techniques did not show significant differences in neonatal adverse events. Trial registration ClinicalTrials.gov [NCT05141435][1] The code used to analyse the data in the paper can be found in the supplemental files. The data underlying the findings in this paper are openly and publicly available and can be found at <https://data.mendeley.com/datasets/66gc4zb37c/1> or Zhu, Xingwang (2025) “NHFOV as Primary Support in Very Preterm Infants With RDS,” Mendeley Data, V1, doi:[10.17632/66gc4zb37c.1][2]. If problems occur accessing the data, please contact the corresponding author. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT05141435&atom=%2Fbmj%2F391%2Fbmj-2025-085569.atom [2]: /lookup/doi/10.17632/66gc4zb37c.1","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228965","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":"\"Fantastic\" deprescribing programme closes due to lack of funding.","authors":"Adele Waters","doi":"10.1136/bmj.r2098","DOIUrl":"https://doi.org/10.1136/bmj.r2098","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"5 1","pages":"r2098"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241109","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 Enoch: campaigning psychiatrist whose book Uncommon Psychiatric Syndromes became a medical classic","authors":"Judith R Harrison","doi":"10.1136/bmj.r2066","DOIUrl":"https://doi.org/10.1136/bmj.r2066","url":null,"abstract":"Credit: Wellcome Collection David Enoch was a doctor who made ministers flinch. “I was a troublemaker,” he recalled decades later, “But it was the only way to get changes made.” It was in 1965, when he took a consultant psychiatry post at Shelton Hospital in Shrewsbury, that he was first exposed to the geriatric wards hidden from public view. Here he introduced regular teaching and therapeutic communities—a democratic, participative group approach—and piloted one of Britain’s first care in the community schemes. He identified a core of progressive psychiatrists in other parts of the country, and they exchanged ideas. Enoch used polite and persistent letters to engage in discourse with politicians across the spectrum in his campaigns for mental healthcare reform. Later, frustrated with a lack of progress, he joined Barbara Robb’s pressure group, Aid for the Elderly in Government Institutions, and contributed to her book Sans Everything: A Case to Answer .1 Robb’s revelations of the appalling conditions in some psychiatric and geriatric hospitals—overcrowding, rough handling, and misuse of tranquillisers—sparked outrage. Although politicians initially dismissed the allegations, the book prompted a public …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209962","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":"Sickle cell disease: doctors must listen and advocate","authors":"Jennifer Darlow","doi":"10.1136/bmj.r2070","DOIUrl":"https://doi.org/10.1136/bmj.r2070","url":null,"abstract":"International sickle cell day coincided with the publication of a new report from the NHS Race and Health Observatory.1 Despite barely making the mainstream news, this study shows stark differences in levels of care for patients with sickle cell disease compared with other genetic diseases.2 The report recommends greater investment in research, funding, and data collection. Traditionally, expectations are …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209964","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 . . . On becoming a doctor","authors":"Jeffrey K Aronson","doi":"10.1136/bmj.r2072","DOIUrl":"https://doi.org/10.1136/bmj.r2072","url":null,"abstract":"A recent online article in The Times newspaper sought to advise school leavers “how to become a doctor.” Its authors would have been better advising them to consider whether they wanted to become doctors at all. I don’t pretend to be able to advise school leavers about that—it is too long since I did it myself, and even when I was doing it the whole process seemed to me akin to driving down an unfamiliar highway in a dense fog, wondering if I was ever going to arrive. My best offer is to suggest that they ask themselves a question similar to a question I was asked when pondering what specialty might suit me best as a trainee: what are their favourite academic subjects? If they are those that fit the needs of the undergraduate curriculum, they should go for it, assuming that current resident doctors don’t strongly advise them not to, for other reasons. And if they have very wide interests, spanning the sciences and humanities, then they should certainly go for it—of all careers, medicine is likely to offer them the best chance of indulging those interests and becoming expert practitioners. My mother had a twin brother who was a general practitioner in their home town of Liverpool and whom she greatly admired. She was also stage-struck and would have loved to have gone on the stage herself. So, under her tutelage, I was destined to be either a doctor or an actor. In fact, I became both. As a young boy growing up in Glasgow, I was sent to what was known locally as the Athenaeum, the equivalent of London’s RADA, where I learnt everything about how to tread the boards, which I did both at school and later on with amateur companies. We played everything from …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"157 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145210006","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 launches website to help Americans buy cheaper drugs, with Pfizer signing up.","authors":"Janice Hopkins Tanne","doi":"10.1136/bmj.r2091","DOIUrl":"https://doi.org/10.1136/bmj.r2091","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"33 1","pages":"r2091"},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215803","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}