The BMJ最新文献_第9页

Sunset cataract 日落白内障

The BMJ Pub Date : 2024-10-24 DOI: 10.1136/bmj-2024-079403

Xinyan Wu, Andina Hu

引用次数: 0

Shifting influence: the unaccountable millions paid by industry to healthcare organisations 影响力的转移：医疗行业向医疗机构支付的数百万元不负责任的费用

The BMJ Pub Date : 2024-10-24 DOI: 10.1136/bmj.q2330

Kamran Abbasi

引用次数: 0

As we launch the NHS 10 year plan, we want to hear from NHS staff about how we can improve services 在我们启动英国国家医疗服务体系十年计划之际，我们希望听取英国国家医疗服务体系员工关于如何改善服务的意见

The BMJ Pub Date : 2024-10-24 DOI: 10.1136/bmj.q2344

Stephen Powis

引用次数: 0

Mpox risk to Europe “low” says EU official, but virus and bird flu need monitoring 欧盟官员称水痘对欧洲的风险 "很低"，但需要监测病毒和禽流感

The BMJ Pub Date : 2024-10-24 DOI: 10.1136/bmj.q2240

Elisabeth Mahase

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Daylight saving time harms health and increases inequalities 夏令时损害健康，加剧不平等

The BMJ Pub Date : 2024-10-24 DOI: 10.1136/bmj.q2335

Karin G Johnson, Lauren Hale, Dayna A Johnson, Beth A Malow

{"title":"Daylight saving time harms health and increases inequalities","authors":"Karin G Johnson, Lauren Hale, Dayna A Johnson, Beth A Malow","doi":"10.1136/bmj.q2335","DOIUrl":"https://doi.org/10.1136/bmj.q2335","url":null,"abstract":"Eliminating this structural barrier would help reduce sleep health inequity, write Karin Johnson and colleagues Daylight saving time, a seasonal hour shift in clock time, is a legislative policy followed by about 70 countries. In the spring clocks are set an hour later for daylight saving time and in the autumn they return to standard time, which more closely aligns to the sun being overhead at noon. Daylight saving time is harmful to sleep and health and disproportionately affects vulnerable populations.1 This practice should therefore be scrapped to try to reduce sleep disturbances and other health inequities.2 In recent years, greater scientific clarity has emerged regarding the public health harms of the biannual switching of the clocks,13 but people are split on whether to end clock change with permanent daylight saving time or permanent standard time. Some business leaders argue that evening light promotes economic activity so therefore argue in favour of permanent daylight saving time. They have used the harms of switching twice yearly4 and the promise of increased evening exercise to promote permanent daylight saving time as the healthy choice.5 The medical and scientific community, including the British Sleep Society, who issued a position statement on daylight saving time,4 support permanent standard time and advocate against permanent daylight saving time.13 Later sunrises and sunsets during daylight saving time are associated with increased rates of cancer,678 obesity,7 heart attacks,7 diabetes,7 suicide,9 and motor vehicle incidents,10 disproportionately affecting minoritised populations. …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488870","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

Cancer cachexia 癌症恶病质

The BMJ Pub Date : 2024-10-23 DOI: 10.1136/bmj-2024-080040

Michael S Yule, Leo R Brown, Rachel Waller, Stephen J Wigmore

{"title":"Cancer cachexia","authors":"Michael S Yule, Leo R Brown, Rachel Waller, Stephen J Wigmore","doi":"10.1136/bmj-2024-080040","DOIUrl":"https://doi.org/10.1136/bmj-2024-080040","url":null,"abstract":"### What you need to know Cancer cachexia is a complex syndrome characterised by tissue loss (fat, cardiac muscle, and skeletal muscle), decreased appetite (anorexia), fatigue, and reduced activity in patients with cancer (fig 1).1 It cannot be fully reversed with nutritional support alone and is caused by inflammation and metabolic dysfunction driven by the interaction between tumour and patient. Consequences include reduced efficacy of cancer treatment, poorer quality of life, and reduced survival.2 This article provides an update on cancer cachexia for healthcare professionals drawing on contemporary research and guidelines developed by the European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO). Fig 1 Characteristics of cancer cachexia ### What is controversial about cancer cachexia? The definition of cancer cachexia remains controversial. The role of inflammation is recognised as a key component; however, some argue that loss of skeletal muscle should be the defining feature. The first international consensus definition was published in 2011, and work is under way to update this. Lack of a clear consensus definition undermines the design of clinical trials. Rates of cancer cachexia vary across different cancer populations (fig 2), with both tumour site and tumour stage key determinants of prevalence. Cachexia is less common in patients with breast, prostate, and skin cancers.3456 Cancers most strongly associated with the syndrome include pancreatic, hepatobiliary, and oesophagogastric. Up to 80% of patients with these cancers are affected.7 Fig 2 Tumour sites most …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487220","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

Mohiuddin Khan Umarkhanji Malik Mohiuddin Khan Umarkhanji Malik

The BMJ Pub Date : 2024-10-23 DOI: 10.1136/bmj.q2322

Sikander KU Malik, Salim KU Malik, Sabreena Malik-Crook, Jasmin Sakhina Tzortzakakis-Malik, Zainab Malik, Salma Mepani, Hajrah Baig, Mariah Lakdawala

引用次数: 0

Pharma pours millions into the NHS for non-research work—but we don’t know what the money is being spent on 制药公司向国家医疗服务体系投入数百万美元用于非研究工作--但我们却不知道这些钱花在了什么地方

The BMJ Pub Date : 2024-10-23 DOI: 10.1136/bmj.q2264

Hristio Boytchev, Piotr Ozieranski, Mostafa Elsharkawy

{"title":"Pharma pours millions into the NHS for non-research work—but we don’t know what the money is being spent on","authors":"Hristio Boytchev, Piotr Ozieranski, Mostafa Elsharkawy","doi":"10.1136/bmj.q2264","DOIUrl":"https://doi.org/10.1136/bmj.q2264","url":null,"abstract":"Many industry payments to NHS organisations are unexplained and disclosure figures can’t be trusted. This raises questions about unrecognised conflicts of interest, find Hristio Boytchev , Piotr Ozieranski , and Mostafa Elsharkawy An analysis by The BMJ has found that pharmaceutical companies pay tens of millions of pounds to the NHS each year without the public being told what the payments are for. The findings have led to calls for a shake-up of current transparency rules so that patients can see why payments are being made to the NHS. Pharmaceutical companies paid £156m to NHS trusts in England between 2015 and 2022, according to new analysis of the Disclosure UK database. The Association of the British Pharmaceutical Industry (ABPI) database requires participating companies to disclose cash payments and other benefits in kind to healthcare professionals and organisations. Even though the scheme has been lauded as one of the best among its industry run peers in Europe,1 The BMJ has uncovered widespread confusion about the intended purpose of the payments. For example, if any of these payments are for “educational” purposes that could be linked to the promotion of pharmaceutical products. “There is a big difference between publishing some numbers and creating effective transparency,” says Margaret McCartney, a general practitioner and transparency campaigner. She questions if it is “in the patient and public interest that such massive transfers of value are occurring between the pharmaceutical industry and the NHS.” “When companies dole out over £156m, they aren’t doing it out of the goodness of their hearts, they are doing it because they expect some kind of return on their investment. The unanswered question, so far, is what they want,” comments Joel Lexchin, professor emeritus at the school of health policy and management at York University, Toronto, Canada. “Transparency is key …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488988","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

Scarlett McNally: Designing patient centred clinics around space, time, and staff 斯嘉丽-麦克纳利围绕空间、时间和人员设计以患者为中心的诊所

The BMJ Pub Date : 2024-10-23 DOI: 10.1136/bmj.q2297

Scarlett McNally

引用次数: 0

David Oliver: We need doctors to take on leadership roles—so why do we bring them down? 大卫-奥利弗我们需要医生发挥领导作用，为什么要把他们拉下马？

The BMJ Pub Date : 2024-10-23 DOI: 10.1136/bmj.q2299

David Oliver

引用次数: 0