“Schizophrenia is perhaps the human condition,” wrote Tim Crow in 2000.1 Crow had been researching schizophrenia for most of his psychiatric career but the origins of this most complex condition had been a particular fascination. What could have given rise to a disease that has been documented throughout history, yet has no animal model and no known social or environmental cause? Crow came up with a simple and elegant theory: the origins of schizophrenia and other psychoses lay in the moment when humans developed the capacity for language—with the light, came the dark.2 “A good theory can be written on the back of an envelope,” he said.3 Angus Mackay, honorary senior research fellow at the University of Glasgow, was a long follower of Crow’s work. “His idea was that, as humans evolved, one cerebral hemisphere became larger than the other, and this asymmetry was associated with that particularly human of abilities, language,” says Mackay. “The model proposed that a perverse outcome of this specialisation was the risk of psychosis.” Crow continued to develop his theory throughout his career, thinking out loud in journal pages and lecture halls. “Developing this model over the years was a major intellectual theme, but one that was not embraced by mainstream psychiatry,” says Mackay. “However, his writings were always thought …
{"title":"Tim Crow: psychiatrist whose original thinking on the origins of schizophrenia ended up in the pages of a Sebastian Faulks novel","authors":"Anne Gulland","doi":"10.1136/bmj.r313","DOIUrl":"https://doi.org/10.1136/bmj.r313","url":null,"abstract":"“Schizophrenia is perhaps the human condition,” wrote Tim Crow in 2000.1 Crow had been researching schizophrenia for most of his psychiatric career but the origins of this most complex condition had been a particular fascination. What could have given rise to a disease that has been documented throughout history, yet has no animal model and no known social or environmental cause? Crow came up with a simple and elegant theory: the origins of schizophrenia and other psychoses lay in the moment when humans developed the capacity for language—with the light, came the dark.2 “A good theory can be written on the back of an envelope,” he said.3 Angus Mackay, honorary senior research fellow at the University of Glasgow, was a long follower of Crow’s work. “His idea was that, as humans evolved, one cerebral hemisphere became larger than the other, and this asymmetry was associated with that particularly human of abilities, language,” says Mackay. “The model proposed that a perverse outcome of this specialisation was the risk of psychosis.” Crow continued to develop his theory throughout his career, thinking out loud in journal pages and lecture halls. “Developing this model over the years was a major intellectual theme, but one that was not embraced by mainstream psychiatry,” says Mackay. “However, his writings were always thought …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451545","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":"Sudan: Attack on last functioning hospital in El Fasher leaves 70 dead, says WHO.","authors":"Owen Dyer","doi":"10.1136/bmj.r191","DOIUrl":"https://doi.org/10.1136/bmj.r191","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"36 1","pages":"r191"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062026","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":"Health officials' plans to overhaul NHS in England are stale and uninspiring, say MPs.","authors":"Adrian O'Dowd","doi":"10.1136/bmj.r189","DOIUrl":"https://doi.org/10.1136/bmj.r189","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"74 1","pages":"r189"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062045","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}
Posts about unexpected pregnancies while using drugs such as Ozempic for weight loss are trending on social media. Does any scientific evidence back this up? Sangeetha Nadarajah reports Amid the rising popularity of glucagon-like peptide-1 (GLP-1) receptor agonists for weight loss such as semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound), anecdotal reports of unintended pregnancies, even in people using oral birth control or with existing fertility challenges, have begun trending on social media. But despite the media attention and the popularity of the hashtag #ozempicbabies, experts have told The BMJ that these cases may be less common than portrayed. “In my practice and among my colleagues, we rarely encounter this issue,” says Nanette Santoro, professor of obstetrics and gynaecology and chair in reproductive endocrinology and infertility at the University of Colorado School of Medicine. Patients’ experiences shared on social media, including Facebook groups such as “I Got Pregnant on Ozempic” and discussion threads on Reddit, reveal a wide range of outcomes. Some women have reported complications while using the drug, including miscarriage or ectopic pregnancy, while others describe healthy pregnancies. One woman wrote that she had unknowingly taken Ozempic during early pregnancy and later had a miscarriage, feeling conflicted about whether the medicine had contributed to the outcome. Another reported having had an ectopic pregnancy despite undergoing tubal ligation more than a decade earlier. However, some women unknowingly took GLP-1 receptor agonists during pregnancy and reported healthy births. One woman, writing on the online forum Reddit, discovered that she was 23 weeks pregnant while still taking Ozempic, and her baby showed normal development on ultrasounds. Another woman wrote that she had discontinued Ozempic after learning of her pregnancy and delivered a healthy baby boy, while a different patient switched to insulin but experienced complications due to unknown reasons, leading to a premature …
{"title":"Ozempic babies: are weight loss drugs leading to unintended pregnancies?","authors":"Sangeetha Nadarajah","doi":"10.1136/bmj.q2440","DOIUrl":"https://doi.org/10.1136/bmj.q2440","url":null,"abstract":"Posts about unexpected pregnancies while using drugs such as Ozempic for weight loss are trending on social media. Does any scientific evidence back this up? Sangeetha Nadarajah reports Amid the rising popularity of glucagon-like peptide-1 (GLP-1) receptor agonists for weight loss such as semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound), anecdotal reports of unintended pregnancies, even in people using oral birth control or with existing fertility challenges, have begun trending on social media. But despite the media attention and the popularity of the hashtag #ozempicbabies, experts have told The BMJ that these cases may be less common than portrayed. “In my practice and among my colleagues, we rarely encounter this issue,” says Nanette Santoro, professor of obstetrics and gynaecology and chair in reproductive endocrinology and infertility at the University of Colorado School of Medicine. Patients’ experiences shared on social media, including Facebook groups such as “I Got Pregnant on Ozempic” and discussion threads on Reddit, reveal a wide range of outcomes. Some women have reported complications while using the drug, including miscarriage or ectopic pregnancy, while others describe healthy pregnancies. One woman wrote that she had unknowingly taken Ozempic during early pregnancy and later had a miscarriage, feeling conflicted about whether the medicine had contributed to the outcome. Another reported having had an ectopic pregnancy despite undergoing tubal ligation more than a decade earlier. However, some women unknowingly took GLP-1 receptor agonists during pregnancy and reported healthy births. One woman, writing on the online forum Reddit, discovered that she was 23 weeks pregnant while still taking Ozempic, and her baby showed normal development on ultrasounds. Another woman wrote that she had discontinued Ozempic after learning of her pregnancy and delivered a healthy baby boy, while a different patient switched to insulin but experienced complications due to unknown reasons, leading to a premature …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054858","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 tension between doctors and physician assistants is a global dilemma and Ghana is no different. Yemisi Bokinni reports “Disappointed chameleons.” That’s how Frank Serebour, president of the Ghana Medical Association, reportedly referred to physician assistants (PAs). His comments sparked calls for his resignation in 2022.1 This sharp rhetoric has stoked tensions, fuelling perceptions of an elitist and ego driven divide in Ghana’s healthcare system. In 2023 the Medical and Dental Council (MDC) de-accredited more than half of Ghana’s university PA training programmes, leading to accusations of professional gatekeeping—particularly since reasons for the de-accreditations were never made public. The BMJ asked the MDC for comment, but did not receive a reply. “About 10 universities were running a PA programme prior to that action by the MDC. Now we have only about five, or maybe fewer than that,” says Joel Padi, secretary general of the West African Association of Physician Assistants (WAAPA). Others say that attempts have been made to restrict PAs’ scope of practice—which is unrealistic when PAs form a central part of the primary healthcare system. “Almost 90% of health centres in Ghana are headed by PAs,” Padi tells The BMJ . The capital city of Accra is the only …
{"title":"Ghana’s physician assistants demand greater autonomy amid rising tensions","authors":"Yemisi Bokinni","doi":"10.1136/bmj.r21","DOIUrl":"https://doi.org/10.1136/bmj.r21","url":null,"abstract":"The tension between doctors and physician assistants is a global dilemma and Ghana is no different. Yemisi Bokinni reports “Disappointed chameleons.” That’s how Frank Serebour, president of the Ghana Medical Association, reportedly referred to physician assistants (PAs). His comments sparked calls for his resignation in 2022.1 This sharp rhetoric has stoked tensions, fuelling perceptions of an elitist and ego driven divide in Ghana’s healthcare system. In 2023 the Medical and Dental Council (MDC) de-accredited more than half of Ghana’s university PA training programmes, leading to accusations of professional gatekeeping—particularly since reasons for the de-accreditations were never made public. The BMJ asked the MDC for comment, but did not receive a reply. “About 10 universities were running a PA programme prior to that action by the MDC. Now we have only about five, or maybe fewer than that,” says Joel Padi, secretary general of the West African Association of Physician Assistants (WAAPA). Others say that attempts have been made to restrict PAs’ scope of practice—which is unrealistic when PAs form a central part of the primary healthcare system. “Almost 90% of health centres in Ghana are headed by PAs,” Padi tells The BMJ . The capital city of Accra is the only …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049813","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":"Researchers call for UK Sunshine Act as Novo Nordisk is again reprimanded over undisclosed payments.","authors":"Elisabeth Mahase","doi":"10.1136/bmj.r178","DOIUrl":"https://doi.org/10.1136/bmj.r178","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"17 1","pages":"r178"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056700","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}
Marni Sommer, Julie Hennegan, Arundati Muralidharan, Caroline W Kabiru, Therese Mahon, Penelope A Phillips-Howard
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, …
{"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}
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