Jon Williamson talks to Kathy Oxtoby about how his love of photography led to him documenting the covid-19 pandemic Countless words have been written about the pandemic—but the photographs taken of doctors and patients during that time were able to communicate in a way that words could not. When covid-19 hit, anaesthetic registrar Jon Williamson used his photographic skills to document it from his perspective working at the Whittington Hospital in north London. His images, some of which were reproduced in the national media, capture the experiences at the hospital at that time. They include a baby born by caesarean section with the mother wearing a facemask, and a simple close up of a colleague coming out of intensive care, whose emotions mirrored his own. The experience of taking such images is complex, says Williamson. “You have a heavy sense of purpose—a large sense of duty to convey the story of what is going on. At times it was emotionally challenging, but there was also a …
{"title":"Why I . . . take photographs","authors":"Kathy Oxtoby","doi":"10.1136/bmj.q1945","DOIUrl":"https://doi.org/10.1136/bmj.q1945","url":null,"abstract":"Jon Williamson talks to Kathy Oxtoby about how his love of photography led to him documenting the covid-19 pandemic Countless words have been written about the pandemic—but the photographs taken of doctors and patients during that time were able to communicate in a way that words could not. When covid-19 hit, anaesthetic registrar Jon Williamson used his photographic skills to document it from his perspective working at the Whittington Hospital in north London. His images, some of which were reproduced in the national media, capture the experiences at the hospital at that time. They include a baby born by caesarean section with the mother wearing a facemask, and a simple close up of a colleague coming out of intensive care, whose emotions mirrored his own. The experience of taking such images is complex, says Williamson. “You have a heavy sense of purpose—a large sense of duty to convey the story of what is going on. At times it was emotionally challenging, but there was also a …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142234440","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 definition of an aphrodisiac in the Oxford English Dictionary is “A drug or preparation inducing sexual desire”; and “preparation” is defined as “A specially prepared or made up substance, as a medicine, cosmetic, foodstuff, etc.” However, these definitions, taken in conjunction, do not cover all the items that have been proposed to have aphrodisiac properties at one time or another. They include: aromas; styles of dress; honeyed words, lewd or titillating pictorial representations, plays, verses, songs, or dances; and behaviours, such as glances, gestures, and other forms of body language. About a half of all supposed aphrodisiacs are based on plants and plant products, including trees, herbs, fungi, fruits, nuts, and vegetables, and another one fifth are based on animals and animal products, including land animals, sea creatures, birds, and insects. The rest can be categorised as foodstuffs and additives; medicines; appearances and behaviours, including language, body language, singing, and dancing; elements, minerals, gemstones, and resins; alcoholic drinks; aromas; charms; and human products. Certain doctrines have in the past been used to justify claims that substances are aphrodisiacs. The Doctrine of Signatures asserts that certain plants, animals, and minerals have distinctive features, particularly marks, shapes, or colours, often considered God-given, that indicate their medicinal properties. The Doctrine of Similars asserts that anything that resembles something else can be used in the same way. And the Doctrine of Analogy asserts that if a substance of a particular kind has an effect, another substance of the same kind is likely to share that property. An aphrodisiac is defined in the Oxford English Dictionary ( OED ) as “A drug or preparation inducing sexual desire.”1 And in its adjectival sense it is defined as “Of or relating to sexual desire: that tends to increase sexual desire.” But these definitions do not do justice …
{"title":"When I use a word . . . Aphrodisiacs—taxonomy and doctrines","authors":"Jeffrey K Aronson","doi":"10.1136/bmj.q2019","DOIUrl":"https://doi.org/10.1136/bmj.q2019","url":null,"abstract":"The definition of an aphrodisiac in the Oxford English Dictionary is “A drug or preparation inducing sexual desire”; and “preparation” is defined as “A specially prepared or made up substance, as a medicine, cosmetic, foodstuff, etc.” However, these definitions, taken in conjunction, do not cover all the items that have been proposed to have aphrodisiac properties at one time or another. They include: aromas; styles of dress; honeyed words, lewd or titillating pictorial representations, plays, verses, songs, or dances; and behaviours, such as glances, gestures, and other forms of body language. About a half of all supposed aphrodisiacs are based on plants and plant products, including trees, herbs, fungi, fruits, nuts, and vegetables, and another one fifth are based on animals and animal products, including land animals, sea creatures, birds, and insects. The rest can be categorised as foodstuffs and additives; medicines; appearances and behaviours, including language, body language, singing, and dancing; elements, minerals, gemstones, and resins; alcoholic drinks; aromas; charms; and human products. Certain doctrines have in the past been used to justify claims that substances are aphrodisiacs. The Doctrine of Signatures asserts that certain plants, animals, and minerals have distinctive features, particularly marks, shapes, or colours, often considered God-given, that indicate their medicinal properties. The Doctrine of Similars asserts that anything that resembles something else can be used in the same way. And the Doctrine of Analogy asserts that if a substance of a particular kind has an effect, another substance of the same kind is likely to share that property. An aphrodisiac is defined in the Oxford English Dictionary ( OED ) as “A drug or preparation inducing sexual desire.”1 And in its adjectival sense it is defined as “Of or relating to sexual desire: that tends to increase sexual desire.” But these definitions do not do justice …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142231462","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}
Women experience varied levels of pain during gynaecological procedures. More research is needed if we want to reduce the risk of severe pain and improve understanding among medical professionals, writes Stephanie O’Donohue The US Centers for Disease Control and Prevention has issued new recommendations advising clinicians to forewarn patients about the potential for pain during intrauterine device (IUD) placement and to give them options to help manage it.1 For years women have spoken up about their experiences of extreme pain during gynaecological procedures. From smear tests to hysteroscopies, insertions to removals of IUDs, too many women continue to experience unacceptably high levels of pain and poor levels of care, leading to physical and psychological trauma.23 Women shouldn’t be left at risk of extreme pain when accessing these vital services. There still doesn’t seem to be a reliable way of predicting when someone might be more likely to experience extreme pain during gynaecological procedures, or an evidence based understanding of why it happens. In the absence of this knowledge, it’s disheartening that there also doesn’t seem to be a consistent approach for supporting patients …
{"title":"Pain during gynaecological procedures: research and compassion are key to improving patients’ experiences","authors":"Stephanie O’Donohue","doi":"10.1136/bmj.q1996","DOIUrl":"https://doi.org/10.1136/bmj.q1996","url":null,"abstract":"Women experience varied levels of pain during gynaecological procedures. More research is needed if we want to reduce the risk of severe pain and improve understanding among medical professionals, writes Stephanie O’Donohue The US Centers for Disease Control and Prevention has issued new recommendations advising clinicians to forewarn patients about the potential for pain during intrauterine device (IUD) placement and to give them options to help manage it.1 For years women have spoken up about their experiences of extreme pain during gynaecological procedures. From smear tests to hysteroscopies, insertions to removals of IUDs, too many women continue to experience unacceptably high levels of pain and poor levels of care, leading to physical and psychological trauma.23 Women shouldn’t be left at risk of extreme pain when accessing these vital services. There still doesn’t seem to be a reliable way of predicting when someone might be more likely to experience extreme pain during gynaecological procedures, or an evidence based understanding of why it happens. In the absence of this knowledge, it’s disheartening that there also doesn’t seem to be a consistent approach for supporting patients …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174973","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":"Gaza: Over 22 000 people with life changing injuries urgently need rehabilitation, WHO warns.","authors":"Elisabeth Mahase","doi":"10.1136/bmj.q2016","DOIUrl":"https://doi.org/10.1136/bmj.q2016","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233475","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":"Call for military to protect staff in Italian hospitals after surge in violent attacks.","authors":"Luke Taylor","doi":"10.1136/bmj.q2008","DOIUrl":"https://doi.org/10.1136/bmj.q2008","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233468","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}
We were surprised to read that the term “deprescribing” raises concerns for Zermansky.1 We counter that deprescribing—both the term and the concept—serve an important and specific function in achieving person centred drug management. Deprescribing is “the process of withdrawal of an inappropriate medication, supervised by healthcare professionals with the goal of managing polypharmacy and improving outcomes.”2 This definition places patients and their drug …
{"title":"Should we deprescribe the term “deprescribing”?","authors":"Lisa Kouladjian O’Donnell, Aili Langford","doi":"10.1136/bmj.q2007","DOIUrl":"https://doi.org/10.1136/bmj.q2007","url":null,"abstract":"We were surprised to read that the term “deprescribing” raises concerns for Zermansky.1 We counter that deprescribing—both the term and the concept—serve an important and specific function in achieving person centred drug management. Deprescribing is “the process of withdrawal of an inappropriate medication, supervised by healthcare professionals with the goal of managing polypharmacy and improving outcomes.”2 This definition places patients and their drug …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174978","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":"BMA calls for talks with London hospitals over \"suppressed\" pay rates for extra shifts.","authors":"Jacqui Wise","doi":"10.1136/bmj.q2017","DOIUrl":"https://doi.org/10.1136/bmj.q2017","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233473","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}
Daniel Creamer, Tatiana Lumb, Carrie D Tibbles, Haur Yueh Lee
### What you need to know A student in her late teens is started on lamotrigine for suspected epilepsy. Thirteen days later her eyes become red and itchy, and the following day she develops a sore throat, chapped lips, and widespread skin itching. She attends the emergency department, is diagnosed with a viral illness, and prescribed antihistamine. The next day she has a fever, malaise, facial rash, and oral ulceration. Within 24 hours the rash spreads to her torso and limbs and has started to blister. She is admitted to the intensive care unit of a specialist burns unit and over the next five weeks is treated for extensive skin loss with severe corneal and oral ulceration. Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) describes an acute, life threatening, mucocutaneous blistering disease resulting from epidermal and mucous membrane keratinocyte apoptosis.1 Blistering of less than 10% of body surface area (BSA) is known as Stevens-Johnson syndrome (SJS), and when greater than 30%, BSA is referred to as toxic epidermal necrolysis (TEN). SJS-TEN overlap exists when BSA involvement lies between 10% and 30%.1 Estimated incidence is five or six cases per million per year.2 In 85% of patients with SJS/TEN, the disorder is caused by a hypersensitivity reaction to a drug. Around 15% of patients have no relevant medication exposure, and in these cases Mycoplasma pneumoniae or viral infections are often the cause, especially in children. During the active phase of SJS/TEN, loss of large …
{"title":"Stevens-Johnson syndrome/toxic epidermal necrolysis: initial assessment","authors":"Daniel Creamer, Tatiana Lumb, Carrie D Tibbles, Haur Yueh Lee","doi":"10.1136/bmj-2024-079986","DOIUrl":"https://doi.org/10.1136/bmj-2024-079986","url":null,"abstract":"### What you need to know A student in her late teens is started on lamotrigine for suspected epilepsy. Thirteen days later her eyes become red and itchy, and the following day she develops a sore throat, chapped lips, and widespread skin itching. She attends the emergency department, is diagnosed with a viral illness, and prescribed antihistamine. The next day she has a fever, malaise, facial rash, and oral ulceration. Within 24 hours the rash spreads to her torso and limbs and has started to blister. She is admitted to the intensive care unit of a specialist burns unit and over the next five weeks is treated for extensive skin loss with severe corneal and oral ulceration. Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) describes an acute, life threatening, mucocutaneous blistering disease resulting from epidermal and mucous membrane keratinocyte apoptosis.1 Blistering of less than 10% of body surface area (BSA) is known as Stevens-Johnson syndrome (SJS), and when greater than 30%, BSA is referred to as toxic epidermal necrolysis (TEN). SJS-TEN overlap exists when BSA involvement lies between 10% and 30%.1 Estimated incidence is five or six cases per million per year.2 In 85% of patients with SJS/TEN, the disorder is caused by a hypersensitivity reaction to a drug. Around 15% of patients have no relevant medication exposure, and in these cases Mycoplasma pneumoniae or viral infections are often the cause, especially in children. During the active phase of SJS/TEN, loss of large …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174994","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":"How to live to 110, win a coin toss, and breathe through the anus-it's the 2024 Ig Nobel awards.","authors":"Janice Hopkins Tanne","doi":"10.1136/bmj.q2012","DOIUrl":"https://doi.org/10.1136/bmj.q2012","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233471","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}
Findings from the MBRRACE-UK report published in October 2023 are a stark reminder of persistent inequalities in birth outcomes for women from ethnic minorities in the UK.1 In 2019-21, the risk of maternal death was 3.8 times higher among black women and 1.8 times higher among Asian women compared with white women in the UK.1 Despite several calls to end inequalities through individualised high quality care and targeted interventions, women from ethnic minority groups often feel they are not listened to or have rarely been asked about solutions.2 That's why it's so important to involve women from ethnic minorities in developing interventions if we want to improve outcomes and patient care. Public involvement is recognised as important in both health service delivery and research design and delivery.234 Uptake and initiation of timely antenatal care is vital in ensuring good perinatal outcomes for women and babies. The MBRRACE-UK report showed that the proportion of women who received recommended levels of antenatal care were low among those who died.1 Women from some ethnic minority groups tend to attend antenatal care later.5 In order to increase the timely uptake of antenatal care in an ethnically diverse and socio-economically disadvantaged area, a project team that I led developed a community-based intervention using a co-production approach.6 The goal was to co-produce a tailored intervention best suited to meet the needs of a diverse …
{"title":"Successful co-production can help tackle inequalities in maternal health outcomes","authors":"Shuby Puthussery","doi":"10.1136/bmj.q1958","DOIUrl":"https://doi.org/10.1136/bmj.q1958","url":null,"abstract":"Findings from the MBRRACE-UK report published in October 2023 are a stark reminder of persistent inequalities in birth outcomes for women from ethnic minorities in the UK.1 In 2019-21, the risk of maternal death was 3.8 times higher among black women and 1.8 times higher among Asian women compared with white women in the UK.1 Despite several calls to end inequalities through individualised high quality care and targeted interventions, women from ethnic minority groups often feel they are not listened to or have rarely been asked about solutions.2 That's why it's so important to involve women from ethnic minorities in developing interventions if we want to improve outcomes and patient care. Public involvement is recognised as important in both health service delivery and research design and delivery.234 Uptake and initiation of timely antenatal care is vital in ensuring good perinatal outcomes for women and babies. The MBRRACE-UK report showed that the proportion of women who received recommended levels of antenatal care were low among those who died.1 Women from some ethnic minority groups tend to attend antenatal care later.5 In order to increase the timely uptake of antenatal care in an ethnically diverse and socio-economically disadvantaged area, a project team that I led developed a community-based intervention using a co-production approach.6 The goal was to co-produce a tailored intervention best suited to meet the needs of a diverse …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174976","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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