US states with tighter restrictions are seeing fewer deaths As election season heats up in the United States, the issue of gun violence has once again secured a prominent position in American political discourse. This has been intensified by the assassination attempt on former president Donald Trump in Butler, Pennsylvania, and, most recently, a high profile mass shooting that claimed four lives at a high school in Winder, Georgia. On one side of the partisan aisle, solutions to the problem have embraced the mantra of “more guns, less crime.”1 Examples of such permissive policies include taking away the discretion of authorities to deny licences to carry concealed firearms, allowing possession of firearms at more locations, and providing increased legal protections to gun owners who use personal weapons in situations where they perceive a threat to self or others. On the other side, solutions have moved towards greater gun control. These restrictive policies include more comprehensive background checks coupled with more rigorous licensing schemes, prohibitions on the availability of certain firearm technologies, and tighter regulation of firearm use and storage as well as firearm possession by high risk …
{"title":"More gun regulation, less firearm harm","authors":"Louis Klarevas","doi":"10.1136/bmj.q1984","DOIUrl":"https://doi.org/10.1136/bmj.q1984","url":null,"abstract":"US states with tighter restrictions are seeing fewer deaths As election season heats up in the United States, the issue of gun violence has once again secured a prominent position in American political discourse. This has been intensified by the assassination attempt on former president Donald Trump in Butler, Pennsylvania, and, most recently, a high profile mass shooting that claimed four lives at a high school in Winder, Georgia. On one side of the partisan aisle, solutions to the problem have embraced the mantra of “more guns, less crime.”1 Examples of such permissive policies include taking away the discretion of authorities to deny licences to carry concealed firearms, allowing possession of firearms at more locations, and providing increased legal protections to gun owners who use personal weapons in situations where they perceive a threat to self or others. On the other side, solutions have moved towards greater gun control. These restrictive policies include more comprehensive background checks coupled with more rigorous licensing schemes, prohibitions on the availability of certain firearm technologies, and tighter regulation of firearm use and storage as well as firearm possession by high risk …","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":"142174980","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":"Calls for system reform as clinical negligence payouts in England climb to £2.9bn.","authors":"Jane Feinmann","doi":"10.1136/bmj.q2014","DOIUrl":"https://doi.org/10.1136/bmj.q2014","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":"142233474","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}
One week after Labour’s general election victory Wes Streeting, the new health and social care secretary, announced a rapid diagnostic review of the state of the NHS, to be led by Ara Darzi—a professor of surgery and a health minister in the last Labour government. Streeting simultaneously announced a working group to produce a 10 year plan for healthcare, reporting next spring.1 Darzi’s Independent Investigation of the National Health Service in England was published on 12 September.2 His remit was to include social care or the wider health of the nation only “in so far as they impact on the NHS.” The report excludes detailed policy recommendations, although it does list seven key themes to inform the development of the 10 year plan. These include greater staff and patient engagement, better productivity in hospitals, “hardwiring financial flows” to support a shift from secondary to community care, and a “tilt towards technology.” It also emphasises the value of good NHS managers at the operational coalface, while criticising the overly complex patchwork of central agencies and regulators. Darzi concludes that the NHS is “in serious trouble” and that “the first step to rebuilding public trust and confidence” is to be “completely honest about where it stands.” His report …
{"title":"David Oliver: Does Darzi’s report move NHS recovery and reform further forward?","authors":"David Oliver","doi":"10.1136/bmj.q2009","DOIUrl":"https://doi.org/10.1136/bmj.q2009","url":null,"abstract":"One week after Labour’s general election victory Wes Streeting, the new health and social care secretary, announced a rapid diagnostic review of the state of the NHS, to be led by Ara Darzi—a professor of surgery and a health minister in the last Labour government. Streeting simultaneously announced a working group to produce a 10 year plan for healthcare, reporting next spring.1 Darzi’s Independent Investigation of the National Health Service in England was published on 12 September.2 His remit was to include social care or the wider health of the nation only “in so far as they impact on the NHS.” The report excludes detailed policy recommendations, although it does list seven key themes to inform the development of the 10 year plan. These include greater staff and patient engagement, better productivity in hospitals, “hardwiring financial flows” to support a shift from secondary to community care, and a “tilt towards technology.” It also emphasises the value of good NHS managers at the operational coalface, while criticising the overly complex patchwork of central agencies and regulators. Darzi concludes that the NHS is “in serious trouble” and that “the first step to rebuilding public trust and confidence” is to be “completely honest about where it stands.” His report …","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":"142174975","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: Polio vaccination campaign gets underway as attacks on humanitarian aid continue.","authors":"Elisabeth Mahase","doi":"10.1136/bmj.q1918","DOIUrl":"https://doi.org/10.1136/bmj.q1918","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":"142233470","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}
Alexandra Cardoso Pinto, Ramya Sriskandarajah, Hamza Ikhlaq
Aleksandra’s article highlights the importance of holistic, person centred care in the context of addiction.1 In our view, patients living with addiction—including alcohol related addictions—can benefit from health coaching. Health coaching is both a skill and a mindset; it aims to support patients to identify and tackle their health related goals. These are specific to them and therefore relevant and …
Aleksandra 的文章强调了以人为本的整体护理对成瘾问题的重要性。1 我们认为，成瘾患者（包括与酒精相关的成瘾）可以从健康指导中受益。健康指导既是一种技能，也是一种心态；它旨在帮助患者确定并实现与健康相关的目标。这些目标都是针对他们的，因此与他们息息相关，并且...
{"title":"Health coaching to support patients with addiction","authors":"Alexandra Cardoso Pinto, Ramya Sriskandarajah, Hamza Ikhlaq","doi":"10.1136/bmj.q1955","DOIUrl":"https://doi.org/10.1136/bmj.q1955","url":null,"abstract":"Aleksandra’s article highlights the importance of holistic, person centred care in the context of addiction.1 In our view, patients living with addiction—including alcohol related addictions—can benefit from health coaching. Health coaching is both a skill and a mindset; it aims to support patients to identify and tackle their health related goals. These are specific to them and therefore relevant and …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170734","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}
Last year I spoke at Kensington Aldridge Academy. My task was to inspire the schoolchildren. I may or may not have succeeded, but the children certainly inspired me. They were full of hope and a clear sense of a better world. Their questions and comments were intelligent and insightful, and it was my favourite speaking engagement of 2023. Kensington Aldridge Academy is at the foot of Grenfell Tower. David Cameron, prime minister during the period leading up to the Grenfell fire, was a previous speaker. I was told that the children had asked him to apologise for the fire that killed 72 people, including five of the academy’s pupils.12 The fire destroyed lives and livelihoods, leaving people with long term physical and psychological sequelae—poor …
{"title":"Grenfell, covid, obesity: excluding commercial interests from public policy making","authors":"Kamran Abbasi","doi":"10.1136/bmj.q1990","DOIUrl":"https://doi.org/10.1136/bmj.q1990","url":null,"abstract":"Last year I spoke at Kensington Aldridge Academy. My task was to inspire the schoolchildren. I may or may not have succeeded, but the children certainly inspired me. They were full of hope and a clear sense of a better world. Their questions and comments were intelligent and insightful, and it was my favourite speaking engagement of 2023. Kensington Aldridge Academy is at the foot of Grenfell Tower. David Cameron, prime minister during the period leading up to the Grenfell fire, was a previous speaker. I was told that the children had asked him to apologise for the fire that killed 72 people, including five of the academy’s pupils.12 The fire destroyed lives and livelihoods, leaving people with long term physical and psychological sequelae—poor …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170735","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":"Diabetes: Once weekly insulin could be as effective as daily injections, studies indicate.","authors":"Jacqui Wise","doi":"10.1136/bmj.q2005","DOIUrl":"https://doi.org/10.1136/bmj.q2005","url":null,"abstract":"","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142231469","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}
During a routine dental examination, a 69 year old man was found to have multiple areas of exposed bone on the lingual aspect of the right mandible (fig 1). He had a history of myeloma and was being treated with lenalidomide and monthly infusions of 4 mg zoledronic acid for chronic …
{"title":"An oral complication of bisphosphonate therapy","authors":"Sagar Khanna, Brandon Prendes","doi":"10.1136/bmj-2024-081080","DOIUrl":"https://doi.org/10.1136/bmj-2024-081080","url":null,"abstract":"During a routine dental examination, a 69 year old man was found to have multiple areas of exposed bone on the lingual aspect of the right mandible (fig 1). He had a history of myeloma and was being treated with lenalidomide and monthly infusions of 4 mg zoledronic acid for chronic …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170733","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}
Earlier this year, a large randomised controlled trial reported that early anticoagulation in people with atrial fibrillation who had sustained a stroke probably carried a small benefit over delayed anticoagulation. However, the confidence intervals around the estimated treatment effects were too wide to make definite recommendations ( N Engl J Med doi:10.1056/NEJMoa2303048). A re-analysis finds that this conclusion isn’t changed when infarct size is taken into account. The important finding is that early treatment with direct acting oral anticoagulants doesn’t carry a higher risk of bleeding complications, intracranial haemorrhage, or other adverse events, even when the infarct is large ( JAMA Neurol doi:10.1001/jamaneurol.2024.1450). Lecanemab and donanemab, both monoclonal …
今年早些时候，一项大型随机对照试验报告称，对中风的心房颤动患者进行早期抗凝治疗可能比延迟抗凝治疗略有益处。然而，估计治疗效果的置信区间太大，无法提出明确的建议（N Engl J Med doi:10.1056/NEJMoa2303048）。一项重新分析发现，当考虑到梗死面积时，这一结论并没有改变。重要的发现是，早期使用直接作用口服抗凝药并不会增加出血并发症、颅内出血或其他不良事件的风险，即使梗死面积较大也是如此（JAMA Neurol doi:10.1001/jamaneurol.2024.1450）。来卡尼单抗和多那尼单抗都是单克隆抗体 ...
{"title":"Anticoagulation and stroke . . . and other stories","authors":"British Medical Journal Publishing Group","doi":"10.1136/bmj.q1930","DOIUrl":"https://doi.org/10.1136/bmj.q1930","url":null,"abstract":"Earlier this year, a large randomised controlled trial reported that early anticoagulation in people with atrial fibrillation who had sustained a stroke probably carried a small benefit over delayed anticoagulation. However, the confidence intervals around the estimated treatment effects were too wide to make definite recommendations ( N Engl J Med doi:10.1056/NEJMoa2303048). A re-analysis finds that this conclusion isn’t changed when infarct size is taken into account. The important finding is that early treatment with direct acting oral anticoagulants doesn’t carry a higher risk of bleeding complications, intracranial haemorrhage, or other adverse events, even when the infarct is large ( JAMA Neurol doi:10.1001/jamaneurol.2024.1450). Lecanemab and donanemab, both monoclonal …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142171028","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}
Angela Burnett, Cornelius Katona, Sophie McCann, Raman Mostafanejad, Anastasios Yfantis
“Quasi-detention” sites are harmful to the health of people seeking asylum and must be replaced with safe and stable accommodation Prolonged confinement of people seeking asylum in mass containment centres is deeply harmful to their health and can in some cases violate international human rights laws.1 Despite this, such centres continue to be used in the UK and have until recently been promoted as a way of controlling migration flows. Since 2020, the UK government has used former military barracks and a barge, the Bibby Stockholm, to house asylum seekers. These mass containment sites are not suitable accommodation for anyone seeking asylum, and they are particularly damaging for people with trauma and poor health. The new government must urgently replace these sites with safe and dignified community based accommodation for people seeking asylum, with access to appropriate and timely healthcare. The new government’s recent announcement that the current contract for the Bibby Stockholm (which expires in January 2025) would not be renewed2 is a welcome first step in this direction. Napier Barracks was initially used as a “pilot” for further mass containment centres, but it continues to be used, despite having “a profound and cumulative corrosive impact on physical and mental health,”3 …
{"title":"Mass containment sites for people seeking asylum must be abandoned","authors":"Angela Burnett, Cornelius Katona, Sophie McCann, Raman Mostafanejad, Anastasios Yfantis","doi":"10.1136/bmj.q2002","DOIUrl":"https://doi.org/10.1136/bmj.q2002","url":null,"abstract":"“Quasi-detention” sites are harmful to the health of people seeking asylum and must be replaced with safe and stable accommodation Prolonged confinement of people seeking asylum in mass containment centres is deeply harmful to their health and can in some cases violate international human rights laws.1 Despite this, such centres continue to be used in the UK and have until recently been promoted as a way of controlling migration flows. Since 2020, the UK government has used former military barracks and a barge, the Bibby Stockholm, to house asylum seekers. These mass containment sites are not suitable accommodation for anyone seeking asylum, and they are particularly damaging for people with trauma and poor health. The new government must urgently replace these sites with safe and dignified community based accommodation for people seeking asylum, with access to appropriate and timely healthcare. The new government’s recent announcement that the current contract for the Bibby Stockholm (which expires in January 2025) would not be renewed2 is a welcome first step in this direction. Napier Barracks was initially used as a “pilot” for further mass containment centres, but it continues to be used, despite having “a profound and cumulative corrosive impact on physical and mental health,”3 …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174972","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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