{"title":"PM says NHS must \"reform or die\" following damning report into state of the service.","authors":"Matthew Limb","doi":"10.1136/bmj.q2001","DOIUrl":"https://doi.org/10.1136/bmj.q2001","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":"142231466","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":"Assisted dying: Citizens' jury calls for law change in England.","authors":"Matthew Limb","doi":"10.1136/bmj.q1994","DOIUrl":"https://doi.org/10.1136/bmj.q1994","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":"142231470","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":"Junk food TV adverts to be banned before 9 pm to tackle childhood obesity.","authors":"Gareth Iacobucci","doi":"10.1136/bmj.q2006","DOIUrl":"https://doi.org/10.1136/bmj.q2006","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":"142231465","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":"Harris and Trump clash over abortion in presidential debate.","authors":"Janice Hopkins Tanne","doi":"10.1136/bmj.q2003","DOIUrl":"https://doi.org/10.1136/bmj.q2003","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":"142231468","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}
Sharmistha Mishra, Christine Navarro, Jeffrey C Kwong
This article discusses definitions of the effect of vaccines across outcomes of interest, from individual level to contacts of vaccinated people to population level. The focus is on the outcome evaluated in an observational study on the effectiveness of mpox vaccine in the context of potential outcomes that could have been measured. When evaluating how well a vaccine works, two categories of outcomes are of interest: infection related outcomes, sometimes referred to as infection blocking effects of vaccines, and disease related outcomes, often referred to as symptomatic disease, morbidity, or mortality outcomes.1 These two categories can then be further divided to reflect those in whom the outcomes are measured: the individual who received the vaccine (direct effects), among contacts of the person who received the vaccine (indirect effects), or at population level (herd immunity).2 Direct effects of a vaccine include reducing the chances of a vaccinated individual becoming infected if exposed to the pathogen (ie, reduced susceptibility) and disease related outcomes despite acquiring infection.1 For some infectious diseases, the direct, protective effect of a vaccine against infection is the primary goal, such as with rabies, whereas for many the added downstream benefit of a …
{"title":"Measures of how well a vaccine works","authors":"Sharmistha Mishra, Christine Navarro, Jeffrey C Kwong","doi":"10.1136/bmj.q1982","DOIUrl":"https://doi.org/10.1136/bmj.q1982","url":null,"abstract":"This article discusses definitions of the effect of vaccines across outcomes of interest, from individual level to contacts of vaccinated people to population level. The focus is on the outcome evaluated in an observational study on the effectiveness of mpox vaccine in the context of potential outcomes that could have been measured. When evaluating how well a vaccine works, two categories of outcomes are of interest: infection related outcomes, sometimes referred to as infection blocking effects of vaccines, and disease related outcomes, often referred to as symptomatic disease, morbidity, or mortality outcomes.1 These two categories can then be further divided to reflect those in whom the outcomes are measured: the individual who received the vaccine (direct effects), among contacts of the person who received the vaccine (indirect effects), or at population level (herd immunity).2 Direct effects of a vaccine include reducing the chances of a vaccinated individual becoming infected if exposed to the pathogen (ie, reduced susceptibility) and disease related outcomes despite acquiring infection.1 For some infectious diseases, the direct, protective effect of a vaccine against infection is the primary goal, such as with rabies, whereas for many the added downstream benefit of a …","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":"142170728","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}
As a cancer survivor who has experienced radiation therapy, I was interested to learn about hypofractionation as an alternative to traditional radiation. In hypofractionation the total dose of radiation is divided into fewer parts and delivered over a shorter time frame than traditional radiation treatment. It reduces the number of visits a patient will have to make to the hospital. For this and other reasons, it offers a co-benefit of reducing the carbon footprint from radiotherapy treatment, while also optimising the hospital experience for cancer patients. Shorter treatment windows have many advantages, most notably the sheer convenience they provide the patient, allowing them to start down the hopeful path of recovery sooner. A cancer patient’s main focus tends to be staying alive, but if treatments that are equally effective also have benefits such as reduced transportation costs and lower greenhouse gas emissions, that is a bonus. Nonetheless, when new treatments or approaches are rolled out, it …
{"title":"Hypofractionation: don’t lose sight of the patient","authors":"Sheilagh Foley","doi":"10.1136/bmj.q1985","DOIUrl":"https://doi.org/10.1136/bmj.q1985","url":null,"abstract":"As a cancer survivor who has experienced radiation therapy, I was interested to learn about hypofractionation as an alternative to traditional radiation. In hypofractionation the total dose of radiation is divided into fewer parts and delivered over a shorter time frame than traditional radiation treatment. It reduces the number of visits a patient will have to make to the hospital. For this and other reasons, it offers a co-benefit of reducing the carbon footprint from radiotherapy treatment, while also optimising the hospital experience for cancer patients. Shorter treatment windows have many advantages, most notably the sheer convenience they provide the patient, allowing them to start down the hopeful path of recovery sooner. A cancer patient’s main focus tends to be staying alive, but if treatments that are equally effective also have benefits such as reduced transportation costs and lower greenhouse gas emissions, that is a bonus. Nonetheless, when new treatments or approaches are rolled out, it …","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":"142170729","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 need to learn from what did, and did not, work during the response to covid, writes Chris Ham Many thousands of words have been expended on assessments of the United Kingdom’s response to the covid pandemic, most recently in the first report from the independent public inquiry chaired by Heather Hallett.1 The challenge now is to learn from what did, and did not, work during the response and identify the changes required to ensure the United Kingdom is better prepared for the next national emergency. An important starting point is to recognise that excess deaths during the pandemic were higher in the United Kingdom than in most western European countries.2 This can be explained by poor underlying health in the population and longstanding inequalities in health, among other factors. An urgent requirement is to agree actions to tackle the wider determinants of health across government and to support the NHS to prevent illness where feasible. Public health funding for local authorities …
{"title":"The opportunity to begin rebuilding the NHS should not be lost","authors":"Chris Ham","doi":"10.1136/bmj.q1999","DOIUrl":"https://doi.org/10.1136/bmj.q1999","url":null,"abstract":"We need to learn from what did, and did not, work during the response to covid, writes Chris Ham Many thousands of words have been expended on assessments of the United Kingdom’s response to the covid pandemic, most recently in the first report from the independent public inquiry chaired by Heather Hallett.1 The challenge now is to learn from what did, and did not, work during the response and identify the changes required to ensure the United Kingdom is better prepared for the next national emergency. An important starting point is to recognise that excess deaths during the pandemic were higher in the United Kingdom than in most western European countries.2 This can be explained by poor underlying health in the population and longstanding inequalities in health, among other factors. An urgent requirement is to agree actions to tackle the wider determinants of health across government and to support the NHS to prevent illness where feasible. Public health funding for local authorities …","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":"142170730","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}
Tom Nolan reviews this week’s research You never have to wait too long for a trial of a new drug for migraine. The latest one is Lu AG09222, a monoclonal antibody to pituitary adenylate cyclase-activating polypeptide (PACAP). The phase 2 trial recruited adults with migraine with an average of 16.7 migraine days per month and for whom two to four preventive treatments had failed. Those given a single infusion of Lu AG09222 750 mg had an average of 6.2 fewer migraine days over the following month, compared with 4.2 fewer in the placebo group (a between-group difference of two days (95% confidence interval −3.8 to −0.3)). With this positive phase 2 result, it’s time for Lu AG09222 to PACAP its bags and go to phase 3. N Engl J Med doi:10.1056/NEJMoa2314577 Infectious disease specialists like to keep fit by lifting heavy parcels of …
{"title":"New treatments for migraine … and other research","authors":"Tom Nolan","doi":"10.1136/bmj.q1967","DOIUrl":"https://doi.org/10.1136/bmj.q1967","url":null,"abstract":"Tom Nolan reviews this week’s research You never have to wait too long for a trial of a new drug for migraine. The latest one is Lu AG09222, a monoclonal antibody to pituitary adenylate cyclase-activating polypeptide (PACAP). The phase 2 trial recruited adults with migraine with an average of 16.7 migraine days per month and for whom two to four preventive treatments had failed. Those given a single infusion of Lu AG09222 750 mg had an average of 6.2 fewer migraine days over the following month, compared with 4.2 fewer in the placebo group (a between-group difference of two days (95% confidence interval −3.8 to −0.3)). With this positive phase 2 result, it’s time for Lu AG09222 to PACAP its bags and go to phase 3. N Engl J Med doi:10.1056/NEJMoa2314577 Infectious disease specialists like to keep fit by lifting heavy parcels of …","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":"142170731","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}
A focus on integrated academic training1 as a method of “fixing” academic medicine would be welcome.2 Unfortunately, the current system means that improvements in this area will provide only limited success. I was funded for the length of the integrated academic training pathway—from graduation in 2010 to near certificate of completion of training (CCT) in 2022 (National Institute for …
2 不幸的是，现行制度意味着这方面的改进只能取得有限的成功。从 2010 年毕业到 2022 年获得培训结业证书（CCT）（美国国家医学研究院，National Institute for ...
{"title":"Post-training employment of clinical academics requires improvement","authors":"Sunil Bhopal","doi":"10.1136/bmj.q1960","DOIUrl":"https://doi.org/10.1136/bmj.q1960","url":null,"abstract":"A focus on integrated academic training1 as a method of “fixing” academic medicine would be welcome.2 Unfortunately, the current system means that improvements in this area will provide only limited success. I was funded for the length of the integrated academic training pathway—from graduation in 2010 to near certificate of completion of training (CCT) in 2022 (National Institute for …","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":"142170732","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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