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Richard Smith fears doctors are too fond of the top down world of Web 1:0, a world where potentates push out stuff that they try to pass off as wisdom. Embrace the anarchic, democratising iconolocastic potential of Web 2:0, is his advice. Have your say on his blog.
In this meta-analysis of seven randomised controlled trials with more than 700 patients, a single dose of parenteral dexamethasone produced a 26% relative reduction in recurrent headache occurring within 72 hours. An accompanying editorial confirms that, although corticosteroids do not relieve acute pain, they do reduce recurrence.
Should we use large scale healthcare interventions without clear evidence that benefits outweigh costs and harms? Yes, says Bernard Crump, who believes implementation with careful monitoring is justified. No, says Seth Landefeld and colleagues, who argue that acting without proof of net benefit is both costly and potentially damaging to health. Have your say on the poll.
With the reality of a 48 hour week looming, is there a need to revisit the current pay structure for UK junior doctors? National European Working Time Directive leads are calling for a review of the current junior doctors’ contract.
In around 1000 adolescents who were immunised during a 1999-2000 national UK campaign, a fifth of current 11-13 year olds have inadequate immunity and need boosters, according to this observational study. Age at vaccination is important for protection and persistence with conjugate vaccines, says the accompanying editorial.
Simplistic and unpiloted NHS reforms are inadvertently damaging patient care in general practice, warns a group of academics. If they are allowed to continue, they add, patients will lose holistic care, doctors will lose job satisfaction and the NHS will become less effective and inefficient.
New guidance from the UK General Medical Council urges doctors to rethink their approach to obtaining patient consent. Implementing the guidance requires systemic and cultural change, says this editorial by Glyn Elwyn.
Multidrug resistant bacteria are responsible for about half of the 37 000 deaths a year in the 27 member states of the European Union that are caused by infections associated with health care, show the preliminary results of research from the European Centre for Disease Prevention and Control in Stockholm.
Doctors should encourage their hospitals or practices to ensure that the surgical instruments they purchase are "ethically procured," a BMA report has said.
Local NHS organisations should be given the freedom from the British government to implement large health centres or "polyclinics" in the way that they think will best serve their population, the head of one of the UK's leading organisations for research into healthcare policy has said.
What can you learn from this BMJ paper? Read Leanne Tite's Paper+