Imported malaria and high risk groups

Failure to comply with prophylaxis or to seek travel advice has led to a rise in imported malaria cases in the UK, says an editorial about this about this observational study using UK surveillance data from 1987-2006.

Sudden cardiac death in young athletes

An editorial about this five year national study backs calls for adding electrocardiography to the screening programmes to help detect more athletes with silent cardiovascular disorders at risk of sudden death. The study found that four fifths of people barred for health reasons from sport in Italy, where pre-screening for heart disease is a legal requirement, were picked up by exercise electrocardiography.

How clean is your water?

Many of the drugs we take end up in the water system. Whether or not drugs in drinking water are potentially harmful to human health is an empirical question that can be investigated by science. But experience of a variety of issues from genetic modification to the effects of low level radiation shows that science is not the only or necessarily the dominant factor in policy making; the issue raises problems of public perception. Geoff Watts investigates.

Should geriatric medicine remain a specialty?

Yes, says Leon Flicker. The geriatrician's training focuses on a whole system approach that has been shown to work and continues to work well. No, say C P Denaro and A Mudge. They argue against defining a specialty by chronological age and call for a return to generalism.

NHS at 60: A fairly happy birthday

In the last of six articles marking 60 years of the NHS, Tony Delamothe looks at the effects of recent reforms and assesses the threat to its founding principles. Find out more about the NHS at 60 at bmj.com/nhs60.
Read other articles in the series:

• Founding principles
• Universality, equity, and quality of care
• A comprehensive service
• A centrally funded health service, free at the point of delivery
• How the NHS measures up

NHS at 60: How the media are failing the health service

Jon Snow, newscaster for Channel 4 news, has been contacted time and again by people who have found the UK health service nowhere near as bad as its media profile would suggest. So why does the NHS get such a bad press?

What does the future hold for the NHS at 60?

Flux and conflict are inevitable, says Rudolf Klein. They can be reduced, but not eradicated, to the degree that the policy making process acknowledges the complexities involved, and do not search for instant fixes.

Drugs for cancer and copayments

Ilora Finlay (pictured) and Nigel Crisp say that principles underpinning copayments must preserve equity, be transparent, and enhance knowledge on treatment outcomes.

Personal view: Top-ups for cancer drugs - can we kill the zombie for good?

Cam Donaldson (pictured) thinks that "copayments" are essentially user charges and that it is wrong, unfair, and ineffective to try to limit consumer and patient access through user fees, and also to dress up this process as actually enhancing access. Instead, we should continue to find effective ways to involve clients and the public more generally in making decisions about the health system and in making good choices about health and health care.

Mental capacity and psychiatric admission

This editorial comments on a cross sectional study and says says that even though some patients will meet the legal criteria for treatment under the Mental Capacity and Mental Health acts at the time of admission to hospital, practitioners dealing with patients with fluctuating mental conditions might prefer to rely on the authority of the Mental Health Act when convinced that the patient needs a sustained programme of care.

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