BMJ – 15/4/17

Some week eh? So human kind still exists despite heavy nuclear posturing from North Korea and the US, and the UK government is panicking at the bucking bronco in the chinashop that is Brexit, leading to a snap general election. And to top it all off, there is a new edition of the BMJ out with its reliable update on the state of the NHS. Ready for a whistlestop tour? Ok, here we go.

Cover Story: Managing electrical injury – So for the first time in weeks the BMJ has a cover that refers to a research article rather than an opinion piece. The lego-yellow image, supposedly meant to remind us of the “Danger! Risk of Death!” signs we see outside electrical power stations, along with the accompanying gory medical pictures, does the trick – you’re morbidly compelled to read on. The article contains graphic descriptions of what can happen to the various organs of the body when electricity passes through them (as you can imagine you get burns, cardiac arrhythmias, renal failure through myoglobin release and even paralysis of the respiratory muscles).

And then it’s back to more opinion-based articles, which include:

Sex and the NHS – No, it’s not quite as exciting as “Sex and the City” but this article is in many ways more shocking than the antics of Carrie and her friends. The Office for National Statistics has revealed that in 2016 the gender pay gap in the medicine arena was GREATER than the country as a whole (expletive, expletive, expletive). Female doctors working full-time earnt 29% less than their male counterparts. How is this possible!? Why was this not the front cover? Well, fear not, Jeremy is on it! Our esteemed Health Secretary has ordered a report into the issue. Great! That’s the problem sorted then <rolls eyes and eats entire tub of Häagen-Dazs>.

Abi Rimmer goes onto pen another article about sex discrimination in the NHS. She lists many of the perceived issues facing women in the medical workplace: the challenges of flexible work with motherhood, unconscious bias against women and the much debated “female traits” of being underconfident and not as assertive when it comes to demanding fairer pay and conditions. Argue ad lib but we can all agree that equality should be the gold standard. The Medical Women’s Federation does noble work in the struggle towards this goal.

And on the theme of sex…Sex and relationship education will soon be mandatory in all secondary schools (was it not before?) but the debate is how to deliver it. Should the teachers do it? Or should it fall to special school sex educators (what a job title, eh)? But with the majority of new STI diagnoses occurring in the 16-24 age range, we should probably make a decision fast and uh, get on with it.

Best of the rest: The Bigger Picture – If we survive US-North Korea-gate then we still have to worry about the impact of the political moves in the US regarding climate change. If the Clean Power Plan in the US is scrapped (as seems to be the plan as of March 2017) global warming and associated climate change will have severe implications for global health through consequences like increased air pollution. As is ever the way, developing countries are more likely to suffer with such changes. This article suggests doctors do their bit and educate patients on the issue.

A spoonful of sugar (does not) help the medicine go down – There is mixed success in the bid to reduce sugar, salt and other “baddies” in our global diets. Whilst there is no replicable evidence of improved health outcomes after food taxes (at least not suggested in this article), Mexico and Denmark both showed reduced consumption of sugar and saturated fats respectively after taxes were introduced. We must continue to fight the good fight, comrades, and no matter how much Jeremy gets to you, please stop at one tub of Haagen Daz.

Worst-case scenario workforce planning – Earlier in April Syria suffered from a suspected chemical weapons attack, which killed 70 and injured many more. In an effort to deal with these terrible situations, the WHO has been training health workers since 2012 for potential chemical weapons attacks. Horrible but necessary, the WHO sets us an example in the importance of workforce planning.

Chuckle of the week: A wee bit of relief – And to end, wee present the findings of some whizz-kid researchers in Australia, who have been focusing their efforts and spending their pennies in the important field of child urination. The results leaked in this issue of the BMJ show that using the QUICK WEE method (placing a cold wet piece of gauze on a child’s suprapubic area) has slashed the times it takes for children to produce a urine sample, with more children in the RCT weeing in under 5 minutes. These are no piddling observations. Needless to say, parents and GPs will find themselves extremely relieved by these findings.   

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