The BMJ
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The BMJ is patient centred, evidence based, and independent. Help us improve the health of our world with the best science, journalism, education, and comment
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Joined October 2008
NEW: Our latest investigation hears from a whistleblower engaged in Pfizer’s pivotal covid-19 vaccine trial. Her evidence raises serious questions about data integrity and regulatory oversight
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Science is being suppressed for political and financial gain. Covid-19 has unleashed state corruption on a grand scale, and it is harmful to public health, argues @KamranAbbasi
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Covid-19 vaccines and drugs were developed at “warp speed” and now experts are concerned that the US Food and Drug Administration inspected too few clinical trial sites. Maryanne Demasi reports
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"No child deserves to be starting life 20 yards behind any other child from the day they are born.". @MarcusRashford calls on healthcare professionals to help spread the word about a scheme to give young children in low income households a healthy start.
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Patients with the omicron variant of covid-19 shed virus for longer after symptoms emerge, show data from Japan, potentially jeopardising hopes that the period of isolation for people testing positive could be shortened
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The government of Mexico City handed out nearly 200 000 “ivermectin based kits” last year to people who had tested positive for covid-19, without telling them they were subjects in an experiment on the drug’s effectiveness.
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"The term “junior doctor” will be replaced in September. The new name, “resident doctor,” gives these doctors the respect they deserve.". We should all get behind the new term “resident doctor”, @scarlettmcnally.
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Congratulations to Professor Christina Pagel for constantly discussing science, breaking it down and making it digestible and keeping the public engaged during the pandemic @chrischirp #TheBMJAwards.
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Congratulations to Professor Devi Sridhar for staying true to science and communicating with clarity in the covid pandemic @devisridhar #TheBMJAwards.
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Once this is done, there must be complete transparency about how the NHS came to be left in this exposed position, how social care had been stripped away, and how those in power will be held accountable @lu_hiam @dannydorling @martinmckee.
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Given the rarity of severe covid-19 outcomes for children and limited clarity of risks, the criteria for emergency use authorization do not appear to be met for children, argue @WesPegden, @VPrasadMDMPH, and @sdbaral.
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"Today we remember those doctors who have sadly died of covid-19 in the UK this year" . @TheBMA
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Spending the equivalent of 77% of the NHS annual revenue budget on an unevaluated, underdesigned national programme leading to an insufficiently supported intervention—in many cases for the wrong people—cannot be defended, say @DrMikeWGill and Muir Gray
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“The best thing you can do is speak up. Ask, ‘Are you ok?’ or ‘You don’t seem yourself. Do you want to talk?’ The smallest gesture can make the greatest difference. Let them know they’re not alone—we all have days when the world gets to us."
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Was it fatalism that allowed 138 000 covid deaths in the UK? "The wording is a weasel explanation for the UK’s calamitous pandemic failures. Negligence, incompetence, and dereliction of duty are closer to the mark," says @KamranAbbasi in Editor's Choice.
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What is the best biscuit for busy NHS staff tea breaks? . Find out by reading the results of the Direct Uptake of Nutrition and Caffeine Study (DUNCS): #BMJInfographic #ChristmasBMJ
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Teachers and their household members were not at increased risk of hospital admission with covid-19 at any time during the 2020-21 academic year compared with similar working age adults, including during periods when schools were fully open, finds study
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"12 years ago we called for the immediate release of raw data from clinical trials. We reiterate that call now. Data must be available when trial results are announced, published, or used to justify regulatory decisions" @KamranAbbasi @fgodlee Peter Doshi
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"Mr Johnson, on behalf of all those who are bereaved, chronically sick, clinically vulnerable, the frontline workers, and ordinary citizens who made sacrifices large and small. You cannot lead us." @trishgreenhalgh
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The health benefits of physical activity are proved and wide ranging, exceeding that of any drug. This #BMJEducation article offers a practical guide to help clinicians discuss physical activity within a consultation #MedEd
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The government has refused to release the minutes of the meeting in which its vaccine advisory committee decided not to recommend vaccinating all 12-15 year olds against covid-19 on the grounds that it intended to publish the minutes “in due course".
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Children are returning to school against a background of community infection levels 26 times higher than at the same time last year, and with the more transmissible Delta variant. This open letter calls for robust mitigation measures to make schools safe.
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"The pandemic has revealed how the medical-political complex can be manipulated in an emergency—a time when it is even more important to safeguard science". Read this powerful editorial by @KamranAbbasi .
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"Denying everyone the best chance of being protected through vaccination and relying instead on 'personal responsibility' to tackle an airborne and highly contagious infectious disease is an abdication of responsibility" @Kit_Yates_Maths
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More than 40% of those eligible for @NHSHealthyStart are still not registered. @MarcusRashford asks healthcare professionals for their help in encouraging as many eligible people as possible to sign up and help children get the best start in life.
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The only reliable count of covid-19 infections in the UK now comes from a weekly survey by the Office for National Statistics. Scrapping it would leave the UK flying blind, says @HelenRSalisbury .
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The absence of strong evidence that asymptomatic people are a driver of transmission is another good reason for pausing the roll out of mass testing in schools, universities, and communities, say @AllysonPollock and James Lancaster.
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Scientists and senior doctors have backed claims by France’s health minister that people showing symptoms of covid-19 should use paracetamol (acetaminophen) rather than ibuprofen, a drug they said might exacerbate the condition
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"Schools are where infections are rising fastest. Yet schools are where the basic mitigations of face coverings, space, & fresh air are not simply missing, but—in the case of masks—have been removed" @dgurdasani1 @HZiauddeen @martinmckee @ReicherStephen
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"One of the difficulties I face with doctors is trying to make them understand that knowing everything about a disease doesn’t mean they know what it is like to live with it" #BMJOpinion #PatientsIncluded
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“We need less research, better research, and research done for the right reasons. Abandoning using the number of publications as a measure of ability would be a start.” Doug Altman, BMJ Editorial, The scandal of poor medical research, 1994:
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The health benefits of physical activity are proved and wide ranging, exceeding that of any drug. So what can physicians do to help patients become more active and help them overcome barriers to change?
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The BMJ and our sister journals will no longer carry ads for breastmilk substitutes. "We believe this is the right thing to do based on our desire to support the WHO code, promote breastfeeding, and campaign against industry influence in this area."
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Authorship anatomy: a guide for scholars. Which one are you?. #BMJInfographic @will_s_t #BMJChristmas.
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The Independent Scientific Advisory Group for Emergencies has renewed its call for urgent reform of the government’s covid-19 test and trace system, urging that it be replaced by a system overseen by the NHS to avoid future lockdowns.
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More than 41 000 children and adults across Europe have been infected with measles in the first six months of 2018 and at least 37 people have died, show figures from @WHO
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Many doctors admit to crying at work. Probably still more have done so but been unwilling to admit it for fear that it could be considered unprofessional. However, it’s increasingly recognised as unhealthy for doctors to bottle up their emotions .
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“Ask, ‘Are you ok?’ or ‘You don’t seem yourself. Do you want to talk?’ The smallest gesture can make the greatest difference. Let them know they’re not alone—we all have days when the world gets to us." #NPSADay @Abi_Rimmer
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Long covid has not only been ignored in policy making decisions, and barely mentioned in the roadmap out of lockdown—it has been almost completely absent from the government’s public messaging @LongCovidSOS
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Decisions taken to end the universal wearing of face masks in hospitals and doctors’ surgeries are placing patients and staff at greater risk of covid infection, a group of healthcare workers in Scotland who are affected by long covid says @ScotHWCoalition
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Doctors in Norway have been told to conduct more thorough evaluations of very frail elderly patients in line to receive the Pfizer BioNTec vaccine against #COVID19, following the deaths of 23 patients shortly after receiving the vaccine
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Doctors share the same basic physiology as pilots and bus drivers, so why doesn't healthcare place the same importance on the effects of fatigue? #BMJAnalysis
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Why Scotland’s slow and steady approach to covid-19 is working @devisridhar @Adriel_KH_Chen
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Remdesivir is not suggested for patients admitted to hospital with covid-19, regardless of how severely ill they are, because there is currently no evidence that it improves survival or the need for ventilation, say a @WHO Guideline Development Group panel
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"Many people seek to make money from those who don’t understand science. Doctors should call out bollocksology when they see it." @mgtmccartney sums up her four and a half years as a BMJ columnist in her last column
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The NHS Test and Trace service in England failed to deliver its central promise to avoid a second national lockdown and there is no clear evidence its “unimaginable” costs have been justified, finds the House of Commons Public Accounts Committee
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“The day after the ban we found the door to the hospital was blocked for women students by Taliban forces.". Female doctors are disappearing after Taliban bans, leaving "huge gaps" in healthcare provision, find @WanderingSal and @GeetanjaliKris1.#IWD2023.
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Azithromycin, hydroxychloroquine, lopinavir-ritonavir, and interferon-beta do not appear to have any important benefits, concludes the latest update to this living systematic review on drug treatments for covid-19.
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NEW analysis argues that UK covid policy did not give children sufficient priority and questions the evidence behind government decisions: @dgurdasani1 @chrischirp @martinmckee @SusanMichie @trishgreenhalgh @Kit_Yates_Maths @GabrielScally @HZiauddeen.
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Patients with long covid may present in primary care with symptoms of palpitations (tachycardia) triggered by standing or minimal exertion. This article summarises the key steps for diagnosis and management, and includes a #BMJInfographic.
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NEW Practice Pointer and #BMJInfographic on treating patients with long covid in primary care . An update to help clinicians to answer their patients' questions on long covid @trishgreenhalgh @sivanmanoj @bcdelaney1 @REvans_Breathe @ruairidhm
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A US study of 46 079 pregnancies has found that vaccination against covid-19 was safe and did not increase the risk of preterm birth or small for gestational age babies
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"We have experienced the hypocrisy of an approach that advises the public to lose weight, exercise, and reduce stress, while driving the medical workforce to work long hours in unhealthy environments with poor nutrition and rest facilities." #BMJOpinion .
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Recent findings on the role of T cells in covid-19 give us cause to be cautiously optimistic that cellular immune responses could be a valuable ally in global efforts to control this and future pandemics
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The FDA has been criticised for taking more than a year to follow up a potential increase in serious adverse events in older people receiving Pfizer’s covid-19 vaccine, @MaryanneDemasi reports.
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Infections both matter and are avoidable. Instead of allowing infections to rise, the government should take urgent actions to inform and protect the public and prepare for autumn, say @chrischirp @ProfJohnDrury @trishgreenhalgh @dgurdasani1 and colleagues.
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For too long, medicine has been a cult that deifies workaholism. We can likely all agree that we need a cultural shift. This starts by senior folks speaking up and standing side by side with junior colleagues, say @dr_mattmorgan @docpgb
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"Resilience should be for the difficult emotional burden of caring—not for unacceptable and potentially dangerous working conditions" David Oliver's latest column
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"If your genuine concern is the health and wellbeing of the population, then you don’t waste time contesting plausible data on excess deaths or refusing to hold meaningful talks with unhappy staff" @KamranAbbasi
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Why many doctors need to change the way they communicate about patients: Our manner of speaking and writing about patients not only reflects, but also impacts how we feel about them @AbraarKaran
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This open letter, signed by more than 100 public health experts, researchers, and healthcare workers, issues an urgent call for global “vaccines-plus” action against covid-19 @adamhamdy @martinmckee @chrischirp @trishgreenhalgh @Kit_Yates_Maths et al.
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Hospitals need to actively encourage staff to make sure they take breaks and are adequately hydrated and fed, and remove any barriers to this in their everyday work #BMJOpinion @BrennanSurgeon @JohnKPHT #giveusabreak.
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The “publish or perish” mantra is well established in academic circles, but do researchers have to sacrifice leisure time to achieve this ideal? Yes, finds new study, which shows that a “culture of overwork” is a literal thing, not just a figure of speech
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Diagnosing and managing hypertension in adults: #BMIInfographic summarises the recommended sequence for medication titration @will_s_t
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Access to medical care, a human right, must also be guaranteed to Julian Assange, says @SeanLoveMD, a physician who has met with him several times
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Preventing suicides among doctors: "The qualities, which make a good and caring doctor, are also the qualities, which place us at higher risk of mental illness" Powerful piece from the widow, herself a doctor, of a doctor who took his own life by suicide
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The UK is an outlier by allowing children to remain unvaccinated at a time when lifting restrictions will increase covid-19 infection rates, say Karl Friston & Anthony Costello (@globalhlthtwit)
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An antibody blood test for covid-19, which the manufacturer Abbott claims is 99% accurate, has been certified for use by the European Union
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Post-acute covid-19 seems to be a multisystem disease, sometimes occurring after a relatively mild acute illness. #BMJEducation article provides guidance for GPs to help support patients with #LongCovid in primary care @trishgreenhalgh
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The UK government is facing legal action from the @GoodLawProject over a £102.6m contract for FFP3 respirators to be worn by healthcare staff treating covid-19 patients, which was granted without competition last July.
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"Children are the least protected group in England and their needs are being forgotten as we race to boost adults.". @chrischirp and @adsquires on what needs to happen next to make schools safer.
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We must remember how scary hospitals can be for our patients: "Many of our patients may be feeling scared when, for us, it’s just another day at work"
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Fifty million face masks bought by the UK government as part of a £252m contract will not be used in the NHS because of safety concerns, the government has admitted. The FFP2 masks were supplied under a contract awarded without advertisement or tender.
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A professor of clinical immunology at the University of Florence has reported how blanket testing in a completely isolated village of roughly 3000 people in northern Italy saw the number of people with covid-19 symptoms fall by over 90% within 10 days
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The catastrophic Brazilian response to covid-19 may amount to a crime against humanity #BMJOpinion @Deisy_Ventura
The charity @MSF has called on the Brazilian government to urgently adopt evidence based public health measures to control the spread of covid-19. The refusal to act appropriately has “sent far too many to an early grave," said @DrChristou.
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Compared with adults of working age who are otherwise similar, teachers and their household members were not found to be at increased risk of hospital admission with covid-19, according to this study.
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Two doses of mRNA covid-19 vaccine during pregnancy are highly effective against delta and moderately effective against omicron infection, and are linked to a lower risk of hospital admission in infants under six months of age, finds this new study.
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The lives of many doctors with long covid have been destroyed by an illness they caught while doing their jobs. They deserve more support from the government and the NHS, reports @AdeleWatersRx.
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A study found that people with a BMI of 23 had the lowest risk of admission to hospital, intensive care, or death with covid-19. As BMI increased, so did the risk of poorer outcomes following covid-19 @NIHRevidence
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The Wellcome Trust, one of the world’s top funders of health research, stands to gain financially from the #covid19 pandemic, raising questions about transparency and accountability #BMJInvestigation.
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"The need for social care is not inevitable. Ageing does not have to be associated with a loss of fitness.". @scarlettmcnally looks at how exercise could be a miracle cure for social care as well as for health.
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"The idea that staff with only two years’ formal training could safely see undifferentiated patients without direct supervision was always fundamentally flawed.". @HelenRSalisbury on the latest developments on physician associates.
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Since the emergence of SARS-CoV-2, there has been an unparalleled global effort to characterise the virus and the clinical course of disease. What do we know about the pathophysiology of the virus so far?.
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Doctors are dying. The combination of a novel virus, no treatment, and inadequate supplies of personal protective equipment is putting frontline health workers at risk of serious harm. The question arises: when does work-based risk become unacceptable?
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Experts have warned that schools must be reopened with caution, amid emerging evidence from Israel and Italy that more young children are being infected with new variants of covid-19.
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Proton pump inhibitors are one of the most widely used classes of drugs globally, often taken for longer than needed and at high financial cost to society. What's the evidence for deprescribing proton pump inhibitors and how can clinicians change practice?.
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#BMJInfographic A waste of lifesaving covid-19 vaccines. New graphic shows billions of doses of vaccines ordered by rich countries are due to expire @will_s_t
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The French Medicines Agency has said that it will file criminal charges with the Marseilles public prosecutor against the local hospital-university institute for infectious diseases, which is run by the microbiologist Didier Raoult.
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Healthcare workers in Hong Kong have condemned the Hong Kong Police Force for failing to abide by international humanitarian norms during clashes with protesters, after doctors and nurses were among those arrested as they tried to leave a protest
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Pandemic policy on children and schools reflected UK based scientific narratives that did not align with global scientific consensus @dgurdasani1 @chrischirp @martinmckee @SusanMichie @trishgreenhalgh @Kit_Yates_Maths @GabrielScally @HZiauddeen
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Brazil's federal government has done everything in its power to let covid-19 follow its natural course, say @Deisy_Ventura and colleagues. "The international community has a duty to acknowledge that this is a crime which targeted the whole of humanity".
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"Doctors should care about cycling, as it’s one of the best preventive health interventions we have" @mgtmccartney
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When a health professional flags up a problem, it is called an incident report. When a patient does the same, it is called a complaint. How language affects safety culture: #patientexperience @patientlibrary.
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Is it risky to sing in a choir or eat in a small restaurant? How much difference does it make if I open windows or clean surfaces?. A new #BMJInfographic helps people decide what to do in everyday situations to protect themselves, and others, from covid-19
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As testing and the Oxford AstraZeneca vaccine are hailed as UK pandemic successes, why won’t Oxford University or the government disclose the “long list” of financial interests of a high profile researcher at the centre of both? @thackerpd investigates.
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Encouraging self-testing at home twice a week for all adults is a misguided policy, unlikely to reduce transmission, warn public health experts @DrMikeWGill @angelaraffle
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As the UK government vote to make vaccination mandatory for care workers, @AllysonPollock and @DrLJBHayes argue why they think it is unnecessary, disproportionate, and misguided:
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Doctors have warned that the current situation in Indian administered Kashmir, where the government has imposed a security lockdown and communications blackout, is preventing people from seeking medical help
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“Keeping animals, whether one or many, can really enrich your life and the lives of those around you, including your patients.". Community doctor Clare Nettleton on how animals on the ward and at home have helped her and her patients
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