Education
Investigating the thyroid nodule
This clinical review is an evidence based guide to investigating and managing thyroid nodules and the myths about them. It also highlights differences between the recently issued second edition of the British Thyroid Association’s guidelines on thyroid cancer, and the American Thyroid Association’s guidelines. (Picture credit of CT showing thyroid nodule: Living Art Enterprises/SPL).
News
Health service should develop expertise in child protection, review urges
Alan Johnson, health secretary for England, "must immediately address the wariness of staff throughout the health services to engage with child protection work," a review of the current state of the system for protecting vulnerable children in England has concluded. Ministers have accepted all 58 recommendations of the inquiry, which was set up after the death of baby P, a 17 month old boy who died at the hands of his mother, her partner and their lodger. (Picture credit of Baby P: ITV News).
Also published on 16 March:
Surgeons have insufficient experience to operate on children, report warns
Reducing greenhouse emissions could cut global disease burden by 25%
Education
Comprehensive care and HIV prophylaxis after sexual assault in rural South Africa
The authors of this practice article conducted the Refentse study (meaning "we shall overcome" in Bantu language Venda) to evaluate a nurse driven, comprehensive, model for care after rape that was integrated into existing services in a rural South African hospital. It concludes that the quality of care can be improved using existing staff and at modest cost and, with additional training, nurses can become the primary providers of this care.
Podcast
Tissue screening after breast reduction
This week's podcast debates the ethics of testing removed breast tissue for cancer following mammoplasty. BMJ editor Fiona Godlee interviews Vivienne Nathanson, head of science and ethics at the BMA, and Duncan Jarvies talks to Mohammed Keshtgar, consultant breast surgeon and lead author of an analysis article about the practice. Tom Treasure, professor of cardiothoracic surgery, wrote one of three accompanying commentaries , and also takes part, alongside Peter C. Gøtzsche, director of the Nordic Cochrane Centre. Finally Sue Mayor talks about the latest news.
Next week's podcast comes from the International Forum on Quality and Safety in Health Care, Berlin .
Also on tissue screening after breast reduction:
Jeremy Sugarman: A call for preventive ethics
Tessa Boase: The lay view
Research
Errors in administration of parenteral drugs in intensive care units
Errors at the drug administration stage are common and a serious safety problem in intensive care units, according to this multinational prospective study. With the increasing complexity of care in critically ill patients, organisational factors such as error reporting systems and routine checks can reduce the risk for such errors. Image of intensive care unit: Ian Hooton/SPL.
Comment
Lack of political will is a clinical issue
The "why" question is more important and relevant than the clinical question of how a poor but relatively healthy pregnant woman dies, and there are many reasons why healthcare workers shy away from asking it. Every clinician should advocate for change where such change is needed to prevent ill health and disease, argued Tarek Meguid. Disease does not start or stop at the clinic, nor should clinical work start or stop there.
Other views and reviews:
Medical classic: Studies on Hysteria
Des Spence: Letter from America
Richard Smith: When death took a holiday
James Owen Drife: A sax and a rose
Theodore Dalrymple: Too much information
Latest articles
news: Surgeons have insufficient experience to operate on children, report warns 16 March 2009
news: Health service should develop expertise in child protection, review urges 16 March 2009
news: Reducing greenhouse emissions could cut global disease burden by 25% 16 March 2009
editorials: Treatment of intermittent claudication 16 March 2009
practice: Management of rheumatoid arthritis: summary of NICE guidance 16 March 2009
feature: Zimbabwe's health challenges 16 March 2009
feature: Saving the planet as well as lives 16 March 2009
practice: Comprehensive care and HIV prophylaxis after sexual assault in rural South Africa: the Refentse intervention study 13 March 2009
clinical review: Investigating the thyroid nodule 13 March 2009
news: Foundation trusts could take over other trusts by next year, government warns 13 March 2009
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