Maternal death rate in UK rises to highest level in 20 years

Sweden’s Karolinska Institute, home to the Nobel Prize in medicine, found surgeon Paolo Macchiarini guilty of scientific misconduct. A subsequent district court case resulted in a suspended sentence of two years’ probation (doi:10.1136/bmj.o1516).1 To Macchiarini’s critics this was an unduly lenient punishment for years of research misconduct and harm to patients resulting from the globetrotting experimentation of a “stem cell charlatan.”

/pdf/retract-or-be-damned-a-dangerous-moment-for-science-and-the-e22jy5ws.pdf

Retract or be damned: a dangerous moment for science and the public

Lifestyle and environmental factors are key determinants in disease causality and progression in neurological conditions, including multiple sclerosis (MS). Lack of exercise, poor diet, tobacco smoking, excessive alcohol intake, social determinants of health, concomitant medications, poor sleep and comorbidities can exacerbate MS pathological processes by impacting brain health and depleting neurological reserves, resulting in more rapid disease worsening. In addition to using disease-modifying therapies to alter the disease course, therapeutic strategies in MS should aim to preserve as much neurological reserve as possible by promoting the adoption of a “brain-healthy” and “metabolically-healthy” lifestyle. Here, we recommend self-regulated lifestyle modifications that have the potential to improve brain health, directly impact on disease progression and improve outcomes in people with MS. We emphasise the importance of self-management and adopting a multidisciplinary, collaborative and person-centred approach to care that encompasses the healthcare team, family members and community support groups.

MS care: integrating advanced therapies and holistic management

In the transition from fragmented to integrated care, tensions are inevitable. Contradictions between the actors of the different professions involved can have negative but also positive effects on change processes in the healthcare system. This is especially true for integrated care, where collaboration among the workforce is pivotal. Therefore, efforts should not be made to avoid tensions from the outset, if this is at all possible, but to deal with them constructively. The attention of leading actors must be increased to recognize, analyse, and successfully manage tensions. The creative potential of tensions can be harnessed to successfully implement integrated care and engage the diverse workforce.

/pdf/tensions-between-the-professions-how-integrated-care-can-2jl575pj.pdf

Tensions between the Professions: How Integrated Care Can Benefit from Better Understanding and Managing Conflicting Perspectives and Demands

The case for prevention is undeniable, if politicians choose to hear it

/pdf/bold-action-is-needed-to-strengthen-primary-prevention-1szgmwxy.pdf

Bold action is needed to strengthen primary prevention

PM says NHS must "reform or die" following damning report into state of the service.

Operating rooms have been accused of “wasting” surgeries, and now record waiting lists require novel solutions. Surgical hubs, overlapping surgery, and better use of data for scheduling could provide answers, but we also need to get the basics right, finds Matthew Limb

Four ways to fix the inefficiency of NHS surgery

As healthcare workers including nurses and ambulance staff engage in ongoing strike action, Matthew Limb examines the looming prospect of doctors joining them

Industrial action: What’s the current state of play for consultants, junior doctors, and GPs?

The government has vowed that its 10 year health plan for England can save the NHS. Matthew Limb examines its key pledges

What is the NHS 10 year plan promising and how will it be delivered?

We previously reported that cannabidiol (CBD), one of the Cannabis sativa-derived cannabinoids, induced functional CD4+CD25+FOXP3+ Tregs in response to low level stimulation of PMA/Io. CBD increased CD25+FOXP3+ cells in CD4+, CD4+CD25+, and CD4+CD25− T cells, as well as in CD4+ T cells derived from FOXP3-GFP mice. T cell stimulation conditions were suboptimal PMA/Io (4 nM/0.05 μM, S/o) and ultrasuboptimal PMA/Io (1 nM/0.0125 μM, Us/o). We also observed that CBD + Us/o increased IL-2, IL-10 and TGF-β1 immunomodulatory cytokines. Here, we measured the effect of CBD + Us/o or S/o on CD4+ cells. Splenocytes were treated with CBD (1–10 μM) for 30 min plus S/o or Us/o activation and cultured for 1 day or 5 days. Immunofluorescence staining showed that CBD + Us/o treatment increased the percentage of CD4+ cells while CBD + S/o treatment decreased the percentage of CD4+cells. CD4+CD25+ expression by Us/o or S/o activation alone was also measured. CD25 expression in response to Us/o activation was lower than that by S/o activation in CD4+ cells. This study will provide important information on the effect of CBD on CD4 cells under differential immunological activation state by PMA/Io.

Vaping is “unlikely to be risk free,” finds evidence review

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