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Academic Insights for the Thinking World

Find the missing millions

A young man in my clinic avoids eye contact. Peaked cap pulled low, he directs his unfocused gaze into a corner of the room. Recently diagnosed with hepatitis B virus (HBV) infection, he doesn’t know whether to believe this news, how to process it, or what it means for his future.

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Immuno-oncology: are the top players changing the field?

Immunotherapy is a form of treatment to improve the natural ability of the immune system to fight diseases and infections, with immuno-oncology (IO) focusing on combatting cancer specifically. Novel immunotherapies are a possible solution for cancers that don’t respond to standard cancer treatments, either as standalone or in combination therapy.

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The goals of medicine do not stop at the edge of the body

Over the last 100 years, the world, people, and our society have changed beyond measure. So have diseases, and we are now almost 75 years into the first ever age where cure of disease, successful organ transplants and near complete recovery from trauma has been possible. Despite all of this change, however, medical school curricula have hardly changed in a hundred years.

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Where do our teeth come from? [excerpt]

We all know that we start with baby teeth which fall out and are replaced with adult teeth, but do we really know why? Where do our baby teeth come from in the first place? This adapted extract below from the Oxford Handbook of Integrated Dental Biosciences highlights how our teeth form, why they erupt through our gums when they do, what causes teething pains, and when baby teeth should begin to appear.

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Brexit threatens food supplies and Ministers know it

The story on the front page of The Sunday Times on 3 June 2018 pulled no punches. Headlined “Revealed: plans for Doomsday Brexit”, it reported on leaked government papers planning for a “no deal” Brexit scenario. They warned that the port of Dover could collapse on day one of exiting the EU, with major food shortages within a few days and medicines shortages within two weeks.

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Keeping high risk patients healthy at home

Staying on top of multiple chronic illnesses such as diabetes and heart failure can be a challenge for even the most well-resourced patient – imagine doing so while battling homelessness and schizophrenia. The result is often frequent trips to the emergency department and the hospital. Not surprisingly, many healthcare systems have started implementing programs to address the needs of these patients.

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Nonsurgical challenges in surgical training

Surgical cases dramatized in popular culture are loosely based on reality, but surgery is decidedly less glamorous on a daily basis. Before embarking on my own surgery training, I mentally prepared myself for the long hours and expected demands of caring for sick surgical patients, but looking back, the lessons I remember most came from small, quiet, and often unexpected moments.

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The end-of-life sector needs concrete solutions to be truly person-centred

In recent years the language used to describe what constitutes good end-of-life care has changed. ‘Shared-decision making’, ‘patient autonomy’, ‘choice’ and ‘advance care planning’ have become buzzwords. This is to be welcomed, of course, but has the sector really changed in practice? According to several policy reports, in addition to feedback from people who use end-of-life services, not particularly.

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Sports impairment in youth with inflammatory bowel disease

Over 80,000 children and adolescents in the United States live with inflammatory bowel diseases (IBD), which includes Crohn’s Disease and Ulcerative Colitis. These are chronic autoimmune diseases that cause inflammation in the gastrointestinal tract.

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Global health as a social movement: Q&A with Dr. Joia Mukherjee

What is social entrepreneurship? In essence, it’s about using the tools of entrepreneurship—opportunity, resourcefulness, innovation—to address stubborn social and environmental problems. A defining feature of social entrepreneurship is the concept of systemic change; that is, change that addresses the underlying social, political, and economic forces that conspire to exclude the poor and marginalised from the opportunities that many of us take for granted.

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A good death beyond dignity?

According to the Australian euthanasia activist Philip Nitschke, to choose when you die is “a fundamental human right. It’s not just some medical privilege for the very sick. If you’ve got the precious gift of life, you should be able to give that gift away at the time of your choosing.” This view combines two extreme standpoints in the debate on euthanasia and assisted suicide.

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Crises and population health

On the day after the horrific shooting that claimed the lives of 17 students at Stoneman Douglas High School in Parkland, Florida, the local state representative predicted what would happen next. “Nothing.”

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Looking back at 100 years of flu [timeline]

This year is the centenary of the Spanish influenza pandemic of 1918. However, it was only by 2010 that the industry had started universal flu vaccine trials, following the Swine flu pandemic in 2009. Explore the last hundred years of flu, as we mark the Spanish flu centenary, from the four major pandemics to the medical advances along the way, with this interactive timeline.

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Improving care for the family and friends who care for cancer patients

Many individuals in the United States will receive a cancer diagnosis this year. Such a diagnosis is upsetting to those who receive it and overwhelming to those—relatives or friends—who love them. Cancer is rarely experienced in isolation. 

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Stroboscopic medicine

The stroboscope is an ingenious device of rapidly flashing lights that allows engineers and scientists to freeze motion and capture brief slices of time. The resulting image is akin to examining a single frame of a motion picture that provides a sharp image, albeit one without context and with neither past nor future. This is now, sadly, an apt metaphor for contemporary clinical encounters.

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Kidney transplants, voucher systems, and difficult questions

It is commonly said that necessity is the mother of invention, and this was certainly the case at UCLA Medical Center in 2014 . Howard Broadman, then aged 64 and a retired judge from San Diego County, California, was concerned that his grandson, Quinn Gerlach, would be unable to secure a transplant kidney when he needed one. And so began the first “voucher system” for kidney procurement.

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