Bookmarkers beware: Bookmarks to pages other than the home page may not work after we change servers in April BMJ No 7125 Volume 316 10 January 1998 This Week in BMJ | Editor's Choice | Press releases Receive this page by email each week Editorials 85 Partnership with patients Tessa Richards 86 What makes a good reviewer of manuscripts? Sandra Goldbeck-Wood 87 Dead sober or dead drunk? Derrick Pounder 88 Minimally invasive coronary surgery: fad or future? Massimo A Mariani, Piet W Boonstra, Jan G Grandjean 89 Managing diabetes in residential and nursing homes Robert Tattersall, Simon Page 90 Changing the law on decision making for mentally incapacitated adults Elaine Gadd News 91 Questions surround Hong Kong's flu crisis Dutch whooping cough epidemic Hungarian doctor's hunger strike over funds German doctors face new liabilities Expensive laxatives not necessarily best Inquiry into Irish hepatitis C scandal Stephen Thornton - is he "Mr Rationing?" Papers 95 Decision analysis model of prolonged oral anticoagulant treatment in factor V Leiden carriers with first episode of deep vein thrombosis François P Sarasin, Henri Bounameaux 100 Socioeconomic gradient in morbidity and mortality in people with diabetes: cohort study findings from the Whitehall study and the WHO multinational study of vascular disease in diabetes Nish Chaturvedi, John Jarrett, Martin J Shipley, John H Fuller 105Commentary: Problems in Finnish or British data - or a true difference? Seppo V P Koskinen 106 Randomised controlled trial of two models of care for discharged psychiatric patients Peter Tyrer, Kathryn Evans, Naresh Gandhi, Alwyn Lamont, Phil Harrison-Read, Tony Johnson 110 Typhoid fever vaccines: a meta-analysis of studies on efficacy and toxicity Eric A Engels, Matthew E Falagas, Joseph Lau, Michael L Bennish 117 Physical dependence on zopiclone: case reports Ian R Jones, Gary Sullivan 116 Retraction: First myocardial infarction in patients of Indian and European origin: comparison of risk factors, management, and long term outcome N Shaukat, J Lear, A Lowy, S Fletcher, D P de Bono, K L Woods 116 Correction: Household survey of locomotor disability caused by poliomyelitis and landmines in Afghanistan Lambert et al 116 Correction: Systematic overview of co-proxamol to assess analgesic effects of addition of dextropropoxphene to paracetamol A Li Wan Po and W Y Zhang General practice 118 Prevalence of asthma symptoms, diagnosis, and treatment in 12-14 year old children across Great Britain (international study of asthma and allergies in childhood, ISAAC UK) Balvinder Kaur, H Ross Anderson, Jane Austin, Michael Burr, Leigh S Harkins, David P Strachan, John O Warner Clinical review 125 Recent advances: Gastroenterology G O Barbezat 129 Statistics Notes: Weighted comparison of means J Martin Bland, Sally M Kerry 130 ABC of palliative care: Communication with patients, families, and other professionals Ann Faulkner Education and debate 133 Integrated care pathways Harry Campbell, Rona Hotchkiss, Nicola Bradshaw, Mary Porteous 138 Russia: sex, drugs, and AIDS and MSF Hans Veeken 140 Meta-analysis: Spurious precision? Meta-analysis of observational studies Matthias Egger, Martin Schneider, George Davey Smith Letters 145 Screening toddlers for iron deficiency anaemia in general practice D Stevens; R J D Moy and A Aukett; D Elbourne and C Dezateux; R C Tamhne 146 Deaths from accidental drug poisoning in teenagers J M Bland and J Taylor; I Roberts and others 147 MRI is best technique for imaging acute osteomyelitis P T McAndrew and C Clark 147 Cognitive behaviour therapy has role in treatment of medically unexplained physical symptoms S Williams 147 Trial of breast cancer screening in younger women is necessary M D Lewars 148 Greater attempts must be made to promote positive roles for elderly people S Ebrahim and A Kalache 148 Alliance between medical profession and consumers already exists in breast cancer H Thornton 148 Practice in prescribing emergency contraceptives in A and E departments varies B Nathan and others 149 Dominant gene probably caused some of defects ascribed to thalidomide D Smithells 149 Allergic contact dermatitis to oestradiol patches might have been expected K Batta and I S Foulds 149 Potential biases were not taken into account in study of waiting times N Black 150 Making the diagnosis of asthma I D Pavord; G K Crompton; I Doull 150 Compliance is not all M Marinker 151 Assessing methodological quality of published papers M Gossop and J Marsden; P Daish 151 Home Office addicts index no longer exists D Tregoning 151 Clostridium botulinum was named because of association with "sausage poisoning" J K Torrens Obituaries 152 W Alcock, M Baddeley, R R B Baxendine, R Billington, F J Birkett, W S Ghai, D B Grant, E K Hernet, C C Jeffery, I Martin, G Melotte, A Morrison, D P Porter, J E West Medicopolitical digest 154 Primary care pilots Health authorities get extra cash MPs criticise supplies authority Junior posts and the new deal BMA notice Views & reviews Soundings 155 The Devil's bargain Liam Farrell Personal views 155 Editorial ethics Solomon R Benatar Kenya eye safari David Orr, Ingrid Cox The poster session: is the writing on the wall? John Paul Leach Medicine and multimedia 158 Guide to Medical Informatics, the Internet and Telemedicine Enrico Coiera Cybermedicine Warner Slack Paul Taylor For the Record P D Clayton, W E Boebbert, G H DeFriese, S P Howell, M L Fennell, K A Frawley, J Glaser, R A Kemmerer, C E Landwehr, T C Rindfleisch, S A Ryan, B J Sams, P Szolovitz, R G Trussel, E Ward, P M Schwartz Privacy and Health Research William W Lowrance Ross Anderson Arcus Quickstat Iain Buchan Nick Freemantle December bestsellers at the BMJ Bookshop Minerva 160 S2 Career Focus Classified supplement Paediatric anaesthesia Steven Cray Editor's choice Beyond informing patients to involving them Communication depends on constant hard work and is easy to get wrong. Jeff Aronson has had his name mis-spelt Aaronson, Tronson, Bronson, and even Arson (p 124). He has learnt to ask patients how they pronounce and spell their names. Marshall Marinker found the wrong preposition used in a Franz Kafka quote in his editorial because of "BT (the telecommunications company), my diction, and the technical editor's hearing (p 150)." Timothy Beringer describes the panic he felt in his membership examination when faced with a boy "with a broad Dublin brogue which his rapid delivery made it almost impossible to follow (p 99)." Ann Faulkner gives advice on communicating with patients, families, and other professionals in her contribution to the ABC of palliative care (p 130). How do you answer questions like: Is there a cure? Why me? How long have I got? Explore the question, recognise that many are rhetorical, and be prepared to admit that you don't know. Failure to communicate well with patients often arises because of poor communication among professionals. Colleagues from different disciplines have problems defining roles, boundaries, and differing philosophies of care. "Integrated care pathways"are an attempt to respond to this problem (p 133). They are "structured multidisciplinary care plans which detail essential steps in the care of specific clinical problems." Some 45 pathways have been published covering conditions like acute myocardial infarction and total hip replacement, but they have not been well evaluated. An important step in communication is to move beyond supplying patients with information to involving them more in decision making. Tessa Richards quotes Angela Towle from British Columbia speaking at a recent meeting in London (p 85): "Assessing people's information needs, identifying treatment options and the evidence that underpins them, establishing preferences, and supporting people to make decisions is a discipline in its own right .... which goes well beyond the current teaching of communication skills." Patients will increasingly be there throughout health services when important decisions are being made, and the British NHS has a strategy to encourage this development. In the long term it will be revolutionary, and Hazel Thornton describes how it is already happening with breast cancer research (p 148). Doctors who sigh at such change may hanker after the autocratic power that doctors had in the old days. A 100 years ago the BMJ described an Ohio bill requiring those wanting to marry to pass a medical examination (p 117). A licence was forbidden to those suffering from "dipsomania, insanity, or tuberculosis." Home | Current contents | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline