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BMJ No 7133 Volume 316 7 March 1998 This Week in BMJ | Editor's Choice | Press releases Receive this page by email each week Editorials 715 MMR vaccination and autism 1998 Angus Nicoll, David Elliman, Euan Ross 716 Hydroxychloroquine retinopathy: is screening necessary? Chris Blyth, Carol Lane 717 Blood transfusion risk: protecting against the unknown John Barbara, Peter Flanagan 718 Patient data, confidentiality, and electronics Grant Kelly 719 Immunosuppressive drugs after lung transplantation Norman Briffa, Randall E Morris 721 Continuing medical education: where next? Peter Toghill 722 Poverty in rural areas Jim Cox News 723 Standards of cleft lip repair criticised Acne drug linked to severe depression More controversy surrounds MMR vaccine Cholesterol screening is not worth while Men arrested for selling organs from China Israel's patent law attacked UK blood products are banned Police surgeon service needs modernising Researchers create designer antibody Special international report on smoking in public In brief Papers 731 Ultrasound treatment for treating the carpal tunnel syndrome: randomised "sham" controlled trial Gerold R Ebenbichler, Karl L Resch, Peter Nicolakis, Günther F Wiesinger, Frank Uhl, Abdel-Halim Ghanem, Veronika Fialka 736 Variations in population health status: results from a United Kingdom national questionnaire survey Paul Kind, Paul Dolan, Claire Gudex, Alan Williams 741 Use of calcium channel blockers and risk of suicide: ecological findings confirmed in population based cohort study Gunnar Lindberg, Kerstin Bingefors, Jonas Ranstam, Lennart Råstam, Arne Melander 745 QT and QTc dispersion are accurate predictors of cardiac death in newly diagnosed non-insulin dependent diabetes: cohort study Abdul A O Naas, Neil C Davidson, Chris Thompson, Fraser Cummings, Simon A Ogston, Roland T Jung, Ray W Newton, Allan D Struthers 746 How often does surgery for peptic ulceration eradicate Helicobacter pylori? Systematic review of 36 studies John Danesh, Paul Appleby, Richard Peto General practice 748 Controversies in primary care: Setting prescribing budgets in general practice 748 Capitation based prescribing budgets will not work Azeem Majeed, Stephen Head 750 Effective prescribing at practice level should be identified and rewarded Trisha Greenhalgh Clinical review 754 Science, medicine, and the future: New techniques in laser therapy Stephen G Bown 758 ABC of allergies: Pathogenic mechanisms: a rational basis for treatment Peter H Howarth Education and debate 762 Personal paper: New drug treatment for Alzheimer's disease: lessons for healthcare policy 765 Should measles be eradicated? F T Cutts, R Steinglass 767 The new genetics: Implications for clinical services in Britain and the United States Ann Louise Kinmonth, John Reinhard, Martin Bobrow, Susan Pauker 771 Continuing medical education: Interprofessional working and continuing medical education Linda A Headrick, Peter M Wilcock, Paul B Batalden Letters 775 Three quarters of delegates drove to conference on impact of environment on health B Hanratty and W Patterson 775 Audit of child protection procedures in an A&E department P O Brennan; M J Bannon and Y H Carter; J E Porter 776 Testing of PRODIGY continues I Purves and others 777 Survey of French prison found that injecting drug use and tattooing occurred M Rotily and others 777 Children with enuresis F C M Forbes; L Light 778 Maybe general surgery no longer exists as a specialty A D Spigelman 778 Is histological examination of tissue removed by GPs always necessary? P Cross; R Parslew and L Rhodes; S K Suvarna and others; A Lowy and others; B Kirby and others 779 Responsibility for decision to give transfusion remains with doctor, not patient N G B Richardson and P M Jones 780 Incidence of epilepsy is now higher in elderly people than children A D Everitt and J W Sander 780 Community institutional care for frail elderly people W R Primrose; D Mukherjee and others 781 Rapid tranquillisation protocol had been published T Davies and Z Atakan 781 Article about Mental Health Act was misleading T H Leigh 781 Self help groups and professionally conducted group interventions are different A Bottomley and R Thomas Obituaries 782 R D A Coxon, W E N Cummings, N J Hunter, J M Macfie, F McDowell, J B McWhinnie, D Rice, J C B Serjeant, J Taylor, M L Walt, R J A Webb, J F Wilkinson Medicopolitical digest 784 BMA to see GMC advice on BUPA scheme Timetable for The new NHS BMA wants action on sanctions Parliament's primary care group Views & reviews Soundings 785 Problem kids Colin Douglas Personal view 785 Who cares David Shiers Medicine and books 787 Life in the Balance: Emergency Medicine and the Quest for Survival Mickey S Eisenberg Tim Ashworth The Audit Society: Rituals of Verification Michael Power Lois Quam Minerva 788 Fillers 753 Motherese Derek Fair 774 Wiser beyond their years Olive M McKendrick 786 "I can't turn my car to the left" Michael Oliver Corrections 747 Birth weight and cognitive function in young adult life: historical cohort study Henrik Toft Sørenson and others 747 Childhood energy intake and adult mortality from cancer: the Boyd Orr cohort study Stephen Frankel and others S2 Career Focus Classified supplement Traditional ways of selecting medical staff Mark Cook Editor's choice Ways of learning Smoking provides so many stories - from the science of addiction, through the epidemiology of causation, to the David and Goliath battles between anti-tobacco activists and the tobacco industry. This week's news round up, on smoking in public places, offers smoking as a backcloth to cultural differences (p 727). Americans and Australians resort pretty quickly to the law; in Britain few specific laws exist, but social pressure has acted to limit smoking in workplaces and public places; in France, in contrast, there are laws to limit smoking in bars and restaurants - but social pressure to ignore them. Another difference between societies is their attitudes to information. On p 762, for example, in describing the way that donepezil was marketed, David Melzer points out that nine months after the launch in Britain of this drug for Alzheimer's disease, the main clinical trials had still not been published. Though the American prescribing leaflet contains a summary of the findings of the main trials, the British product information does not, and no information is available from the UK's Medicines Control Agency, which "currently works in secret (although limited information would have been released if European licensing procedures had been followed)." He wants to see full trial results (in patients representative of those for whom the drug will be licensed) published before a drug is launched and an emphasis on clinical benefits and risks. He is particularly critical of advertisements that refer to data that are not publicly available. We conclude our series on continuing medical education with an article by Linda Headrick and colleagues on interprofessional learning and working (p 771) and Peter Toghill's account of what the British royal colleges are doing (p 721). Headrick and her colleagues quote Schön, who wrote that too much education occupied the "high ground," where manageable problems lend themselves to solutions through research based theory and techniques, whereas most problems lie in the "swampy lowland" and defy technical solution. Their message is that getting the occupants of the swamp to work together on clearing it is an important part of learning and development. Most weeks, in among the randomised controlled trials, the systematic reviews, the ABCs, and the other educational articles, we publish some small insights into how doctors really learn. Our "fillers" are the short pieces on memorable patients and other topics that fill spaces at the ends of pages, and in one this week (p 774) Olive McKendrick tells how she learnt from a 12 year old boy the importance of enabling ill people to keep some control over their lives - and of how intimidating sitting in a low chair before someone in a higher one can be. We plan to list these fillers on our contents page, and we are also looking for a new name for them. Any suggestions? Home | Current contents | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline