Recent rapid responses

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML+RDFa 1.0//EN" "http://www.w3.org/MarkUp/DTD/xhtml-rdfa-1.dtd">     <html xml:lang="en" lang="en" dir="ltr" >    <head profile="http://www.w3.org/1999/xhtml/vocab"> <meta charset="utf-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <link rel=”apple-touch-icon-precomposed” href=”/sites/default/themes/bmj/the_bmj/img/icon.png”/> <meta http-equiv="X-UA-Compatible" content="IE=edge">  <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <meta name="twitter:card" content="summary_large_image"><meta name="twitter:title" content="Recent rapid responses" /><link href="//netdna.bootstrapcdn.com/font-awesome/4.0.3/css/font-awesome.css" rel="stylesheet" media="all" type="text/css" /> <link rel="shortcut icon" href="https://www.bmj.com/sites/default/themes/bmj/the_bmj/favicon.ico" type="image/vnd.microsoft.icon" /> <script>window.dataLayer = window.dataLayer || [];window.dataLayer.push({"page":{"hwTitle":"Recent rapid responses","hwUrl":"https://www.bmj.com/rapid-responses","hwPath":"/rapid-responses","hwType":"other page"},"user":{"hwMemberID":"","hwLoggedIntoInstitutionID":"","hwLoggedIntoInstitution":"","hwAccessUsageTerms":"guest","hwRegisteredUser":"no","mail":"e3b0c44298fc1c149afbf4c8996fb92427ae41e4649b934ca495991b7852b855"},"content":{"hwTabView":"rapid-responses"}}); //--><!]]></script> <meta name="generator" content="Drupal 7 (http://drupal.org)" /> <link rel="canonical" href="https://www.bmj.com/rapid-responses" /> <link rel="shortlink" href="https://www.bmj.com/rapid-responses" /> <meta name="twitter:card" content="summary" /> <meta name="twitter:url" content="https://www.bmj.com/rapid-responses" /> <meta name="twitter:title" content="Recent rapid responses" /> <title>Recent rapid responses | The BMJ</title>   <link type="text/css" rel="stylesheet" href="https://www.bmj.com/sites/default/files/advagg_css/css__pJxGDlKWbRstPhPalOfabFpC-rcc_3-hqiXP5Ybd6dk__ZKGiHmn_xjE3Rg8hriUDX-FRi0jtJPx7mEr4HGwMv9E__a7Jq5VSqcMKMeR_gboGw1x4AC4g6SRpO1Geb_4xJjYc.css" media="all" /> <link type="text/css" rel="stylesheet" href="https://www.bmj.com/sites/default/files/advagg_css/css__hcEfBsSfdZ2na-rT9Jhk7K2mHyy5KBdPKm6ia_F7MYU__4716zpuGoj4DfVIEENbeOWgAOX_pf_t16EI4fvJGo7A__a7Jq5VSqcMKMeR_gboGw1x4AC4g6SRpO1Geb_4xJjYc.css" media="print" /> <link type="text/css" rel="stylesheet" href="https://www.bmj.com/sites/default/files/advagg_css/css__b-tWEqg3_twqP_ufdNXyA5V14StJgBdiIxG1UIi0LYc__3z5eyFP7TvyPE6DkwNj3xM94b3mZNfr4lSWEChDxsvU__a7Jq5VSqcMKMeR_gboGw1x4AC4g6SRpO1Geb_4xJjYc.css" media="screen" /> <link type="text/css" rel="stylesheet" href="https://www.bmj.com/sites/default/files/advagg_css/css__-BkZ71IF4pBXmZfP4vYyswWdIhuaKktrUUQ4i2vtUVo__0i_0YcYkMECNn0z7FdhNoJ8gLWleqnTtjnHRAmLijvc__a7Jq5VSqcMKMeR_gboGw1x4AC4g6SRpO1Geb_4xJjYc.css" media="all" /> <link href="/sites/default/themes/bmj/the_bmj/css/fonts.css" rel="stylesheet" media="all" type="text/css"> <style media="screen" type="text/css"> .page-news #latest-blogs h2.pane-title, .bootstrap-threecol-4-4-4 #latest-blogs h2.pane-title { width: 153px !important; } #navigation-wrapper #navigation .main-navigation .menu.nav>li.last { display: block !important; } </style>  <script src="https://cdn.cookielaw.org/consent/tcf.stub.js"" type="text/javascript" charset="UTF-8"></script>  <script src="https://cookie-cdn.cookiepro.com/scripttemplates/otSDKStub.js" type="text/javascript" charset="UTF-8" data-domain-script="565e50dd-f6e9-46d6-91cd-5c40a270264f"></script> <script type="text/javascript"> function OnetrustAdsConsent(){ if(googletag.apiReady){ //console.log("GoogleTag API ready") googletag.pubads().disableInitialLoad(); if(OptanonActiveGroups.match(/,4,/)){ googletag.pubads().setRequestNonPersonalizedAds(0); //googletag.pubads().refresh(); } else{ googletag.pubads().setRequestNonPersonalizedAds(1); // googletag.pubads().refresh(); } } else{ OnetrustAdsConsent(); } } function OptanonWrapper() { OnetrustAdsConsent(); } </script>  <script src="https://www.bmj.com/sites/default/files/advagg_js/js__WABquebcu-gxdJy4p3XUIEPwZprzET9dBQUtwm_NaQ8__cCs36pQeczr7X_itUS-qWKCSbV_6XA3jxWXnZXxbakg__a7Jq5VSqcMKMeR_gboGw1x4AC4g6SRpO1Geb_4xJjYc.js"></script> <script src="https://www.bmj.com/sites/default/files/advagg_js/js__yOhrJUBmMpN-jsuQlJYmS8ovkQU6I6KInr295HrSTb0__kNZOwQe90NfE8C-hWOgsFXPKntAJ9VAwAGq-qlrYUcQ__a7Jq5VSqcMKMeR_gboGw1x4AC4g6SRpO1Geb_4xJjYc.js"></script> <script src="https://www.bmj.com/sites/default/files/advagg_js/js__0H4wQYqcRMKL-l4njB_SdGYL5pDTZV40DWw8wYV2U8A__yqtu3Jz6X-z7bCbRppMsstrXHpAKezxd3Ae9Edgrbuo__a7Jq5VSqcMKMeR_gboGw1x4AC4g6SRpO1Geb_4xJjYc.js"></script> <script src="https://www.bmj.com/sites/default/files/advagg_js/js__CRsQ8ZCuHWo0Gz-wnsdWqia4TAmy5LRiclDb8XoYGqY__urfADqrQ7eKl3csEhAF2b120SfBotjnv-Cf-QnhxEYw__a7Jq5VSqcMKMeR_gboGw1x4AC4g6SRpO1Geb_4xJjYc.js"></script> <script src="https://www.bmj.com/sites/default/files/advagg_js/js__JmLmeDX4FWECu0S6gLChFJSg2ThgJNq7r0o8URKSpFU__fjElDBur5Z5nlEApF0xuutO8M9WK9I2mTAdwRkLH-FY__a7Jq5VSqcMKMeR_gboGw1x4AC4g6SRpO1Geb_4xJjYc.js"></script> <script>var _prum=[['id', '612e3f1b1733500011000061'], ['mark', 'firstbyte', (new Date()).getTime()]]; (function() { var s=document.getElementsByTagName('script')[0], p=document.createElement('script'); p.async='async'; p.src='//rum-static.pingdom.net/prum.min.js';s.parentNode.insertBefore(p,s);})();</script> <script>jQuery.extend(Drupal.settings,{"basePath":"\/","pathPrefix":"","ajaxPageState":{"theme":"the_bmj","theme_token":"uM0ibaRoP1vFOEqkH-U4GkKJtDAHjbyv6_nJQ4IjDiw","jquery_version":"1.8","css":{"modules\/system\/system.base.css":1,"misc\/ui\/jquery.ui.core.css":1,"misc\/ui\/jquery.ui.theme.css":1,"sites\/all\/libraries\/chosen\/chosen.css":1,"sites\/all\/modules\/contrib\/chosen\/css\/chosen-drupal.css":1,"sites\/all\/modules\/contrib\/date\/date_api\/date.css":1,"sites\/all\/modules\/contrib\/date\/date_popup\/themes\/datepicker.1.7.css":1,"modules\/field\/theme\/field.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_draw\/css\/highwire-draw.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_folders\/highwire_folders.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_saved_searches\/highwire_saved_searches.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire_user\/highwire_user.css":1,"sites\/all\/modules\/contrib\/views\/css\/views.css":1,"sites\/all\/modules\/contrib\/ckeditor\/css\/ckeditor.css":1,"sites\/all\/modules\/contrib\/colorbox\/styles\/default\/colorbox_style.css":1,"sites\/all\/modules\/contrib\/ctools\/css\/ctools.css":1,"sites\/all\/modules\/highwire\/highwire\/highwire.style.highwire.css":1,"sites\/all\/modules\/highwire\/highwire\/css\/nlm-elements.css":1,"sites\/all\/modules\/contrib\/panels\/css\/panels.css":1,"sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css":1,"sites\/all\/modules\/highwire\/highwire\/css\/highwire.gtranslate.css":1,"sites\/default\/modules\/contrib\/custom_search\/custom_search.css":1,"sites\/default\/themes\/bmj\/the_bmj\/css\/print.css":1,"sites\/default\/themes\/bmj\/the_bmj\/css\/screen.css":1,"sites\/default\/themes\/bmj\/the_bmj\/css\/screen_2.css":1,"sites\/default\/themes\/bmj\/the_bmj\/css\/screen_3.css":1,"sites\/all\/modules\/highwire\/highwire\/css\/highwire-forms.css":1},"js":{"sites\/all\/libraries\/modernizr\/modernizr.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/jquery\/1.8\/jquery.min.js":1,"misc\/jquery-extend-3.4.0.js":1,"misc\/jquery.once.js":1,"misc\/drupal.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/ui\/minified\/jquery.ui.core.min.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/ui\/external\/jquery.cookie.js":1,"sites\/all\/modules\/contrib\/jquery_update\/replace\/misc\/jquery.form.min.js":1,"misc\/ajax.js":1,"sites\/all\/modules\/contrib\/jquery_update\/js\/jquery_update.js":1,"sites\/all\/libraries\/chosen\/chosen.jquery.min.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.equal-heights.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.panels-ajax-tab.js":1,"sites\/all\/libraries\/colorbox\/jquery.colorbox-min.js":1,"sites\/all\/modules\/contrib\/colorbox\/js\/colorbox.js":1,"sites\/all\/modules\/contrib\/colorbox\/styles\/default\/colorbox_style.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_user\/js\/highwire_user_meta.js":1,"sites\/default\/modules\/contrib\/custom_search\/js\/custom_search.js":1,"sites\/all\/modules\/highwire\/highwire\/js\/highwire.gtranslate.js":1,"sites\/all\/modules\/highwire\/highwire\/highwire_datalayer\/js\/highwire_datalayer.js":1,"sites\/all\/modules\/contrib\/views\/js\/base.js":1,"sites\/all\/modules\/contrib\/views\/js\/ajax_view.js":1,"sites\/all\/modules\/contrib\/chosen\/chosen.js":1,"sites\/default\/themes\/bmj\/the_bmj\/bootstrap\/js\/bootstrap.min.js":1,"sites\/default\/themes\/bmj\/the_bmj\/js\/modernizr.min.js":1,"sites\/default\/themes\/bmj\/the_bmj\/js\/jquery.cookieBar.js":1,"sites\/default\/themes\/bmj\/the_bmj\/js\/script.js":1,"sites\/default\/themes\/bmj\/the_bmj\/js\/uuid.js":1,"sites\/default\/themes\/bmj\/bootstrap\/js\/modules\/views\/js\/ajax_view.js":1}},"colorbox":{"opacity":"0.85","current":"{current} of {total}","previous":"\u00ab Prev","next":"Next \u00bb","close":"Close","maxWidth":"98%","maxHeight":"98%","fixed":true,"mobiledetect":true,"mobiledevicewidth":"480px"},"custom_search":{"form_target":"_self","solr":1},"urlIsAjaxTrusted":{"\/rapid-responses":true,"\/views\/ajax":true,"\/login":true},"chosen":{"selector":"select:visible","minimum_single":20,"minimum_multiple":20,"minimum_width":250,"options":{"disable_search":false,"disable_search_threshold":0,"search_contains":false,"placeholder_text_multiple":"Choose some options","placeholder_text_single":"Choose an option","no_results_text":"No results match","inherit_select_classes":true}},"views":{"ajax_path":"\/views\/ajax","ajaxViews":{"views_dom_id:3632816237ecbc8b9c0e4e6a754601ec":{"view_name":"bmj_rapid_responses","view_display_id":"rapid_response_archive","view_args":"","view_path":"rapid-responses","view_base_path":"rapid-responses","view_dom_id":"3632816237ecbc8b9c0e4e6a754601ec","pager_element":0}}},"highwire":{"dataLayer":"{\u0022page\u0022:{\u0022hwTitle\u0022:\u0022Recent rapid responses\u0022,\u0022hwUrl\u0022:\u0022https:\\\/\\\/www.bmj.com\\\/rapid-responses\u0022,\u0022hwPath\u0022:\u0022\\\/rapid-responses\u0022,\u0022hwType\u0022:\u0022other page\u0022},\u0022user\u0022:{\u0022hwMemberID\u0022:\u0022\u0022,\u0022hwLoggedIntoInstitutionID\u0022:\u0022\u0022,\u0022hwLoggedIntoInstitution\u0022:\u0022\u0022,\u0022hwAccessUsageTerms\u0022:\u0022guest\u0022,\u0022hwRegisteredUser\u0022:\u0022no\u0022,\u0022mail\u0022:\u0022e3b0c44298fc1c149afbf4c8996fb92427ae41e4649b934ca495991b7852b855\u0022},\u0022content\u0022:{\u0022hwTabView\u0022:\u0022rapid-responses\u0022}}"},"orcidLogo":{"svg":"\/sites\/default\/themes\/bmj\/the_bmj\/img\/vector_iD_icon.svg"},"bootstrap":{"anchorsFix":"1","anchorsSmoothScrolling":"1","popoverEnabled":"1","popoverOptions":{"animation":1,"html":0,"placement":"right","selector":"","trigger":"click","title":"","content":"","delay":0,"container":"body"},"tooltipEnabled":"1","tooltipOptions":{"animation":1,"html":0,"placement":"auto left","selector":"","trigger":"hover focus","delay":0,"container":"body"}}});</script> <script type="text/javascript"> window.dataLayer = window.dataLayer || []; </script>    <style>.async-hide { opacity: 0 !important} </style> <script>(function(a,s,y,n,c,h,i,d,e){s.className+=' '+y;h.start=1*new Date; h.end=i=function(){s.className=s.className.replace(RegExp(' ?'+y),'')}; (a[n]=a[n]||[]).hide=h;setTimeout(function(){i();h.end=null},c);h.timeout=c;})(window,document.documentElement,'async-hide','dataLayer',4000,{'GTM-NF7HCLL':true});</script>   <script>var googletag = window.googletag || {cmd: []};</script> <script async src="//securepubads.g.doubleclick.net/tag/js/gpt.js"></script> <script> var topBottomSizes = [ [970,250],[970,90],[728,90],[468,60],[300,50],[320,100] ]; var mpuSizes = [ [300,250],[300,600],[600,600], ]; //googletag.cmd.push(function() { googletag.display('div-gpt-ad-7326006-1'); }); googletag.cmd.push(function() { googletag.defineSlot('/21798771943/BMJ.com_HomePage_TOPBanner', topBottomSizes,'div-gpt-ad-7326006-1').addService(googletag.pubads()).setTargeting("pgid", "pubgrade_lib_disabled"); googletag.defineSlot('/21798771943/BMJ.com_HomePage_MPU1', mpuSizes, 'div-gpt-ad-7326006-2').addService(googletag.pubads()); googletag.defineSlot('/21798771943/BMJ.com_HomePage_MPU2', mpuSizes, 'div-gpt-ad-7326006-3').addService(googletag.pubads()); googletag.defineSlot('/21798771943/BMJ.com_HomePage_BOTTOM', topBottomSizes, 'div-gpt-ad-7326006-4').addService(googletag.pubads()); googletag.pubads().setTargeting('url', window.parent.location.pathname); // Some examples of ways to enable below. Normally, only one of these // methods should be used. // A) Enable with defaults. googletag.pubads().enableLazyLoad({ fetchMarginPercent: 0, // Fetch slots within 1 viewports. renderMarginPercent: 0, // Render slots within 1 viewports. mobileScaling: 2.0 // Double the above values on mobile. }); googletag.enableServices(); }); </script> <script> let cookies = parseCookies(); let bmj_uuid = cookies.bmj_uuid; let bmj_ppid = cookies.bmj_ppid; window.dataLayer = window.dataLayer || []; function checkUserLoginStatus(dataLayer) { const userMail = dataLayer.find((item) => item.user)?.user?.mail; if (!userMail) { return false; } return userMail !== anonMailId; } const anonMailId = 'e3b0c44298fc1c149afbf4c8996fb92427ae41e4649b934ca495991b7852b855'; let nonAnonMailId = ((dataLayer.find(item => item.user)?.user)?.mail) === anonMailId ? null : (dataLayer.find(item => item.user)?.user)?.mail; let userId = ((dataLayer.find(item => item.user)?.user)?.['data-ics']) ?? ((dataLayer.find(item => item.user)?.user)?.mail && nonAnonMailId) ?? bmj_ppid ?? bmj_uuid; document.cookie = 'bmj_ppid=' + userId + '; domain=.bmj.com; path=/; max-age=31622400; SameSite=None; Secure'; googletag.cmd.push(function() { googletag.pubads().setPublisherProvidedId(userId); googletag.pubads().setTargeting("islogged", checkUserLoginStatus(dataLayer) ? "true" : "false"); googletag.enableServices(); }); window.dataLayer.push({ 'bmj_uuid': bmj_uuid }); </script> </head>   <script type="text/javascript">(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-NF7HCLL');</script>  </head>  <body class="html not-front not-logged-in no-sidebars page-rapid-responses" >  <noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-NF7HCLL" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>  <div id="skip-link"> <a href="#main-content" class="element-invisible element-focusable">Skip to main content</a> </div> <div id="wrapper-outer"> <div id="wrapper"> <header> <div class="bmj-disclaimer"> <p>Intended for healthcare professionals</p> </div> <div class="ad-leaderboard"> <div id='div-gpt-ad-7326006-1'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-7326006-1'); }); </script> </div> </div>   <div id="top-nav" role="navigation" class="navbar navbar-static-top"> <div class="container"> <div id="userbar-status"> <ul id="status"> <li class="user-status-link user-status-subscribe phone-menu-item"> <a href="/us/subscribe">Subscribe</a> </li> <li class="user-status-myaccount phone-menu-item"> <div class="btn-group has-submenu"> <a class="btn dropdown-toggle" aria-expanded="false" aria-haspopup="true" data-toggle="dropdown" href="#" > My Account <span class="caret" aria-expanded="true"></span> </a> <ul class="jnl-bmj-user-my-account dropdown-menu"><li class="0 first last"><a href="//myaccount.bmj.com/myaccount/account/hw-registration.html">My email alerts</a></li> </ul></div> </li> <li class="user-status-bma phone-menu-item"> <a href="//bmjverification.bma.org.uk/validate/userdetails?url=https://www.bmj.com/rapid-responses?sso=">BMA member login</a> </li> <div class="btn-group has-submenu"> <a class="btn dropdown-toggle" aria-expanded="false" aria-haspopup="true" data-toggle="dropdown" href="#" > Login <span class="caret" aria-expanded="true"></span> </a> <ul class="jnl-bmj-user-signin-popup dropdown-menu"><li class="0 first last"><span><form action="/login" method="post" id="jnl-bmj-user-login-form" accept-charset="UTF-8"><div><input type="hidden" name="form_build_id" value="form-n9rvshZn8hGzIQlNzTTFj1KEd6MOgB601_OA7Tt57CA" /> <input type="hidden" name="form_id" value="jnl_bmj_user_login_form" /> <div class="form-type-textfield form-item-name form-item form-group"> <label for="article-p-name">Username <span class="form-required" title="This field is required.">*</span></label> <input class="form-control form-text required" type="text" id="article-p-name" name="name" value="" size="15" maxlength="60" /> </div> <div class="form-type-password form-item-pass form-item form-group"> <label for="article-p-pass">Password <span class="form-required" title="This field is required.">*</span></label> <input class="form-control form-text required" type="password" id="article-p-pass" name="pass" size="15" maxlength="128" /> </div> <div class="link"><div id="edit-forgot" class="form-type-item form-item form-group"> <label for="edit-forgot"><a href="https://www.bmj.com/user/password" title="Retrieve your credentials.">Forgot your log in details?</a> </label> </div> </div><div class="link"><div id="edit-activate" class="form-type-item form-item form-group"> <label for="edit-activate"><a href="//journals.bmj.com/cgi/activate/basic">Need to activate</a> </label> </div> </div><input class="btn form-submit" type="submit" id="edit-submit--8" name="op" value="Login" /><div id="edit-message" class="form-type-item form-item form-group"> </div> <hr /><div id="edit-bma-members" class="form-type-item form-item form-group"> <label for="edit-bma-members"><a href="//bmjverification.bma.org.uk/validate/userdetails?url=https%3A//www.bmj.com/rapid-responses%3Fsso%3D" title="Log in here if you are a BMA member.">BMA Member Log In</a> </label> </div> <div id="edit-athens" class="form-type-item form-item form-group"> <label for="edit-athens"><a href="https://openathens-sp.highwire.org/session/init?entityID=https%3A//idp.eduserv.org.uk/openathens&subcode=bmjjournals&hw-shib-return-uri=https%253A%252F%252Fwww.bmj.com%252Frapid-responses">Log in via OpenAthens</a> </label> </div> <div id="edit-shibboleth" class="form-type-item form-item form-group"> <label for="edit-shibboleth"><a href="/login/shibboleth?uri=https%3A%2F%2Fwww.bmj.com%2Frapid-responses&subcode=bmjjournals&env=prod">Log in via your institution</a> </label> </div> </div></form></span></li> </ul></div> </ul> <div id="userbar"> <div class="region region-userbar"> <section id="block-panels-mini-jnl-bmj-country-portal-switcher" class="block block-panels-mini clearfix"> <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_bmj_country_portal_switcher"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-country-switcher" > <div class="pane-content"> <span class="country-label">Edition: </span> <div class="btn-group has-submenu"> <a class="btn dropdown-toggle" aria-expanded="false" aria-haspopup="true" data-toggle="dropdown" href="#" id=country-switcher> US <span class="caret" aria-expanded="true"></span> </a> <ul class="jnl-bmj-country-portal-country-switcher dropdown-menu"><li class="0 first"><a href="/bmj_countries/switch/uk?destination=rapid-responses">UK</a></li> <li class="1"><a href="/bmj_countries/switch/india?destination=rapid-responses">South Asia</a></li> <li class="2 last"><a href="/bmj_countries/switch/international?destination=rapid-responses">International</a></li> </ul></div> </div> </div> </div> </div> </div> </section>  </div> </div> <div id="cmp-link"> <div class="pane-content"> <span class="country-label"><a href="/company?int_source=tbmj&int_medium=header&int_campaign=URLswitch">Our company</a></span> </div> </div> </div> </div> </div>  <div id="main-nav" data-spy="affix" data-offset-top="125"> <div class="primary-navigation-bar"> <div id="navigation-wrapper"> <div class="container">  <a href="#" id="btn-nav" class=""> <span class="sr-only">Toggle navigation</span> </a>  <a class="logo navbar-btn pull-left" href="/" title="Home">  <div class="bmj-logo">The BMJ logo</div> </a> <div class="ie6-site-map"><a href="/sitemap">Site map</a></div>  <div class="main-nav-search"> <div id="search">  <a href="#" class="dropdown-toggle" data-toggle="dropdown" title="Search"><div class="search"><em class="fa fa-search" alt="Search"></em><span class="search-label">Search</span></div></a> <div class="dropdown-menu"> <div class="header-search-form container"> <div class="searchbar"> <div class="region region-search-block"> <section id="block-search-form" class="block block-search clearfix"> <form class="search-form form-search content-search" action="/rapid-responses" method="post" id="search-block-form" accept-charset="UTF-8"><div><div> <h2 class="element-invisible">Search form</h2> <div class="input-group"><input title="Enter the terms you wish to search for." class="container-inline input-append form-control form-text" placeholder="Search The BMJ" type="text" id="edit-search-block-form--2" name="search_block_form" value="" size="15" maxlength="128" /><span class="input-group-btn"><button type="submit" class="btn btn-default">Search</button></span></div><button class="element-invisible btn btn-primary btn btn-primary form-button" type="submit" id="edit-submit--3" name="op" value="Search">Search</button><input type="hidden" name="form_build_id" value="form-BR117yb7YJ-z1e2rkQmHhefpDoCNYcOFm3iEIO7mKHU" /> <input type="hidden" name="form_id" value="search_block_form" /> <input type="hidden" name="custom_search_paths" value="search/advanced/[key]" /> </div> </div></form> </section>  </div> </div> <div class="advanced-search"> <ul class="list-inline"> <li><a href="/search/advanced" title="Advanced search">Advanced search</a></li> <li><a href="/rapid-responses" title="Search responses">Search responses</a></li> <li><a href="//blogs.bmj.com/bmj/" title="Search blogs">Search blogs</a></li> </ul> </div> </div> </div> </div> </div>  <a href="#" id="toggle-mobile-top-nav"> <span class="fa fa-cog"></span> <span class="sr-only">Toggle top menu</span> </a>  <div id="navigation" class="navigation">  <div class="main-navigation"> <nav role="navigation"> <ul class="menu nav navbar-nav"><li class="first leaf"><a href="/coronavirus">covid-19</a></li> <li class="expanded dropdown"><a href="/us/research" data-target="#" class="dropdown-toggle" data-toggle="dropdown">Research</a><ul class="dropdown-menu"><li class="first leaf"><a href="/us/research">At a glance</a></li> <li class="leaf"><a href="/us/research/research">Research papers</a></li> <li class="leaf"><a href="/us/research/research%20methods%20%26amp%3B%20reporting">Research methods and reporting</a></li> <li class="last leaf"><a href="/us/research/minerva">Minerva</a></li> </ul></li> <li class="expanded dropdown"><a href="/us/education" data-target="#" class="dropdown-toggle" data-toggle="dropdown">Education</a><ul class="dropdown-menu"><li class="first leaf"><a href="/us/education">At a glance</a></li> <li class="leaf"><a href="/us/education/clinical%20review">Clinical reviews</a></li> <li class="leaf"><a href="/us/education/practice">Practice</a></li> <li class="leaf"><a href="/us/education/minerva">Minerva</a></li> <li class="leaf"><a href="/us/education/endgames">Endgames</a></li> <li class="leaf"><a href="/specialties/state-art">State of the art</a></li> <li class="leaf"><a href="/specialties/what-your-patient-thinking">What your patient is thinking</a></li> <li class="leaf"><a href="/rapid-recommendations">Rapid recommendations</a></li> <li class="last leaf"><a href="/student">Student</a></li> </ul></li> <li class="expanded active-trail dropdown"><a href="/us/news" class="active-trail dropdown-toggle" data-target="#" data-toggle="dropdown">News & Views</a><ul class="dropdown-menu"><li class="first leaf"><a href="/us/news">At a glance</a></li> <li class="leaf"><a href="/us/news/news?category=News">News</a></li> <li class="leaf"><a href="/us/news/feature">Features</a></li> <li class="leaf"><a href="/us/news/editorial">Editorials</a></li> <li class="leaf"><a href="/us/news/analysis">Analysis</a></li> <li class="leaf"><a href="/news/opinion">Opinion</a></li> <li class="leaf"><a href="/us/news/head%20to%20head">Head to head</a></li> <li class="leaf"><a href="/us/news/editor%27s%20choice">Editor's choice</a></li> <li class="leaf"><a href="/us/news/letter">Letters</a></li> <li class="leaf"><a href="/us/news/obituary">Obituaries</a></li> <li class="leaf"><a href="/careers-articles">Careers</a></li> <li class="last leaf active-trail"><a href="/rapid-responses" class="active-trail active">Rapid responses</a></li> </ul></li> <li class="expanded dropdown"><a href="/campaigns" data-target="#" class="dropdown-toggle" data-toggle="dropdown">Campaigns</a><ul class="dropdown-menu"><li class="first leaf"><a href="/campaigns">At a glance</a></li> <li class="leaf"><a href="/better-evidence">Better evidence</a></li> <li class="leaf"><a href="/campaign/climate-emergency">Climate change</a></li> <li class="leaf"><a href="/divestment">Divestment from fossil fuels</a></li> <li class="leaf"><a href="/campaign/patient-partnership">Patient and public partnership</a></li> <li class="last leaf"><a href="/too-much-medicine">Too much medicine</a></li> </ul></li> <li class="last expanded dropdown"><a href="/careers" data-target="#" class="dropdown-toggle" data-toggle="dropdown">Jobs</a><ul class="dropdown-menu"><li class="first leaf"><a href="/careers">Doctor Jobs UK</a></li> <li class="leaf"><a href="/careers/jobs/hospital/">Hospital Jobs UK</a></li> <li class="leaf"><a href="/careers/jobs/general-practice/">GP Jobs UK</a></li> <li class="last leaf"><a href="/careers/jobs/international/">International Jobs</a></li> </ul></li> </ul>  <div class="second-navigation"> <ul class="secondary-nav" id=""> <li class="even"><a href="/archive" class="">Archive</a></li> <li class="odd"><a href="/about-bmj/resources-authors" class="">For authors</a></li> <li class="odd last"><a href="http://hosted.bmj.com" class="">Hosted</a></li> </ul> </div> </nav> </div> </div> </div> </div> </div> </div> </header> <div class="main-container container" id="page">   <div class="row"> <section class="col-sm-12" > <ol class="breadcrumb"><li class="first"><a href="/us/news">News & Views</a></li> <li class="active last">Recent rapid responses</li> </ol> <a id="main-content"></a> <div class="region region-content"> <section id="block-system-main" class="block block-system clearfix"> <div class="panel-display row bootstrap-onecol" > <div class="panel-panel col-xs-12 col-sm-12 col-md-12 col-lg-12"> <div class="panel-pane pane-block pane-jnl-bmj-quick-search-jnl-bmj-quick-search-rr-form" > <h2 class="pane-title"> Search all rapid responses </h2> <div class="pane-content"> <form action="/rapid-responses" method="post" id="jnl-bmj-quick-search-rapid-responses-form" accept-charset="UTF-8"><div><div class="form-type-textfield form-item-jnl-bmj-quick-search-rapid-responses-form form-item form-group"> <label class="element-invisible" for="edit-jnl-bmj-quick-search-rapid-responses-form--2">Search </label> <input title="Enter the terms you wish to search for." class="form-control form-text" type="text" id="edit-jnl-bmj-quick-search-rapid-responses-form--2" name="jnl_bmj_quick_search_rapid_responses_form" value="" size="15" maxlength="128" /> </div> <input type="hidden" name="form_build_id" value="form-cDttJtHWMMgoAzYMzK7cvjYcKeOBbU5ftU18Wmo_z14" /> <input type="hidden" name="form_id" value="jnl_bmj_quick_search_rapid_responses_form" /> <input class="btn btn-primary form-submit" type="submit" id="edit-submit" name="op" value="Search" /></div></form> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-views-panes pane-bmj-rapid-responses-rapid-response-archive" > <h2 class="pane-title"> All rapid responses </h2> <div class="pane-content"> <div class="view view-bmj-rapid-responses view-id-bmj_rapid_responses view-display-id-rapid_response_archive view-dom-id-3632816237ecbc8b9c0e4e6a754601ec"> <div class="view-header"> <div id="response-header-description"> <p> Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. <i>The BMJ</i> reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation. </p> <p> From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit. </p> <p> The word limit for letters selected from posted responses remains 300 words. </p> </div> </div> <div class="view-filters"> <form action="/rapid-responses" method="get" id="views-exposed-form-bmj-rapid-responses-rapid-response-archive" accept-charset="UTF-8"><div><div class="views-exposed-form"> <div class="views-exposed-widgets clearfix"> <div class="views-exposed-widget views-widget-sort-by"> <div class="form-type-select form-item-sort-by form-item form-group"> <label for="edit-sort-by">Sort by </label> <select class="form-control form-select" id="edit-sort-by" name="sort_by"><option value="field_highwire_a_epubdate_value_1" selected="selected">Date Published</option></select> </div> </div> <div class="views-exposed-widget views-widget-sort-order"> <div class="form-type-select form-item-sort-order form-item form-group"> <label for="edit-sort-order--2">Order </label> <select class="form-control form-select" id="edit-sort-order--2" name="sort_order"><option value="ASC">Ascending</option><option value="DESC" selected="selected">Descending</option></select> </div> </div> <div class="views-exposed-widget views-widget-per-page"> <div class="form-type-select form-item-items-per-page form-item form-group"> <label for="edit-items-per-page">Items per page </label> <select class="form-control form-select" id="edit-items-per-page" name="items_per_page"><option value="5">5</option><option value="10" selected="selected">10</option><option value="20">20</option><option value="40">40</option><option value="60">60</option><option value="80">80</option><option value="100">100</option><option value="120">120</option><option value="140">140</option><option value="160">160</option><option value="180">180</option><option value="200">200</option></select> </div> </div> <div class="views-exposed-widget views-submit-button"> <input class="btn btn-info form-submit" type="submit" id="edit-submit-bmj-rapid-responses" name="" value="Apply" /> </div> </div> </div> </div></form> </div> <div class="view-content"> <div class="views-row views-row-1 views-row-odd views-row-first"> <div class="node node-highwire-comment node-promoted clearfix"> <div class="row rr-header"> <div class="rr-left-column" class=""> <div class="response-title"> <a href="/content/389/bmj.r658/rr-2"><h3>Re: Smartphone and social media harms: why we failed in our duty of care</h3> </a> </div> <div class="article-response-title"> Re: <a href="/content/389/bmj.r658">Smartphone and social media harms: why we failed in our duty of care</a> <strong>Kamran Abbasi. </strong> 389:doi <strong>10.1136/bmj.r658</strong> </div> <div class="content"> <div class="response-body"> <p>Dear Editor</p> <p>We write in response to your editorial entitled ‘Smartphone and social media harms: why we failed in our duty of care’ (Abbasi, 2025). As you observe, the show “Adolescence” has injected urgency into discussions about online harms to teenagers. We commend your article and the series for highlighting this issue. </p> <p>In “Adolescence”, we are first presented with the incongruence of a 13 year old killer. This is a rare phenomenon but not a new one, which understandably attracts public attention. In the UK, there have been homicides perpetrated by children under 13 years every few decades: Mary Bell (1968); Thompson and Venables (1993). None of these children had mobile phones or unfettered access to the internet, underlining the importance of looking more deeply into the reasons behind such tragic events. Loeber and Farrington (2000) suggest 2% of homicides by juveniles in the US between 1980 and 1997 were by children under 12 years. We are concerned that these rare events have influenced public opinion such that the Minimum Age of Criminal Responsibility in England and Wales (at 10 years) remains much lower than that recommended by the United Nations. </p> <p>Society may be tempted to focus blame for violence on easily identifiable, single factors. This can include the impact of online bullying on smartphones or the attractions of toxic masculinity for lonely boys, who lack strong masculine support and attention as they go into adolescence. However, causes of violence are multi-factorial (Adshead, 2024). The existence and interaction of individual, family, peer and societal factors is well rehearsed in the academic literature. For example, exposure to four or more kinds of childhood adversity, (especially neglect and emotional abuse), is a known risk factor for violence (Baglivio et al, 2014; Fox et al, 2015). Equally, childhood adversity and/or social isolation can render a young person more susceptible to risky on line material. </p> <p>More positively, early interventions for children, and their parents, can make a real difference to young people’s risk of future violence. There is a wealth of evidence that a range of programmes, both holistic and health focused, based in a range of settings in the community, can improve a young person’s psychological sense of security and protect them from social isolation and disconnection. Sadly, such services are either overloaded or degraded. Yet they can provide toe holds for both age appropriate child development and digital education, as recommended by Goodyear and colleagues (2025) in the same issue as your editorial. </p> <p>More controversially still, “Adolescence” concludes by sympathetically depicting the experience of the perpetrator’s family after the killing. The publicity surrounding such cases in real life is often profoundly negative and hostile to families at an extremely difficult time. Families can experience competing emotions of love and concern for their child and horror at what they have done, as vividly described by the mother of one of the Columbine killers (Klebold, 2016). Siblings can be innocent casualties of the aftermath of this kind of event too (Bartlett et al, 2018). Assuming rehabilitation is the goal, families can be an important support to child killers post conviction as we prepare them for a crime-free adult life. Families need support not judgement at these times. </p> <p>We are grateful this debate has begun. We call for a review of the Minimum Age of Criminal Responsibility as we are out of line with the international consensus. We highlight the need for more support services both to prevent harms that can lead to serious violence and to help children and their families to rehabilitate when the unspeakable has occurred.</p> <p>Yours sincerely<br /> Dr Gwen Adshead, Consultant Forensic Psychiatrist, West London NHS Trust<br /> Dr Annie Bartlett, Professor of Offender Care, City St George’s, University of London<br /> Dr Heidi Hales, Consultant Adolescent Forensic Psychiatrist, Betsi Cadwaladr University Health Board</p> <p>References<br /> Abbasi, K. (2025) Smartphone and social media harms: why we failed in our duty of care. BMJ: 389: r658. Smartphone and social media harms: why we failed in our duty of care | The BMJ<br /> Loeber, R. & Farrington, D.P. (2000) Young children who commit crime: Epidemiology, developmental origins, risk factors, early interventions, and policy implications. Development and Psychopathology. 12: 737-762.<br /> Adshead, G (2024, in press) Four questions about violence: The 2024 BBC Reith Lectures. Lecture 1: is violence normal? London, Faber.<br /> Baglivio, M.T., Wolff, K.T., Piquero, A.R. and Epps, N. (2015). The relationship between adverse childhood experiences (ACE) and juvenile offending trajectories in a juvenile offender sample. Journal of Criminal Justice, 43(3): 229-241.<br /> Fox, B.H., Perez, N., Cass, E., Baglivio, M.T. and Epps, N (2015) Trauma changes everything: Examining the relationship between adverse childhood experiences and serious, violent and chronic juvenile offenders. Child abuse & neglect, 46: 163-173.<br /> Goodyear VA, James C, Orben A, Quennerstedt M, Schwartz G, Pallan M. (2025) Approaches to children’s smartphone and social media use must go beyond bans. BMJ;388:e082569 Approaches to children’s smartphone and social media use must go beyond bans | The BMJ<br /> Klebold, S. (2016) A Mother’s Reckoning. Crown Publishers: United States<br /> Bartlett, A., Warner, L. & Hales, H. (2018) Young people’s secure care: Professionals’ and parents’ views of its purpose, placements and practice. NHS Gateway. secure-settings-for-young-people-a-national-scoping-exercise-paper-3-interview-report.pdf</p> </div> <div class="response-competing"> <p><strong>Competing interests: </strong> No competing interests</p> </div> </div> </div> <div class="rr-right-column" class=""> <div class="response-date"> <strong>10 April 2025</strong> </div> <div class="response-author"> Heidi Hales </div> <div class="response-occupation"> Consultant adolescent forensic psychiatrist </div> <div class="response-other_authors"> Annie Bartlett, Gwen Adshead </div> <div class="response-affiliation"> Betsi Cadwaladr University Health Board </div> <div class="response-address"> North Wales Adolescent Service, Abergele </div> <div class="twitter-address"> <a href="https://twitter.com/"></a> </div> <div class="response-links"> <div class="respond-to-article"> <a href="/content/389/bmj.r658/submit-a-rapid-response">Respond to this article</a> </div> <div class="response-read-all"> <a href="/content/389/bmj.r658/rapid-responses">Read all responses to this article</a> </div> </div> </div> <div class="rr-separator" class="clearfix"> <div class="light-grey-line"></div> </div> </div> </div> </div> <div class="views-row views-row-2 views-row-even"> <div class="node node-highwire-comment node-promoted clearfix"> <div class="row rr-header"> <div class="rr-left-column" class=""> <div class="response-title"> <a href="/content/389/bmj.r478/rr"><h3>Electroconvulsive therapy should be offered early in medication-resistant depressive illness</h3> </a> </div> <div class="article-response-title"> Re: <a href="/content/389/bmj.r478">Finding the right treatment for severe depression</a> <strong>Tony Frais. </strong> 389:doi <strong>10.1136/bmj.r478</strong> </div> <div class="content"> <div class="response-body"> <p>Dear Editor</p> <p>Frais's insightful perspective on seeking an effective treatment for his medication-resistant depressive illness highlights the important place of electroconvulsive therapy (ECT) in management of the condition (1). Not only is ECT the most efficacious treatment for this disorder (2), it retains good effectiveness following pharmacotherapy failure (3). Despite this, Frais's experience of starting the treatment late in the course of his illness only after he had requested it himself (1) is all too common. Many outpatients and families lack his resourcefulness and are never offered ECT despite its potential benefits.</p> <p>It is vitally important for community and inpatient psychiatrists to offer ECT early, alongside other options, to patients with resistant moderate or severe illness. ECT is not a treatment of last resort.</p> <p>Yours faithfully</p> <p>Dr Richard Braithwaite MRCPsych<br /> Consultant Psychiatrist, Sussex Partnership NHS Foundation Trust<br /> Chair, Committee on Electroconvulsive Therapy & Related Treatments, Royal College of Psychiatrists</p> <p>Mr Neil Kinlay<br /> Expert by Experience, Committee on Electroconvulsive Therapy & Related Treatments, Royal College of Psychiatrists</p> <p>Prof Julie Langan Martin<br /> Professor of Psychiatry and Honorary Consultant Psychiatrist, University of Glasgow<br /> Chair, Scottish Electroconvulsive Therapy Audit Network</p> <p>Prof Declan M McLoughlin PhD MRCPsych<br /> Head of Discipline, Dept of Psychiatry, Trinity College Dublin<br /> Member, Committee on Electroconvulsive Therapy & Related Treatments, Royal College of Psychiatrists</p> <p>Prof George Kirov<br /> Clinical Professor, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University<br /> Member, Committee on Electroconvulsive Therapy & Related Treatments, Royal College of Psychiatrists</p> <p>References<br /> 1. Frais A. Finding the right treatment for severe depression. BMJ 2025;389:r478.<br /> 2. UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet. 2003 Mar 8;361(9360):799-808.<br /> 3. Heijnen WT, Birkenhäger TK, Wierdsma AI, van den Broek WW. Antidepressant pharmacotherapy failure and response to subsequent electroconvulsive therapy: a meta-analysis. J Clin Psychopharmacol. 2010 Oct;30(5):616-9.</p> </div> <div class="response-competing"> <p><strong>Competing interests: </strong> RB, NK and JLM have no competing interests. DMM has received speaker’s honoraria from MECTA, Otsuka, and Janssen and an honorarium from Janssen for participating in an esketamine advisory board meeting. GK receives royalties from a book about ECT. </p> </div> </div> </div> <div class="rr-right-column" class=""> <div class="response-date"> <strong>10 April 2025</strong> </div> <div class="response-author"> Richard Braithwaite </div> <div class="response-occupation"> Consultant Psychiatrist </div> <div class="response-other_authors"> Neil Kinlay, Julie Langan Martin, Declan M McLoughlin, George Kirov </div> <div class="response-affiliation"> Sussex Partnership NHS Foundation Trust </div> <div class="response-address"> Meadowfield Hospital, Arundel Rd, Worthing, West Sussex BN13 3EP, United Kingdom </div> <div class="twitter-address"> <a href="https://twitter.com/"></a> </div> <div class="response-links"> <div class="respond-to-article"> <a href="/content/389/bmj.r478/submit-a-rapid-response">Respond to this article</a> </div> <div class="response-read-all"> <a href="/content/389/bmj.r478/rapid-responses">Read all responses to this article</a> </div> </div> </div> <div class="rr-separator" class="clearfix"> <div class="light-grey-line"></div> </div> </div> </div> </div> <div class="views-row views-row-3 views-row-odd"> <div class="node node-highwire-comment node-promoted clearfix"> <div class="row rr-header"> <div class="rr-left-column" class=""> <div class="response-title"> <a href="/content/389/bmj.r670/rr-4"><h3>Re: Prescribing parkrun: medicalising a walk in the park</h3> </a> </div> <div class="article-response-title"> Re: <a href="/content/389/bmj.r670">Prescribing parkrun: medicalising a walk in the park</a> <strong>Margaret McCartney. </strong> 389:doi <strong>10.1136/bmj.r670</strong> </div> <div class="content"> <div class="response-body"> <p>Dear Editor</p> <p>I find the term 'nudge' quite offensive as being deliberately covert. 'Prescribing' is mainly understood as a medical term which although becoming more accepted as part of the role of health workers undermines the autonomy of people who should be given information and evidence of the benefits of exercise by health workers and information as to where they can be accessed in the so called 'community'. Running has provided a cheap and for many enjoyable activity but it would be nice if all had equal access to decent well kept parks or runs through the lovely countryside or posh areas of the cities, The environment matters. How many people from 'deprived communities' by the way are prescribed a ski trip or nudged into payed for surfing lessons.</p> <p>There is another important aspect to happiness and well being. That of learning the joys of just wandering about and strolling, alone (what!) or with others. As the poet once said: What is this life if full of care we have no time to stand and stare'. Give the running shoes a rest sometimes.</p> </div> <div class="response-competing"> <p><strong>Competing interests: </strong> No competing interests</p> </div> </div> </div> <div class="rr-right-column" class=""> <div class="response-date"> <strong>10 April 2025</strong> </div> <div class="response-author"> susanne stevens </div> <div class="response-occupation"> retired </div> <div class="response-other_authors"> </div> <div class="response-affiliation"> </div> <div class="response-address"> Hay on Wye </div> <div class="twitter-address"> <a href="https://twitter.com/"></a> </div> <div class="response-links"> <div class="respond-to-article"> <a href="/content/389/bmj.r670/submit-a-rapid-response">Respond to this article</a> </div> <div class="response-read-all"> <a href="/content/389/bmj.r670/rapid-responses">Read all responses to this article</a> </div> </div> </div> <div class="rr-separator" class="clearfix"> <div class="light-grey-line"></div> </div> </div> </div> </div> <div class="views-row views-row-4 views-row-even"> <div class="node node-highwire-comment node-promoted clearfix"> <div class="row rr-header"> <div class="rr-left-column" class=""> <div class="response-title"> <a href="/content/388/bmj.q2829/rr-3"><h3>Re: Is the dissection of cadavers a necessary part of medical education?</h3> </a> </div> <div class="article-response-title"> Re: <a href="/content/388/bmj.q2829">Is the dissection of cadavers a necessary part of medical education?</a> <strong>Steven Jacques, et al. </strong> 388:doi <strong>10.1136/bmj.q2829</strong> </div> <div class="content"> <div class="response-body"> <p>Dear Editor, </p> <p>At what stage in medical training does one know whether or not they would like to become a surgeon? I have participated in Dissection Room teaching as both a student and an educator, and I have experienced and witnessed moments of inspiration that are unique to the setting. </p> <p>Having spent a session diligently using a hammer and chisel to open the skull and expose the dura mater, I know one of my students is now contemplating a career in Neurosurgery. I myself was initially drawn to the prospect of becoming an ENT surgeon or an anaesthetist after an especially memorable lesson in which I performed a Cricothyrotomy on a body donor. </p> <p>Furthermore, we see a different side of some students when in a unique environment. One of my quietest students in the classroom comes out of their shell in the Dissection Room, and has shown skill with surgical tools that would otherwise have lain dormant. </p> <p>One cannot contemplate such a significant change to a medical curriculum without reflecting on the loss of opportunities. </p> </div> <div class="response-competing"> <p><strong>Competing interests: </strong> No competing interests</p> </div> </div> </div> <div class="rr-right-column" class=""> <div class="response-date"> <strong>10 April 2025</strong> </div> <div class="response-author"> Thomas J Guindy </div> <div class="response-occupation"> Clinical Teaching Fellow </div> <div class="response-other_authors"> </div> <div class="response-affiliation"> </div> <div class="response-address"> Leicester </div> <div class="twitter-address"> <a href="https://twitter.com/"></a> </div> <div class="response-links"> <div class="respond-to-article"> <a href="/content/388/bmj.q2829/submit-a-rapid-response">Respond to this article</a> </div> <div class="response-read-all"> <a href="/content/388/bmj.q2829/rapid-responses">Read all responses to this article</a> </div> </div> </div> <div class="rr-separator" class="clearfix"> <div class="light-grey-line"></div> </div> </div> </div> </div> <div class="views-row views-row-5 views-row-odd"> <div class="node node-highwire-comment node-promoted clearfix"> <div class="row rr-header"> <div class="rr-left-column" class=""> <div class="response-title"> <a href="/content/388/bmj-2025-084613/rr-5"><h3>Re: Physician associates and anaesthetic associates in UK: rapid systematic review of recent UK based research</h3> </a> </div> <div class="article-response-title"> Re: <a href="/content/388/bmj-2025-084613">Physician associates and anaesthetic associates in UK: rapid systematic review of recent UK based research</a> <strong>Trisha Greenhalgh, Martin McKee. </strong> 388:doi <strong>10.1136/bmj-2025-084613</strong> </div> <div class="content"> <div class="response-body"> <p>Dear Editor,</p> <p>The Leng review: an independent review into physician associate and anaesthesia associate professions was established by the Secretary of State for Health and Social Care in November 2024. Professor Gillian Leng was appointed to lead this review.</p> <p>Professor Greenhalgh’s systematic review, published 7 March 2025 has been formally submitted to the Leng review where it will be considered in full. We are grateful to Professor Greenhalgh for this contribution but note that this was not commissioned by the Leng Review.</p> <p>To support the review, Prof Leng commissioned an independent review from the Policy Research Unit at King’s College London. We have ensured that the team at PRU is aware of Professor Greenhalgh’s review, and that it informs their own work where appropriate. </p> <p>Alongside assessments of published research, we are also collating a range of other evidence and data, including a call for evidence, a dedicated survey and focus groups to gather views of patients. This will help ensure the review’s findings are based on the best available evidence. </p> <p>We are grateful to the team at King’s College for conducting the independent review, as well as all those who have submitted evidence thus far.</p> <p>Kind regards, </p> <p>Professor Gillian Leng CBE</p> </div> <div class="response-competing"> <p><strong>Competing interests: </strong> Independent review of physician associate and anaesthesia associate</p> </div> </div> </div> <div class="rr-right-column" class=""> <div class="response-date"> <strong>10 April 2025</strong> </div> <div class="response-author"> Gillian C Leng </div> <div class="response-occupation"> Health administrator, academic, visiting professor at King's College London, president at RSM </div> <div class="response-other_authors"> </div> <div class="response-affiliation"> </div> <div class="response-address"> 39 Victoria Street, Department of Health and Social Care, SW1H 0EU </div> <div class="twitter-address"> <a href="https://twitter.com/"></a> </div> <div class="response-links"> <div class="respond-to-article"> <a href="/content/388/bmj-2025-084613/submit-a-rapid-response">Respond to this article</a> </div> <div class="response-read-all"> <a href="/content/388/bmj-2025-084613/rapid-responses">Read all responses to this article</a> </div> </div> </div> <div class="rr-separator" class="clearfix"> <div class="light-grey-line"></div> </div> </div> </div> </div> <div class="views-row views-row-6 views-row-even"> <div class="node node-highwire-comment node-promoted clearfix"> <div class="row rr-header"> <div class="rr-left-column" class=""> <div class="response-title"> <a href="/content/389/bmj.r670/rr-3"><h3>Social prescribing or community referral? Either way, let's do it!</h3> </a> </div> <div class="article-response-title"> Re: <a href="/content/389/bmj.r670">Prescribing parkrun: medicalising a walk in the park</a> <strong>Margaret McCartney. </strong> 389:doi <strong>10.1136/bmj.r670</strong> </div> <div class="content"> <div class="response-body"> <p>Dear Editor, </p> <p>Let’s not get caught up in the terminology “prescribing,” although perhaps the expression “community referral” may be more appropriate in some cases (Napierala et al., 2022). As a clinical pharmacist who has studied and researched health promotion, including community initiatives such as parkrun (Dunne et al., 2024), I would like to apply a health promotion lens rather than the traditional bio-medical model to this issue. </p> <p>One of the tenets of health promotion is “re-orienting the health services” (WHO, 1986). An important part of this re-orientation is developing and using community initiatives to promote physical and mental health and wellbeing. In my experience, the parkrun practice initiative is so much more than just “prescribing parkrun”. It allows healthcare professionals to model healthy behaviour by attending parkrun themselves. It may also involve referring patients to community initiatives that they may not be aware of and supporting patients who may need that little bit of extra help to attend activities that are available in the local community. Not forgetting that referral may include suggesting that patients can volunteer at parkrun, which has health benefits in it’s own right (Haake et al., 2022). </p> <p>Whether we refer patients to parkrun, a community choir, gardening group or book club; as healthcare professionals we should look beyond the traditional prescribing model and do whatever we can to support the health and wellbeing of our patients and community members, regardless of what label we use to describe that process. </p> <p>Dunne, A., Quirk, H., Bullas, A., & Haake, S. (2024). 'My parkrun friends.' A qualitative study of social experiences of men at parkrun in Ireland. Health promotion international, 39(3). <a href="https://doi.org/10.1093/heapro/daae045">https://doi.org/10.1093/heapro/daae045</a><br /> Haake, S., Quirk, H., & Bullas, A. (2022). The health benefits of volunteering at a free, weekly, 5 km event in the UK: A cross-sectional study of volunteers at parkrun. PLOS global public health, 2(2), e0000138. <a href="https://doi.org/10.1371/journal.pgph.0000138">https://doi.org/10.1371/journal.pgph.0000138</a><br /> Napierala, H., Krüger, K., Kuschick, D., Heintze, C., Herrmann, W. J., & Holzinger, F. (2022). Social Prescribing: Systematic Review of the Effectiveness of Psychosocial Community Referral Interventions in Primary Care. International journal of integrated care, 22(3), 11. <a href="https://doi.org/10.5334/ijic.6472">https://doi.org/10.5334/ijic.6472</a><br /> WHO. (1986). Ottawa Charter for Health Promotion, World Health Organization, Geneva. </p> </div> <div class="response-competing"> <p><strong>Competing interests: </strong> No competing interests</p> </div> </div> </div> <div class="rr-right-column" class=""> <div class="response-date"> <strong>10 April 2025</strong> </div> <div class="response-author"> Allison R Dunne </div> <div class="response-occupation"> University Lecturer </div> <div class="response-other_authors"> </div> <div class="response-affiliation"> </div> <div class="response-address"> University of Galway </div> <div class="twitter-address"> <a href="https://twitter.com/"></a> </div> <div class="response-links"> <div class="respond-to-article"> <a href="/content/389/bmj.r670/submit-a-rapid-response">Respond to this article</a> </div> <div class="response-read-all"> <a href="/content/389/bmj.r670/rapid-responses">Read all responses to this article</a> </div> </div> </div> <div class="rr-separator" class="clearfix"> <div class="light-grey-line"></div> </div> </div> </div> </div> <div class="views-row views-row-7 views-row-odd"> <div class="node node-highwire-comment node-promoted clearfix"> <div class="row rr-header"> <div class="rr-left-column" class=""> <div class="response-title"> <a href="/content/388/bmj.r323/rr-0"><h3>Re: Identification, assessment, and management of gambling-related harms: summary of NICE guideline</h3> </a> </div> <div class="article-response-title"> Re: <a href="/content/388/bmj.r323">Identification, assessment, and management of gambling-related harms: summary of NICE guideline</a> <strong>Liz Ritchie, Matthew Gaskell, et al. </strong> 388:doi <strong>10.1136/bmj.r323</strong> </div> <div class="content"> <div class="response-body"> <p>Dear Editor,</p> <p>I would like to support the recent summary of NICE guidelines regarding the many harms and suffering resulting from gambling:<br /> "Adverse impacts of gambling, known as gambling-related harms, include loss of employment, debt, crime, breakdown of relationships, domestic violence, and suicide. They affect people who gamble, their families and others close to them, and society."</p> <p>I would like too to support the idea of a "Public Health Approach" stated by NICE and by Fell and colleagues in their Rapid Response of 19th March. However, please allow me to raise and add "a new religious approach" in order to address and prevent this rising complex medical social financial problem / disaster (Gambling) in our society, especially as there will be more gamblers on the way now in our society as a result of the high cost of living, high cost of energy bills and the stopping of a lot of benefits, etc...</p> <p>I humbly recommend to "utilise" some religious texts which will be effective on the behaviour of some believers who believe in these religious texts. Reminding them of these texts will work wonders and make them stop "THE Vices" they are doing especially when the medical social mental financial harms are exposed and shown to them.</p> <p>Over the years, I have been using this approach successfully and effectively on many Muslim TV and Muslim radio stations to avoid smoking, drugs, alcohol, harmful unhealthy diets, unhealthy sexual behaviour etc.... This is by bringing them the health medical social data.</p> <p>If I can give you one example in the issue we are discussing now: Gambling.<br /> I like to mention some religious quotations against Gambling in Islam and in Christianity which will help and will motivate some believers to STOP GAMBLING altogether, especially as many believers are/were not aware of the prohibition and the opposition of their religions to what they are doing.</p> <p>Gambling in Islam<br /> Gambling is forbidden in the final Holy Book AL QUR'AN :<br /> In the Name of GOD, the most Compassionate, the most Merciful<br /> "O you who believe! Intoxicants (all kinds of alcoholic drinks), gambling, al-Ansab [sacrifices for idols, etc.] and al-Azlam [arrows for seeking luck or decision] are an abomination of Shaytan’s (Satan) handiwork. So avoid (strictly all) that (abomination) in order that you may be successful. Shaytan wants only to excite enmity and hatred between you with intoxicants (alcoholic drink) and gambling, and hinder you from the remembrance of GOD (Allah) and from al-Salah (the prayer). So, will you not then abstain?”<br /> [Qur'an: Chapter 5-Verses 90-91]</p> <p>Gambling in The Bible<br /> (1) Gambling directly appeals to covetousness and greed “which is idolatry” according to the Apostle Paul (Colossians 3:5). Gambling breaches the 1st, 2nd, 8th and 10th commandments. It enthrones personal desires in place of God. Jesus warned: “you cannot serve both God and Money” (Matthew 6:24).<br /> In 1 Timothy 6:10, which states, "For the love of money is a root of all kinds of evil."<br /> (1 Corinthians 6:9, 10; Ephesians 5:3, 5) Gamblers hope to gain money through the losses of others, but the Bible condemns coveting other people's possessions. —Exodus 20:17; Romans 7:7; 13:9, 10. Gambling, even for small amounts, can arouse a destructive love of money. —1 Timothy 6:9, 10.</p> <p>Dr Majid Katme<br /> Retired Medical Doctor<br /> Former President of Islamic Medical Association in UK<br /> TV/RADIO broadcaster</p> </div> <div class="response-competing"> <p><strong>Competing interests: </strong> No competing interests</p> </div> </div> </div> <div class="rr-right-column" class=""> <div class="response-date"> <strong>10 April 2025</strong> </div> <div class="response-author"> Majid Katme </div> <div class="response-occupation"> Retired Psychiatrist </div> <div class="response-other_authors"> </div> <div class="response-affiliation"> </div> <div class="response-address"> London </div> <div class="twitter-address"> <a href="https://twitter.com/"></a> </div> <div class="response-links"> <div class="respond-to-article"> <a href="/content/388/bmj.r323/submit-a-rapid-response">Respond to this article</a> </div> <div class="response-read-all"> <a href="/content/388/bmj.r323/rapid-responses">Read all responses to this article</a> </div> </div> </div> <div class="rr-separator" class="clearfix"> <div class="light-grey-line"></div> </div> </div> </div> </div> <div class="views-row views-row-8 views-row-even"> <div class="node node-highwire-comment node-promoted clearfix"> <div class="row rr-header"> <div class="rr-left-column" class=""> <div class="response-title"> <a href="/content/389/bmj.r670/rr-1"><h3>Re: Prescribing parkrun: medicalising a walk in the park</h3> </a> </div> <div class="article-response-title"> Re: <a href="/content/389/bmj.r670">Prescribing parkrun: medicalising a walk in the park</a> <strong>Margaret McCartney. </strong> 389:doi <strong>10.1136/bmj.r670</strong> </div> <div class="content"> <div class="response-body"> <p>Dear Editor</p> <p>We thank the authors for their thoughtful analysis and welcome the chance to discuss the broader implications of “prescribing parkrun” within the context of social prescribing. We agree that parkrun is a remarkable community‐based initiative that demedicalises health promotion, shifting focus away from traditional, command‐driven models toward an empowering, participatory approach. We address several key points raised in the article.</p> <p>Demedicalising and Empowering through Social Prescribing</p> <p>Critics argue that using the term “prescribing” implies a top–down model of authority, yet this view overlooks how social prescribing is practised in clinical discussions about group physical activity such as parkrun. The term “prescribing” is aimed at clinicians, legitimising evidence‐based treatment options beyond medications. There is robust evidence that group physical activity improves health outcomes (1), although many clinicians and patients remain unaware of its efficacy compared to medication. By framing physical activity like parkrun as an added treatment option, clinicians support demedicalisation by avoiding unnecessary prescriptions—a practice preferred by patients. Just as forcing medication would be poor practice, dictating behavior is similarly inappropriate and unlikely.</p> <p>From a patient’s perspective, calling parkrun a prescription is misleading because the event remains free and accessible to all. The term ‘prescribing’ here is meant solely to encourage clinicians to signpost it as a valid option. Facilitating access to this community‐led opportunity to enhance physical and mental health is sound practice, regardless of semantic debates. This aligns with evidence that community‐focused interventions can transform patient engagement by promoting autonomy and self‐directed improvement, especially among marginalised and deprived groups (2).</p> <p>Evidence of Impact and Cost-Effectiveness</p> <p>Recent research, including a study by Haake and colleagues from Sheffield Hallam University (3), shows that parkrun participation is linked with statistically significant improvements in life satisfaction over six months. The study reported a weighted, seasonally adjusted increase of 0.26 points in life satisfaction among new participants, with the greatest gains in those previously inactive. The cost‐effectiveness analysis is compelling; benefit‐cost ratios range from 16.7:1 with a conservative estimate to as high as 98.5:1 when broader wellbeing impacts are included. These figures underscore the economic and public health benefits of incorporating social interventions like parkrun into primary care.</p> <p>Primary Care Engagement and Adoption</p> <p>It is important to clarify that over 2000 general practices now participate in parkrun practices, not merely 1800 as previously suggested (4). This level of engagement demonstrates that GPs recognise the value of linking patients to community assets. Primary care professionals are championing a shift toward a holistic and preventative approach that de‐emphasises traditional pharmacological treatments in favour of community participation and self‐care.</p> <p>Countering the Misconception of “Medicalising” Exercise</p> <p>Critics claiming that “prescribing” parkrun reinforces a hierarchical framework misinterpret social prescribing. Integrating parkrun into primary care promotes a model where community resources, not medications, take centre stage. This approach does not reduce patient autonomy; it provides a flexible, enjoyable option for self‐directed health improvement supported by professional advice. Rather than undermining community exercise, it legitimises parkrun as a vital component of modern, patient‐centred health promotion.</p> <p>In Summary</p> <p>In summary, the evidence affirms that parkrun is a paradigm of demedicalisation rather than an overly medicalised intervention. It embodies social prescribing by connecting patients with their communities while delivering measurable improvements in life satisfaction and wellbeing. With over 2000 general practices involved, ‘prescribing’ parkrun is a justified, cost‐effective public health strategy that merits ongoing support and expansion. These findings and practice insights not only reinforce the validity of social prescribing models but also highlight the transformative potential of community‐based health initiatives in reshaping modern primary care. Overall, parkrun integration into primary care offers significant, measurable, and enduring public health advantages globally.</p> <p>1) Burke, Shauna M., et al. "Group versus individual approach? A meta-analysis of the effectiveness of interventions to promote physical activity." Journal of sport & exercise psychology 2 (2006): 19-35.<br /> 2) What works: Community engagement and empowerment to address health inequalities - Health Equity Evidence Centre<br /> 3) HAAKE, Steve, QUIRK, Helen and BULLAS, Alice (2024). The impact of parkrun on life satisfaction and its cost-effectiveness: A six-month study of parkrunners in the United Kingdom. PLOS Global Public Health, 4 (10).<br /> 4) Royal college of GPs 2000 GP surgeries in the UK now registered to parkrun practices 28 March 2025 <a href="https://www.rcgp.org.uk/News/2000-GP-surgeries-registered-parkrun-practices">https://www.rcgp.org.uk/News/2000-GP-surgeries-registered-parkrun-practices</a> </p> </div> <div class="response-competing"> <p><strong>Competing interests: </strong> Dr Hussain Al-Zubaidi: Royal College of GPs Lifestyle and Physical activity champion; parkrun Health Partnerships Lead. Dr Ellen Fallows: British Society of Lifestyle Medicine Vice President.</p> </div> </div> </div> <div class="rr-right-column" class=""> <div class="response-date"> <strong>10 April 2025</strong> </div> <div class="response-author"> Hussain A Al-Zubaidi </div> <div class="response-occupation"> GP </div> <div class="response-other_authors"> Dr Ellen Fallows (Vice President of the British Society of Lifestyle Medicine) </div> <div class="response-affiliation"> RCGP </div> <div class="response-address"> 30 Euston Square, London NW1 2FB </div> <div class="twitter-address"> <a href="https://twitter.com/"></a> </div> <div class="response-links"> <div class="respond-to-article"> <a href="/content/389/bmj.r670/submit-a-rapid-response">Respond to this article</a> </div> <div class="response-read-all"> <a href="/content/389/bmj.r670/rapid-responses">Read all responses to this article</a> </div> </div> </div> <div class="rr-separator" class="clearfix"> <div class="light-grey-line"></div> </div> </div> </div> </div> <div class="views-row views-row-9 views-row-odd"> <div class="node node-highwire-comment node-promoted clearfix"> <div class="row rr-header"> <div class="rr-left-column" class=""> <div class="response-title"> <a href="/content/388/bmj.r610/rr-5"><h3>Re: In a healthcare system under increasing pressure, can a palliative care commission drive meaningful change?</h3> </a> </div> <div class="article-response-title"> Re: <a href="/content/388/bmj.r610">In a healthcare system under increasing pressure, can a palliative care commission drive meaningful change?</a> <strong>Irene J Higginson, Natalie Ramjeeawon. </strong> 388:doi <strong>10.1136/bmj.r610</strong> </div> <div class="content"> <div class="response-body"> <p>Dear Editor,<br /> This commentary by Higginson is relevant to health systems in low-, middle- and high-income countries. Comprehensive palliative care that is available in a timely way for people with a life-limiting illness (but not limited only to the terminal stages of that illness) does improve the quality of care while reducing the resources used. Indeed, the opportunity of low- and middle-income countries is to learn from the poor decisions made in high-income countries when providing care in the last year of life and not replicate the mistakes that have been made. </p> <p>Timely recognition that a person is at high risk of an 'expected death' in the coming months or years should be a flag for clinicians to plan the care with that person and their family and friends. We have robust ways of identifying many such people, but do little with that knowledge. </p> <p>The benefits of palliative care outlined in the commentary to date have not included the wellbeing and health of carers in the years after the person's death, but evidence suggests that palliative care is associated with improvements that need to be quantified in detail. </p> <p>At its most fundamental level, there is untold suffering that needs to be relieved with a systematic and well-funded approach as evidence of a humane society that values every person, even when they do not have a voice. </p> </div> <div class="response-competing"> <p><strong>Competing interests: </strong> No competing interests</p> </div> </div> </div> <div class="rr-right-column" class=""> <div class="response-date"> <strong>09 April 2025</strong> </div> <div class="response-author"> David C. Currow </div> <div class="response-occupation"> Medical Practitioner </div> <div class="response-other_authors"> </div> <div class="response-affiliation"> University of Technology Sydney </div> <div class="response-address"> Faculty of Health, University of Technology Sydney, Broadway, Sydney. NSW. Australia. 2007 </div> <div class="twitter-address"> <a href="https://twitter.com/"></a> </div> <div class="response-links"> <div class="respond-to-article"> <a href="/content/388/bmj.r610/submit-a-rapid-response">Respond to this article</a> </div> <div class="response-read-all"> <a href="/content/388/bmj.r610/rapid-responses">Read all responses to this article</a> </div> </div> </div> <div class="rr-separator" class="clearfix"> <div class="light-grey-line"></div> </div> </div> </div> </div> <div class="views-row views-row-10 views-row-even views-row-last"> <div class="node node-highwire-comment node-promoted clearfix"> <div class="row rr-header"> <div class="rr-left-column" class=""> <div class="response-title"> <a href="/content/389/bmj.r670/rr-0"><h3>Re: Prescribing parkrun: medicalising a walk in the park</h3> </a> </div> <div class="article-response-title"> Re: <a href="/content/389/bmj.r670">Prescribing parkrun: medicalising a walk in the park</a> <strong>Margaret McCartney. </strong> 389:doi <strong>10.1136/bmj.r670</strong> </div> <div class="content"> <div class="response-body"> <p>Dear Editor</p> <p>The word prescribing is wrong in my view. But there is a lot of evidence that GPs can nudge people to healthier activities. In our local park runs we also have a sub group of C25K (couch to 5 K as per the NHS app) supportive people who help encourage people to gradually get more active, park walkers for those who don't want to or can't run, once a month cancer survivors etc. I assume many other park runs do the same. We also have many non running volunteers who come out and help at the same time as combating social isolation and loneliness. As we get more evidence that exercise is the best medicine for knee pain, COPD, back pain and depression let's not get stuck on the word prescribe but share our hobbies and nudge/encourage others to join. I thought vitality was a supplement till I read this article!</p> </div> <div class="response-competing"> <p><strong>Competing interests: </strong> I have taken up running since stopping full time work (couch to 5 k, park runs and now age 69 my first marathon) and love adult and children park runs </p> </div> </div> </div> <div class="rr-right-column" class=""> <div class="response-date"> <strong>09 April 2025</strong> </div> <div class="response-author"> john sharvill </div> <div class="response-occupation"> Nearly retired GP, </div> <div class="response-other_authors"> </div> <div class="response-affiliation"> NHS </div> <div class="response-address"> Kent </div> <div class="twitter-address"> <a href="https://twitter.com/"></a> </div> <div class="response-links"> <div class="respond-to-article"> <a href="/content/389/bmj.r670/submit-a-rapid-response">Respond to this article</a> </div> <div class="response-read-all"> <a href="/content/389/bmj.r670/rapid-responses">Read all responses to this article</a> </div> </div> </div> <div class="rr-separator" class="clearfix"> <div class="light-grey-line"></div> </div> </div> </div> </div> </div> <h2 class="element-invisible">Pages</h2><ul class="pager"><li class="pager-current first">1</li> <li class="pager-item"><a title="Go to page 2" href="/rapid-responses?page=1">2</a></li> <li class="pager-item"><a title="Go to page 3" href="/rapid-responses?page=2">3</a></li> <li class="pager-item"><a title="Go to page 4" href="/rapid-responses?page=3">4</a></li> <li class="pager-item"><a title="Go to page 5" href="/rapid-responses?page=4">5</a></li> <li class="pager-item"><a title="Go to page 6" href="/rapid-responses?page=5">6</a></li> <li class="pager-item"><a title="Go to page 7" href="/rapid-responses?page=6">7</a></li> <li class="pager-item"><a title="Go to page 8" href="/rapid-responses?page=7">8</a></li> <li class="pager-item"><a title="Go to page 9" href="/rapid-responses?page=8">9</a></li> <li class="pager-ellipsis">…</li> <li class="pager-next"><a title="Go to next page" href="/rapid-responses?page=1">next ›</a></li> <li class="pager-last last"><a title="Go to last page" href="/rapid-responses?page=13543">last »</a></li> </ul> </div> </div> </div> </div> </div> </section>  </div> </section> </div> </div>  <div class="footer-wrapper"> <div class="container"> <footer id="footer"> <div class="region region-footer"> <section id="block-panels-mini-bmj-footer" class="block block-panels-mini clearfix"> <div class="panel-display bootstrap-footer" id="mini-panel-bmj_footer"> <div class="footer-top-row"> <div id="footer-social-media" class="footer-column panel-panel col-xs-12 col-sm-3 col-md-3 col-lg-3"> <div class="panel-pane pane-block pane-menu-block-2" > <h2 class="pane-title"> Follow us on </h2> <div class="pane-content"> <div class="menu-block-wrapper menu-block-2 menu-name-menu-footer parent-mlid-1298 menu-level-1"> <ul class="menu nav"><li class="first leaf menu-mlid-1299"><a href="http://twitter.com/bmj_latest" target="_blank">Twitter</a></li> <li class="leaf menu-mlid-1301"><a href="https://www.facebook.com/bmjdotcom" target="_blank">Facebook</a></li> <li class="leaf menu-mlid-1300"><a href="http://youtube.com/user/BMJmedia" target="_blank">YouTube</a></li> <li class="last leaf menu-mlid-1302"><a href="http://feeds.bmj.com/bmj/recent">RSS</a></li> </ul></div> </div> </div> </div> <div class="footer-content col-xs-12 col-sm-9 col-md-9 col-lg-9"> <div id="footer-top-row" class="row"> <div class="footer-column panel-panel col-xs-6 col-sm-4 col-md-4 col-lg-4"> <div class="panel-pane pane-block pane-menu-block-3" > <h2 class="pane-title"> Content links </h2> <div class="pane-content"> <div class="menu-block-wrapper menu-block-3 menu-name-menu-footer parent-mlid-1303 menu-level-1"> <ul class="menu nav"><li class="first leaf menu-mlid-125058"><a href="http://www.bmj.com/collections">Collections</a></li> <li class="leaf menu-mlid-125036"><a href="http://www.bmj.com/health-in-south-asia">Health in South Asia</a></li> <li class="leaf menu-mlid-125034"><a href="http://www.bmj.com/content/women%E2%80%99s-children%E2%80%99s-and-adolescents%E2%80%99-health-0">Women’s, children’s & adolescents’ health</a></li> <li class="leaf menu-mlid-17959"><a href="http://www.bmj.com/freezikaresources">Zika virus</a></li> <li class="leaf menu-mlid-1305"><a href="/us/research">Research</a></li> <li class="leaf menu-mlid-1306"><a href="/us/education">Education</a></li> <li class="leaf menu-mlid-6506"><a href="/us/news">News and views</a></li> <li class="leaf menu-mlid-1310"><a href="http://blogs.bmj.com/bmj/">BMJ Opinion</a></li> <li class="leaf active-trail active menu-mlid-7612"><a href="/rapid-responses" class="active-trail active">Rapid responses</a></li> <li class="last leaf menu-mlid-1309"><a href="/archive">Archive</a></li> </ul></div> </div> </div> </div> <div class="footer-column panel-panel col-xs-6 col-sm-4 col-md-4 col-lg-4"> <div class="panel-pane pane-block pane-menu-block-4" > <h2 class="pane-title"> About us </h2> <div class="pane-content"> <div class="menu-block-wrapper menu-block-4 menu-name-menu-footer parent-mlid-1314 menu-level-1"> <ul class="menu nav"><li class="first leaf menu-mlid-6487"><a href="/about-bmj">About us</a></li> <li class="leaf menu-mlid-1316"><a href="/about-bmj/editorial-staff">Editorial staff</a></li> <li class="leaf menu-mlid-1317"><a href="/about-bmj/editorial-staff/bmj-united-states">BMJ in the USA</a></li> <li class="leaf menu-mlid-127585"><a href="/health-in-latin-america">BMJ in Latin America</a></li> <li class="leaf menu-mlid-1318"><a href="/about-bmj/editorial-staff/bmj-south-asia">BMJ in South Asia</a></li> <li class="leaf menu-mlid-1319"><a href="/about-bmj/advisory-panels">Advisers</a></li> <li class="leaf menu-mlid-1320"><a href="/about-bmj/resources-authors/forms-policies-and-checklists">Policies</a></li> <li class="last leaf menu-mlid-1323"><a href="http://mc.manuscriptcentral.com/bmj">Submit your paper</a></li> </ul></div> </div> </div> </div> <div class="footer-column panel-panel col-xs-6 col-sm-4 col-md-4 col-lg-4"> <div class="panel-pane pane-block pane-menu-block-5" > <h2 class="pane-title"> Resources </h2> <div class="pane-content"> <div class="menu-block-wrapper menu-block-5 menu-name-menu-footer parent-mlid-1324 menu-level-1"> <ul class="menu nav"><li class="first leaf menu-mlid-1325"><a href="/about-bmj/resources-authors">Authors</a></li> <li class="leaf menu-mlid-1326"><a href="/about-bmj/resources-reviewers">Reviewers</a></li> <li class="leaf menu-mlid-1327"><a href="/about-bmj/resources-bma-members">BMA members</a></li> <li class="leaf menu-mlid-1329"><a href="/about-bmj/resources-readers">Readers</a></li> <li class="leaf menu-mlid-1328"><a href="/about-bmj/resources-subscribers">Subscribers</a></li> <li class="leaf menu-mlid-1330"><a href="/about-bmj/resources-advertisers-and-sponsors">Advertisers and sponsors</a></li> <li class="leaf menu-mlid-1331"><a href="/about-bmj/resources-media">Media</a></li> <li class="last leaf menu-mlid-7610"><a href="https://recruiter.bmj.com/">Recruiters</a></li> </ul></div> </div> </div> </div> <div class="footer-column panel-panel col-xs-6 col-sm-4 col-md-4 col-lg-4"> <div class="panel-pane pane-block pane-menu-block-6" > <h2 class="pane-title"> Explore BMJ </h2> <div class="pane-content"> <div class="menu-block-wrapper menu-block-6 menu-name-menu-footer parent-mlid-1332 menu-level-1"> <ul class="menu nav"><li class="first leaf menu-mlid-7613"><a href="https://www.bmj.com/company/?int_source=tbmj&int_medium=footer&int_campaign=URLswitch">Our company</a></li> <li class="leaf menu-mlid-7421"><a href="https://jobs.bmj.com/">BMJ Careers</a></li> <li class="leaf menu-mlid-7423"><a href="http://learning.bmj.com/">BMJ Learning</a></li> <li class="leaf menu-mlid-7424"><a href="http://masterclasses.bmj.com">BMJ Masterclasses</a></li> <li class="leaf menu-mlid-7425"><a href="http://journals.bmj.com">BMJ Journals</a></li> <li class="leaf menu-mlid-7422"><a href="/student">BMJ Student</a></li> <li class="leaf menu-mlid-7426"><a href="http://www.bmj.com/about-bmj/resources-readers">Academic edition of The BMJ</a></li> <li class="leaf menu-mlid-7427"><a href="http://bestpractice.bmj.com/">BMJ Best Practice</a></li> <li class="last leaf menu-mlid-17958"><a href="http://thebmjawards.bmj.com/home">The BMJ Awards</a></li> </ul></div> </div> </div> </div> <div class="footer-column panel-panel col-xs-6 col-sm-4 col-md-4 col-lg-4"> <div class="panel-pane pane-block pane-menu-block-7" > <h2 class="pane-title"> My account </h2> <div class="pane-content"> <div class="menu-block-wrapper menu-block-7 menu-name-menu-footer parent-mlid-1343 menu-level-1"> <ul class="menu nav"><li class="first leaf menu-mlid-1344"><a href="http://myaccount.bmj.com/myaccount/account/hw-registration.html">Email alerts</a></li> <li class="last leaf menu-mlid-1345"><a href="http://journals.bmj.com/cgi/activate">Activate subscription</a></li> </ul></div> </div> </div> </div> <div class="footer-column panel-panel col-xs-6 col-sm-4 col-md-4 col-lg-4"> <div class="panel-pane pane-block pane-menu-block-8" > <h2 class="pane-title"> Information </h2> <div class="pane-content"> <div class="menu-block-wrapper menu-block-8 menu-name-menu-footer parent-mlid-1346 menu-level-1"> <ul class="menu nav"><li class="first leaf menu-mlid-1347"><a href="/about-bmj/contact-us">Contact us</a></li> <li class="last leaf menu-mlid-1321"><a href="/about-bmj/complaints-procedure">Complaints</a></li> </ul></div> </div> </div> </div> </div> </div> </div> <div id="footer-bottom-row" class="row"> <div class="panel-panel col-xs-12 col-sm-12 col-md-12 col-lg-12"> <div class="panel-pane pane-block pane-menu-block-9 hidden-phone" > <div class="pane-content"> <div class="menu-block-wrapper menu-block-9 menu-name-menu-footer parent-mlid-1349 menu-level-1"> <ul class="menu nav"><li class="first leaf menu-mlid-125888"><a id="ot-sdk-btn" class="ot-sdk-show-settings" clickable="false">Cookie settings</a></li> <li class="leaf menu-mlid-1350"><a href="https://www.bmj.com/company/your-privacy/cookies-policy/">Cookie Policy</a></li> <li class="leaf menu-mlid-125299"><a href="https://www.bmj.com/company/your-privacy/">Privacy policy</a></li> <li class="leaf menu-mlid-1351"><a href="http://www.bmj.com/company/legal-information/">Website T&Cs</a></li> <li class="leaf menu-mlid-1352"><a href="http://group.bmj.com/group/about/revenue-sources">Revenue Sources</a></li> <li class="leaf menu-mlid-1353"><a href="http://home.highwire.org/">HighWire Press</a></li> <li class="last leaf menu-mlid-8093"><a href="/sitemap">Sitemap</a></li> </ul></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-bmj-copy-right" > <div class="pane-content"> <div class="copyright">Copyright © 2025 BMJ Publishing Group Ltd</div> </div> </div> </div> </div> </div> </section>  </div> </footer>  </div> </div> </div>  </div>  <script> setTimeout(function(){var a=document.createElement("script"); var b=document.getElementsByTagName("script")[0]; a.src=document.location.protocol+"//dnn506yrbagrg.cloudfront.net/pages/scripts/0014/4896.js?"+Math.floor(new Date().getTime()/3600000); a.async=true;a.type="text/javascript";b.parentNode.insertBefore(a,b)}, 1);</script> <script>jQuery(".page-search .pane-quick-search-results .search-snippet").text(function (_, old){ return old.replace(/\S+@\S+\.\S+/, "");});</script> <script type="text/javascript"> /* <![CDATA[ */ var google_conversion_id = 973817434; var google_custom_params = window.google_tag_params; var google_remarketing_only = true; /* ]]> */ </script> <script type="text/javascript" src="//www.googleadservices.com/pagead/conversion.js"> </script> <noscript> <div style="display:inline;"> <img height="1" width="1" style="border-style:none;" alt="" src="//googleads.g.doubleclick.net/pagead/viewthroughconversion/973817434/?value=0&guid=ON&script=0"/> </div> </noscript> <script async src="https://cdn.pbgrd.com/core-bmj.js"></script> </body> </html>

CINXE.COM

Recent rapid responses | The BMJ