w "What's the point in living, in a body I don't want" - how the NHS treats trans people By feeds.bmj.com Published On :: Mon, 11 Apr 2016 16:45:18 +0000 James Barrett, president of the British Association of Gender Identity Specialists, and Nina, a trans woman, join us to discuss how difficult it can be for trans people to access gender clinics, and what barriers are faced by the community after their transition has been completed. Read James Barrett's personal... Full Article
w BMJ roundtable: How to fix out of hours care By feeds.bmj.com Published On :: Wed, 27 Apr 2016 14:39:06 +0000 The BMJ recently held a discussion between experts in the fields of general practice, emergency medicine, and paediatrics about the state of out of hours care in the UK, and crucially offered their vision for a better service. Are children a special case, can urgent care ‘hubs’ be a silver bullet, is NHS 111 up to the job of triaging patients,... Full Article
w "The information we get can be harmfull"; Informed consent is not a panacea By feeds.bmj.com Published On :: Mon, 09 May 2016 17:01:43 +0000 Providing information to enable informed choices about healthcare sounds immediately appealing to most of us. But Minna Johansson, GP trainee and PhD student at the University of Gothenburg, argues that preventive medicine and expanding disease definitions have changed the ethical premises of informed choice and our good intentions may... Full Article
w "Women deliver, and not only babies" By feeds.bmj.com Published On :: Mon, 16 May 2016 10:34:24 +0000 Katja Iversen, CEO of Women Deliver, joins Rebecca Coombes to explain why the UN sustainable development goals are unachievable if we don't empower women and girls to take control of their health, wellbeing, and reproductive rights. http://womendeliver.org/ Full Article
w The Weekend Effect - what's (un)knowable, and what next? By feeds.bmj.com Published On :: Fri, 20 May 2016 16:09:24 +0000 We do we know about the weekend effect? As Martin McKee puts it in an editorial on thebmj.com, "almost nothing is clear in this tangled tale" In this roundtable, Navjoyt Ladher, Analysis editor for The BMJ is joined by some of the key academics who have published research and commented on the weekend effect to make sense of what we know and... Full Article
w Women and the Zika Virus By feeds.bmj.com Published On :: Wed, 25 May 2016 11:01:18 +0000 Interviews from the Women deliver conference in Copenhagen. Donna McCarraher, director of reproductive, maternal, newborn and child health at FHI 360, explains why women should be at the centre of efforts to mitigate the effect of Zika Virus in Brazil. Full Article
w "What has convinced me is the evidence" - why mandatory treatment for drug use is a bad idea By feeds.bmj.com Published On :: Fri, 10 Jun 2016 15:07:07 +0000 Global evidence indicates that mandated treatment of drug dependence conflicts with drug users’ human rights and is not effective in treating addiction. Karsten Lunze, associate professor at the Boston University School of Medicine, joins us to describe the evidence, and why he is convinced seemingly counter intuitive hard reduction... Full Article
w Caring for patients with delirium at the end of their life By feeds.bmj.com Published On :: Tue, 14 Jun 2016 16:15:33 +0000 Delirium is common in the last weeks or days of life. It can be distressing for patients and those around them. A clinical update explains why successful management involves excluding reversible causes of delirium and balancing drugs that may provoke or maintain delirium while appreciating that most patients want to retain clear cognition at the... Full Article
w Should we scrap the internal market in England's NHS By feeds.bmj.com Published On :: Fri, 15 Jul 2016 13:45:11 +0000 The "internal market" was created after the 1987 UK general election focused attention on inadequate funding in the NHS, long waiting lists for elective surgery, and large unwarranted variations in clinical care. Economists attributed these problems to a lack of incentives for efficiency, and the remedies offered included increasing competition... Full Article
w What went wrong with care.data? By feeds.bmj.com Published On :: Fri, 22 Jul 2016 16:20:00 +0000 Failures in implementation of data sharing projects have eroded public trust. In the wake of NHS England’s decision to close down its care.data programme, Tjeerd-Pieter van Staa professor of health e-research at the University of Manchester, examines what lessons must be learnt, and what we can do better next time. Read the full... Full Article
w How does maximizing shareholder value distort drug development? By feeds.bmj.com Published On :: Thu, 28 Jul 2016 09:01:43 +0000 With the emergence of sofobuvir, a new direct acting antiviral, treatment for Hepatitis C infection is currently undergoing it's greatest change since the discovery of the virus 25 years ago. However Gilead, who manufacture the treatment, are under fire for the cost of the druge - around $90 000 for a course of treatment. Victor Roy, doctoral... Full Article
w A maladaptive pathway to drug approval By feeds.bmj.com Published On :: Fri, 19 Aug 2016 14:04:41 +0000 The European Medicines Agency (EMA) has embraced a new model of drug testing and marketing called “adaptive pathways”, allowing new drugs for “unmet medical needs” to be launched on the market faster, on the basis of fewer data. While industry claims this is necessary, an analysis on thebmj.com looks at the assumptions underlying the new pathway,... Full Article
w Reprehensible, but the people carrying out atrocities have very low rates of mental disorders By feeds.bmj.com Published On :: Thu, 08 Sep 2016 14:46:46 +0000 Oversimplification and lack of evidence stigmatise people with mental illness and impede prevention efforts, says Simon Wessley, professor of psychiatry at King's College London, in an editorial published on thebmj.com. Read the full editorial: http://www.bmj.com/content/354/bmj.i4869 Full Article
w Margaret McCartney wants to fix the NHS By feeds.bmj.com Published On :: Mon, 28 Nov 2016 17:15:18 +0000 Glasgow GP, writer, broadcaster, and The BMJ's weekly columnist Margaret McCartney joins us to talk about her new book "The State of Medicine: Keeping the Promise of the NHS". Read all of Margaret's columns: goo.gl/iKmmie Full Article
w Nanny state knows best By feeds.bmj.com Published On :: Tue, 03 Jan 2017 11:44:39 +0000 State regulation is necessary for safety, says Simon Capewell, professor of public health and policy at the University of Liverpool. Richard Lilford, professor of public health at the University of Warwick, argues that restricting adults’ choice can undermine such aims. Read the debate: http://www.bmj.com/content/355/bmj.i6341 Full Article
w Helping patients with medically unexplained symptoms By feeds.bmj.com Published On :: Fri, 17 Feb 2017 16:59:25 +0000 Persistent physical symptoms are common and include those symptoms that last at least three months and are insufficiently explained by a medical condition after adequate examination and investigation. Observational studies in primary care report that women, especially those aged 35-45 years, more commonly present with these symptoms. In this... Full Article
w How people die remains in the memory of those who live on - supporting the relatives of the dying By feeds.bmj.com Published On :: Tue, 21 Feb 2017 11:00:38 +0000 All doctors, irrespective of their specialty or the setting in which they work, will care for patients who die. Around half of all deaths occur in hospitals. Evidence suggests that the quality of communication around this process is poorer in hospitals than in other settings, according to responses from relatives who have experienced bereavement.... Full Article
w American healthcare - what next? By feeds.bmj.com Published On :: Wed, 29 Mar 2017 09:10:02 +0000 For seven years, Republicans have vowed to repeal the Affordable Healthcare Act (Obamacare), and that promise took a central place in President Trump's campaign. The first major vote to replace it was due to happen last week, but was cancelled at the 11th hour. In advance of the potential vote, The BMJ published a debate asking "Should US doctors... Full Article
w Fighting inequality, corruption, and conflict - how to improve South Asia's health By feeds.bmj.com Published On :: Tue, 11 Apr 2017 15:29:46 +0000 The BMJ has published a series of articles, taking an in-depth look at health in South Asia. In this collection, authors from India, Pakistan, Nepal, Bangladesh, Sri Lanka, and Afghanistan collaborate to identify evidence-based solutions to shape health policy and interventions, and drive innovations and research in the region. In this podcast,... Full Article
w "We're kicking the can down the road" - how to get agreement on the future of the NHS By feeds.bmj.com Published On :: Wed, 12 Apr 2017 14:54:57 +0000 Our latest debate asks whether there should be a Royal Commission (a high level enquiry, with statutory powers) into the future of the NHS. A high level inquiry could detoxify the radical changes needed and command wide support, say Maurice Saatchi, conservative peer, and Paul Buchanan, The BMJ's patient editor; but Nigel Crisp, independent peer,... Full Article
w “I had two herniated discs in my back, and I was still running” - addicted to exercise By feeds.bmj.com Published On :: Thu, 27 Apr 2017 10:05:01 +0000 It’s been called “the universal panacea” - exercise has a positive effect on almost all health measures, and governments are actively campaigning for us to do more. But at the opposite end of the scale, the realisation that some people may be addicted to exercise is gaining traction. In this podcast we're joined by Heather Hausenblas - professor... Full Article
w Helping patients with complex grief By feeds.bmj.com Published On :: Thu, 18 May 2017 16:44:07 +0000 Each individual’s grief process is unique, when confronted with the death of a loved one, most people experience transient rather than persistent distress - however 10% of bereaved individuals, with an increased risk following the death of a partner or child and loss to unnatural or violent circumstances, experience prolonged grief disorder. In... Full Article
w How to build a resillient health system By feeds.bmj.com Published On :: Thu, 08 Jun 2017 11:02:37 +0000 The 2014 west African Ebola epidemic shone a harsh light on the health systems of Guinea, Liberia, and Sierra Leone. While decades of domestic and international investment had contributed to substantial progress on the Millennium Development Goals, national health systems remained weak and were unable to cope with the epidemic. Margaret Kruk... Full Article
w Stress at work By feeds.bmj.com Published On :: Fri, 16 Jun 2017 15:59:27 +0000 Stress is one of the leading causes of work absence, recently overtaking back-pain, and an increasing part of a GPs workload. However good quality evidence about how to deal with stress is hard to come by. Alexis Descatha, an occupational/emergency practitioner, at the University hospital of Poincaré, gives some practical advice on what to do... Full Article
w James Kinross and Chris Hankin WannCry about NHS IT By feeds.bmj.com Published On :: Fri, 14 Jul 2017 16:13:20 +0000 Earlier this year, the WannaCry ransomeware attack took control of computers in 40 NHS trusts, blocking access to the data held on them. This wasn’t the first time that NHS computers had been infected by malware, but it brought the danger of cyber attack into the consciousness of doctors and patients. In this podcast we hear from two people who... Full Article
w What's going on with life expectancy? By feeds.bmj.com Published On :: Fri, 21 Jul 2017 13:35:10 +0000 The increase in life expectancy in England has almost “ground to a halt” since 2010 and austerity measures are likely to be a significant contributor. In this podcast Michael Marmot, director at University College London’s Institute of Health Equity, joins us to discuss what might be causing that drop off, and why a decrease in early life chances... Full Article
w Mike Richards has "never been politically interfered with" By feeds.bmj.com Published On :: Fri, 28 Jul 2017 13:43:03 +0000 Mike Richards is well known in the UK - former Cancer Tzar, he now heads up the Care Quality Commission - regulator of all health and social care services, and therefore the body responsible for inspecting hospitals and GP practices. In this interview, BMJ’s head of news and views, Rebecca Coombes went to the CQC’s headquarters in London, and... Full Article
w The World Bank - why it matters for global health By feeds.bmj.com Published On :: Fri, 01 Sep 2017 08:59:54 +0000 The world bank was set up in 1944. In the aftermath of the second world war, the institution was there to give loans to countries rebuilding after the conflict. Their first loan went to France - but with stipulations about repayment that set a tone for future funds. A new series, authored by Devi Sridhar, and her team from the University of... Full Article
w The World Bank - Universal Healthcare By feeds.bmj.com Published On :: Fri, 01 Sep 2017 09:01:34 +0000 The world bank was set up in 1944. In the aftermath of the second world war, the institution was there to give loans to countries rebuilding after the conflict. Their first loan went to France - but with stipulations about repayment that set a tone for future funds. A new series, authored by Devi Sridhar, and her team from the University of... Full Article
w The World Bank - trust funds By feeds.bmj.com Published On :: Fri, 01 Sep 2017 09:03:51 +0000 The world bank was set up in 1944. In the aftermath of the second world war, the institution was there to give loans to countries rebuilding after the conflict. Their first loan went to France - but with stipulations about repayment that set a tone for future funds. A new series, authored by Devi Sridhar, and her team from the University of... Full Article
w The World Bank - the Global Financing Facility By feeds.bmj.com Published On :: Fri, 01 Sep 2017 09:05:03 +0000 The world bank was set up in 1944. In the aftermath of the second world war, the institution was there to give loans to countries rebuilding after the conflict. Their first loan went to France - but with stipulations about repayment that set a tone for future funds. A new series, authored by Devi Sridhar, and her team from the University of... Full Article
w HIV in pregnancy - "without the big picture, people aren't going to be able to take the medication" By feeds.bmj.com Published On :: Fri, 15 Sep 2017 17:11:27 +0000 A new Rapid Recommendation from The BMJ suggests that for pregnant women, they may wish to avoid certain antiviral treatments for HIV. This recommendation differs from the WHO's, and to discuss why that is, and what makes that difference important, we're joined by Reed Siemieniuk, a physician and methodologist from McMaster University, and Alice... Full Article
w The problems with peer review By feeds.bmj.com Published On :: Tue, 19 Sep 2017 14:10:31 +0000 One of the hurdles that anyone who submits research or analysis to The BMJ has to deal with is peer review. The problems of the process, and some of the potential solutions, was a big part of the Peer Review Congress which took place last week. In this interview, Sophie Cook, The BMJ's UK research editor, talks to Lisa Bero, who’s a professor... Full Article
w Diabetes remission - "treating blood glucose, when the disease process is to do with body fat" By feeds.bmj.com Published On :: Fri, 22 Sep 2017 15:25:47 +0000 In the UK - type 2 diabetes now affects between 5-10% of the population - and accounts for around 10% of our total NHS budget. For the individuals affected, treatments are effective at helping control glucose levels - however, the sequela associated with the disease - vascular problems, and a life expectancy that’s 6 years shorter - are still an... Full Article
w What Choosing Wisely looks like in the UK By feeds.bmj.com Published On :: Wed, 27 Sep 2017 10:36:30 +0000 Choosing Wisely was launched in the US, to much fanfare. Since then the movement has spread around the world, with successful chapters set up in Canada, Australia Brazil, Italy, Japan, new Zealand - and most recently the UK. The campaigns have not been without criticism – from how individual recommendations were chosen, to the way in which... Full Article
w Telephone consultations - no cost savings, but increased GP workload By feeds.bmj.com Published On :: Thu, 28 Sep 2017 15:02:02 +0000 If you're a patient in the UK, increasingly, your first interaction with the healthcare system won't be the traditional face to fact chat with your doctor - instead you'll have a telephone consultation. The prevalence of these telephone consultations is increasing, and being promoted by CCGs and private companies who administer them - usually as... Full Article
w Exercise in old age - "we need kendo classes in Huddersfield" By feeds.bmj.com Published On :: Wed, 18 Oct 2017 16:24:10 +0000 There's a crisis in old age care - not just in the UK, around the world, as population demographics shift, and the proportion of older people increase - there's a worry about who's going to look after them, and how much is it going to cost? However, a new analysis on bmj.com says this picture need not be so gloomy - they say that encouraging... Full Article
w I thought I wasn't thin enough to be anorexic By feeds.bmj.com Published On :: Sun, 10 Dec 2017 16:57:03 +0000 Assessing young people with possible eating disorders can be complex for a variety of reasons. Building a therapeutic relationship with a young person with a possible eating disorder and their family is key to enabling a thorough assessment and ongoing management, but it introduces difficult issues regarding confidentiality and risk. In this... Full Article
w Winter pressures - "You run the risk of dropping the ball" By feeds.bmj.com Published On :: Wed, 10 Jan 2018 17:35:17 +0000 Winter pressures on NHS services have kicked in a little bit earlier than usual. So here to discuss that, and also the issue of how local NHS leaders can support staff in times of extreme pressure. Discussing that with Rebecca Coombes, The BMJ’s head of news and views, are Matthew Inada-Kim, a consultant in acute and general medicine at... Full Article
w They can't hear you - how hearing loss can affect care. By feeds.bmj.com Published On :: Fri, 19 Jan 2018 12:31:52 +0000 Many older adults have difficulty understanding speech in acute healthcare settings owing to hearing loss, but the effect on patient care is often overlooked. Jan Blustein professor of health policy and medicine at New York University, and who has also experienced the affects of hearing loss, joins us to explain what that's like, and gives some... Full Article
w How does it feel, to help your patient die? By feeds.bmj.com Published On :: Thu, 08 Feb 2018 11:55:00 +0000 Sabine Netters is an oncologist in The Netherlands - where assisted dying is legal. There doctors actually administer the drugs to help their patients die (unlike proposed legislation in the UK). In this moving interview, Sabine explains what was going through her head, the first time she helped her patient die - and how in the subsequent years,... Full Article
w "We don't really know the impact of these products on our health": Ultraprocessed food & cancer risk By feeds.bmj.com Published On :: Thu, 15 Feb 2018 10:47:09 +0000 A study published by The BMJ today reports a possible association between intake of highly processed (“ultra-processed”) food in the diet and cancer. Ultra-processed foods include packaged baked goods and snacks, fizzy drinks, sugary cereals, ready meals and reconstituted meat products - often containing high levels of sugar, fat, and salt, but... Full Article
w SDGs - How many lives are at stake? By feeds.bmj.com Published On :: Sat, 17 Feb 2018 12:58:17 +0000 In a new analysis John McArthur and Krista Rasmussen, from the Global Economy and Development Program at the Brookings Institution, and Gavin Yamey from Duke University, have set out to analyse the potential for lives saved by the goals set in the Sustainable Development Goals In this conversation I talked to Gavin and John about the numbers,... Full Article
w Katherine Cowan - Reaching A Priority By feeds.bmj.com Published On :: Fri, 02 Mar 2018 15:59:43 +0000 Its now widely agreed that one of the key ways of reducing the current high level of "waste " in biomedical research is to focus it more squarely on addressing the questions that matter to patients - and the people and medical staff that care for them. In this interview, Tessa Richards - the BMJ's patient partnership editor, talks to... Full Article
w How to stop generic drug price hikes (or at least reduce them) By feeds.bmj.com Published On :: Fri, 23 Mar 2018 16:27:36 +0000 Ravi Gupta, is a resident in internal medicine at Johns Hopkins in Baltimore - and as he said has seen the influence of sudden price hikes on his patients - between 2010 and 2015 more than 300 drugs in the U.S. have seen sudden increases of over %100. Ravi and his co-authors have suggested, and tested the feasibility of, a possible answer to... Full Article
w Can we regulate intellectual interests like financial ones? By feeds.bmj.com Published On :: Fri, 13 Apr 2018 19:07:09 +0000 We talk about financial conflicts of interest a lot atThe BMJ - and have take taken the decision that our educational content should be without them. We also talk a lot about non-financial conflicts of interest, but the choppy waters of those are much more difficult to navigate. In this podcast, we discuss whether we should, or if we could even... Full Article
w What forced migration can tell us about diabetes By feeds.bmj.com Published On :: Tue, 08 May 2018 17:04:46 +0000 Worldwide, the rate of type II diabetes is estimated to be around 1 in 11 people - about 9%. For the Pima people of Arizona, 38% of the adult population have the condition - but across the border in Mexico, the rate drops down to 7%. The difference between the groups is their life experience - one side displaced, the other on their traditional... Full Article
w New antivirals for Hepatitis C - what does the evidence prove? By feeds.bmj.com Published On :: Sat, 12 May 2018 11:44:15 +0000 There’s been a lot of attention given to the new antirviral drugs which target Hepatitis C - partly because of the burden of infection of the disease, and the lack of a treatment that can be made easily accessible to around the world, and partly because of the incredible cost of a course of treatment. But a new article on BMJ talks about the... Full Article
w Antidepressants and weight gain By feeds.bmj.com Published On :: Fri, 25 May 2018 16:56:21 +0000 Patients who are depressed and prescribed antidepressants may report weight gain, but there has been limited research into the association between the two. However new observational research published on bmj.com aims to identify that association. Rafael Gafoor, a psychiatrist and researcher at Kings College London, and one of the authors of that... Full Article
w Ashish Jha tries to see the world as it is. By feeds.bmj.com Published On :: Fri, 08 Jun 2018 17:02:48 +0000 There’s a lot going on in the world at the moment - Ebola’s back, Puerto Rico is without power and the official estimations of death following the hurricane are being challenged. The WHO’s just met to decide what to do about it all, as well as sorting out universal healthcare, access to medicines, eradicating polio, etc etc. To make sense of that... Full Article