l “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
l Drug promotion, prescription, and value By feeds.bmj.com Published On :: Thu, 04 May 2017 09:55:13 +0000 Pharma companies say that money spent on promotion is essential to educate doctors about the best drugs - but when a medical student asked Joseph Ross, associate professor of medicine and public health at Yale, if those companies are promoting the right drugs for that message to be true, the answer wasn't available. Ross and Tyler Greenaway, his... Full Article
l 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
l Future Earth - linking health and environmental research By feeds.bmj.com Published On :: Fri, 02 Jun 2017 15:02:50 +0000 The rapid changes in the global environment have led many scientists to conclude that we are living in a new geological epoch—the Anthropocene—in which human activities have become the dominant driving force transforming the Earth’s natural systems. A recent joint publication by the World Health Organization and Convention on Biological Diversity... Full Article
l 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
l "The interest of diesel drivers over the interest of the public" - tackling air pollution By feeds.bmj.com Published On :: Thu, 15 Jun 2017 16:47:27 +0000 Air pollution is a truly damaging environmental insult to the human body. The numbers of premature deaths, in the UK alone, that can be attributed to it are calculated to be 40,000 a year. Yet despite this, action to tackle the problem - as with the other huge environmental issue of our time, climate change - is distinctly lacking. Robin... Full Article
l Childhood IQ and cause of death By feeds.bmj.com Published On :: Thu, 29 Jun 2017 11:23:49 +0000 Findings from a range of prospective cohort studies based around the world indicate that higher intelligence in children is related to a lower risk of all cause mortality in adulthood - and now a new study, published on bmj.com, is trying to dig into that association further, with a whole population cohort and data on cause specific... Full Article
l Dementia prevalance in 2040 By feeds.bmj.com Published On :: Wed, 05 Jul 2017 17:07:08 +0000 The Alzheimer’s society, in the UK, predicts that if the rates of dementia remain constant there’ll be 1.7 million people in the country living with the condition by 2050. We also know that things like improvements in cardiovascular health are changing those rates. New research published on bmj.com attempts to model what the outcomes of those... Full Article
l Biomarkers - miracle or marketing? By feeds.bmj.com Published On :: Tue, 18 Jul 2017 16:20:32 +0000 The BMJ has been campaigning for an end to “too much medicine” - the pernicious effect of marketing on the range of tests and treatments that doctors offer patients - tests and treatments which are motivated by the financial reward to the system, than the health of the individual. A new analysis on BMJ.com takes a look at what’s happening in the... Full Article
l 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
l 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
l Helping Bereaved people By feeds.bmj.com Published On :: Thu, 03 Aug 2017 15:11:16 +0000 Loss of a loved one can be very painful. When seeking support, some people turn to their doctor. Because of their pivotal role in the community, physicians can provide excellent support for bereaved people and can often direct them to additional resources. Katherine Shear, a physician, and Stephanie Muldberg, a bereaved mother, join us to discuss... Full Article
l Preventing Overdiagnosis 2017 - Stacy Carter on the culture of overmedicalisation By feeds.bmj.com Published On :: Thu, 17 Aug 2017 18:17:17 +0000 In this interview from Preventing Overdiagnosis 2017 (preventingoverdiagnosis.net) Stacy Carter, associate professor at Sydney Health Ethics - and the author of a recently written BMJ essay the ethical aspects of overdiagnosis, joins us to talk about how the cultural context of medicine seeps into our decision making processes and affects how... Full Article
l 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
l 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
l 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
l 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
l Nigel Crisp - The NHS isn't just a cost to society, it's a benefit By feeds.bmj.com Published On :: Fri, 08 Sep 2017 17:18:17 +0000 If you google "The NHS" you'll see screaming headlines from the Daily Mail about cost and waste - debate in parliament is about how much of our GDP we should be spending - and each year, hospital trusts go cap in hand to ask for more funding. Against this backdrop, a new analysis, and a first in a series, published on bmj.com, looks at what it... Full Article
l 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
l 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
l 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
l 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
l Selling off NHS silver? By feeds.bmj.com Published On :: Wed, 27 Sep 2017 16:04:41 +0000 Should we welcome plans to sell off NHS land? The government seems likely to back the recommendations of Robert Naylor (national adviser on NHS property and estates) to raise capital by selling off inefficiently used assets, but Kailash Chand (GP) worries that services could be threatened and that public consultation is lacking. Read the Head... Full Article
l 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
l 01 Fiona Godlee By feeds.bmj.com Published On :: Wed, 18 Oct 2017 06:33:15 +0000 Who better to kick off a series on all things health and evidence than the exceptional and erudite Editor-in-Chief of The BMJ, Dr Fiona Godlee. In this episode, Fiona chats to Ray about the BMJ's ongoing and often controversial campaigns to change medicine - and broader society - for the better. She also looks to a future that addresses the... Full Article
l 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
l Three talks to good decision making By feeds.bmj.com Published On :: Fri, 10 Nov 2017 17:59:32 +0000 The Three Talk Model of shared decision is a framework to help clinicians to think about how to structure their consultation to ensure that shared decision making can most usefully take place. The model is based around 3 concepts - option talk, decision talk, and team talk - with active listening at the centre. Three Talk was first proposed in... Full Article
l Early detection of eating disorders By feeds.bmj.com Published On :: Sun, 10 Dec 2017 16:56:04 +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
l Manflu - are men immunologically inferior? By feeds.bmj.com Published On :: Tue, 12 Dec 2017 16:26:51 +0000 Manflu, the phenomenon that men experience the symptoms of viral illness more than woman, is usually used with derision - but a new review, published in the Christmas edition, is asking - is there a plausible biological basis for this sex difference? Kyle Sue is a clinical assistant professor in family medicine at Memorial University of... Full Article
l 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
l neoadjuvant treatment for breast cancer - not living up to the promise By feeds.bmj.com Published On :: Thu, 11 Jan 2018 18:07:35 +0000 Neoadjuvant chemotherapy for breast cancer is a new strategy that was introduced towards the end of the 20th century with the aim of reducing tumour size - rendering an otherwise inoperable tumour operable, allowing more conservative surgery, and hopefully improving overall survival. Although data indicate that the first rationale remains valid,... Full Article
l MVA85A trial investigation - press conference. By feeds.bmj.com Published On :: Thu, 11 Jan 2018 18:34:38 +0000 Trial MVA85A - monkey trials for a booster vaccine for BCG, developed by researchers at Oxford University, is the subject of an investigation published on bmj.com. Experts warn that today’s investigation is just one example of “a systematic failure” afflicting preclinical research and call for urgent action “to make animal research more fit for... Full Article
l 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
l 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
l "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
l 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
l Should doctors prescribe acupuncture for pain? By feeds.bmj.com Published On :: Thu, 08 Mar 2018 18:00:54 +0000 Our latest debate asks, should doctors recommend acupuncture for pain? Asbjørn Hróbjartsson from the Center for Evidence-based Medicine at University of Southern Denmark argues no - evidence show's it's no worse than placebo. Mike Cummings, medical director of the British Medical Acupuncture Society argues yes - that there is evidence of efficacy,... Full Article
l Unprofessionalism - "blaming other people, I put that at the top of the impact list" By feeds.bmj.com Published On :: Mon, 12 Mar 2018 12:16:34 +0000 That’s Jo Shapiro is a surgeon and manager in Brigham and Women’s hospital, she’s also director of the Center for Professionalism and Peer Support, and has written an editorial for The BMJ on tackling unprofessional behaviour. In this discussion, she and I talked about what she thinks (beyond the illegal) are the most damaging behaviours seen... Full Article
l 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
l Online Consultations - general practice is primed for a fight By feeds.bmj.com Published On :: Wed, 28 Mar 2018 15:28:48 +0000 The first digital banking in the UK was launched in 1983, Skype turns 15 this year, but 2017 finally saw panic over the impact that online consultations may have on general practices. In this podcast Martin Marshall, professor of healthcare improvement at University College London joins us to discuss whether video conference actually is a... Full Article
l Civilians under siege in Eastern Ghouta By feeds.bmj.com Published On :: Tue, 03 Apr 2018 10:03:35 +0000 In 2016, from an estimated pre-war population of 22 million, the United Nations (UN) identified 13.5 million Syrians requiring humanitarian assistance, of which more than 6 million are internally displaced within Syria, and around 5 million are refugees outside of Syria. In this podcast, Aula Abarra, consultant in infectious disease from London,... Full Article
l 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
l 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
l 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
l 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
l Don Berwick - you can break the rules to help patients By feeds.bmj.com Published On :: Fri, 15 Jun 2018 12:52:40 +0000 Don Berwick, president emeritus of the Institute of Healthcare Improvement, and former Administrator of the Centers for Medicare and Medicaid Services. In this conversation he discusses how he went from being a paediatrician to running Medicare for Obama, how we can create headroom in stressed systems, and breaking the rules to make things better... Full Article
l When an investigative journalist calls By feeds.bmj.com Published On :: Fri, 22 Jun 2018 17:11:23 +0000 At Evidence Live this year, the focus of the conference was on communication of evidence - both academically, and to the public. And part of that is the role that investigative journalism has to play in that. At the BMJ we’ve used investigative journalistic techniques to try and expose wrong doing on the part of government and industry - always... Full Article
l What does the public think of the NHS? By feeds.bmj.com Published On :: Thu, 12 Jul 2018 17:02:32 +0000 It’s been quite a year for the NHS - it just turned 70, had a winter crisis like never before, got over junior doctor strikes, but then was hit by a series of scandals about breast screening, and now opiate prescriptions. At the same time, we’ve seen demonstrations in favour of the service and even widespread public backing for more money. So... Full Article
l Mendelian Randomisation - for the moderately intelligent By feeds.bmj.com Published On :: Mon, 16 Jul 2018 18:47:48 +0000 Mendelian randomisation - it’s a technique that uses the chance distribution of genes in a population, combined with big data sets, to investigate causative relationships. But there are a lot of questions we have in The BMJ about how the technique works - the association between genes and apparently non-biologically mediated behaviours, how much... Full Article
l 15 seconds to improve your workplace By feeds.bmj.com Published On :: Fri, 27 Jul 2018 16:23:56 +0000 15s30m is a social movement to reduce frustration & increase joy - the idea is to spend 15 seconds of your time now, and save someone else 30 minutes down the line. To talk about their movement we're joined by the founders, Rachel Pilling, consultant ophthalmologist, and Dan Wadsworth, transformation manager - both from Bradford Teaching... Full Article