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From dance class to social prescription - starting and evaluating an idea

If you read the Christmas BMJ in the last few weeks, you might have noticed a lot around art and health - the way in which engagement in arts can help in prevention and treatment, but can also affect those more nebulous things which really matter to patients - loneliness, self expression, being connected to the wider community. That obviously...




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Michael West - GMC Report On Wellbeing

Michael West is professor of organisational psychology, at Lancaster University, and co-author of a new GMC report into the wellbeing of NHS staff. The review he led together with the clinical psychiatrist Denise Coia, focused on primary interventions related to workplace factors and the systems that doctors work in, rather than secondary...




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Is it possible to have fair pricing for medicines

Is it possible to have a fair price for medicines? Yes, according to a new collection just published on bmj.com. The authors set out to evaluate how we could improve the functioning of the market for medicines, to honestly compensate industry for innovation, whilst allowing the poorest to afford them. Suerie Moon, co-director of global health at...




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Surviving childhood cancer treatment

In a British cohort, 30% of patients who had survived childhood cancer had died within 45 years of diagnosis; only 6% were expected to have died. 51% had developed a new primary cancer, but a 26% died of cardiovascular disease - thought to be caused by their treatment. Consequently, efforts to reduce long term mortality have focused on reducing...




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Talk Evidence - Sepsis, talc and blindsided by blinding

Welcome to the festive talk evidence, giving you a little EBM to take you into the new year. As always Duncan Jarvies is joined by Helen Macdonald (resting GP and editor at The BMJ) and Carl Heneghan (active GP, director of Oxford University’s CEBM and editor of BMJ Evidence)* This month: (1.20) Carl tells us about new research on treating...




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Prevalence and treatment of precocious puberty

Precocious puberty, that is puberty that starts before age 8 in girls and 9 in boys seems to be on the rise, but whether that’s because of an increase in incidence, or greater attention is unknown - what we do know that precocious puberty in girls is commonly idiopathic, while in boys is a red flag for pathology. But either way ther first point of...




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QI and improvement are not synonyms

In October 2019, Mary Dixon-Woods, director of the THIS Institute, dedicated to healthcare improvement. In that she explained how she believed healthcare improvement could be improved. The essay took the position that "Quality Improvement" isn't necessarily the best way to improve healthcare, and that more rigour needs to be brought to the field....




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Writing a good outpatient letter means addressing it to the patient

In many countries (including the UK and Australia) it is still common practice for hospital doctors to write letters to patients’ general practitioners (GPs) following outpatient consultations, and for patients to receive copies of these letters. However, Hugh Rayner, consultant nephrologist, and Peter Rees, former Chair of the Academy of...




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Big Tan - Is the sunbed industry targeting research?

In 2012, Eleni Linos, professor of dermatology at Stanford university, published a systematic review and meta-analysis of the link between non-melanoma cancer and sun-beds. That bit of pretty standard research, and a particular rapid response to it, has kicked of years of work - and in this podcast I talk to Eleni and her colleagues Stanton...




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David Williams - everyday discrimination is an independent predictor of mortality

There comes a tipping point in all campaigns when the evidence is overwhelming and the only way to proceed is with action. According to David Williams, it’s time to tackle the disproportionate effects of race on patients in the UK. David Williams, from Harvard University, developed the Everyday Discrimination Scale that, in 1997, launched a new...




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Talk Evidence - Building an evidence base for covid-19

We're taking a break from the usual Talk Evidence to focus on the new corona virus that has emerged in China. With a brand new disease, we have to build our evidence base from scratch - basic virology, epidemiology, pathogenicity, transmissibility, and ultimately treatment are all unknowns. In this episode of Talk Evidence, we're trying to get...




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Born equal - the launch of The BMJ special issue on race in medicine

Last week the BMJ published it’s first special edition into Racism in Medicine. The issues tacked ranged from differential attainment in medical school, to the physiological effects that experiencing everyday discrimination has. The issue was guest edited by Victor Adebowale, the Chief Executive of the social care enterprise Turning Point, and...




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Yvonne Coghill is trying to fix racism in the NHS

In this week's special episode of Sharp Scratch, we've got something a little different for you! Last week the panel talked microaggressions, so this week we're hearing from an expert guest who is leading the work the NHS is doing to combat inequality in healthcare. If you like this special edition, let us know on Facebook, Instagram or Twitter...




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Why we are failing patients with multimorbidity

We know that the number of people living with multiple health conditions is rising year on year, and yet training, guidelines, organisations and physical spaces in healthcare still largely focus on single diseases or organ systems. The means that patients in the NHS are often treated as if their conditions exist in isolation, and that their care...




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Cycling - Does the health benefit outweigh the accident risk (in the UK)

We all know we should be doing more exercise, and one way to do that is by active commuting - journeying to work on foot or by bike. One thing preventing people from taking up cycling is the fear of being involved in road traffic accidents, and that the risk isn't worth the benefit of the extra exercise. It’s even more confusing when air...




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For a greener NHS - a call for evidence

The NHS is a world leader in sustainable healthcare - and it's the staff who have have been leading the charge. The For A Greener NHS campaign is asking everyone who has made a change to the way they work, to submit evidence and help shape the whole organisation's response to the climate emergency. In this podcast, Isobel Braithwaite, public...




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Talk Evidence - testing under the microscope and opioid prescription

This edition of talk evidence was recorded before the big increase in covid-19 infections in the UK, and then delayed by some self isolation. We'll be back with more evidence on the pandemic very soon. As always Duncan Jarvies is joined by Helen Macdonald (resting GP and editor at The BMJ) and Carl Heneghan (active GP, director of Oxford...




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Organisational kindness during covid-19

Reports from Italy, and more recently from the U.S. show the strain the healthcare system is under during this pandemic. We know that staff will step up in an emergency, but this isn’t a fire or a bombing, this is going to last for months. So how can organisations be proactive in supporting staff, and how can leaders try to mitigate the...




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Talk Evidence Covid-19 update - Confused symptoms, fatality rate uncertainty, Iceland's testing

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give...




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Look after yourself during covid-19

Continuing our series on wellbeing during the pandemic, in this podcast we speak to Occupational Psychologist Roxane Gervais about how doctors can look after themselves during the covid-19 pandemic. We discuss the importance of reaching out to friends and family during this difficult time, how to deal with the loss of control, as well how to...




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Wellbeing - Some advice on working in PPE

Wellbeing might not seem the obvious place to talk about PPE - but lack of appropriate PPE is causing healthcare staff a great deal of stress now. Mary Brindle is a pediatric surgeon and the director of The EQuIS (Efficiency Quality Innovation and Safety) Research platform at Alberta Children’s hospital. In this podcast she reflects on the use...




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Talk Evidence covid-19 update - pneumonia, guidelines, preprints and testing

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give...




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The public health response to covid - 19

As part of our response to the covid-19 pandemic, we’re going to be running a series of discussions with experts about some of the big issues arising from the virus. In this one, we’re asking about the public health response to an outbreak - what’s necessary, and is it possible to go to far. Joining us are Martin Mckee - professor of european...




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Talk Evidence covid-19 update - hydroxy/chloroquinine, prognostic models and facemaskss

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give...




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Front line stories - How corona is changing acute care

As we cover the covid-19 outbreak, we want to hear some of the stories from the frontline - And who better to heart of what this pandemic is doing to the profession in the UK, than some of the people who write regularly for The BMJ? In this first one, we wanted to look specifically at acute care - those at the sharp end of the response, so we're...




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Wellbeing - some advice for telehealth in secondary care

We’ve published info on Telehealth in primary care - and have been overwhelmed by the response from GPs who are finding it useful. But it’s not only primary care that is dramatically shifting to remote care - routine hospital care is moving online too, so we’ve asked Rowena McCash - GP and out of hours triage trainer joins us to give some tips...




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Talk Evidence - Remdesivir, care homes, and death data

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give...




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Wellbeing – advice from a military medic to frontline clinicians

There is no doubt that anxiety levels that clinicians are feeling during this pandemic are high. One military medic believes the current situation is comparable to his experience when posted during British campaigns in Afghanistan and Iraq. Cormac Doyle offers advice on how to deal with high-stress conditions, both in a work and at home, as...




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Feeling the fear with Iona Heath and Danielle Ofri

A new podcast from The BMJ, to help GP's feel more connected, heard, and supported. Subscribe on; Apple podcasts - https://bit.ly/applepodsDBI Spotify - https://bit.ly/spotifyDBI Google podcasts - https://bit.ly/googlepodsDBI This week, our topic is fear: we try to get a better understanding of fear, how it affects all of us as clinicians for...




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Teleconsulting with Trish Greenhalgh and Fiona Stevenson

A new podcast from The BMJ, to help GP's feel more connected, heard, and supported. Subscribe on; Apple podcasts - https://bit.ly/applepodsDBI Spotify - https://bit.ly/spotifyDBI Google podcasts - https://bit.ly/googlepodsDBI In our first episode, we discuss the highs and lows of video consultations, and how coronavirus has altered the landscape...




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Talk Evidence - covid ethics, waste and a minimum RCT size

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give...




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Frontline stories - working as a GP during covid

As the pandemic plays out - the way in which doctors in the UK practice is changing, hospitals are reconfigured to increase critical care capacity, GPs are working from home and doing their day to day work remotely. Some of the changes have come at the detriment of staff and patient wellbeing but covid-19 has also helped cut through some of the...




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Public Health Vs The Economy

Around the world, as the covid pandemic plays out, and some countries are starting to ease their restrictions, this narrative of the economy and public health being opposing weights on a set of scales keeps returning - they need to be balanced. But before this, a healthy population is very much seen as being supportive of the economy. So is a...




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Wellbeing – how one junior doctor found a way to support frontline staff

How can we help frontline clinicians? Sometimes medics may feel uneasy or even guilty and that they could be doing more. That was what a junior doctor in Abergavenny in Wales felt and she did something about it. In this podcast, we speak to Josie Cheetham about how she started her initiative to provide support boxes in hospitals for her...




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Talk Evidence covid-19 update - lack of testing transparency, how to give good debate

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give you...




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Frontline stories - caring for non-covid patients

As the pandemic plays out - hospitals are reconfigured to increase critical care capacity, outpatient clinics become virtual, and elective procedures delayed. How are these affecting care for those who are in hospital but don't have covid-19? In this podcast, Matt Morgan,honorary senior research fellow at Cardiff University, consultant in...




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Coping with Covid with Monica Schoch-Spana and Jud Brewer

In this week’s episode, we discuss bystander guilt, convergence, brain hacks and “how you can sneeze on someone’s brain from anywhere in the world”. How can GPs cope with the myriad worries around treating patients during the current pandemic, both on the frontline and in general practice? How do we recognise and break unhelpful anxious behaviour...




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Wellbeing – coping with Covid fatigue

We are more than six weeks into the lockdown and if you were to gauge the mood of the nation, it would be one of fatigue. It started as an all-hands-on-deck emergency situation, but it now transpires that the current work situation for healthcare professionals is not going to change any time soon. This is a marathon rather than a sprint. So how...




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Talk evidence covid-19 update: natural history of covid, include patients in guidelines

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give you...




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Glucose-Induced Reactive Oxygen Species Cause Apoptosis of Podocytes and Podocyte Depletion at the Onset of Diabetic Nephropathy

Katalin Susztak
Jan 1, 2006; 55:225-233
Complications




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Prospective Analysis of The Insulin-Resistance Syndrome (Syndrome X)

Steven M Haffner
Jun 1, 1992; 41:715-722
Original Article




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Fuel selection in human skeletal muscle in insulin resistance: a reexamination

DE Kelley
May 1, 2000; 49:677-683
Articles




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C-Reactive Protein Is an Independent Predictor of Risk for the Development of Diabetes in the West of Scotland Coronary Prevention Study

Dilys J. Freeman
May 1, 2002; 51:1596-1600
Complications




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5' AMP-activated protein kinase activation causes GLUT4 translocation in skeletal muscle

EJ Kurth-Kraczek
Aug 1, 1999; 48:1667-1671
Articles




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The Effect of Thiazolidinediones on Plasma Adiponectin Levels in Normal, Obese, and Type 2 Diabetic Subjects

Joseph G. Yu
Oct 1, 2002; 51:2968-2974
Obesity Studies




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Diabetes and Cardiovascular Disease: The "Common Soil" Hypothesis

Michael P Stern
Apr 1, 1995; 44:369-374
Perspectives in Diabetes




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Morbidity and Mortality in Diabetics In the Framingham Population: Sixteen Year Follow-up Study

Mariano J Garcia
Feb 1, 1974; 23:105-111
Original Contribution




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Moving GLUT4: The Biogenesis and Trafficking of GLUT4 Storage Vesicles

Shane Rea
Nov 1, 1997; 46:1667-1677
Perspectives in Diabetes




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High Incidence of Metabolically Active Brown Adipose Tissue in Healthy Adult Humans: Effects of Cold Exposure and Adiposity

Masayuki Saito
Jul 1, 2009; 58:1526-1531
Metabolism




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Endothelial Progenitor Cell Dysfunction: A Novel Concept in the Pathogenesis of Vascular Complications of Type 1 Diabetes

Cindy J.M. Loomans
Jan 1, 2004; 53:195-199
Complications