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Jackie Applebee GP - the funding formula is hurting deprived practices

Jackie Applebee is a GP in Tower Hamlets in London, and is concerned that the way the GP funding formula is working doesn't take account of the earlier health needs of people in deprived areas. For more about the Tower Hamlets Save Our Surgery campaign, visit their facebook page https://www.facebook.com/SaveOurGPsurgeries BMJ Voices is a...




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Has the balance of screening for AAA tipped towards harm?

Abdominal aortic aneurysms (AAA) are usually asymptomatic until they rupture, which is fatal in more than 80% of cases. Screening aims to detect the aneurysm before it ruptures, enabling preventive surgery and hence reducing morbidity and mortality. However, preventive surgery has a mortality of 3.9-4.5%. As the prevalence of risk factors, ie...




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Obioma Ezekobe GP - patients need to be educated about resources

Obioma Ezekobe is a GP in an urgent care centre in Central Middlesex Hospital. She believes that the public need to be educated about the use of NHS resources, and be taught when it is appropriate to seek care. If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427...




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Time to target older women for cervical cancer screening?

Cervical screening programmes in many countries stop at around the age of 65 and much of the focus is often on younger women. However, comparatively little attention has been given to older women despite the fact that they account for about a fifth of cases each year and half of deaths. In this podcast Susan Sherman, a senior lecturer in...




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GI bleeding, slow to diagnose, slow to treat

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has been examining the treatment of acute GI bleeds in England's NHS. Two of the authors, Martin Sinclair, consultant surgeon, and Simon McPherson, consultant vascular radiologist, join us to talk about their findings. Read the full...




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Why do the Scottish do fewer knee arthroscopies?

The “correct” rates of discretional interventions are difficult to define. However, David Hamilton and Colin Howie point out that discrepancies in usage of knee arthroscopy within the UK suggest the organisation of the care pathway may be an important determinant Read their full analysis: http://www.bmj.com/content/351/bmj.h4720




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This house believes that medicine is the best career in the world.

Medicine has long been a rewarding career, but doctors say the profession needs to overcome the frustrations of working in the NHS to ensure it remains so. During the Big Debate at BMJ Live in London last week six speakers argued for and against the motion, “This house believes that medicine is the best career in the world.” After presentations...




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The more you see, the more you eat

Larger portions of food increase consumption. Theresa Marteau, director of the Behaviour and Health Research Unit at the University of Cambridge, joins us to discuss how government action to tackle portion size and packaging could help reset our appetites and make us thinner. Read the full analysis: http://www.bmj.com/content/351/bmj.h5863




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The big (research) book of British teeth

Despite what hollywood says, science has proven that British teeth are actually better than American. Richard Watt, head of the Research Department of Epidemiology and Public Health at UCL explains how they came to that conclusion. Read the full research: http://www.bmj.com/cgi/doi/10.1136/bmj.h6543




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Cancer screening - does it save lives?

The claim that cancer screening saves lives is based on fewer deaths due to the target cancer. Vinay Prasad, assistant professor at Oregon Health and Science University, joins us to argue that reductions in overall mortality should be the benchmark and call for higher standards of evidence for cancer screening. Read the full...




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What is vaginal seeding - and is it safe?

How should health professionals engage with this increasingly popular but unproved practice? Aubrey Cunnington, a consultant paediatrician from Imperial College London joins us to discuss. Read the full editorial: http://www.bmj.com/content/352/bmj.i227




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"We're pulling the rug out from under the feet of [GPs]"

Gareth Iacobucci talks to Candace Imison, director of policy at The Nuffield Trust, about the problems facing GPs, and how primary care could be changed. "5 minutes with... Candace Imison": http://www.bmj.com/content/352/bmj.i1378




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The Weekend Effect - what's (un)knowable, and what next?

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...




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You've been ICE'd

We’re taught that patients' ideas, concerns, and expectations are central to a successful consultation, but has ICEing gone too far? A “What your patient is thinking” article published this week talks about the pressure that asking questions in the wrong way can put on a patient. Sophie Cook, education editor for The BMJ, is joined by the author...




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"We're kicking the can down the road" - how to get agreement on the future of the NHS

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,...




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Mike Richards has "never been politically interfered with"

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...




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The problems with peer review

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...




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01 Fiona Godlee

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...




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Exercise in old age - "we need kendo classes in Huddersfield"

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...




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Three talks to good decision making

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...




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How does it feel, to help your patient die?

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,...




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Ashish Jha tries to see the world as it is.

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...




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HAL will see you now

Machines that can learn and correct themselves already perform better than doctors at some tasks, but not all medicine is task based - but will AI doctors ever be able to have a therapeutic relationship with their patients? In this debate, Jörg Goldhahn, deputy head of the Institute for Translational Medicine at ETH Zurich thinks that the...




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Carers need a voice in the NHS

Until recently, The BMJ had a campaign of patient partnership - now we have a patient and public partnership campaign. The reason for that change is that medicine has an effect beyond the individual being treated - and this podcast interview is a very good example of that. Anya De Iong, patient editor for The BMJ, talks to Christine Morgan -...




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Should we be screening for AF?

Current evidence is sufficient to justify a national screening programme, argues Mark Lown clinical lecturer at the University of Southampton, but Patrick Moran, senior research fellow in health economics at Trinity College Dublin, thinks there are too many unanswered questions and evidence from randomised trials is needed to avoid...




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Nuffield 2019 - How can the NHS provide a fulfilling lifelong career

More doctors are choosing to retire early, doctors who take career breaks find it hard to return to practice, and doctors at all stages of their careers are frustrated by the lack of support given to training and development in today’s NHS. Each year the BMJ holds a roundtable discussion at the Nuffield Summit - where health leaders come...




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Testing for TB is only skin deep

A TB infection can take two forms, active and latent. Active disease is transmissible, and causes the damage to the lungs which makes TB one of the biggest killers in the world. In the latent form, the bacteria Mycobacterium tuberculosis is quiescent and can stay that way for years until it becomes active and causes those clinical signs. Testing...




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Talk Evidence - aggravating acronyms, a time to prescribe, and screening (again)

Talk Evidence is back, with your monthly take on the world of EBM with Duncan Jarvies and GPs Carl Heneghan (also director for the Centre of Evidence Based Medicine at the University of Oxford) and Helen Macdonald (also The BMJ's UK research Editor). This month Helen talks about the messy business of colon cancer screening - which modality is...




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The need for (psychiatrists') speed

The internecine takes on medical specialty are a common thread in the Christmas BMJ, and this year we're doing it through the lens of driving. Which speciality speeds the most, who has the nicest cars? André Zimerman, soon to be cardiologist, and researcher lets us know - and also why you can't rely on being a doctor to get off a speeding ticket....




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

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




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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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Relation Between Antioxidant Enzyme Gene Expression and Antioxidative Defense Status of Insulin-Producing Cells

Markus Tiedge
Nov 1, 1997; 46:1733-1742
Original Article




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High glucose level and free fatty acid stimulate reactive oxygen species production through protein kinase C--dependent activation of NAD(P)H oxidase in cultured vascular cells

T Inoguchi
Nov 1, 2000; 49:1939-1945
Articles




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Free fatty acid-induced insulin resistance is associated with activation of protein kinase C theta and alterations in the insulin signaling cascade

ME Griffin
Jun 1, 1999; 48:1270-1274
Articles




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Quantification of the Relationship Between Insulin Sensitivity and {beta}-Cell Function in Human Subjects: Evidence for a Hyperbolic Function

Steven E Kahn
Nov 1, 1993; 42:1663-1672
Original Article




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Workers blame Iberostar for failure to benefit from SET Cash COVID relief - Employees charge that hotel did not to pay over tax deductions to State

Western Bureau: Some displaced Iberostar employees in Rose Hall, St James, are angry with their employer, charging that they have been unable to benefit from the Government’s COVID-19 relief programme because of the hotel’s failure to pay over...




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Longing to see mom

May 10, Mother’s Day, is a special day on the calendar when many people make big plans to spend the day or the weekend with their mothers. However, this year some people may rethink their plans as they would not want to expose their beloved mothers...




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Type 2 diabetes: sweetened drinks pose greater risk than other sugary foods




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Rammya Mathew: Liquid diets offer promise, but we still need upstream solutions




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Partha Kar: Covid-19—we must keep faith in our experts




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All you need to know for Reds Spring Training

Reds Spring Training in Goodyear, Ariz., will feature a new manager in David Bell, a new coaching staff and several new players. Here is what you need to know about 2019 camp.




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Asking price for Realmuto too steep for Reds

One of the best catchers in baseball was available all winter in J.T. Realmuto, and the Reds were very much one of the teams in hot pursuit in trade talks with the Marlins. But on Thursday, it was the Phillies who acquired Realmuto from Miami.




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Top 10 moments in Frank Robinson's career

Few figures in baseball history have accomplished as much as Frank Robinson. A feared slugger, a World Series champion, a pioneer for minority managers and an ambassador for the game, Robinson had an impact that can be felt in all corners of the sport.




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Frank Robinson, legend and pioneer, dies

Frank Robinson, a trailblazing figure who was Major League Baseball's first African-American manager and one of its greatest players during a career that spanned 21 seasons, died Thursday after a prolonged illness. He was 83.




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Puig in different city but keeping personality

Though some Reds fans were disappointed that Billy Hamilton wasn't brought back this season, it didn't take long for Cincinnati to find another dynamic player who also brings flash and unpredictability. That would be outfielder Yasiel Puig.




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Reds' Spring Training opens to a different feel

It wasn't just that there were new faces when Reds camp opened Tuesday with the reporting of pitchers and catchers for physicals, there was a different vibe that could be felt in the hallways and clubhouse.




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This week’s shutterbugs