la

Helping patients with medically unexplained symptoms

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...




la

How people die remains in the memory of those who live on - supporting the relatives of the dying

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....




la

Emergency care plans at the end of life

When a person’s heart or breathing stops and the cause is reversible, immediate cardiopulmonary resuscitation (CPR) offers a chance of life. However, when a person is dying—for example, from organ failure, frailty, or advanced cancer—and his or her heart stops as a final part of a dying process, CPR will not prevent death and may do harm. But...




la

Education round up - HIV testing, legal highs and care for relatives of the dying

The BMJ publishes a lot of educational articles, and in an attempt to help you with your CPD, we have put together this round-up. Our authors and editors will reflect on the key learning points in the articles we discuss, and explain how they may change their practice in light of that new understanding. In this week's round up we're...




la

Dementia prevalance in 2040

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...




la

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...




la

Unprofessionalism - "blaming other people, I put that at the top of the impact list"

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...




la

Can we regulate intellectual interests like financial ones?

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...




la

15 seconds to improve your workplace

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...




la

Patient information is key to the therapeutic relationship

Sue Farrington is chair of the Patient Information Forum, a member organisation which promotes best practice in anyone who produces information for patients. In this podcast, she discusses what makes good patient information, why doctors should be pleased when patients arrive at an appointment with a long list of questions, and why patients are...




la

The counter intuitive effect of open label placebo

Ted Kaptchuk, professor of medicine at Harvard Medical school - and leading placebo researcher, has just published an analysis on bmj.com describing the effect of open label placebo - placebos that patient's know are placebos, but still seem to have some clinical effect. Ted joins us to speculate about what's going on in the body, what this means...




la

Making multisectoral collaboration work

A new collection of articles published by The BMJ includes twelve country case studies, each an evaluation of multisectoral collaboration in action at scale on women’s, children’s, and adolescent’s health. Collectively these twelve studies inform an overarching synthesis and accompanying commentaries, drawing together lessons learned in...




la

How Coca-Cola shaped obesity science and policy in China

Susan Greenhalg is a research professor of chinese society in Harvard’s department of anthropology - not a natural fit for a medical journal you may think, but recently she has been looking at the influence of Coca Cola on obesity policy in China. She has written up her investigation in an article published on bmj.com this week, and joins us in...




la

Ebola - Stepping up in Sierre Leone

In 2014, Oliver Johnson was a 28 year old British doctor, working on health policy in Sierre Leone after finishing medical school. Also working in Freetown was Sinead Walsh, then the Irish Ambassador to the country. Then the biggest outbreak of Ebola on record happened in West Africa, starting in Guinea and quickly spreading to Liberia, Sierre...




la

Helping parents with children who display challenging behaviour

Looking after a young child is hard enough, but when that child has learning difficulties and displays challenging behaviour - the burden on parents can be extreme. That behaviour may prompt a visit to the doctor, and in this podcast we’re talking about how parents can be supported in that - what services are available. We’ll also be discussing...




la

Planning for the unplannable

Hi impact, low probability events are a planners nightmare. You know that you need to think about them, but how can you prioritise which event - terrorist attack, natural disaster, disease outbreak, deserves attention - and how can you sell the risks of that, but not oversell them? Risky business is a conference where some of these kind of things...




la

Tackling burnout in The Netherlands

We heard a few podcasts ago about burnout - what it is, and why it should be thought of as a systems issue. Now a project in the Netherlands is trying to investigate who it is that is particularly at risk of burnout, and hopes to test whether individually tailored coaching and counselling can help those who are experiencing the symptoms change the...




la

The government is lacking detail over Brexit planning

Brexit. Who knows what’s going to happen in the next few weeks, months, years - the uncertainty is high. In the face of that, you’d hope that the government was doing all it could to plan for any eventuality - let alone for a massive, country altering one like suddenly crashing out without a deal - but Martin McKee, professor of public health at...




la

Brexit - Planning for medicine shortages

This week we saw the release of the much awaited Yellowhammer documents from the government, documents which outline some of the risks involved with Britain’s sudden departure from the EU. The documents themselves outline that there are risks to the supply of medicines - but do not set out the detail of how those risks have been mitigated, and...




la

Cancer drug trials used for regulatory approval are at risk of bias

Around half of trials that supported new cancer drug approvals in Europe between 2014 and 2016 were judged to be at high risk of bias, in a new study. Huseyin Naci,assistant professor of health policy a the London School of Economics joins us to talk about why potential bias may mean potential exaggeration of treatment effects, and could be...




la

Minimum unit pricing in Scotland

On the 1st of May, 2018 Scotland was the first country to try a new way of reducing alcohol consumption in its population. It introduced a minimum unit prices for alcohol. Now new research just published on BMJ.com is looking at the effect of that price increase - and measuring how well it has achieved the goal of reducing drinking in...




la

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...




la

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...




la

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...




la

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...




la

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




la

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




la

Diabetes and Cardiovascular Disease: The "Common Soil" Hypothesis

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




la

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




la

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




la

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

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




la

Inflammatory Cytokines and the Risk to Develop Type 2 Diabetes: Results of the Prospective Population-Based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study

Joachim Spranger
Mar 1, 2003; 52:812-817
Pathophysiology




la

A Lesson in Metabolic Regulation Inspired by the Glucokinase Glucose Sensor Paradigm

Franz M Matschinsky
Feb 1, 1996; 45:223-241
Banting Lecture 1995




la

Intramyocellular triglyceride content is a determinant of in vivo insulin resistance in humans: a 1H-13C nuclear magnetic resonance spectroscopy assessment in offspring of type 2 diabetic parents

G Perseghin
Aug 1, 1999; 48:1600-1606
Articles




la

Mechanisms of Pancreatic {beta}-Cell Death in Type 1 and Type 2 Diabetes: Many Differences, Few Similarities

Miriam Cnop
Dec 1, 2005; 54:S97-S107
Section III: Inflammation and beta-Cell Death




la

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




la

Skeletal Muscle Triglyceride Levels Are Inversely Related to Insulin Action

D A Pan
Jun 1, 1997; 46:983-988
Original Article




la

Exendin-4 stimulates both beta-cell replication and neogenesis, resulting in increased beta-cell mass and improved glucose tolerance in diabetic rats

G Xu
Dec 1, 1999; 48:2270-2276
Articles




la

Banting Lecture 2001: Dysregulation of Fatty Acid Metabolism in the Etiology of Type 2 Diabetes

J. Denis McGarry
Jan 1, 2002; 51:7-18
Banting Lecture 2001




la

Method for the Isolation of Intact Islets of Langerhans from the Rat Pancreas

Paul E Lacy
Jan 1, 1967; 16:35-39
Original Contribution




la

Elevated Levels of Acute-Phase Proteins and Plasminogen Activator Inhibitor-1 Predict the Development of Type 2 Diabetes: The Insulin Resistance Atherosclerosis Study

Andreas Festa
Apr 1, 2002; 51:1131-1137
Complications




la

The Relationship of Glycemic Exposure (HbA1c) to the Risk of Development and Progression of Retinopathy in the Diabetes Control and Complications Trial

The Diabetes Control and Complications Trial Research Group
Aug 1, 1995; 44:968-983
Original Article




la

A Preprandial Rise in Plasma Ghrelin Levels Suggests a Role in Meal Initiation in Humans

David E. Cummings
Aug 1, 2001; 50:1714-1719
Rapid Publications




la

PPAR{gamma} Ligands Increase Expression and Plasma Concentrations of Adiponectin, an Adipose-Derived Protein

Norikazu Maeda
Sep 1, 2001; 50:2094-2099
Pathophysiology




la

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




la

Triggering and amplifying pathways of regulation of insulin secretion by glucose

JC Henquin
Nov 1, 2000; 49:1751-1760
Articles




la

PPAR-gamma: adipogenic regulator and thiazolidinedione receptor

BM Spiegelman
Apr 1, 1998; 47:507-514
Articles




la

Isolation of INS-1-derived cell lines with robust ATP-sensitive K+ channel-dependent and -independent glucose-stimulated insulin secretion

HE Hohmeier
Mar 1, 2000; 49:424-430
Articles




la

Changes in Gut Microbiota Control Metabolic Endotoxemia-Induced Inflammation in High-Fat Diet-Induced Obesity and Diabetes in Mice

Patrice D. Cani
Jun 1, 2008; 57:1470-1481
Metabolism




la

Classification and Diagnosis of Diabetes Mellitus and Other Categories of Glucose Intolerance

National Diabetes Data Group
Dec 1, 1979; 28:1039-1057
Articles