the "I thought I was the worst person with type I..." - Self management of diabetes By feeds.bmj.com Published On :: Mon, 14 Mar 2016 11:20:56 +0000 Nick Oliver, consultant diabetologist at Imperial Healthcare NHS Trust and Philippa Cooper, who has type I diabetes, join us to explain how structured education works for patients, and give tips on self management. Read the full review: http://www.bmj.com/content/352/bmj.i998 Full Article
the "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
the The pattern of damage caused by Zika virus in the brains of 23 foetuses By feeds.bmj.com Published On :: Thu, 14 Apr 2016 17:47:57 +0000 In February World Health Organization (WHO) declared the microcephaly epidemic in South America an international public health emergency. Today, the US Centers for Disease Control and Prevention, the CDC, has confirmed that it’s is Zika virus which is causing that microcephaly. The outbreak was originally spotted in Recife, in Brazil, and it’s... Full Article
the Medical error—the third leading cause of death in the US By feeds.bmj.com Published On :: Wed, 04 May 2016 09:29:03 +0000 Medical error is not included on death certificates or in rankings of cause of death. Martin Makary, professor of surgery at Johns Hopkins University School of Medicine, joins us to explain why we don't measure medical error, and why it is so important that we start. Read the full analysis: http://www.bmj.com/content/353/bmj.i2139 Full Article
the The science of improvement By feeds.bmj.com Published On :: Fri, 06 May 2016 15:50:16 +0000 Or, the one where Fiona Moss and Don Berwick tells us what they think quality improvement is. Fiona Moss is dean, Royal Society of Medicine, and Don Berwick is president emeritus and senior fellow, Institute for Healthcare Improvement. Don's talk and the interview with Fiona were both recorded at the International Forum on Quality and Safety in... Full Article
the "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
the 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
the 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
the "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
the 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
the 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
the Late effects of anticancer chemotherapy: It's hard to trust your body, after it's betrayed you By feeds.bmj.com Published On :: Thu, 08 Sep 2016 13:30:40 +0000 Lily was diagnosed at 14 years old with stage four Hodgkin's lymphoma and received six rounds of chemotherapy and two weeks of radiotherapy. She survived but now lives with the long term effects of that therapy - and joins us to discuss how it has impacted her quality of life. We're also joined by Saif Ahmad and Thankamma Ajithkumar, oncologists... Full Article
the 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
the Blinding the randomisation By feeds.bmj.com Published On :: Fri, 18 Nov 2016 15:58:27 +0000 Allocation concealment - blinding which arm of a trial a patient is randomised to - is being questioned in an analysis published on thebmj.com. David Torgerson, director of the York Trials Unit at the university of York and colleagues have been looking at the way in which trials do this randomisation, and how they subsequently report it - and... Full Article
the 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
the 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
the The inadequacy of the UK's childhood obesity strategy By feeds.bmj.com Published On :: Thu, 02 Mar 2017 17:39:18 +0000 The UK government published its report Childhood Obesity: a Plan for Action, in August 2016. A new analysis article takes them to task for the inadequacy of that response to a growing problem. Neena Modi is a professor of neonatal medicine, at Imperial College London, and president of the Royal College of Paediatrics and Child Health, and joins... Full Article
the Emergency care plans at the end of life By feeds.bmj.com Published On :: Wed, 08 Mar 2017 16:48:04 +0000 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... Full Article
the Education round up - HIV testing, legal highs and care for relatives of the dying By feeds.bmj.com Published On :: Fri, 17 Mar 2017 15:44:23 +0000 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... Full Article
the "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
the The evidence manifesto - better trials, better use of trial data By feeds.bmj.com Published On :: Fri, 21 Apr 2017 15:48:21 +0000 We're creating a manifesto for better evidence. The centre for Evidence Based Medicine at the University of Oxford, and the BMJ, are asking what are the problem with medical evidence, and how can we fix them? In this second discussion we went to Nottingham University, to find out what the people who create the bread and butter of EBM -... Full Article
the The magic of shared decision making By feeds.bmj.com Published On :: Tue, 09 May 2017 09:48:25 +0000 Adoption of shared decision making into routine practice has been remarkably slow, despite 40 years of research and considerable policy support. In 2010, the Health Foundation in the UK commissioned the MAGIC (Making Good Decisions in Collaboration) programme to design, test, and identify the best ways to embed shared decision making into... Full Article
the "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
the The Evidence Manifesto - it's time to fix the E in EBM By feeds.bmj.com Published On :: Fri, 23 Jun 2017 17:06:38 +0000 "Too many research studies are poorly designed or executed. Too much of the resulting research evidence is withheld or disseminated piecemeal. As the volume of clinical research activity has grown the quality of evidence has often worsened, which has compromised the ability of all health professionals to provide affordable, effective, high value... Full Article
the "For the first time in 15 years the quitting rate has gone up" - ecigarettes smoking cessation By feeds.bmj.com Published On :: Thu, 27 Jul 2017 10:54:03 +0000 It’s been 10 years since electronic cigarettes hit the shelves in a big way - and since there controversy has reigned about their health effects - are they less unhealthy than smoking traditional tobacco cigarettes, and will they increase nicotine dependence? Its to that last point that new research, published on BMJ.com is looking into -... Full Article
the 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
the 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
the 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
the 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
the 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
the 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
the 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
the 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
the 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
the 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
the Taking the temperature of 37°C By feeds.bmj.com Published On :: Wed, 13 Dec 2017 17:00:09 +0000 Average body temperature is 37°C, right? That was the conclusion of Carl Wunderlich in his magnum opus, The Course of Temperature in Diseases - Wunderlich published that in 1868, following his extensive collection of body temperature readings - and 37°C stuck. But, it’s not as simple as that Philip Mackowiak, emeritus professor of medicine, and... Full Article
the 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
the 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
the 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
the Virginia Murray - the science of disaster risk reduction By feeds.bmj.com Published On :: Wed, 24 Jan 2018 10:42:11 +0000 Virginia Murray, public health consultant in global disaster risk reduction at Public Health England, was instrumental in putting together the Sendai Framework for Disaster Risk Reduction - an international agreement which aims to move the world from reacting to disasters, to proactively preventing them. In this podcast, she explains what they... Full Article
the The tone of the debate around assisted dying By feeds.bmj.com Published On :: Thu, 08 Feb 2018 11:47:22 +0000 Bobbie Farsides is professor of clinical and biomedical ethics at Brighton and Sussex Medical School. She’s been described as one of the few people that is acceptable to “both sides” of the assisted dying debate. This week she joins us to talk about the way in which the debate on euthanasia has played out in the UK - and hear why she thinks it’s... Full Article
the "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
the 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
the 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
the 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
the 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
the 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
the 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
the Doctors and vets working together for antibiotic stewardship By feeds.bmj.com Published On :: Wed, 11 Jul 2018 15:00:36 +0000 Doctors and the farming industry are often blamed for overuse of antibiotics that spurs the growing problem of antimicrobial resistance - but the professions are using different methods to combat resistance and reduce overuse. In this roundtable, we bring medics and vets together to discuss the problem - where antibiotic resistance arises, how... Full Article
the 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