in Diabetes Insipidus - the danger of misunderstanding diabetes By feeds.bmj.com Published On :: Fri, 01 Mar 2019 18:10:43 +0000 Diabetes is synonymous with sugar, but diabetes insipidus, "water diabetes", can't be forgotten. Between 2009 and 2016, 4 people died in hospital in England, when lifesaving treatment for the condition was not given. In this podcast, we hear some practical tips for non-specialists to aid diagnosis, and how patients should be managed during... Full Article
in Nuffield 2019 - How can the NHS provide a fulfilling lifelong career By feeds.bmj.com Published On :: Wed, 06 Mar 2019 18:23:54 +0000 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... Full Article
in Ebola - Stepping up in Sierre Leone By feeds.bmj.com Published On :: Fri, 08 Mar 2019 16:36:33 +0000 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... Full Article
in Passing on the secret knowledge of loop diuretics By feeds.bmj.com Published On :: Fri, 15 Mar 2019 17:07:15 +0000 In every generation there are a few that know the secret; the counterintuitive effects of loop diuretics. In this podcast Steven Anisman, cardiologist at the Dartmouth Hitchcock Department of Cardiovascular Medicine, joins us to explain about the threshold effects of these drugs, and why that might change the way in which you think about... Full Article
in An acutely disturbed person in the community By feeds.bmj.com Published On :: Thu, 21 Mar 2019 17:46:42 +0000 It can be difficult to know what to do when a person in severe psychological distress presents to a general practice or community clinic, particularly if they are behaving aggressively, or if they are refusing help. Most patients who are acutely disturbed present no danger to others, however situations can evolve rapidly. Frontline staff need to... Full Article
in Is opt-out the best way to increase organ donation? By feeds.bmj.com Published On :: Fri, 22 Mar 2019 16:43:46 +0000 As England’s presumed consent law for 2020 clears parliament, Veronica English, head of medical ethics and human rights at the BMA, say that evidence from Wales and other countries shows that it could increase transplantation rates. But Blair L Sadler, physician and senior adviser to California State University, consider such legal changes a... Full Article
in Talk Evidence - Shoulders, statins and doctors messes By feeds.bmj.com Published On :: Thu, 28 Mar 2019 08:37:29 +0000 Helen Macdonald and Carl Heneghan are back again talking about what's happened in the world of evidence this month. They start by talking about shoulders - what does the evidence say about treating subacromial pain, and why the potential for a subgroup effect shouldn't change our views about stop surgery (for now, more research needed). (16.00)... Full Article
in Applying new power in medicine By feeds.bmj.com Published On :: Mon, 01 Apr 2019 11:41:04 +0000 Change requires the application of power - the way in which individuals can accrue power has shifted in our digitally connected world. Traditional ways of influencing change in healthcare (getting the chief executive on side, having a quiet chat with the medical director) are not the only way to build a momentum. Henry Timms - author of “New... Full Article
in Social prescribing By feeds.bmj.com Published On :: Thu, 04 Apr 2019 15:04:24 +0000 Non-medical interventions are increasingly being proposed to address wider determinants of health and to help patients improve health behaviours and better manage their conditions - this is known as social prescribing. In England, the NHS Long Term Plan states that nearly one million people will qualify for referral to social prescribing schemes... Full Article
in Could open access have unintended consequences? By feeds.bmj.com Published On :: Fri, 19 Apr 2019 11:43:04 +0000 An “author pays” publishing model is the only fair way to make biomedical research findings accessible to all, say David Sanders, professor of gastroenterology at Sheffield University, but James Ashton and worries that it can lead to bias in the evidence base towards commercially driven results - as those are the researchers who can pay for open... Full Article
in Introducing Sharp Scratch - our new podcast for students and junior doctors By feeds.bmj.com Published On :: Fri, 26 Apr 2019 16:22:39 +0000 Here's a taster for our new student podcast - Sharp Scratch. We're talking about the hidden curriculum, things you need to know to function as a doctor, but are rarely formally taught. This is a taster - if you enjoy, subscribe! https://podcasts.apple.com/gb/podcast/student-bmj-podcast/id331561304 Sharp Scratch episode 1: Surviving the night... Full Article
in Doctors and extinction rebellion By feeds.bmj.com Published On :: Fri, 03 May 2019 16:39:15 +0000 Starting in the middle of April, the group “Extinction Rebellion” have organised a series of non-violent direct action protests. Most notably bringing central London to a standstill - but these events are now continuing around the country. Predictably, they have received a lot of criticism - they have also received a lot of support - amongst... Full Article
in Tackling gambling By feeds.bmj.com Published On :: Fri, 10 May 2019 14:38:04 +0000 In the UK we have a complex relationship with gambling, the government licences the national lottery, and uses profit from that to fund our art and museum sector - horse racing is a national TV event, and we've seen a proliferation of betting shops on our high streets. At the same time, there's increasing acceptance that gambling causes problems... Full Article
in Helping parents with children who display challenging behaviour By feeds.bmj.com Published On :: Fri, 17 May 2019 14:50:07 +0000 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... Full Article
in What caused the drop in stroke mortality in the UK By feeds.bmj.com Published On :: Thu, 23 May 2019 10:12:07 +0000 Stroke mortality rates have been declining in almost every country, and that reduction could result from a decline in disease occurrence or a decline in case fatality, or both. Broadly - is that decline down to better treatment or better prevention. Olena Seminog, a researcher, and and Mike Rayner, professor of population health, both from the... Full Article
in Talk evidence - cancer causing food, prostate cancer and disease definitions By feeds.bmj.com Published On :: Sat, 25 May 2019 12:11:43 +0000 Helen Macdonald and Carl Heneghan are back again talking about what's happened in the world of evidence this month. (1.05) Carl rants about bacon causing cancer (7.10) Helen talks about prostate cancer, and we hear from the author of the research paper which won Research Paper Of The Year at the BMJ awards. We also cover disease definition and... Full Article
in Finding out who funds patient groups By feeds.bmj.com Published On :: Wed, 29 May 2019 16:32:22 +0000 We’ve been banging the drum about transparency of payment to doctors for years - we’ve even put a moratorium on financial conflicts of interest in the authors of any of our education articles. Not because we think that all doctors who receive money from industry are being influenced to push their agenda - but because we have no way of telling when... Full Article
in Planning for the unplannable By feeds.bmj.com Published On :: Tue, 11 Jun 2019 17:13:58 +0000 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... Full Article
in Thoroughly and deliberately targeted; Doctors in Syria By feeds.bmj.com Published On :: Fri, 14 Jun 2019 18:08:51 +0000 As Syria enters its ninth year of conflict, doctors are struggling to provide health care to a badly damaged country. While dealing with medicine shortages, mass casualties and everything that comes with working in a warzone, healthcare facilities and their staff are also facing an unprecedented number of targeted and often repeated attacks.... Full Article
in Working as a team, and combating stress, in space By feeds.bmj.com Published On :: Tue, 18 Jun 2019 15:04:19 +0000 Nicole Stott is an engineer, aquanaut and one of the 220 astronauts to have lived and worked on the International Space Station. In a confined space, under huge pressure, with no way out, it's important that teams maintain healthy dynamics, and individuals can manage their stress adequately, and in this podcast Nicole explains a little about... Full Article
in Did international accord on tobacco reduce smoking? By feeds.bmj.com Published On :: Thu, 20 Jun 2019 10:51:30 +0000 WHO Director-General Dr. Tedros recently said “Since it came into force 13 years ago, the Framework Convention on Tobacco Control remains one of the world’s most powerful tools for promoting public health,”. But is it? That’s what a to studies just published on bmj.com try and investigate - one of which pulls together all the data we have on... Full Article
in Talk Evidence - Z drugs, subclinical hypothyroidism and Drazen's dozen By feeds.bmj.com Published On :: Tue, 25 Jun 2019 16:58:44 +0000 This week on the podcast, (2.02) a listener asks, when we suggest something to stop, should we suggest an alternative instead? (8.24) Helen tells us to stop putting people on treatment for subclinical hypothyroidism, but what does that mean for people who are already receiving thyroxine? (20.55) Carl has a black box warning about z drugs, and... Full Article
in I have never encountered an organisation as vicious in its treatment of whistleblowers as the NHS By feeds.bmj.com Published On :: Thu, 04 Jul 2019 10:23:06 +0000 Margaret Heffernan has thought a lot about whistleblowing, and why companies don't respond well to it. She wrote the "Book Wilful Blindness: Why We Ignore the Obvious at our Peril". In this podcast she talks about how culture, and groupthink, leads to a culture where whistleblowers are ignored, and why the NHS needs to change the way it treats... Full Article
in Talk evidence - smoking, gloves and transparency By feeds.bmj.com Published On :: Wed, 10 Jul 2019 11:11:50 +0000 This month we have some more feedback from our listeners (2.20) Carl says it's time to start smoking cessation (or stop the reduction in funding for smoking reduction) (11.40) and marvels at how pretty Richard Doll's seminal smoking paper is. It's gloves off for infection control (22.20) Andrew George, a non-executive director of the Health... Full Article
in Fighting bad science in Austria By feeds.bmj.com Published On :: Wed, 17 Jul 2019 16:29:32 +0000 Cochrane Austria have been asking the public what they'd like to know about health. Not whether the latest drug is more efficacious, but whether glacier stone power cures hangovers. Gerald Gartlehner, director of the Cochrane Austria Centre joins us to explain what they do, and how their evidence has been received. Read more about the project... Full Article
in Cannabinoid Hyperemesis Syndrome By feeds.bmj.com Published On :: Fri, 19 Jul 2019 15:47:49 +0000 Cannabinoid hyperemesis syndrome is a relatively newly recognised condition - but, according to one study, can account for up to 6% of patients presenting to emergency departments. The causal mechanism is as yet unclear - but currently the only known way to prevent the syndrome is for the patient to stop their cannabis use. Yaniv Chocron, chief... Full Article
in Patient's rights in research - moving beyond participation By feeds.bmj.com Published On :: Thu, 25 Jul 2019 14:54:57 +0000 At EBM live recently, we ran a workshop with researchers, patients and clinicians to talk about patient rights in research - should patients be setting the full research agenda? Should they be full participants and authors? Helen Macdonald, BMJ’s UK research editor and co-host of our talk evidence podcast sat down to Paul Wicks, researcher and... Full Article
in Sustainable health By feeds.bmj.com Published On :: Fri, 02 Aug 2019 16:49:08 +0000 The UK has just seen it’s hottest July on record, including the highest ever temperature recorded. With climate change in the forefront of our minds, it’s timely that we have two editorials on the sustainability and health. Michael Depledge, emeritus professor of environment and human health at University of Exeter Medical School, and author of... Full Article
in Burnout - Don't try to make the canary in the coal mine more resilient By feeds.bmj.com Published On :: Thu, 08 Aug 2019 16:59:04 +0000 Burnout is a problem in healthcare - it’s a problem for individuals, those who experience it and decide to leave a career they formerly loved, but it’s also a problem for our healthcare system. Burnout is associated with an increase in medical errors, and poor quality of care. Fundamentally it’s a patient safety issue. But, unlike other patient... Full Article
in Gottfried Hirnschall is optimistic about ending the HIV epidemic By feeds.bmj.com Published On :: Thu, 15 Aug 2019 16:45:11 +0000 In 2001, Gottfried Hirnschall joined the WHO to work on the global response to HIV/AIDs, 18 years later he just retired as the director of WHO’s department for HIV and Hepatitis. The intervening period, almost half the time we’ve been aware of the disease the fight against the infection has been characterised by scientific breakthroughs, and... Full Article
in Physical activity and mortality - "The least active quartile did less than 5 minute per day" By feeds.bmj.com Published On :: Fri, 23 Aug 2019 14:29:32 +0000 We know that exercise is good for you - the WHO recommends at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity aerobic physical activity each week. That recommendation is built on evidence that relied on self reporting that may underestimate the amount of lower intensity exercise those people were doing, and at the... Full Article
in Tackling burnout in The Netherlands By feeds.bmj.com Published On :: Fri, 30 Aug 2019 16:35:45 +0000 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... Full Article
in The government is lacking detail over Brexit planning By feeds.bmj.com Published On :: Wed, 04 Sep 2019 17:43:31 +0000 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... Full Article
in Extending the UK's sugar tax to snacks By feeds.bmj.com Published On :: Fri, 06 Sep 2019 11:54:58 +0000 In the UK, for just over a year, we've been paying the "Soft Drinks Industry Levy" - a tax on sugary beverages intended to reduce our consumption of free sugars. That was based on taxes that had happened in other countries, however, in the UK high sugar snacks, such as confectionery, cakes, and biscuits make a greater contribution to intakes of... Full Article
in Vaping deaths - does this change what we think about public health messages By feeds.bmj.com Published On :: Thu, 12 Sep 2019 16:58:18 +0000 This week the Trump administration has banned the sale of flavoured vapes in the USA. The reason for that is the sudden rash of cases of pulmonary disease, including deaths, linked to vaping. The mechanism by which vaping may be causing damage to the lungs is as yet unclear, and our understanding is hampered by the heterogeneous nature of the... Full Article
in Brexit - Planning for medicine shortages By feeds.bmj.com Published On :: Fri, 13 Sep 2019 18:22:17 +0000 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... Full Article
in Talk Evidence - Recurrent VTE, CRP testing for COPD, CMO report, and a consultation By feeds.bmj.com Published On :: Mon, 23 Sep 2019 10:21:58 +0000 Helen talks about new research on prevention of recurrent VTE - and Carl things the evidence goes further, and we can extend prophylaxis for a year. 13.00 - CRP testing for antibiotic prescription in COPD exacerbations, should we start doing it in primary care settings - and what will that mean. We also hear from Chris Butler, one of the... Full Article
in Minimum unit pricing in Scotland By feeds.bmj.com Published On :: Thu, 26 Sep 2019 17:47:38 +0000 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... Full Article
in Talk Evidence - eating less, drinking less, drug approval data By feeds.bmj.com Published On :: Fri, 04 Oct 2019 16:41:57 +0000 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 Carl talks about evidence that restricting your diet might improve health at a... Full Article
in A new way to look at behaviour change in UK GPs By feeds.bmj.com Published On :: Tue, 08 Oct 2019 14:52:42 +0000 In quality improvement, measurement is seen as a key driver of change - how well do you know you’re doing, if you can’t actually measure it. So, when something changes in the NHS (say a new guideline) how can you tell how quickly that’s filtering down to the front line. Ben goldacre, from the Nuffield Department of Primary Care Health Sciences... Full Article
in How Blockchain could improve clinical trial transparency By feeds.bmj.com Published On :: Sat, 12 Oct 2019 13:06:50 +0000 Blockchain is the digital technology that underpins cryptocurrencies such as bitcoin, and has been proposed as the digital panacea of our times. But Leeza Osipenko, from the London School of Economics, has thought about how it could actually be used in clinical trials, and what else would need to change in our regulatory environment to make that... Full Article
in Statins for primary prevention - How good is the evidence By feeds.bmj.com Published On :: Mon, 21 Oct 2019 10:12:15 +0000 Statins are now the most commonly used drug in the UK and one of the most commonly used medicines in the world, but debate remains about their use for primary prevention for people without cardiovascular disease. Paula Byrne from the National University of Ireland Galway, joins us to talk about the evidence of benefit for low risk individuals,... Full Article
in Testing for TB is only skin deep By feeds.bmj.com Published On :: Fri, 25 Oct 2019 18:36:01 +0000 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... Full Article
in Nudging the calories off your order By feeds.bmj.com Published On :: Thu, 31 Oct 2019 17:25:39 +0000 There has been a lot of noise made about calorie counts on labels - the idea being it’s one of those things that might nudge people to make healthier choices. So much so that in 2018, in the USA, it became mandatory for food chains with more than 20 outlets to label the calories in their food. But the effectiveness of that is hard to gauge -... Full Article
in Creating support for doctors in the NHS By feeds.bmj.com Published On :: Tue, 05 Nov 2019 10:50:47 +0000 The NHS Practitioner Health Programme - once only for doctors in London, now it’s being rolled out across the NHS to provide the largest, publicly funded, comprehensive physician health service, in the world. However, while helping the individual is essential, systemic change needs to be made to support doctors in our healthcare system. Clare... Full Article
in Creating a speak out culture By feeds.bmj.com Published On :: Thu, 07 Nov 2019 17:00:38 +0000 Giving staff the confidence to speak out is important in healthcare - It's a key aspect of the WHO patient safety checklist, decreasing incidence of medical error, but it's also important to stop incidents of harassment and abuse which undermine staff and increase burnout. Creating that culture is a difficult task, but two hospitals in the... Full Article
in Talk Evidence - aggravating acronyms, a time to prescribe, and screening (again) By feeds.bmj.com Published On :: Mon, 11 Nov 2019 11:51:44 +0000 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... Full Article
in Reversing our preconceptions about where innovation comes from By feeds.bmj.com Published On :: Thu, 14 Nov 2019 16:51:19 +0000 Reverse innovation may sound like some attempt to return to the dark ages - but it has a specific meaning, especially when it comes to med-tech. It’s about where we look for innovation - and overturning our preconceived ideas of where new ideas come from. Mark Skopec, and Matthew Harris - both from Imperial College London are two of the authors... Full Article
in Behind the campaign promises - GP numbers, and appointment slots By feeds.bmj.com Published On :: Fri, 15 Nov 2019 16:59:59 +0000 A UK general election has been called - polling day is on the 12th of December, and from now until then we’re going to be bringing you a weekly election-themed podcast. We want to help you make sense of the promises and pledges, claims and counter-claims, that are being made around healthcare and the NHS out on the campaign trail. This week has... Full Article
in Behind the campaign promises - Health and social care spending By feeds.bmj.com Published On :: Fri, 22 Nov 2019 16:21:30 +0000 A UK general election has been called - polling day is on the 12th of December, and from now until then we’re going to be bringing you a weekly election-themed podcast. We want to help you make sense of the promises and pledges, claims and counter-claims, that are being made around healthcare and the NHS out on the campaign trail. This week... Full Article