Nudging seemed to be all the rage a few years ago - a way of changing individual behaviours to help people make better choices, about their diet, exercise and other habits. A lot of hype ensued, the UK government under Tony Blair even set up a “nudge unit” - but questions were asked about the efficacy of the approaches used, confusion about what a nudge actually was, and how to turn it into actual scalable change have followed the discipline. In this podcast Craig Fox, behavioural scientist at U...
Sep 21, 2020•27 min
Dr Anthony Fauci needs no introduction, as head of the NIAID for almost four decades, and the U.S. government's leading advisor on infectious diseases, and leader in the country's response to Covid-19. In this interview with The BMJ, Dr Fauci covers parallels in his experience in the HIV/AIDS crisis with this latest public health emergency. He talks about how his understanding of Covid-19 has changed. We also tackle the reports of political intrusion into the CDC and, address worries about the r...
Sep 18, 2020•33 min
Fatphobia has been described as society’s last ‘ism’. Whilst our understanding of weight and health has changed over time, there is still a stigma towards people who are overweight or obese, and an assumption that they must be unhealthy, and unhealthy by choice. However, the correlation between weight and health may not be as clear cut as our societal biases would lead us to believe, and, therefore, the challenge for GPs is to make a conscious efforts to overcome our preconceptions so that they ...
Sep 10, 2020•59 min
The social norms that guide our behaviour in the world aren’t often quick to change - but the imperative to wear a mask in public has rapidly taken hold, establish by law, but policed by the public. Mask shaming is a new phenomenon, but in this podcast, Brandy Schillace, author, historian and editor in chief of Medical Humanities (a BMJ journal) joins Cat and Abi to discuss how ineffective shaming is as a tool for behaviour change, and what mask-shaming reveals about the ways in which society tr...
Sep 05, 2020•30 min
There are have been local lockdowns in the UK, in places such as Oldham, Birmingham, Manchester – but what is the criteria for making that decision? In the non-Covid world: does honey alleviate symptoms in upper-respiratory tract infections? When does unexpected weight-loss warrant further investigation for cancer in primary care? Plus, in the light of findings from the Cumberlege review of safety in medical devices, the team discuss the issue of doctors’ declaration of interests.
Aug 28, 2020•33 min
Contraceptive pill check-up appointments used to be simple and straightforward for GPs, and frequently felt like a welcome reprieve from more complex consultations. However, there’s often more to them these days, especially given the rise in tailored regimens, with more and more women moving away from the standard of 21 pills followed by a 7-day break. In this week’s episode, we discuss common misconceptions around the pill cycle compared with a woman’s natural cycle, the various side effects ca...
Aug 28, 2020•59 min
In Australia, a staggering 25% of doctors have had thoughts of suicide in the past 12 months, a recent survey said. Mental health problems are higher in medicine than any other job – and yet healthcare professionals are still stigmatised for seeking help. Partly in response to his own struggles, Geoff Toogood, a cardiologist in Melbourne, started an ingenious campaign called CrazySocks4Docs to highlight the issue. https://www.crazysocks4docs.com.au/
Aug 21, 2020•30 min
Trisha Greenhalgh, professor of primary care health sciences at the University of Oxford has been a powerhouse of covid-19 evidence synthesis. She pulled together advice on doing remote consultations, on wearing masks to prevent spread, and a host of other information. She’s now turning her attention to “long-covid” - as we learn more about the disease, it’s becoming apparent that it’s not just an acute infection, patients are reporting chronic long term consequences of having the virus. In this...
Aug 20, 2020•29 min
1.00) Carl has been looking at PCR testing, and explains why it picks up both viable SARS-cov-2, but also fragments of it’s RNA - leading to potential over diagnosis. (8.50 ) What did the Living systematic review and accompanying guidelines say about treatment options for covid-19 (14.35) Helen talks to Reed Siemieniuk, general internist from McMaster University, about creating a living network meta-analysis, to try and synthesis all the evidence on covid-19 (22.48) Helen also talks to Bram Roch...
Aug 15, 2020•43 min
Interest in vitamin D, and it’s association with a range of health outcomes continues - at least if the regular flurry of papers on the subject that are submitted to The BMJ are anything to go by, and with Covid-19, interest has piqued again. GPs are regularly asked to prescribe it, and to test for deficiencies. Low levels of vitamin D are associated with a large number of health outcomes, but, given the high costs and low accuracy of tests, would it be easier just to recommend taking supplement...
Aug 13, 2020•1 hr 1 min
Fresh outbreaks of covid in Europe and a wave of infections in the United States have been in the news this week, highlighting the renewed need for social distancing – but to what extent? In this edition, we explore the real-world evidence for physical distancing measures as well as the research into whether or not facemasks make us behave more recklessly. We also discuss the non-covid themes of research transparency and a BMJ investigation into the lucrative business of orphan drugs.
Jul 31, 2020•41 min
In light of the publication of the Independent Medicines and Medical Devices Safety Review (the Cumberlege report) in early July, which assessed the use of vaginal mesh, sodium valproate and Primodos and their associated under-acknowledged complications, this week we discuss trust between patients and doctors, and how that relationship of trust can break down when patients feel that their concerns and their pain are not being recognised and supported. We talk about the influence of racial inequa...
Jul 31, 2020•49 min
Lockdown has been such a stressful period that many healthcare professionals developed abnormal behaviours to cope. Addiction is one such behaviour, be it to a substance – alcohol for example – or any other obsessive activity like exercise. Dr Caroline Walker, an NHS psychiatrist and therapist who has personal experience of addiction discusses the harmful behaviours to look out for and what to do about them.
Jul 30, 2020•26 min
This time of year we would usually be doing some podcasts from the BMJ awards - but the pandemic has delayed our plans. We’re still working on acknowledging some of the best medicine from around the UK, but in the meantime we’ve decided to give out the awards for outstanding contribution to health, and research paper of the year. In the following interview, Fiona Godlee - the BMJ’s editor in chief, talks to Marian Knight, lead author of the ANODE trial - The BMJ's research paper of the year. For...
Jul 25, 2020•21 min
This time of year we would usually be doing some podcasts from the BMJ awards - but the pandemic has delayed our plans. We’re still working on acknowledging some of the best medicine from around the UK, but in the meantime we’ve decided to give out the awards for outstanding contribution to health, and research paper of the year. In the following interview, Fiona Godlee - the BMJ’s editor in chief, talks to David Pencheon, director of the NHS sustainability unit about his work. For more about Th...
Jul 25, 2020•31 min
As the pandemic play out, we’ve seen ways in which the collection of covid data - and it’s sharing, has been flawed, with reports in the UK that local authorities haven't got granular data, and in the US that the CDC is being circumvented for data reporting. Kathleen Bachynski, assistant professor of public health at Muhlenburgh College, and Sridhar Venkatapuram, director of global health education & training at King's College London join us to discuss why data is fundamental to the social c...
Jul 22, 2020•31 min
Vaccines have been in the news this week - but when you dig into the stories, it turns out that the hype is about phase 1 trials. We're a long way from being sure any of the 150 possible vaccines being developed actually work. In this talk evidence we're talking to a researcher, a regulator, and a manufacturer about the way in covid-19 is upending normal vaccine development, which hurdles they'll have to reach to get onto the market, and how we'll know which one to choose when they are there. Th...
Jul 17, 2020•37 min
The signs and symptoms of racism have long permeated our society, and are embedded in our clinical practice and medical education. Recent events in the US, including the murder of George Floyd, have brought the Black Lives Matter movement to the fore of public consciousness, and have sparked outrage and protests in countries around the world. COVID-19 has exposed the inequalities in our healthcare systems, as the virus has had a disproportionate impact on some ethnic minority communities. In thi...
Jul 16, 2020•1 hr 3 min
A series of medical scandals prompted Jeremy Hunt, former UK health secretary to launch the Independent Medicines and Medical Devices Safety Review - with the explicit aim of strengthening the patient voice in order to help build a "system that listens, hears and acts – with speed, compassion and proportionality" That report is out, and describes a system that does anything but. In this podcast, Sir Cyril Chantler, the review's vice chair discusses their recommendations, for better regulation, t...
Jul 15, 2020•29 min
US President Donald Trump has been pushing hard for an American vaccine against Covid-19. He's named the program Operation Warp Speed, which has many people worried that safety tests will be rushed. What are the prospects for an American vaccine against Covid-19? If the US is first, will it make its vaccines available to other countries? And what if it's not first? Three American vaccine experts talk with the BMJ about prospects for an American vaccine against the new coronavirus. Joining us are...
Jul 10, 2020•37 min
We all know that healthcare professionals are stretching themselves to provide the care that’s needed right now. But there are instances when you might find yourself out of your comfort zone or being pushed too hard or fast. When is it ok to say no to these demands? We spoke to Kate Burnett who educates NHS staff on empowerment about how to voice your position clearly and how to reconcile the guilt you might feel of letting the side down. www.bmj.com/wellbeing
Jul 08, 2020•35 min
In this week's Talk Evidence we're hearing about how the death rate has dropped below average, disappointment about HIV drugs for covid-19 treatment, a trial to reduce polypharmacy, and why academic promotions matter to everyone else. 1.35 - Carl gives us one of his death updates 3.30 - Helen asks if it’s finally time to be able to do the international comparisons we’ve been waiting for? 16.10 - New research suggests that extreme PPE prevents transmission - but PPE came with a whole range of oth...
Jul 03, 2020•45 min
The relaxation of the COVID-19 lockdown regulations is raising a lot of questions, both for doctors and for patients. This week, we discuss how the lack of clarity and coherence in public health messages over the past few months has caused anxiety and confusion for our patients, especially those who have been told to shield. We talk about GPs tailoring shielding advice to suit the individuals they treat, the politicisation of mask wearing, and the flaws of ‘abstinence-only’ health messaging. How...
Jul 02, 2020•54 min
For a long time, the BMJ has been interested in conflicts of interest and how that skews the research base. We also heard in our podcast on "Big Tan" that science is being used to sow seeds of doubt into the association between sunbeds and skin cancer, by scrutinizing the minutiae of a research paper, but ignoring it's bigger message. Now it's all just happening in medicine. This is an industry tactic. And to talk about that we're joined by David Michaels - who was the longest serving head of th...
Jul 01, 2020•38 min
In the third part of our series of podcasts “Corona Virus as Seen Through a US Lens,” features editor for The BMJ, Joanne Silberner, talks to Dr. Adeline Goss about the experience of being a new mom and a hospital resident during the crisis. In The BMJ, Dr Goss recently wrote about the challenges facing medical residents as they deal with working during the virus. When she went on maternity leave a few months ago, nothing seemed amiss, beyond the normal stress of being a new mom. But when she re...
Jun 26, 2020•18 min
This week we're looking beyond the press release for dexamethasone, the long awaited review of antibody testing, and how well people are recovering after surviving acute covid-19. (2.36) The preprint for dexamethasone is finally out - considerably after the press release. Carl digs into it to find out how good the news actually is. (8.49) There are a couple of newly published systematic reviews on antibody testing, so we return to our testing guru Jon Deeks - professor of biostatistics at the Un...
Jun 25, 2020•39 min
Earlier this year, the bmj published a racism in medicine issue - the issue was guest edited by Lord Victor Adebowale, chief executive of the NHS Confederation and Professor Mala Rao, professor of public health at Imperial College London. At the event to launch the issue, they managed to persuade Simon Stephens , chief executive of the NHS, to put money into a “race in health observatory” Mala joins us to talk about what that observatory is going to do, how it will maintain independence, it's ro...
Jun 17, 2020•24 min
In this week’s episode, our focus is on what the post-COVID world of general practice might look like. The pandemic has exposed the inequalities in our social and healthcare systems, but has also given GPs some much-needed headspace to reflect on changes to make going forward. Will we be able to turn general practice off and on again, like a faulty computer? Will we just drift back to the status quo, or will we seize this opportunity to shake up the old routines in order to redefine the role of ...
Jun 17, 2020•1 hr 6 min
At the end of May, the WHO said that South America has become the new epicentre of the covid-19 pandemic. The majority of those with covid are in Brazil - not entirely surprising given it is the most populous - but in neighbouring Peru, numbers are growing too. And it’s to Peru that we turn to talk to our guest today, Valerie Paz-Soldan is a social scientist and director of the Tulane Health Office for Latin America - part of the university’s school of public health and tropical medicine. She jo...
Jun 15, 2020•20 min
n normal times, around this time we’d start thinking about weekend breaks and summer holidays abroad. More than most healthcare staff and other key workers are in dire need of time out. Given the uncertainties around foreign travel, how can we recreate in some way that holiday feeling. Simon Calder, travel correspondent for The Independent newspaper, offers his staycation tips and alternative travel advice.
Jun 15, 2020•21 min
