How involved are doctors in the non medical aspects of patient care? An analysis on bmj.com this week examines the problem of nutrition and fluid balance in hospitalised patients. Helen Macdonald, a junior doctor and editor at the BMJ, asks Richard Leach, clinical director of Guy's and St Thomas' NHS Foundation Trust, about how it should best be handled. Also this week, a summary of the BMJ round table on the future of primary care, which is available in full on the podcast page.
Aug 07, 2013•22 min
Of the myriad of clinical decision support tools, what features actually improve patient outcomes? Pavel Romanov, medical student at Western University in Canada, discusses his research. Also this week: Is it feasible to get governments to consider the public health impact of every policy decision they make? Politicians in Wales have drafted legislation to make the devolved nation the first in the world to implement this WHO recommendation. Adam Fletcher, senior lecturer in social science and he...
Aug 07, 2013•18 min
In the wake of the Francis report, the BMJ gathered experts to discuss compassion in the health service. This is the discussion in full. Taking part are: Domhnall MacAuley, BMJ primary care editor Anthony Silverstone, consultant at UCH Peter Carter, chief executive for the Royal College of Nursing Jocelyn Cornwall, director, The Point of Care programme, The King's Fund Joanne Watson, consultant at Musgrove Park Hospital Sean O'Brien, head of the patient experience group at Musgrove Park Hospital...
Aug 07, 2013•39 min
If patients living in one area have more diagnoses than those living in another, use more care, but have similar mortality rates, you would think they were simply sicker, but that the extra care they were receiving must be good and making them better. Not so, says new research published on bmj.com. John Wennberg, emeritus professor of community and family medicine at the Dartmouth Institute in the US, joins us to explains how this flawed logic is harmfully perpetuating overdiagnosis and variatio...
Aug 07, 2013•17 min
Andrew Witty is the CEO of GlaxoSmithKline. He’s been credited with taking on a pharma company with a history of behaving badly in the past – as shown by a record $3bn fine levied by the US government last year. How much is he able or willing to change the culture of an industry, which is under pressure to alter its practices? Rebecca Coombes finds out. Also this week, Michael Dowling, president and CEO of the North Shore-LIJ Health System in New York, has built his organisation up from two hosp...
Aug 07, 2013•19 min
Recorded at the recent Nuffield health policy summit, this round table asks how to impliment the Francis reports recommendations. Taking part were: Robert Francis, chair of The Mid Staffordshire NHS Foundation Trust Public Enquiry Simon Stevens, president of global health at the UnitedHealth Group Sam Barrell, chief clinical officer of South Devon and Torbay CCG Niall Dickson, CEO of the General Medical Council Stephen Dorrell MP, chair of the HOC Health Select Committee Nigel Edwards, director ...
Aug 06, 2013•49 min
Are all calories equal? Thermodynamics would say that energy is energy, be it derived from carbohydrate, fat, or protein. But things get more complicated when appetite is taken into consideration , says Robert Lustig, professor of pediatric endocrinology at the University of California, San Francisco. Also this week, life expectancy in Europe is increasing, but at the same time health inequalities are widening. Claudia Stein, director of the Division of Information, Evidence, Research, and Innov...
Aug 06, 2013•23 min
A clinical review this week looks at the diagnosis and treatment of carotid atherosclerosis, including when to screen and the threshold for intervention. Alun Davies, professor of vascular surgery at Imperial College London, also answers how useful or harmful screening offered commercially is. Also this week, the BMJ’s editorial board met to discuss how patient participation should be represented and encouraged by the journal. We captured some of their views.
Aug 06, 2013•20 min
The issues of hidden data are well known, and the BMJ’s open data campaign page documents some of the problems which have arisen as a result of clinical trial data remaining undisclosed. At Evidence Live 2013 in Oxford this week, Fiona Godlee, BMJ editor in chief, convened a group of those closely involved with the AllTrials campaign, to discuss where we are now and what still needs to be done
Aug 06, 2013•15 min
The World Health Organization has chosen hypertension as the public health threat it will focus on for the next year. The problem is particularly pressing in India, and Anita Jain, the BMJ's India editor, spoke to François Decaillet, Coordinator for Health Programs, WHO India, about what needs to be done to tackle hypertension in the country's population.
Aug 06, 2013•13 min
Delirium is often missed in primary and secondary care. Edison Vidal, assistant professor in internal medicine at the Universidade Estadual Paulista, Brazil, advises on diagnosing and managing the condition. Rheumatoid arthritis, non-biological drug treatments, or both, might suppress tumour surveillance and in theory increase the risk of melanoma. Pauline Raaschou, consultant in clinical pharmacology at the Karolinska Institutet, Sweden, explains what she found while investigating the associati...
Aug 06, 2013•21 min
This week, we discuss how Australia’s national human papillomavirus (HPV) vaccination programme has caused a dramatic drop in genital warts. Does this foretell elimination of all disease caused by HPV in the country? And some advice on how to diagnose and manage pulmonary hypertension.
Aug 06, 2013•28 min
Patients are increasingly going online to find and discuss information about their condition. What are they getting on the web that they’re not getting from clinicians, and how is this changing healthcare? Also, how to care for a dying patient in hospital.
Aug 06, 2013•27 min
Mabel Chew, practice editor at the BMJ, talks to Tushar Kotecha, a cardiology specialist registrar at Charing Cross Hospital in London, about when to suspect heart failure, and how to diagnose the condition.
Aug 06, 2013•14 min
The BMJ Awards were held last Thursday. Fiona Godlee, the BMJ's editor in chief, announced that the Britain Nepal Otology Service (BRINOS) was named Medical Team of the Year. BRINOS (brinos.org.uk) started out in 1988 by setting up joint British and Nepalese surgical camps to treat ear disease among patients living outside the reach of hospitals in the capital of Kathmandu. A national survey in 1991 found that among the 19m people in Nepal, 2.7m were deaf and 1.5m had abnormal ear drums indicati...
Aug 06, 2013•10 min
In a drive to improve safety, many cyclists now wear helmets. But how useful is legislation that mandates their use when compared with all the other safety initiatives available? Jessica Dennis, a PhD candidate from the Dalla Lana School of Public Health at the University of Toronto, tells us about her research into accident trends. Also this week, doctors play a key role in spotting when a vulnerable person is experiencing abuse, but it can be difficult to know how to tackle the issue. A clinic...
Aug 06, 2013•20 min
Until now, the increased risk of cancer from CT scans has been modelled from the data gathered from survivors of the Hiroshima and Nagasaki bombings. However, new BMJ research, based on a large Australian cohort, offers new evidence to support the modelling. John Matthews, from the university of Melbourne, joins us to explain what they found. Also this week, social media is relatively new – but did you realise that doctors had been using social networks to improve health for centuries? Enrico Co...
Aug 05, 2013•19 min
This month the UK parliament has been looking at the big accountancy firms' involvement in drafting tax laws. Conversely, the Department of Health has hidden the involvement of tobacco lobbyists in proposed plain packaging legislation. Jeff Collin, professor of global health policy at the University of Edinburgh, argues that this culture of industry participation is worrying, but the lack of transparency by government is even worse. Also this week, what day of the week is safest for surgery? Pau...
Aug 05, 2013•14 min
Despite repeated calls to prohibit or limit conflicts of interests among authors and sponsors of clinical guidelines, the problem persists. Jeanne Lenzer explains what's going wrong. And is giving birth at home as safe for the mother as giving birth in hospital? New research from the Netherlands suggests that it is, and that risk assessment is key.
Aug 05, 2013•19 min
This week, the World Health Organisation called for healthcare providers to be more aware of intimate partner and sexual violence against women, calling it a "global health problem of epidemic proportions." We look into what doctors need to know. And we discuss advice on diagnosing and treating first trimester miscarriage.
Aug 05, 2013•26 min
Recent research shows that some non-steroidal anti-inflammatory drugs increase cardiovascular risk in some patients. Given their widespread use, and breadth of indications for prescription, should clinicians be more circumspect about their practice? In this podcast, Mabel Chew BMJ's practice editor, talks to Richard O'Day, professor of clinical pharmacology at the University of New South Wales and author of a recent therapeutics article, about the latest research on NSAIDs
Aug 05, 2013•18 min
Last week saw the start of a campaign to publish patient death rates for individual surgeons. Bruce Keogh, medical director of the NHS in England, talks to BMJ editor in chief Fiona Godlee about the initiative and the background to it. Also, the WHO has launched its Guidelines and Global Progress in HIV/AIDs report. Anne Gulland interviews Gottfried Hirnschall, a Director of the WHO’s HIV/AIDS Department, and his his scientist colleague, Philippa Easterbrook.
Aug 05, 2013•33 min
This week a head to head article asks: "Does adding routine antibiotics to animal feed pose a serious risk to human health? The authors David Wallinga, a physician member of the steering committee of Keep Antibiotics Working: the Campaign to End Antibiotic Overuse in Animal Agriculture, and David Burch, a veterinarian and consultant on antibiotic use in agriculture from Octagon Services, argue their sides. Also this week, a BMJ investigation looks at changes in rationing patterns in the new NHS ...
Aug 05, 2013•29 min
This week, we look at how to help patients have better deaths at home. BMJ assistant editor Sophie Cook talks to Emily Collis, a consultant in palliative medicine and the author of a recent clinical review about caring for dying patients in the community. BMJ columnist Des Spence, a GP in Glasgow, explains why the dying deserve better from GPs.
Aug 05, 2013•21 min
Blood transfusion is an essential part of modern healthcare and can be lifesaving when used appropriately. In this podcast, Sophie Cook, The BMJ's clinical reviews editor, talks to Michael Murphy, consultant haematologist and professor of blood transfusion medicine at NHS Blood and Transplant at the John Radcliffe Hospital, Oxford, about best practice for the safety of patients receiving blood; including ways to reduce unnecessary transfusion, and the warning signs of an adverse reaction.
Aug 05, 2013•14 min
Plain packaging on tobacco products is the latest strategy aimed at reducing smoking. Campaigners had hoped the UK would follow Australia’s example. But they have been disappointed as the UK government postpones the plans until “more evidence” is available. We hear from Linda Bauld, professor of public policy at the University of Stirling, about why she thinks the current evidence is convincing enough. Also this week, one of the most difficult consultations a doctor can have doesn’t involve a co...
Aug 05, 2013•27 min
