The healthcare landscape in the England is shifting, with cuts, competition and tendering some of the major changes. Secondary care must adapt to these, but how? Joining BMJ features editor Rebecca Coombes to discuss the issues are: Yi Mien Koh, chief executive of Whittington Health, London Jan Filochowski, chief executive of West Hertfordshire Hospitals NHS Trust Fergus Gleeson, divisional director of Critical Care, Theatres, Diagnostics and Pharmacy at Oxford University Hospitals Nigel Edwards...
Aug 27, 2013•22 min
Barack Obama saw his Affordable Care Act remain law last week, as the US Supreme Court ruled it is constitutional. Ed Davies (BMJ US news and features editor) talks to Janice Hopkins Tanne (freelance journalist based in New York) about the ruling’s implications. And what are the options for tackling childhood obesity? Li Ming Wen (research and evaluation manager at Sydney University) believes intervention needs to be early, and has demonstrated that giving new mothers simple nutrition messages r...
Aug 27, 2013•17 min
It seems the race to implement telehealth is on – the UK government’s response to its Whole System Demonstrator pilot has been very positive. But has it been over-hyped? We find out from Jennifer Dixon, Director of the Nuffield Trust, which has evaluated the pilot. Also, alcohol: beneficial or detrimental? Evidence shows it depends on what aspects of health you look at. Research published on bmj.com this week adds to the picture by looking at the association between alcohol consumption and the r...
Aug 27, 2013•22 min
It has been almost exactly a year since Anders Breivik bombed government buildings in Oslo, and then carried out a mass shooting on the island of Utøya, where he killed 69 people, mostly teenagers. In that time there has been much discussion about his mental state. Vivienne Nathanson and Julian Sheather from the BMA join us to discuss the moral and ethical problems that a diagnosis of insanity bring to the case. Also this week, seven articles on bmj.com look at the science behind sports product ...
Aug 27, 2013•15 min
Daniel Hackam, associate professor at Western University in Canada, explains how shift patterns can have a detrimental effect on the vascular health of workers. Also this week Seena Fazel, Wellcome Trust senior research fellow in clinical science at the University of Oxford, queries the predictive value of the risk assessment tools routinely used to predict violent behaviour
Aug 27, 2013•18 min
A feature this week asks "Should patients be able to control their own records?". The website renalpatientview.org allows patients to do exactly that. Neil Turner, a professor of nephrology at Edinburgh Royal Infirmary, explains how he and colleagues developed the resource. Also Steven Woloshin and Lisa Schwartz, authors of the "Not So Stories" column have turned their statistical scrutiny onto a recent advert by Susan G. Komen for the Cure®, the breast cancer charity. They explain how the case ...
Aug 27, 2013•22 min
This week we’ll hear why Donald Light, professor of comparative health systems research at the University of Medicine and Dentistry of New Jersey, thinks the innovation crisis in the development of drugs is more marketing rhetoric than reality. Also this week, a research paper on bmj.com looks at how subclinical psychological distress affects mortality. Tom Russ, Alzheimer Scotland clinical research fellow at the University of Edinburgh and one of the paper's authors, explains what they found....
Aug 27, 2013•22 min
Marion Nestle is the Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University. She has written widely about food and nutrition, and is an iconoclast in the world of food politics. In this podcast she explains how economic forces have changed the food industry, and how that change is fuelling the obesity epidemic.
Aug 27, 2013•15 min
Over the decades public health has had many incarnations. Geof Rayner and Tim Lang (Center for Food Policy) argue that public health today needs an overhaul, and to focus on our co-existence with nature and relationships with each other. They explain why, and how. Many of the issues Dr Rayner and Professor Lang are concerned about are being taken up by the People's Health Movement. Member Jonny Currie explains what he wants the movement to achieve, and others involved talk about actions they are...
Aug 27, 2013•19 min
In 2008 the rates of suicide in the UK began to increase. Is it a coincidence that this was also when the financial crisis hit? Ben Barr, research fellow in the department of Public Health and Policy at the University of Liverpool, explains what his study found. Those who've attempted to kill themselves once are at high risk of doing so again, but interventions to prevent this have been hard to find. Merete Nordentoft, professor at the Mental Health Centre Copenhagen, University of Copenhagen, t...
Aug 27, 2013•14 min
It's increasingly obvious that acutely ill patients have received less than gold standard care. Deficiencies in training are often blamed. Paul Frost, consultant in intensive care medicine at the University Hospital of Wales, takes us through the admission of an acutely ill patient. Also this week, BRCA mutations and ionising radiation both increase the risk of developing cancer, but how do these risk factors combine? Anouk Pijpe, an epidemiologist at the Netherlands Cancer Institute, explains t...
Aug 27, 2013•25 min
A BMJ head to head article this week asks: "Are the causes of obesity primarily environmental?" John Wilding, Head of the Department of Obesity and Endocrinology at the University of Liverpool, and Tim Frayling, professor of human genetics at the University of Exeter, argue their cases. Also this week, David Williams, a consultant obstetric physician at University College Hospital London, explains why pre-eclampsia is easily missed.
Aug 27, 2013•29 min
This week we concentrate on diabetes "The difference between insulin management in type 1 and type 2 diabetes is rather like the difference between driving a sports car and driving a lorry," says Edwin Gale, emeritus professor of diabetes at the University of Bristol. He tells us why this means the newer insulins that have benefits in the treatment of type 1 diabetes may not be as good for type 2. Sripal Bangalore, director of research at the New York University School of Medicine, discusses his...
Aug 27, 2013•22 min
Schemes which reduce emergency admissions sound like a good thing, but Martin Rowland, professor of health services research, Cambridge Centre for Health Services Research, University of Cambridge, explains how they can go off track. And Mabel Chew gets some advice on the prognosis of children with acute coughs from Matthew Thompson, a senior clinical scientist in the Department of Primary Care Health Sciences, Oxford University.
Aug 27, 2013•22 min
A head to head article this week asks: "Does celebrity involvement in public health campaigns deliver long term benefit?”. The British Heart Foundation’s Hands Only CPR campaign, featuring Hollywood actor Vinnie Jones, seems to be having positive effects. Maura Gillespie, head of policy and advocacy at the BHF, explains why. Also this week, care for the homeless is often fragmented and transient. A team at University College Hospital in London is trying to unite the disparate agencies involved t...
Aug 27, 2013•19 min
In the US, overly aggressive treatment is estimated to cause 30 000 deaths among Medicare recipients alone each year. Reporter Jeanne Lenzer has investigated the problem for the BMJ, and explains why she thinks profit driven healthcare is to blame. And, experience of treating rare conditions can take time to build. Rej Bhumbra, a surgical trainee in orthopaedic oncology, explains how his time in India fast tracked his learning.
Aug 27, 2013•15 min
Bariatric surgery is under scrutiny from NCEPOD, the National Confidential Enquiry into Patient Outcome and Death, Ian Martin, NCEPOD's clinical co-ordinator for surgery, takes us through the highlights of its latest report. Also this week, Julie Paik, instructor and physician at Harvard Medical School, tells us about a new risk factor for primary hyperparathyroidism. And finally, some neuromuscular agents may lead to respiratory complications after surgery. Matthias Eikermann, director of resea...
Aug 27, 2013•25 min
Deborah Cohen explains how a joint BMJ and Daily Telegraph investigation helped uncover problems with device regulation in Europe. Previous research has shown smoking reduces life expectancy by about a decade, but only by four years if you are Japanese. Sarah Darby, from the University of Oxford, explains why her new research shows they are actually just as unhealthy as their British counterparts.
Aug 27, 2013•18 min
Rajiv Chowdury, a research associate from the Department of Public Health and Primary Care at the University of Cambridge, explains why eating whole fish is better than fish oil - at least when it comes to cerebrovascular disease. Also this week Peter Doshi and Tom Jefferson from the Cochrane Collaboration talk about the BMJ's open data campaign, and how publishing correspondence with Roche, the WHO and Centers for Disease Control and Prevention might reveal the missing data on Tamiflu.
Aug 27, 2013•20 min
This week, Al Mulley, Dartmouth Center for Health Care Delivery Science, and Tessa Richards, BMJ associate editor, discuss the silent misdiagnosis: that of patient preferences. Removing pre-cancerous cells spotted through screening is the foremost defence against cervical cancer. However, a recent BMJ paper has shown that women who go through this have a fourfold risk of going on to develop cancer compared to women who’ve only ever had normal smears, even if they complete follow up and are given...
Aug 27, 2013•19 min
Last year 125 people died in Pakistan after taking contaminated cardiac medication. The disaster is one example of the dangers of counterfeit and substandard medicines, an issue the WHO is struggling to control. In this podcast we hear from Amir Attaran, Canada research chair in law, population health, and global development policy at the University of Ottawa, on the international wrangling he sees at the political level. And Sania Nishtar, president of Heartfile, an independent think tank based...
Aug 27, 2013•18 min
Lasse Krogsbøll, from the Nordic Cochrane Centre, explains research into whether general health checks improve mortality and morbidity in the population. Also, the European Medicines Agency (EMA) this week announced plans to make trial data used as the basis for its decisions publicly available. BMJ Deputy editor Trish Groves finds out more from some of the key players in the campaign for open data.
Aug 27, 2013•16 min
Helen Macdonald, assistant editor at the BMJ, talks to Neil Marlow, professor of neonatal medicine at University College London, about his update to the EPICure study looking at outcomes for extremely premature babies. Jane Feinmann talks to writer and surgeon Atul Gawande, about Lifebox – which has been chosen again as the BMJ’s Christmas appeal for 2012.
Aug 27, 2013•30 min
Is too much oxygen a good thing? Christine Roffe, consultant physician, Stoke Stroke Research Group, North Staffordshire Combined Healthcare NHS Trust, talks Mabel Chew, BMJ associate editor, through the evidence for routinely treating stroke patients with oxygen. And Russell Gruen, professor of surgery and public health, Alfred and Monash University, Melbourne, explains how and when tranexamic acid should be used after trauma.
Aug 27, 2013•20 min
Many patients are following a wheat free diet, which they believe helps with their gastrointestinal symptoms, yet they don't exhibit markers of coeliac disease. Mabel Chew finds out from David Sanders, a professor of gastroenterology at the Royal Hallamshire Hospital, about non-coeliac gluten sensitivity. Also, Fiona Godlee gives us an update on the open data campaign.
Aug 27, 2013•16 min
We know that speed bumps have an important public health role, but a Christmas BMJ paper shows they're also clinically useful, and can help diagnose appendicitis. Helen Ashdown, academic clinical fellow in general practice, University of Oxford, and Mike Puttick, consultant surgeon, Stoke Mandeville Hospital, explain. And want to know how many carrots you need to eat to balance out that festive champagne? David Spiegelhalter, Winton professor for the public understanding of risk, University of C...
Aug 27, 2013•20 min
The final article in the analysis series examining prison health in England and Wales is published this week. To sum up, Francis Crook, Director of the Howard League for Penal Reform - the UK's oldest charity examining prison conditions - joins us to discuss prison reform. Also this week, Myasthenia gravis; Jennifer Spillane, clinical research associate at the Institute of Neurology in London, explains why it's easily missed.
Aug 27, 2013•23 min
You may well assume that a programme supported by organisations such as the World Bank and the World Health Organization does what it says on the tin. However, it turns out this is not the case with deworming initiatives in countries such as Africa and India. Paul Garner, co-author of the Cochrane review on the topic, explains what's going on. And Michael Wilson, instructor of medicine at the Mayo Clinic, gives us some advice on diagnosing Klinefelter's syndrome.
Aug 27, 2013•19 min
The authors of the recent meta-analysis on dietary sugar and body weight, Lisa Te Morenga, and Jim Mann, from the Departments of Human Nutrition and Medicine at the University of Otago, join us to discuss their findings. Also this week, the BMA wants doctors to be more involved in influencing policy on recreational drugs. Vivienne Nathanson, its director of professional activities, explains its new report, and how individual testimony can combine to convince governments to change policy....
Aug 27, 2013•18 min
An epidemiological investigation on bmj.com discusses the first probable case of human to human transmission of novel avian influenza A (H7N9). The author of the accompanying editorial, James Rudge, from the London School of Hygiene and Tropical Medicine, explains what this means for public health. Also this week, we know that standardised mortality rates are tricky and have to be interpreted carefully. David Spiegelhater, Winton Professor for the Public Understanding of Risk at the university o...
Aug 12, 2013•18 min
