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 Edinburgh, and published on bmj.com, looks at where the World Bank has come. The series is , and the articles will cover; Why the World Bank matters to globa...
Sep 01, 2017•19 min
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 Edinburgh, and published on bmj.com, looks at where the World Bank has come. The series is , and the articles will cover; Why the World Bank matters to globa...
Sep 01, 2017•17 min
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 Edinburgh, and published on bmj.com, looks at where the World Bank has come. The series is , and the articles will cover; Why the World Bank matters to globa...
Sep 01, 2017•17 min
In our last podcast from Preventing Overdiagnosis 2017, we convened an impromptu roundtable of clinicians who are attending the conference to see how some of the big themes that were discussed at the conference are going to impact their everyday practice. Joining us were; Jessica Otte - Family physician from Canada David Warriner - Cardiologist from the UK. Jack O’Sullivan - Junior doctor from Australia Imran Sajid - GP from the UK To read more, have a look at our Too much medicine campaign - bm...
Aug 24, 2017•24 min
This week we’re at the over diagnosis conference in Quebec Canada, Preventing overdiangosis is a forum to discuss the harms associated with using uncertain methods to look for disease in apparently healthy people - and is part of the BMJ’s too much medicine campaign. One of the ways in which the public’s attitudes and wishes around health is measured are citizen or community juries - set up in a similar way to a criminal jury - with an information gathering, and a deliberation phase - recently o...
Aug 19, 2017•15 min
The Preventing overdiagnosis conference covers how physicians, researchers and patients can implement solutions to the problems of over diagnosis and overuse in healthcare. If you’re a doctor on twitter, you’ve probably come across our guest - Vinay Prasad, assistant prof. of medicine at Oregon Health and Science University, and author of the book Ending Medical Reversal.
Aug 19, 2017•32 min
This week we’re at the Preventing Overdiagnosis conference in Quebec Canada, The conference is a forum to discuss the harms associated with using uncertain methods to look for disease in apparently healthy people - and is part of the BMJ’s too much medicine campaign. The literature on overdiagnosis has mostly been published since 2013 - partly because of The BMJ, but in large part because of the work of Rita Redberg, professor of clinical medicine, and a working cardiologist, at UCSF, and editor...
Aug 18, 2017•22 min
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 people conceptualise the risks of too much medicine. Read Stacy's full essay: http://www.bmj.com/content/358/bmj.j3872
Aug 17, 2017•24 min
This week the annual Preventing over diagnosis conference is happening in Quebec, Canada. The conference is put together with a wide range of partners, including The BMJ, and aims to tackle the some of the problems of Too Much Medicine. To kick off our content for the conference, this week we’ve published an article looking at some of the drivers - and hence potential solutions for over diagnosis. Two of the authors of that paper. Thanya Pathirana, and Ray Moynihan, both from Bond University’s C...
Aug 16, 2017•18 min
Loss of a loved one can be very painful. When seeking support, some people turn to their doctor. Because of their pivotal role in the community, physicians can provide excellent support for bereaved people and can often direct them to additional resources. Katherine Shear, a physician, and Stephanie Muldberg, a bereaved mother, join us to discuss how grief can play out in the consultation, and explain the importance of doctors acknowledging the death of a patient's loved one. Read their full pra...
Aug 03, 2017•26 min
If you’ve listened to more than one of our podcasts, you’ll probably be aware of the problem of the opacity of clinical trial data - trials which are conducted by never see the light of day, or results within those trials which are never published. Pharmaceutical companies have their own policies on what they are willing to make public, when, and for the first time a new audit, published on bmj.com, collates and analyses those policies. To discuss that study I’m joined by two of the authors - Be...
Jul 28, 2017•32 min
Mike Richards is well known in the UK - former Cancer Tzar, he now heads up the Care Quality Commission - regulator of all health and social care services, and therefore the body responsible for inspecting hospitals and GP practices. In this interview, BMJ’s head of news and views, Rebecca Coombes went to the CQC’s headquarters in London, and spoke to Mike Richards - who defends the record of hospital inspection on his watch. This is an edited version of the interview - read the full write up: h...
Jul 28, 2017•20 min
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 - specifically, do e-cigarettes help people quit tobacco? Professor Shu-Hong Zhu, Director of the Center for Research & Intervention in Tobacco Control at th...
Jul 27, 2017•25 min
The increase in life expectancy in England has almost “ground to a halt” since 2010 and austerity measures are likely to be a significant contributor. In this podcast Michael Marmot, director at University College London’s Institute of Health Equity, joins us to discuss what might be causing that drop off, and why a decrease in early life chances is particularly problematic. Read more about the report: http://www.bmj.com/content/358/bmj.j3473
Jul 21, 2017•30 min
The BMJ has been campaigning for an end to “too much medicine” - the pernicious effect of marketing on the range of tests and treatments that doctors offer patients - tests and treatments which are motivated by the financial reward to the system, than the health of the individual. A new analysis on BMJ.com takes a look at what’s happening in the the first part of that - testing. New biomarkers for disease, and new ways of monitoring, have the potential to diagnose disease more quickly, but is th...
Jul 18, 2017•18 min
Earlier this year, the WannaCry ransomeware attack took control of computers in 40 NHS trusts, blocking access to the data held on them. This wasn’t the first time that NHS computers had been infected by malware, but it brought the danger of cyber attack into the consciousness of doctors and patients. In this podcast we hear from two people who have been thinking hard about cyber security in the NHS - James Kinross, a surgeon and lecturer at Imperial College London, and Chris Hankin, director of...
Jul 14, 2017•37 min
The FDA faces perpetual criticism that it is too slow in it’s approval process for getting drugs to market, but one former FDA employee Tom Marciniak, and one professor, Victor Serebruany from Johns Hopkins University have analysed that process and disagree. Tom Marciniak has been a commentator on the approval process, both critical of industry and the FDA in The BMJ - and in this interview he talks about that process, his new analysis, and how he thinks we could be more sure about the safety an...
Jul 11, 2017•22 min
Twenty years ago the statistician Doug Altman railed against, “The Scandal of Poor Medical Research,” in an editorial in The BMJ. 10 years later, Iain Chalmers and Paul Glaziou calculated that costs $170 billion annually in wasted research grants. In this podcast, recorded at Evidence Live, we spoke to Altman and Chalmers about their campaigns to improve the design, conduct, and reporting of clinical trials, and why that level of waste still occurs. Reward Alliance - http://rewardalliance.net/ E...
Jul 07, 2017•27 min
The Alzheimer’s society, in the UK, predicts that if the rates of dementia remain constant there’ll be 1.7 million people in the country living with the condition by 2050. We also know that things like improvements in cardiovascular health are changing those rates. New research published on bmj.com attempts to model what the outcomes of those changing factors might be, and Sara Ahmadi - Abhari, a research associate in the Department of Epidemiology and Public Health at the University College Lon...
Jul 05, 2017•20 min
Two articles published on the bmj.com aim to help doctors treat patients who request support with their gender identity. Firstly a practice pointer on how to refer to gender clinic, and secondly a What Your Patient Is Thinking article about trans people's experiences in the healthcare system. In this podcast, two of the authors of that patient experience article, Emma-Ben and Reubs, join us to discuss identity, pronouns and what genderqueer means. I am your trans patient http://www.bmj.com/conte...
Jun 30, 2017•31 min
Findings from a range of prospective cohort studies based around the world indicate that higher intelligence in children is related to a lower risk of all cause mortality in adulthood - and now a new study, published on bmj.com, is trying to dig into that association further, with a whole population cohort and data on cause specific mortality. Ian J Deary, professor of differential psychology at the University of Edinburgh and one of the authors of that study, joins us to discuss what this tells...
Jun 29, 2017•19 min
"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 care for patients.” Evidence is in crisis, and Carl Heneghan, director for the Centre for Evidence Based Medicine, and Fiona Godlee, editor in chief of ...
Jun 23, 2017•42 min
Stress is one of the leading causes of work absence, recently overtaking back-pain, and an increasing part of a GPs workload. However good quality evidence about how to deal with stress is hard to come by. Alexis Descatha, an occupational/emergency practitioner, at the University hospital of Poincaré, gives some practical advice on what to do when you suspect stress is the underlying cause of a consultation, and what to do once you have confirmed that. Read the full practice article: http://www....
Jun 16, 2017•17 min
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 Russel-Jones dermatologist and chair of Help Rescue the Planet - joins us to discuss what should be done to tackle the problem. Read the full analysis: http://w...
Jun 15, 2017•14 min
The 2014 west African Ebola epidemic shone a harsh light on the health systems of Guinea, Liberia, and Sierra Leone. While decades of domestic and international investment had contributed to substantial progress on the Millennium Development Goals, national health systems remained weak and were unable to cope with the epidemic. Margaret Kruk associate professor of global health at the Harvard TH Chan School of Public Health, joins us to discuss what makes a health system resilient, and how Liber...
Jun 08, 2017•27 min
A new study on BMJ.com, examines the effect of moderate drinking on brain structure. We know that heavy drinking has a deleterious effect on our brains, and is linked to dementias. However, for sometime it’s been thought that moderate drinking is actually protective. Anya Topiwala, clinical lecturer in old age psychiatry at the University of Oxford, joins us to discuss the association between alcohol consumption and those structural elements. Read the full research: http://www.bmj.com/content/35...
Jun 07, 2017•15 min
The rapid changes in the global environment have led many scientists to conclude that we are living in a new geological epoch—the Anthropocene—in which human activities have become the dominant driving force transforming the Earth’s natural systems. A recent joint publication by the World Health Organization and Convention on Biological Diversity articulated the myriad connections between biodiversity and health and the threats to both posed by environmental change. Andy Haines, professor of pub...
Jun 02, 2017•18 min
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 third discussion we went to Scotland, to find out what the people who create policy think about the issues with evidence synthesis, and how the information they create is being used in practice. evidencelive.org/manifesto/ - join the discussion, read, and comment on our manifesto....
Jun 02, 2017•34 min
Available data suggest about 50% of delirium is hypoactive; this and the mixed motor subtype account for 80% of all cases of delirium. It can be more difficult to recognise, and is associated with worse outcomes, than hyperactive delirium. In this podcast, Christian Hosker, consultant liaison psychiatrist at the Leeds Liaison Psychiatry Service outlines when to suspect hypoactive delirium, how to assess, and appropriately manage patients. Infographic explaining diagnosis: http://www.bmj.com/cont...
May 26, 2017•23 min
Each individual’s grief process is unique, when confronted with the death of a loved one, most people experience transient rather than persistent distress - however 10% of bereaved individuals, with an increased risk following the death of a partner or child and loss to unnatural or violent circumstances, experience prolonged grief disorder. In this podcast, Paul Boelen, a professor of psychiatry at Utrecht University, and Geert Smid, psychiatrist and senior researcher from the Dutch National Ps...
May 18, 2017•19 min
