Medicine and Science from The BMJ

In this week’s podcast Jayati Das-Munshi, from the Institute of Psychiatry, London, talks about her study into the mental health effects of ethnic density. Also, hyper/hypo - antonyms that can sound almost identical. Adam Frankel and Phillip Vecchio from the Princess Alexandra Hospital in Woolloongabba, Australia, explain their their plan to do away with these troublesome prefixes.

China’s New Rural Cooperative Medical Scheme, aims to provide health insurance to 800 million rural citizens. We’ll be finding out from Scott Rozelle, from Stanford University and Qingye Meng from Peking University, the background to the formation of the scheme, and its place in the wider Chinese medical system.

A BMJ investigation this week raises concerns about the ability of the US Food and Drug Administration to monitor the safety of medical devices through post-approval surveillance. We ask: is the FDA giving device manufacturers an easy regulatory ride? Also, the National Institute for Health and Clinical Excellence (NICE) is set to lose the power to restrict the use of any drug that exceeds its £30k cost per quality adjusted life year ceiling. Alan Maynard, professor of health economics at the University of York, discusses what this will mean.

This week the podcast’s all about risk, as we bring you two reports from Risky Business, the conference where speakers from a wide range of hazardous industries came together to share ideas. Pat Crosskerry tells Rebecca Coombes how his work shows thinking more analytically, and less intuitively, could help doctors make better diagnostic decisions, and save lives. We also look at the contentious subject of medical litigation, and ask if it improves patient safety.

This week Dulcie McBride, a consultant in public health at University College London, joins us to talk about the UK’s practice variation in referring to secondary care. Also Simon Wright, head of health at Save the Children, the BMJ’s Christmas charity, talks to Rebecca Coombes about how the money you donate helps health care in some of the world’s poorest countries.

This week we’re joined by Jack Wennberg, author of the Dartmoth Atlas of Healthcare. He and Fiona Godlee discuss his work, and what the UK can learn from the US. Also this week what do you buy a MAMIL (Middle Aged Man in Lycra) for Christmas?

In this week’s cracker of a show… Firstly, could how you park your car indicate your choice of specialty? Secondly, how a team of scientists managed to solve the mystery of the missing French monarch. And are doctors in ITU more likely to be oliguric, and at greater risk of acute kidney injury than their patients? We read a modern fable, which has an important message for the management of complex clinical collaborations. And finally, how much beauty is there in beauty sleep?

In the final BMJ podcast of 2010, David Payne asks the Independent’s Jeremy Laurance about the year past, and BMJ authors how they feel going into the one ahead. Also, Adama Traore tells us about the work Save the Children are doing in Sierra Leone. The charity has been instrumental in implementing free healthcare for women and children there, and we hear about their success.

This week we find out the best way to treat a Mesobuthus tamulus (indian red scorpion) sting. We also discuss the current state of healthcare in Iraq; and how Andrew Wakefield’s article linking the MMR vaccine and autism was not bad science, but deliberate fraud.

In this week’s podcast we hear from Tom Jefferson of the Cochrane Collaboration about the problem of publication bias – and a tool that could help researchers dowse for hidden data. Also, Brian Deer discusses his features and explains why it’s been so long from the original publication of Wakefield’s work in the Lancet to the revelations just published in the BMJ. And David Payne talks to us about the new BMJ iPad app.

Andrew Lansley said this week his NHS reforms are needed because the UK’s health outcomes are amongst the poorest in Europe. However John Appleby, chief economist at the King’s Fund, tells us why the comparisons are flawed. We also hear from Turkey’s minister of health, Recep Akdağ, on the strides his country has made in providing healthcare.

In this week’s podcast Theresa Marteau, director of the Behaviour and Health Research Unit at the University of Cambridge, wonders if a nudge is enough to change our health behaviours. Also this week, Aziz Sheikh, from the E-medicine Group at The University of Edinburgh, explains how telemedicine is going to be an integral part of future healthcare.

In this week’s podcast Andrew Farmer from the National Institute of Health Research, Health Technology Assessment programme (NIHR HTA), tackles uncertainty. Also, Andrew Clark from the University of Hull tells us that the case for administering oxygen isn’t air tight.

This week we find out about diabetes. Mabel Chew, our Sydney based associate editor, discovers why it’s important not to miss the diagnosis of type I diabetes in children. And we learn about a new therapeutic agent for type II diabetes: glucagon-like peptide-1 analogues.

In this week’s podcast we find out from Susan Brien and Paul Ronksley about the cardioprotective effects of alcohol. Also, Annabel Ferriman tells us about the nominees for the BMJ Group lifetime achievement award.

Between March 2010 and March 2011 the cost of maize and wheat doubled. This is just the latest in a series of price hikes in food staples. In an editorial this week, Joachim Von Braun sets out some of the problems that this price rise is going to cause. David Nabarro, UN special representative of the secretary-general on food security and nutrition, describes why and how we should control the price rise.

In this week’s podcast, Johan Sundstrom explains how blood pressure in adolescents effects mortality in adults. And John Appleby, chief economist of the King’s Fund, talks waiting times.

This month marks the 30th anniversary of the first diagnosed case of AIDS. Bertrand Audoin, from the International AIDS Society, brings us up to date with the latest developments in the fight against the disease. Also this week, Francesco Capuccio from Warwick University explains the importance of sleep as a “health commodity” and the problems with its sacrifice, in our increasingly busy lives.

This week the British government has tabled an amendment to remove maximum pricing from the Health and Social Care Bill. We convened a round table discussion to find out what other elements of the bill need re-examining. Joining us in the studio at BMA house were: John Black - president of the Royal College of Surgeons. Clare Gerada - chair of the Royal College of General Practitioners Michelle Drage - chief executive of the London Wide LMCs Nigel Edwards – acting chief executive of the NHS Confederation Anna Dixon - director of policy at the King’s Fund

As the world’s attention turns to Fukushima, we hear from Ryuki Kassai, Director of Community and Family Medicine at Fukushima Medical University, about the situation on the ground there. He tells us about the difficulties they currently face, and the uncertainty of the next few days and weeks. Also this week, Paul Mackin of Newcastle University discusses the use and efficacy of atypical antipsychotic

Jamie Love, Knowledge Ecology International, and Hans Hogerzeil, director of essential medicines and pharmaceutical policies at the World Health Organization (WHO), discuss the ongoing EU trade negotiations with India. They set out their concerns that it may lead to an interruption in the supply of new generic drugs to the developing world.

At BMA house, we convened a group of world experts in shared decision making. Inspired by the Salzburg Global Summit meeting we discussed the background, practical challenges, and how to engage patients with their health The participants were: Fiona Godlee , editor in chief, BMJ Angela Coulter , director of global initiatives, Foundation for Informed Medical Decision Making Albert Mulley , co-founder, Foundation for Informed Medical Decision Making, and director, Dartmouth Center for Health Care Delivery Science Glyn Elwyn, research professor with an interest in shared decision making, Cardiff University Muir Gray , chair of the Information Standard, Department of Health, and co-editor (with Gerd Gigerenzer of the new book Better Doctors, Better Patients, Better Decisions: Envisioning Health Care 2020 Marion Collict, national programme manager, shared decision making, NHS (UK’s National Health System) Alf Collins , consultant in pain medicine, Taunton and Somerset NHS Foundation Trust, and national clinical lead for Co-Creating Health Margaret McCartney , writer and GP Anu Dhir , junior surgical trainee and co-signatory of the Salzburg Statement Gerd Gigerenzer , director, Center for Adaptive Behaviour and Cognition, Max Planck Institute for Human Behaviour Lisa Schwartz , professor of medicine, Dartmouth Medical School, author (with Steve Woloshin (see below)) of Know Your Chances available free online. Steve Woloshin , professor of medicine, Dartmouth Medical School “e-Patient Dave” deBronkart , co-chair, Society for Participatory Medicine Tessa Richards , analysis editor, BMJ Sue Ziebland , research director of the Health Experiences Research Group and a reader in qualitative health research, Department of Primary Health Care, University of Oxford

At BMA house, we convened a group of world experts in shared decision making. Inspired by the Salzburg Global Summit meeting we discussed the background, practical challenges, and how to engage patients with their health The participants were: Fiona Godlee , editor in chief, BMJ Angela Coulter , director of global initiatives, Foundation for Informed Medical Decision Making Albert Mulley , co-founder, Foundation for Informed Medical Decision Making, and director, Dartmouth Center for Health Care Delivery Science Glyn Elwyn, research professor with an interest in shared decision making, Cardiff University Muir Gray , chair of the Information Standard, Department of Health, and co-editor (with Gerd Gigerenzer of the new book Better Doctors, Better Patients, Better Decisions: Envisioning Health Care 2020 Marion Collict, national programme manager, shared decision making, NHS (UK’s National Health System) Alf Collins , consultant in pain medicine, Taunton and Somerset NHS Foundation Trust, and national clinical lead for Co-Creating Health Margaret McCartney , writer and GP Anu Dhir , junior surgical trainee and co-signatory of the Salzburg Statement Gerd Gigerenzer , director, Center for Adaptive Behaviour and Cognition, Max Planck Institute for Human Behaviour Lisa Schwartz , professor of medicine, Dartmouth Medical School, author (with Steve Woloshin (see below)) of Know Your Chances available free online. Steve Woloshin , professor of medicine, Dartmouth Medical School “e-Patient Dave” deBronkart , co-chair, Society for Participatory Medicine Tessa Richards , analysis editor, BMJ Sue Ziebland , research director of the Health Experiences Research Group and a reader in qualitative health research, Department of Primary Health Care, University of Oxford

At BMA house, we convened a group of world experts in shared decision making. Inspired by the Salzburg Global Summit meeting we discussed the background, practical challenges, and how to engage patients with their health The participants were: Fiona Godlee , editor in chief, BMJ Angela Coulter , director of global initiatives, Foundation for Informed Medical Decision Making Albert Mulley , co-founder, Foundation for Informed Medical Decision Making, and director, Dartmouth Center for Health Care Delivery Science Glyn Elwyn, research professor with an interest in shared decision making, Cardiff University Muir Gray , chair of the Information Standard, Department of Health, and co-editor (with Gerd Gigerenzer of the new book Better Doctors, Better Patients, Better Decisions: Envisioning Health Care 2020 Marion Collict, national programme manager, shared decision making, NHS (UK’s National Health System) Alf Collins , consultant in pain medicine, Taunton and Somerset NHS Foundation Trust, and national clinical lead for Co-Creating Health Margaret McCartney , writer and GP Anu Dhir , junior surgical trainee and co-signatory of the Salzburg Statement Gerd Gigerenzer , director, Center for Adaptive Behaviour and Cognition, Max Planck Institute for Human Behaviour Lisa Schwartz , professor of medicine, Dartmouth Medical School, author (with Steve Woloshin (see below)) of Know Your Chances available free online. Steve Woloshin , professor of medicine, Dartmouth Medical School “e-Patient Dave” deBronkart , co-chair, Society for Participatory Medicine Tessa Richards , analysis editor, BMJ Sue Ziebland , research director of the Health Experiences Research Group and a reader in qualitative health research, Department of Primary Health Care, University of Oxford

This week’s podcast is a summary of the shared decision making round table - looking at it’s history, practicalities of implementation and how to get patients involved. The full round table can be found on bmj.com/podcasts.

Should we screen for prostate cancer? A study published on bmj.com suggests that it doesn’t improve survival rates, and could lead to over treatment. Gabriel Sandblom, of the Karolinska Institute, tells us about his research. Also, James Ritter, emeritus professor of pharmacology at King’s College London, explains the As in the ABCD of hypertension treatment.

Information abounds in our burgeoning knowledge economy, but how much is useful - let alone essential? Martin Dawes from the University of British Colombia tells us about the hierachy of evidence. Also this week, data journalist and author of Information is Beautiful, David McCandless, talks to us about the power and the pitfalls of graphically representing data.

Regulation of genetic testing kits is difficult, so how do we start to control this growing market? Christine Hauskeller, from the ESRC Centre for Genomics in Society at the University of Exeter, discusses her idea for an international standard which will help consumers make the right choices. Also this week, management of type 2 diabetes could be improved using an “artificial pancreas”. Roman Hovorka, principal research associate at the Institute of Metabolic Science, University of Cambridge, describes his new intelligent system for insulin delivery.

The problems associated with arsenic in drinking water have been known for some time, but new research published in the BMJ helps quantify that risk with respect to cardiovascular disease. Yu Chen, New York University School of Medicine, joins us to discuss her research. Also this week, requests for travel information for pregnant women are on the increase, but the available information is patchy. Lucy Chappell, a lecturer at Kings College London School of Medicine and one of the authors of a new clinical review on the subject, joins us in the studio to talk about the evidence and how to assess risk.

What are the health impacts of cold homes and fuel poverty? Michael Marmot, professor of epidemiology and public health at University College London, talks about findings of the report he co- authored for environmental charity Friends of the Earth. BMJ editor in chief Fiona Godlee and deputy editor Trish Groves talk about the BMJ Group’s evidence to the UK parliamentary science and technology select committee inquiry into peer review.

Richard Peto, renowned epidemiologist at Oxford University, won the BMJ Group lifetime achievement award this week. We hear from him about his work, and some of impact it has had. Also this week, Martin Thornhill, from the University of Sheffield, talks about his research, which shows the effect of a change to NICE guidance on antibiotic prophylaxis for endocarditis.

In this week’s podcast Babatunde Osotimehin, executive director of the UN population fund, joins us in the studio to talk about climate change and reproductive rights. Also, Barry Taylor from the University of Otago in New Zealand, describes his research into the link between sleep, BMI, and body fat in children.

In this week’s podcast Trish Groves talks to Marzio Babille, UNICEF representative in Chad, about the country with the lowest immunisation rates in the world. Sophie Cook finds out from Davor Jurkovic, from University College Hospital London, about clinical signs of ectopic pregnancy that may be easy to miss.

How can doctors and police sharing information help stop violent crime? Jonathan Shepherd, from Cardiff University, explains the Cardiff Violence Prevention Programme - and his research into its effectiveness. Also this week, as a new antiplatelet agent is being considered by the National Institute for Health and Clinical Excellence (NICE), Albert Ferro, from King’s College London, takes us through this class of drugs, their effectiveness, and their indications.

In this week’s podcast, we look at the ups and downs of postural hypotension. Also, beansprouts have been fingered as the cause of the recent E coli outbreak in Germany, David Payne investigates this microbiological detective story.

If everyone were to stop smoking, what would be the major public health hazards, and what would happen to health inequalities? Laurence Gruer, director of public health science at NHS Health Scotland, tells podcast producer Duncan Jarvies what his cohort study, examining Scottish women who have never smoked, reveals. And BMJ web editor David Payne talks to editor-in-chief Fiona Godlee about what came to pass at the BMA Annual Representatives Meeting this week.

In this week’s podcast, Margaret McCartney examines Hydration for Health, Quentin Anstee explains how big a problem non-alcoholic fatty liver disease is, and Patrick Keown explains the association between provision of mental health beds and the involuntary admission of mental health patients.

In this week’s podcast, Duncan Jarvies speaks to Alexander Seifalian, professor of nanotechnology and regenerative medicine, about a groundbreaking procedure that enabled a multinational surgical team to implant an entirely synthetic organ—a trachea—into a patient. And Norman Williams, president of the Royal College of Surgeons, talks about the college’s plans for improving the quality of surgical research.

In this week’s podcast Jeremy Myerson, from the Royal College of Art, tells us how good design techniques can make cities more friendly places to grow old gracefully. Clive Ballard, from Kings College London, explains how important pain relief is for dementia patients. Elizabeth Draper, from the University of Leicester, talks us through her investigation into how socioeconomic class affects how women deal with severe congenital abnormalities during pregnancy.

In this week’s podcast we discuss publishing medical details with former health editor of The Sun, Jacqui Thornton. Rogaia Abuelgasim Abdelrahim, the UN Population Fund’s deputy representative in Somalia, explains how the drought and subsequent crop failure there has been exacerbated by existing political problems and led to widespread famine. And Natalie Grazin, Assistant Director of the Health Foundation, talks about making shared decision making a reality.

In this week’s podcast, Sue Rabbit Roff describes how she thinks a system of paid for kidney donations could work in practice. Al Story, clinical lead of the Find and Treat programme – a travelling team who scour the streets of London for tuberculosis – explains the programme’s mission.

A recent study compared cost efficiency of different healthcare systems around the world. We hear from Colin Pritchard, from Bournemouth University, about how the NHS came out near the top. Also this week, the International Committee of the Red Cross has a mandate under the Geneva convention to protect the victims of both international and internal armed conflict. Head of mission Geoff Loane explains why they’re finding that increasingly difficult to do.

Last week BMJ Group held an inaugural global health conference http://globalhealth.bmj.com/ in London, looking at policies for sustainable and effective healthcare. David Heymann, chair of the UK Health Protection Agency, and Martha Gyansa-Lutterodt, Director of Pharmaceuticals at the Ministry of Health, Ghana, discuss how vertical aid programmes can lead to systemic improvements in lower income countries. And, Kalipso Chalkidou, Director of NICE International, explains a bit more about its work. Also, smoking is known to increase TB mortality. A modelling study this week suggests that the number of excess deaths from TB, caused by tobacco consumption, could be as high as 40 million over the next 40 years. Stanton Glantz, Director of the Centre for Tobacco Control Research and Education at the University of California, San Francisco, joins us to set out the numbers.

In this week’s podcast, Shaun Walker reports on alcohol consumption in Russia. Ewan Hoyle explains why he wants the Lib Dems to discuss drug policy. And we found out how realistic comic book villains’ mental health problems are.

This week, chocolate is good for your emotional heart, but what about your physical one? Oscar Franco, clinical lecturer in public health at the University of Cambridge, tells us about the results of his recent meta-analysis. Also, Irfan Dhalla , an internist and lecturer at the University of Toronto, highlights the problem of opioid related death in the USA, and how he thinks we can avoid a crisis.

John Young, professor of elderly care medicine at Leeds University, gives Mabel Chew tips on carrying out a cognitive assessment of an older person. Also this week, Harlan Krumholz explains to Deborah Cohen how he got Medtronic to agree to independent scrutiny of their data that is “unprecedented in the medical industry”.

Research has found that the gap in all-cause mortality between psychiatric patients after discharge, and the general population, is growing. Uy Hoang (Oxford University) tells us what his paper reveals about the trend, and we discuss possible ways to tackle the disparity with Fiona Gaughran and Shubulade Smith (Institute of Psychiatry, South London and Maudsley NHS Foundation Trust). Also, a UN conference this week aims to tackle non-communicable disease. Rebecca Coombes, BMJ features editor, explains how they’re doing that, and some of the problems with the negotiations.

This week, the UK’s General Medical Council is reviewing its standards of good medical practice. Helen Jaques quizzes Niall Dickson, the council’s chief executive, about the possible changes. Also this week, Ian Cameron, head of the rehabilitation studies unit at the University of Sydney, explains how doctors should care for the carers of older patients.

Seth Berkley, CEO of GAVI (formerly the “Global Alliance for Vaccines and Immunisation”), talks to Rebecca Coombes about the future of vaccination funding. Also this week, the Health and Social Care bill, set to change the English NHS, is about to enter the House of Lords before becoming law. We find out which areas will receive most scrutiny from members of the Upper House from liberal democrat peer Baroness Shirley Williams of Crosby, a leading critic of the changes.

The Health and Social Care Bill for England has now reached the House of Lords. With the proposed demise of deaneries, questions still remain about how medical training will be carried out in the future. Niall Dickson, chief executive of the General Medical Council, explains how the council hopes to maintain professional standards whatever the outcome, and what changes to postgraduate education are on the horizon. Also this week, James Chalmers takes us through the steps in treating a non-responding presumed lower respiratory tract infection.