Medicine and Science from The BMJ

US President Donald Trump has signed an executive order to withdraw the US out of the WHO. This would cut funding for the UN’s medical agency by one-fifth. Will they really exit, or can a deal be made? Lawrence Gostin hopes so, and as a professor of law at Georgetown, and director of the World Health Organisation Collaborating Center on National and Global Health Law, he is working with senior US and WHO officials to try and understand what reforms could be made to WHO what would allow a such a deal to be be struck. Gostin also believes that the president cannot withdraw from the WHO with an executive order, but instead requires congressional approval - and is exploring the options for legal challenge to the move. 00:00 Intro 01:01 US history with the WHO 03:31 Executive order 06:35 WHO’s relationship with China 11:14 Funding 12:47 Benefits to US from the WHO 18:05 H5N1 threat 19:43 World benefits from US involvement 21:57 A deal to be made? 24:55 Legal action? 26:37 Administration responses Read Professor Larry Gostin’s co-written opinion piece on the dangers of a US withdrawal from the WHO here: https://www.bmj.com/content/388/bmj.r116

In the last podcast of 2024, Richard Smith, former editor of The BMJ and head of UKHACC will be making the case for being more convivial. Tina Korownyk, professor of family medicine at the University of Alberta is the ghost of Christmas past for TV doctors. Tim Feeny and Navjoyt Ladher take us through this year's Christmas research papers. And finally, Mari Martensen, a paramedic, explains what makes being a medic in Svalbard bear-able. Reading list. The dangers of industrialisation—why we need to rebuild a convivial society Televised medical talk shows—what they recommend and the evidence to support their recommendations Christmas 2024: How to transport a polar bear, and other idiosyncrasies for Arctic emergency medical services The full Christmas archive

Conflicts of interest harm health, and a new investigation uncovers the infiltration of big food manufacturers into UK schools. Emma Wilkinson reports on that investigation. Kamran and Rebecca Coombes, head of journalism, discuss moves to reduce industry's impact on food policy in the UK. A new research paper has identified a link between eating chocolate and lower rates of diabetes. Binkai Liu, doctoral student and Qi Sun, associate professor, at the Harvard T.H. Chan School of Public Health explain what they found. Finally, Sam Hutt is a doctor in the NHS, but is better known by his stage persona “Hank Wangford”. Hank performed a celebration of the NHS at Glastonbury this year, and has now released that song. He joins us to talk about what inspired him. Reading list Food industry has infiltrated UK children’s education: stealth marketing exposed Chocolate intake and risk of type 2 diabetes Hank Wangford

In today’s episode, new research, which has looked at the impact staff turnover is having on patient outcomes. Giuseppe Moscelli, associate professor at the University of Surrey joins Navjoyt Ladher to explain more. Also, every year the BMJ has a Christmas appeal - and this year we have chosen the International Rescue Committee as our partner. To talk more about what they do, and to give us some insight into how geopolitics are affecting health we're joined David Milliband, president and chief executive officer of the International Rescue Committee, and former UK foreign secretary. Reading list; Nurse and doctor turnover and patient outcomes in NHS acute trusts in England The BMJ Appeal 2024-25: David Miliband on hospital attacks, Trump, and the International Rescue Committee in a “flammable world”

This week we’re at the World Innovation Summit for Health, where we’re a media partner - the meeting is focussing on conflict, equity and resilience. In that vein, we’re joined by Christos Christou, international president of Médecins Sans Frontières (MSF) to talk about attacks on healthcare staff, and the difficulty and importance of maintaining neutrality in conflict zones. Ara Darzi, surgeon, executive chair of the conference, and author of the recent NHS review, joins us to talk about antimicrobial resistance, and how diagnostics and a small funding commitment could head off the problem. And finally, we change our focus to the US, and hear about new research into adverse events during surgery with authors Antoine Duclos and David Bates from Harvard Medical School. Reading list. We need to do more to keep antibiotics working WISH report - Tackling Antimicrobial Resistance: How to Keep Antibiotics Working for the Next Century Safety of inpatient care in surgical settings: cohort study

In this episode, we speak to the doctor overseeing the WHO’s emergency response for the eastern mediterranean region - including Gaza, Lebanon, Sudan and Yemen. Richard Brennan joins us to talk about protecting health services, and workers, in the escalating armed conflicts that are affecting the region. Menaka Paranathala and Emma Rourke, from The BMJ, are on to talk about improving research into women’s health. A new UK project, MESSAGE, aims to give consideration to sex and gender in life science research. Palliative care is not just for end-of-life, and rethinking how it’s integrated into every speciality is the key to improving care for patients, argue Richard Harding, Anna Peeler, and Oladayo Afolabi from the Cicely Saunders Institute. Links WISH report - Protecting Health in Armed Conflict MESSAGE (Medical Science Sex and Gender Equity) project BMJ Opinion - Palliative care is an overlooked global health priority WISH report - Palliative Care

It’s an often cited statistic that if healthcare was a country, it would be the fifth largest carbon emitter. At The BMJ we want to change that, and move healthcare towards a more sustainable future. In this week’s episode, we’ll hear about our annual climate edition from two of The BMJ’s editors, Sophie Cook and Juliet Dobson. We’ll be diving into Cli-Fi and asking how climate fiction can galvanise our collective response to climate change. Our panel includes Howard Frumkin, professor emeritus at University of Washington. Lakshmi Krishnan, internist and Director of Medical Humanities at Georgetown university, and Sarah Grossman, journalist and author of Fire So Wild. And Finally, Tereza Kasaeva, director of the WHO’s Global Tuberculosis Programme, explains how migration and food insecurity, exacerbated by climate change, are affecting TB - and why, despite effective treatment, there are still over a million deaths from the disease annually. Our panel's cli-fi book recommendations A Fire So Wild - Sarah Grossman The Last Man - Mary W. Shelly The Broken Earth - NK Jemisin Oryx and Crake - Margaret Attwood The Ministry for the Future - Kim Stanley Robinson Olga Dies Dreaming - Xóchitl González Land of Milk and Honey - C Pam Zhang Day of the Triffids - John Wyndham Links The BMJ’s annual climate issue Cli-Fi—helping us manage a crisis Writing towards a healthier future amid climate disaster WISH report - Tuberculosis Lakshmi’s references Fundamental Role of Arts and Humanities in Medical Education Capable of being in uncertainties’: applied medical humanities in undergraduate medical education The introduction of medical humanities in the undergraduate curriculum of Greek medical schools: challenge and necessity The medical humanities at United States medical schools

How science can be transformed into policy? One of the seemingly intractable issues when it comes to legislative change in the US is gun control. One reason policy change is so difficult, is the US specific evidence vacuum, but that’s beginning to change. We're joined by Louis Klarevas, an academic at the University of Colombia and author of the book “Rampage Nation, securing america from gun violence" and Shannon Watts, from Moms Demand Action which is a grassroots movement of Americans fighting for public safety measures that can protect people from gun violence. Even when there is evidence, the trade-offs needed for legislative change can still paralyse policy makers. Citizen assemblies, a form of democratic participation that asks the public for their views, has helped clarify some key healthcare issues, from assisted dying in Jersey, to abortion access in Ireland. Rebecca McKee from the Institute of Government argues they could be used to fix the NHS, and joins us to explain how. Reading list More gun regulation, less firearm harm Citizens’ assemblies, health, and health policy

Under-nutrition harms health, but so does over-nutrition. The Bill and Melinda Gate’s foundation has just released their Goalkeepers' report - highlighting the detrimental impact that poor nutrition is having on children’s health. Rasa Izadnegahdar, director of Maternal, Newborn, Child Nutrition & Health at the foundation joins us to explain how they are targeting nutritional interventions. Also this week, a new investigation in The BMJ has found that the UK government’s Scientific Advisory Committee on Nutrition - the people who help guide the UK’s nutrition policy - have competing interests with the food industry. We hear from Chris van Tulleken, University College London; Rob Percival, the Soil Association; and Alison Tedstone, chair of the Association for Nutrition. Reading list: Goalkeepers Report 2024 UK government’s nutrition advisers are paid by world’s largest food companies, BMJ analysis reveals

There's a real drive to strengthen quality of care in facilities around the world. However, no matter where you are, improving healthcare depends on quality data—and collecting and using that data can be challenging without the time and expertise. In this podcast, we explore how different healthcare systems, especially those with limited resources, are tackling the challenge of data collection and use head-on. The BMJ has partnered with the World Health Organization and the World Bank on a Collection on Quality of Care. This podcast, the second in a series exploring themes from the Collection, features researchers and implementers from Ghana, Qatar, and the US. They share insights on improving and using data in resource-constrained environments, offering valuable perspectives relevant to healthcare systems worldwide facing similar challenges. Provenance statement: This podcast is part of a Collection on Quality of Care proposed and funded by the World Health Organization and the World Bank. The BMJ commissioned, edited, and published the podcast. Emma Veitch, Rachael Hinton and Duncan Jarvis were the lead editors for The BMJ.

The news that GPs in England have voted for industrial action has spooked the healthcare system - Katie Bramall-Stainer, the chair of the BMA's General Practice Committee explains what's lead to this, and why trust in the government has gone. After the games, olympians and paralympians return to their normal lives - but what does that mean for their healthcare, especially in the US where insurance is expensive? Jonathan Finnoff, chief medical officer for the US Olympic and Paralympic committee joins us to explain how athletes are supported outside the games. Reading list; GP leader: “If general practice is the bedrock of the NHS, then the NHS is collapsing”

This week we're questioning the effectiveness of the Galleri Test for early cancer detection with investigation authors Margaret McCartney and Deborah Cohen. They delve into the decision-making and politics behind this test's introduction in the UK. The episode also covers the growing NHS waiting list crisis and how Imran Ahmed and his team at Guy's and St. Thomas' NHS Trust are using high intensity theatre (HIT) lists to increase surgical throughput - and what other teams need to know, if a national rollout of this model is to happen. Reading list Galleri promises to detect multiple cancers—but new evidence casts doubt on this much hyped blood test Are surgical HIT lists the answer to bringing down NHS waiting times?

The Paris games have just started - and France has made a concerted effort to ensure that this year's Olympics will have a legacy of physical activity for the whole population. However, mega sporting events don't always have that effect, and Fiona Bull, head of physical activity for the WHO, joins us to explain why it's increasingly important that they do. We'll also hear from Professor Sir Denis Perera Gray about how a lifetime of general practice, and why continuity needs to be at the heart of any improvement to primary care. Finally, Harry Brunjes went from being a village GP to the chair of English National Opera, and explains what the two careers have in common. Reading list Olympic Games: linking sports mega events to population physical activity

We celebrate 10 years of patient and public partnership strategy at The BMJ with a patient-centred podcast. We ask how should the new Labour government engage patients in shaping the future of the NHS. We also dive into the concepts of social care and peer support, and learn from Brazil's experience in social participation. Highlights: 01:52 - The Patient "takeover" 05:43 - Social care with Charlotte Augst 19:53 - Peer support groups with Claire Reid and Partha Kar 31:48 - WHO’s resolution on social participation with Mark Barone Reading: Editor's Choice - Listening to patients at all levels of healthcare, Emma Doble, patient editor

Women's Health, breast cancer screening, epidurals, and GP voices New U.S. guideline on breast cancer screening have been extended to women in their 40s - Katy Bell, from the University of Sydney, and Stacy Carter, from the University of Wollongong explain why the good intention of that change wont be mirrored in outcomes - and may even induce harm. Research in The BMJ shows epidurals during labour can reduce severe maternal morbidity Rachael Kearns describes why analgesia may improve those outcomes, and why some myths about epidurals may be reducing their usage. Lastly, a GP confronts the Prime Minister on the disintegration of the NHS and its effects on general practitioners. 02:23 Breast cancer screening guidelines 14:00 Epidurals and maternal morbidity 26:42 A GP confronts the Prime Minister Reading list: Breast cancer screening from age 40 in the US Epidural analgesia during labour and severe maternal morbidity: population based study GP who confronted Rishi Sunak received “hundreds” of supportive messages from doctors

As increasing numbers of mammalian, and human, cases of H5N1 are documented we askShould we worry about a growing threat from “bird flu”? Wendy Barclay, from Imperial college London, and Christopher Dye, from Oxford University join us to explain why they think we should. Our commission on the future of the NHS has released a manifesto for a sustainable NHS that still meets it's founding principles. Helen Salisbury, GP and BMJ columnist, joins the podcast to lay it out. Finally, a musical interlude from the World Doctor's Orchestra. 00:18 H5N1 Bird Flu: Rising Threat 15:35 The manifesto for a better NHS 27:46 World Doctors' Orchestra Reading list; BMJ Editorial - Should we worry about a growing threat from “bird flu”? BMJ Opinion - A manifesto for a healthier NHS, a healthier UK https://www.world-doctors-orchestra.org Stay up to date with our daily email alert - https://www.bmj.com/today

In the UK, a general election has been called - and around the world, ½ the global population will be voting this year; so in this episode we’ll be talking about how elections and health intersect. Firstly, what are the UK parties’ plans for health? Abi Rimmer, The BMJ's UK features editor joins us with the latest information. The world’s largest democracy is polling, so how are Indian politicians talking about health? Sanjay Nagral, surgeon and director of the Department of Surgical Gastroenterology at Jaslok Hospital & Research Centre in Mumbai takes us through the campaign promises. And finally, Jody Heymann is founding director of the WORLD Policy Analysis Center at UCLA and explains why this is the most consequential US election for woman's health in a generation. 01:30 Election Fever and NHS Plans 07:35 Impact of Elections on Health in India 21:20 Women's Health in the US Elections Reading list Feature: The untold health toll of voting Editorial: Workplace rights around pregnancy and childbirth

With the anticipation of a new government in the UK, shadow health secretary Wes Streeting will hit the ground running - with a winter season (and it's inevitable crisis) and ongoing industrial desputes with junior doctors. Elisabeth Mahase ask him about his plans to handle these challenges if elected. We also find our selves in the puzzling situation of potential GP unemployment in the UK despite a high demand for primary care doctors, Helen Salisbury, GP and columnist for The BMJ explains how we've got into this situation. Finally, Peter Doshi has been looking at the financial entanglement of FDA heads with the companies they are regulating - 9 of the previous 10 FDA heads have gone on to work for industry in some respect. He has also investigated how complex financial instruments can make these conflicts more opaque. 02:03 Anticipating a New Government and the NHS Winter Crisis 10:50 The Kafkaesque Dilemma of GP Unemployment 23:10 FDA Leaders' Financial Entanglements: A Deep Dive Reading list Workforce and winter under Labour: Wes Streeting on his plan for the NHS Helen Salisbury: No jobs for GPs—we’ll be missed when we’re gone Revolving doors: board memberships, hedge funds, and the FDA chiefs responsible for regulating industry

Where next for psychological safety? Amy Edmundson is professor of Leadership and Management at the Harvard Business School. Her work on psychological safety has underpinned so much quality improvement, and she joins us fresh of the stage at the International Forum on Quality and safety in healthcare to talk about the next steps in creating a safe work place. The BMJ has published two new investigations, looking at the alcohol and tobacco industry funding of public health and education - we’ll hear how the companies who create the problems, are now styling themselves as the solution. Rebecca Coombes joins us to explain what The BMJ has found, and May van Schalkwyk, a researcher from the London School of Hygiene & Tropical Medicine, explains how commercial conflicts are shaping the wrong education tactics. And finally, our NHS commissioners have more recommendations - this time on workforce issues. Mary Dixon-Woods, director of THIS institute at the University of Cambridge, and Matt Morgan, intensive care consultant in Cardiff, tell the NHS to get serious about staffing. 02:03 Amy Edmondson on Future Health and Psychological Safety 10:24 The Impact of Corporate Funding on Public Health 19:57 Addressing NHS Workforce Challenges: Insights and Solutions Reading list; Our new podcast - Future Health International forum keynote - Medscape caves in on courses funded by tobacco giant Philip Morris, while medics fear global push into medical education Investigation - Big alcohol: Universities and schools urged to throw out industry-funded public health advice Commission on the future of the NHS - The future of the NHS depends on its workforce

Hilary Cass, the former president of the Royal College of Paediatrics, has spent the last 3 years collating the evidence for treatment of gender questioning young people; engaging with those young people, their families and their clinicians - all with the aim of improving NHS treatment of this complex and vulnerable group. In this interview, Kamran Abbasi, editor in chief of The BMJ, speaks in depth to Cass about her review - about evidence base for transitioning, but also about the way in which the siloing of care for young trans people has failed them. They discuss the need to support young people in their journey - Cass is clear that the NHS should allow young people to explore their gender, but that ultimately, that may not mean medical intervention at all. Reading list The Cass Review - final report The systematic review and meta-analyses published in Archives of Disease in Childhood BMJ Opinion: Gender medicine for children and young people is built on shaky foundations

Derogation, the way in which striking doctors can be recalled to the ward to protect patient safety, was agreed by NHS England and the BMA. Now, new data The BMJ has uncovered shows that the mechanism was rarely used - and when it was tried, was often rejected. Gareth Iacobucci explains what that means about relations between the government, the NHS, and doctors. Felice Jacka, director of the Food & Mood Centre at Deakin University, is one of the authors of our recent ultra-processed foods umbrella review - and joins the podcast to talk about the link between diet and health; and why goverments need to pay more attention to the food system. Finally, John Appleby, senior associate at the Nuffield Trust, and Gillian Leng, dean and president elect of the Royal Society of medicine, have been thinking about healthcare funding, and how more stability is essential in securing the service's future. Reading list Hospital leaders warned that failure to recall striking doctors risked patient safety in some trusts, documents show Ultra-processed food exposure and adverse health outcomes NHS funding for a secure future Chapters 00:31 Derogation and doctor strikes 06:59 Ultra processed food producers and health 13:59 Rethinking NHS funding

In this week's podcast: How AI will affect the clinician-patient relationship? Our annual Nuffield Summit roundtable asks how the promise of tech tools stacks up against reality, and how the future of the therapeutic relationship can be protected (participants below). Your code is as important as your methods, which is why The BMJ now requires you to share it - Ben Goldacre and Nick De Vito, from the Bennett Institute for Applied Data Science at the University of Oxford, explain why it's so important, and how The BMJ's new data and code sharing policy could change research transparency. Nye Bevin set up the NHS when the UK was in the economic doldrums, and the public's need for care was becoming an emergency - BMJ columnist Matt Morgan has helped turn that story into a play, currently showing at the National Theatre; and reflects on the parallels between now and then. 1:58 Nuffield Summit roundtable 17:32 New BMJ rules on data and code sharing 29:03 Aneurin "Nye" Bevan play Taking part in our roundtable were: Rebecca Rosen, Senior Fellow at the Nuffield Trust and GP Juliet Bouverie, CEO of The Stroke Association Daniel Elkeles, CEO of London Ambulance Service Neil Sebire, Professor and Chief Research Information Officer at Great Ormond Street Hospital Reading list: How is technology changing clinician-patient relationships? Mandatory data and code sharing for research published by The BMJ Scalpels and spotlights: bringing theatre to the theatre

The U.S. Supreme Court is hearing a case on the approval of mifepristone for medical abortion - a case which could change the availability of the drug in the US, and which hinges on papers linking abortion to mental distress. However, those papers are contested (including a paper published by BMJ), and some have been retracted already - Julia Littell and Antonia Biggs tell us how that science is being used in court, and why retraction is essential. Awakening from anaesthetic is difficult enough, but imagine you're three and only communicate through sign language - which no one can understand. We hear from Kirsten, a mother who thinks everyone should learn at least a few key sign language phrases. Finally, the London Medical Orchestra is turning 70 - having had their start in The BMJ's letters pages. Stuart Delve and Peter Gough help explain the orchestra's longevity. 01:00 The Supreme Court Case on Medical Abortion 10:27 The Role of Journal Editors in Scientific Integrity 19:54 The Impact of Deafness on Patient Experience 30:57 The Joy of Music in a Medical Career: London Medical Orchestra References Analysis: Correcting the scientific record on abortion and mental health outcomes WYPIT: The importance of British Sign Language Asha's instagram for BSL tips London Medical Orchestra's 70th anniversary concert - 6:30pm, Sun, 10 Mar 2024

Social media, and the rate at which the online world is changing, is worrying - especially the speed at which health disinformation can speed around the globe. We look to tech companies for a solution to the problems of their own making - but Heidi Larson, director of the Vaccine Confidence Project, and professor of anthropology, risk and decision science at LSHTM, joins us to explain why we should be cautious about focussing our attention there. Next on the podcast, research just published in The BMJ looks at the efficacy of exercise at controlling depressive symptoms - but helps finally answer the key question - which exercise works best. Lead author, Michael Noetel, senior lecturer in psychology at the University of Queensland, joins us to explain the research, and how well exercise stacks up against pharmacological treatments. Finally, while it’s tempting to try and put the pandemic behind us, its effects linger - and many healthcare staff are still dealing with their experience of that time. Rachel Clarke, a palliative care doctor in the UK, joins us to explain why she has felt the need to document the pandemic, first in a book and now in a new TV drama set to air in the UK next week. 06:15 Heidi Larson on vaccine confidence and social media 15:31 Exploring the effectiveness of exercise for depression 26:56 Rachel Clark on seeing her experiences reflected on screen Reading list BMJ Collection: How are social media influencing vaccination Feature: Medical misinformation on social media—are the platforms equipped to be the judge? Research: Effect of exercise for depression

With a new logo, and new music, comes a revamped The BMJ Podcast. Every two weeks we’ll be bringing you a magazine style show, more variety and perspectives on medicine, health, and wellbeing. In this episode: Former chief executive of the NHS, Nigel Crisp, explaining why the UK is facing a national health and care emergency (01:22) The guest editors of our US covid series, Gavin Yamey and Ana Diez Roux, discuss the US pandemic response, and how problems are built into the US constitution (19:48) How The BMJ’s ActionAid appeal will help people in Gaza, Syria and Somalia (33:06) Reading list: The BMJ Commission on the Future of the NHS US covid-19 lessons for future health protection and preparedness The BMJ Appeal 2023-24: ActionAid offers immediate and long term help

In this festive edition of the BMJ podcast, we hear about what medicine can learn from music, when it comes to giving a convincing performance, and how we can grow an evidence base for nature prescribing. Professors Roger Kneebone and Aaron William of the Centre for Performance Science raise the curtain on the performance of medicine, and we hear what your consultation technique could learn from a hairstylist. Ruth Garside, Professor of Evidence Synthesis, Kerryn Husk, Associate Professor of Health Sciences and Edward Chapman from the Health and Environment Public Engagement Group then discuss 'nature prescribing', and wonder about how to balance maintaining the joy derived from nature and yet create an evidence base for the medicinal benefits associated with it. Reading list Medicine: a performing art Nature prescribing 00:13 Introduction to the BMJ Podcast 00:36 Exploring the Themes of the Christmas Edition 01:38 The Intersection of Medicine and Performance 02:33 The Art and Science of Performance in Medicine 05:04 The Role of Performance in Music 06:29 The Similarities Between Medicine and Music 08:06 The Role of Experiential Learning in Performance 14:11 The Impact of Audience on Performance 19:04 The Benefits of Nature and Green Prescribing 24:52 The Challenges of Measuring the Impact of Nature Prescribing 30:37 The Community's Engagement with Nature Prescribing 33:01 Conclusion and Farewell

There’s an inherent tension between creating quality standards that are very clinically focussed, and standards which are very patient centred - especially in settings where clinical outcomes can be compromised by basic lack of resources. The use of oxytocin to prevent bleeding after birth is an example of this - WHO quality guidelines clearly measure and incentivise use of the drug, but in more wealthy healthcare systems, adherence patient preference is the key measure. How can we ensure that less wealthy healthcare systems are also patient centred? Our guests for this discussion; Nana Twum-Danso, ​senior vice president, Institute for Healthcare Improvement (IHI) Paul Dsane-Aidoo, health specialist, UNICEF Ghana Keith Cloete, head of department at Western Cape Government: Health Hosted by Emma Veitch, Collections editor for The BMJ This podcast is part of The BMJ Quality of Care collection, in collaboration with the World Health Organization and the World Bank, which offers critical thinking on both the unfinished agenda and emerging priorities for improving quality of care in low- and middle-income countries. 00:00 Introduction to the podcast 00:48 Introduction of experts and their backgrounds 02:54 Challenges in healthcare systems: south africa's perspective 04:15 The importance of patient-centred care 04:56 The role of data in improving quality of care 06:11 Community engagement and feedback in healthcare 07:58 Tackling global disparities in healthcare 08:41 Balancing clinical outcomes and patient-centred care 10:58 Addressing inequities in healthcare 22:43 The role of governance in improving quality of care 32:56 Overcoming resource constraints in healthcare 36:22 The need for system redesign in healthcare 37:18 Adapting to changing times in healthcare

In this specially curated three-part podcast series from The BMJ, we explore the importance of community and connection to foster adolescent wellbeing. The discussion covers athe wide array of issues young people face, with a particular focus on the unique challenges of adolescence from a social perspective. The episode unpacks the significance of having supportive relationships within families, schools, and communities and the influence of these relationships on the mental and behavioural health outcomes of adolescents. It also explores the impact of digitalization on adolescent connection, with discussions on how to balance online interactions with offline engagements. Importantly, it highlights the need for further research into understanding digital and social media interactions and their influence on the health and wellbeing of adolescents in a rapidly evolving digital landscape. Our guests: Ulises Ariel Vélez Gauna, Transmitiendo Diversidad Flavia Bustreo, Fondation Botnar Richard Dzikunu, YIELD Hub Shelani Palihawadana, Young Experts Tech for Health. Joanna Lai, United Nations International Children’s Emergency Fund (UNICEFUnicef) Hosted by Adam Levy Supported by the Fondation Botnar and PMNCH, the Partnership for Maternal, Newborn, and Child Health. Read the full cCollection of articles showing the importance of investing in adolescent wellbeing. 00:04 Introduction to the podcast series 00:36 Understanding adolescence from a social perspective 01:00 The impact of community and connection on adolescents 01:07 Personal experiences: growing up as an LGBT+ teenager 01:38 The role of supportive relationships in adolescents' lives 02:05 The importance of connectedness in adolescence and beyond 03:27 Treating safe spaces for LGBT+ adolescents 05:23 The unique role of community during adolescence 07:02 The impact of political landscape on LGBT+ community 07:54 The importance of community and connectedness: expert opinions 08:56 The interconnection of social, health, and educational well-being 12:14 The role of digital technology in adolescents' lives 16:56 The importance of investing in adolescents' well-being 43:18 The role of schools in fostering connectedness 45:41 Conclusion: personal reflections on connectedness

This is the second episode of a special three-part podcast series that delves into adolescent health and wellbeing, focusing on creating a positive trajectory of health from a young age. The podcast explores physical and mental health issues affecting young people globally, particularly in sexual and reproductive health. We hear how young people are excluded from decisions about their own health, and how grassroots groups around the world are empowering them to take responsibility for their own wellbeing. We also hear how young people are becoming leaders in social movements, from tackling structural racism to improving nutrition in schools, and how their unique perspectives are vital in making those changes. Our guests: Natasha Salifyanji Kaoma, Copper Rose Zambia Alaa Murabit, The Bill and Melinda Gates Foundation Donald Bundy, London School of Hygiene and Tropical Medicine Anshu Banerjee, World Health Organisation Dev Sharma, Bite Back 2030 Hosted by Adam Levy Supported by the Fondation Botnar and PMNCH, the Partnership for Maternal, Newborn, and Child Health. Read the full cCollection of articles showing the importance of investing in adolescent wellbeing. 00:05 Introduction to adolescent health 01:00 Young womens’ menstrual health 02:11 Discussion on candid pride project 03:29 Importance of sexual and reproductive health 04:49 The role of young people in health advocacy 06:17 The epidemiology of early health and lifecourse 10:08 Impact of adolescent health on future generations 18:29 How young people become activists 28:51 Advocacy for women in Libya 28:54 Global forum for adolescents 40:15 Success stories 44:54 Conclusion and preview of next episode

In the final episode of this three-part podcast series from The BMJ, we dive into the vital topic of education for adolescents and how it influences the course of life. This podcast explores barriers, burdens and possibilities of change in the educational system to better support young people, and how the traditional system of schooling is failing to equip young people with the skills and knowledge to lead healthy lives. We also hear how the value of informal education and its impact on subjects ranging from health to gender equality, and that learning isn’t limited to young people, and the intergenerational benefits of education and its role in shaping societal norms and individual health. Our guests; Maziko Matemvu, Uwale Joanna Herat, UNESCO Janani Vijayaraghavan, Plan Canada Atika Ajra Ayon, Plan International Stefan Germann, Fondation Botnar Hosted by Adam Levy Supported by the Fondation Botnar and PMNCH, the Partnership for Maternal, Newborn, and Child Health. Read the full cCollection of articles showing the importance of investing in adolescent wellbeing. 00:03 Introduction to the podcast 00:11 The importance of education for adolescents 03:26 The role of education in health and wellbeing 04:43 The impact of education on society 10:21 The power of peer education 11:15 The role of media in education 12:31 The importance of meaningful engagement in education 14:45 The impact of education on health 17:48 The challenges in access to education 26:25 The role of education in combating child marriage 36:37 The impact of climate change on education 44:53 The role of education in mental wellbeing 45:59 Conclusion of the podcast

The December edition of the Talk Evidence podcast discusses the complexities of seeking consent from patients who are part of large data sets, and some new research to help patients living with diabetes in places without certain power supplies. First patient consent and data - in the UK, two stories that have made the public worry about the use of their health data. Firstly the news that UK biobank, who hold a lot of genomic and health data, allowed research by an insurance company, and second that the NHS has entered a contract with Palentir to do analysis on NHS data. Natalie Banner, director of ethics at Genomics England has been thinking hard about putting patients at the centre of decision making about their data, and explains why she thinks a sole reliance on a consent model falls short. Next, uncertain power supplies, such as in conflict or disaster zones, means uncertain refrigeration. Hard enough for most people to survive, but if you need to keep your insulin cold, it can be lifethreatening. However a new cochrane review has found good news about the thermostability of insulin at room temperature. We ask Phillipa Boulle, MSF Intersectional NCD Working Group Leader and Cyrine Farhat,is a global diabetes advocate based in Lebanon, how this will affect care for patients around the world. Reading list Thermal stability and storage of human insulin Outline 00:06 introduction and overview 00:24 the challenge of seeking consent in big data sets 01:34 understanding consent issues in large datasets 01:52 the role of participant panels in data accountability 02:44 the complexity of public attitudes towards data use 04:54 the importance of transparency and engagement in data use 05:48 the impact of external factors on public trust in data use 07:49 the ethical challenges of using health data 09:17 the limitations of consent in ethical discussions 09:23 the need for more conversation about group benefits, risks, and harms 10:41 the role of governance in ethical decision making 12:05 discussion on the interview with natalie banner 14:59 the challenge of managing chronic conditions in disaster zones 15:15 the impact of temperature and storage conditions on insulin 17:32 interview with Philippa Boulle from medecins sans frontieres 29:10 interview with Cyrine Farhat, a person living with diabetes in lebanon 36:18 discussion on the interviews and the challenges of diabetes management

We were accepting of an increase in deaths every winter 'flu season, but Ashish Jha thinks that is not longer a tenable position. Lessons he learned during his time as the White House Covid-19 coordinator have convinced him we should be taking a different approach to the winter season. In this interview with Mun-Keat Looi, The BMJ's international features editor, we hear about living with COVID, the future of antivirals, vaccines, and surveillance. They talk about long COVID, the investment required to fight future outbreaks effectively, and the role of the US in the global health response.

Each episode of Talk Evidence we take a dive into an issue or paper which is in the news, with a little help from some knowledgeable guests to help us to understand what it all means for clinical care, policy, or research. In this episode: Helen Macdonald take a deep dive into cancer screening tests, prompted by a paper in JAMA which showed most have no effect on all cause mortality, and news that the NHS is evaluating a single test which screens for 50 common cancers - we ask Barry Kramer, former director of the Division of Cancer Prevention, at the U.S. National Cancer Institute to help explain how to hold those two pieces of knowledge. Juan Franco has been looking into diet and obesity, prompted by new research in The BMJ and a new Cochrane review, looking at the role of low glycemic index foods in weightloss - we ask Khadidja Chekima, nutritional researcher at Taylor’s University in Malaysia, to define low GI foods, and why it’s so hard to research their role in diet and weightloss Reading list; JAMA research - Estimated Lifetime Gained With Cancer Screening Tests; A Meta-Analysis of Randomized Clinical Trials The BMJ news - Clinicians raise concerns over pilot of blood test for multiple cancers The BMJ research - Association between changes in carbohydrate intake and long term weight changes: prospective cohort study Cochrane review - Low glycaemic index or low glycaemic load diets for people with overweight or obesity

Organisational and student leaders explore the responsibilities of the British Medical Association and The BMJ to understand and respond to its colonial history. Our panel Kamran Abassi, editor in chief, The BMJ, London, UK Omolara Akinnawonu, Foundation year doctor, Essex, UK, and outgoing co-chair of the BMA medical students committee Latifa Patel, elected chair of the UK BMA's Representative Body and BMA EDI lead Host - Navjoyt Ladher, clinical editor for The BMJ

Leaders from academic and funding organisations discuss the transformative change required to overcome extractive and inequitable research practices in global health, and the need for examining power and privilege within traditional research institutions. Our panel Samuel Oti, senior program specialist, International Development Research Centre, Ottawa, Canada, and member of the Global Health Decolonization Movement in Africa (GHDM-Africa) Muneera Rasheed, clinical psychologist and behaviour scientist and former faculty, Aga Khan University, Karachi, Pakistan Liam Smeeth, professor of clinical epidemiology and director of the London School of Hygiene and Tropical Medicine, London, UK Angela Obasi, senior clinical lecturer, Liverpool School of Tropical Medicine, UK Seye Abimbola, editor of BMJ Global Health, and health systems researcher from Nigeria currently based at the University of Sydney, Australia Jocalyn Clark, international editor, The BMJ, London, UK Host - Navjoyt Ladher, clinical editor for The BMJ

International health leaders discuss how feminist and decolonial advocates in health face similar resistance and attempts to sow divisiveness, and how they can join forces to promote health equity and justice for all. Our panel Raewyn Connell, sociologist and professor emerita at the University of Sydney, Australia Sarah Hawkes, professor of global public health and director of the Centre for Gender and Global Health, University College London, UK Sanjoy Bhattacharya, head of the school of history and professor of medical and global health histories, University of Leeds, UK Asha George, professor and South African research chair in health systems, complexity, and social change, University of the Western Cape, South Africa Host - Navjoyt Ladher, clinical editor for The BMJ

Experts discuss how failing to confront colonial pasts is linked to present lack of progress in global health equity, why health leaders need historical educations, and how, for Indigenous peoples, it’s not just a colonial history but a colonial present. Our panel Seye Abimbola, editor of BMJ Global Health, and health systems researcher from Nigeria currently based at the University of Sydney, Australia Catherine Kyobutungi, Ugandan epidemiologist and executive director of the African Population and Health Research Center, Nairobi, Kenya Sanjoy Bhattacharya, head of the school of history and professor of medical and global health histories, University of Leeds, UK Chelsea Watego, professor of Indigenous Health at Queensland University of Technology, Australia Host - Navjoyt Ladher, clinical editor for The BMJ

Healthcare leaders discuss the ways in which colonial-era bias and eugenics persist in today’s medical education and clinical practice in the UK and beyond, and what meaningful change is required to overcome racial and other healthcare inequalities Our panel Annabel Sowemimo, sexual and reproductive health registrar and part-time PhD student and Harold Moody Scholar at King’s College London, UK Thirusha Naidu, head of clinical psychology, King Dinuzulu Hospital, and associate professor, Department of Behavioural Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa Subhadra Das, UK based researcher and storyteller who specialises in the history and philosophy of science, particularly scientific racism and eugenics Amali Lokugamage, honorary associate professor, Institute of Women's Health, University College London, and consultant obstetrician and gynaecologist, Whittington Hospital, London, UK Host - Richard Hurley, collections editor at The BMJ

We’ve heard throughout the series from people who have a passion for sustainability, and have successfully made changes in their organisations to reduce the planetary impact of their work. In doing so, they will have recruited other people who have a similar outlook - but they will have also convinced people who aren’t prioritising sustainability. In this last podcast of the series, we’re delving into that - how to talk to colleagues and patients, in ways which connect with their own needs and preferences. To help with that, we’re joined by David Pencheon, director of the Sustainable Development Unit for NHS England, who’s been successfully talking about these issues for years, and Kate Wylie, executive director of Doctors for the Environment Australia.

One element of sustainable healthcare is simply reducing the amount of healthcare you’re doing by not doing the things that are of no value to patients. However, how do we do this in practice? And why is it often so hard? What is the role of fear in this discussion? These are all questions we will discuss in this episode. To help us with this we’ll be joined by Prof Ben Newell (cognitive psychologist from University of New South Wales, whose research interest includes judgement and decision making). and Dr Lucas Chartier, emergency medicine physician at the University Health Network in Toronto. Ben Newell also has also recently released a book, Open Minded, co-authored with David Shanks on the role of the unconscious mind in our decisions making

Acting on climate change is often framed as having to give stuff up, to cost more money, to make sacrifices. Yet in healthcare we find the opposite can often be true: there are many actions we can take which reduce the carbon footprint of healthcare which actually end up with better outcomes for our patients. In this episode, we hear from two examples of that. Singing for breathing is a type of social prescribing to help people with chronic lung disease manage their breathlessness, reducing their need to be reliant on healthcare to do this, while also finding joy and a sense of community. Stephen is one patient who has benefited from this service, and will tell us more about the impact it had on his life. In another example, Lynn Riddell, an HIV consultant will tell us how a change in their clinical pathway helped a cohort of patients reduce the amount of travelling to and from the clinic, still manage their condition safely and give them back precious time and control. https://www.bartscharity.org.uk/our-news/singing-sessions-to-improve-patients-lung-health/

Ooops! If you listened to episode 3 when it first came out you may have realised that the title didn't quite match the content. We've just updated the title and the show notes below, and stay tuned for when we'll be soon releasing an episode on how sustainable healthcare can be good for patients. In a system where healthcare workers are continually described as overworked and burnt out, how can we expect them to find the time to act on the climate? In this episode we turn that assumption on its head, and, in fact, show how acting to reduce the environmental impact of healthcare can help staff find joy in their work again. Our two guests today are Tracy Lyons, founder of Pharmacy Declares and medicines optimisation pharmacist in Dorset, UK, and David Smith, general surgeon at North York General Hospital in Toronto, Canada. The very worst thing is sometimes to have a problem you feel you can’t solve, and action mitigates anxiety: these are two of the many lessons that came out of today’s episode. We also touch on the different levels that you can start to take action at: from the small and tangible to influencing change at a system level. Related links: https://cascadescanada.ca/ https://www.pharmacydeclares.co.uk/ https://twitter.com/TLyons00

In this month's Talk Evidence, Helen and Juan are reporting from Preventing Overdiagnosis - the conference that raises issues of diagnostic accuracy, and asks if starting the process of medicalisation is always the right thing to do for patients. In this episode, they talk about home testing, sustainability and screening. They're also joined by two guests to talk about the overdiagnosis of obesity - when that label is stigmatising and there seem to be few successful treatments that medicine can offer, and the need to educate students in the concepts of overdiagnosis and too much medicine, to create a culture change in medicine. Links; The Preventing Overdiagnosis conference The BMJ EBM papers on choosing wisely.

Healthcare is a complex system, and if we want to make changes such as those needed for sustainable healthcare, we need to work across multiple teams, and make sure we hear everyone’s voice, including our patients’. In this episode we’ll discuss how we can communicate and work with those different groups, and some novel ways of getting the message across from T-rexes worth of plastic gloves to art made out of surgical waste. Guests for this episode: Nicola Wilson, lead clinical educator, Great Ormond Street Children’s hospital, and Maria Koijck, artist and former patient. You can read more about the Gloves are Off project here https://www.gosh.nhs.uk/news/gloves-are-off/ You can see Maria’s film here: https://www.mariakoijck.com/

Planet centred care is new podcast series for the BMJ exploring issues related to environmentally sustainable healthcare, aimed at all clinicians, and anyone working in healthcare, who want to make sure they can continue to help patients while not harming the planet. In this episode we’ll discuss that first radicalising moment. That moment where you start to see all the things you can do to make healthcare more sustainable and how it is hard to un-see that. For everyone, that moment may come from a different place, or different perspective. Our guests for this episode: Gareth Murcutt who was at first reluctant until he saw the size of the impact he could make; Gwen Sims whose eyes were opened by moving health systems (and continents) and Alifia Chakera who didn’t expect to find a huge sustainability saving so close to home when she took up a new clinical role before the pandemic. Hosts: Loren De Freitas and Florence Wedmore, the BMJ

In our final episode of this season, we're going quantitative, with the newly released data on how trainees in the UK are faring. Each year the UK's General Medical Council, the doctor's regulator, surveys trainees in the NHS to ask them questions about stress and burnout, harassment and discrimination, and how well supported they feel in their training. They also ask trainers about the same things. Unsurprisingly, the year the results look bad - with increasing levels of burnout across the board, but particularly in new trainees. At the same time trainers are feeling unable to use their time supporting learning, and instead are propping up the system. To discuss this, Clara Munro and Ayisha Ashmore are joined by Colin Melville, medical director, and director of education and standards, at the GMC. All the data discussed, and the interactive tool that Colin mentions, are available on the GMC's National training survey 2023 results page.

In this month's Talk Evidence, we're getting a little meta - how do we keep an eye on research to make sure it's done with integrity. Helen Macdonald is BMJ's Publication ethics and content integrity editor - and we quiz her about what that actually means on a day to day basis. Ensuring the integrity of research could be made both easier, and harder, by the ascendance of large language models, Ian Mulvany, BMJ's chief technology officer joins us to talk about how we can harness the power of this new technology.

They're the trusted public figures of the medical profession, but many of the most famous medics in the UK will have been approached by, and accepted money from, companies wishing to promote their products - and the public will never know. To talk about conflicts of interest in media doctors, we’re joined by two of the most recognisable medics on our screens - Chris and Xand van Tulleken, and the GP who persuaded them to think about what they receive cash for, Margaret McCartney. Read our investigation into how the UK's medical royal colleges receive millions from drug and medical devices companies and Margaret McCartney's plea that “You have to be above reproach”: why doctors need to get better at managing their conflicts of interest

In this episode of Talk Evidence, Helen Macdonald, Joe Ross, and Juan Franco are back to update us on what's happening in the world of medical evidence. Firstly, the news about the end of the covid-19 pandemic was trumpeted, but the changes to research funding have been more quite - and the team discuss what this means for ongoing work to understand the effects of covid, but also in terms of preparedness for the next pandemic. Next, breast cancer screening recommendations, in the USA, have been reduced from women over the age of 50, to those over the age of 40. We discuss the modelling study which lead to that recommendation change, and what the consequence may be in terms of overdiagnosis. Finally, 40 years ago, the U.S. Orphan Drug act was passed to encourage the development of treatments for rare conditions - but new research looks at how many clinically useful drugs have come onto market, and an analysis examines the way in which the system could be gamed by narrowing disease definitions to create small populations of patients. Reading list Is the UK losing its world leading covid surveillance network just when it needs it most? Breast cancer: US recommends women start screening at 40 FDA approval, clinical trial evidence, efficacy, epidemiology, and price for non-orphan and ultra-rare, rare, and common orphan cancer drug indications

We're in pride month, and this year the celebration of LGBT+ people seems to be increasingly contentious. Healthcare's treatment of queer people has improved hugely since the days when being gay was considered a mental disorder, and would end a doctor's career - but that doesn't mean that everything is equal. In this episode of Doctor Informed, we're hearing from two doctors who are out and proud at work, about what it's been like to be queer in medicine, and what good allyship looks like. Our Guests Michael Farqhuar is consultant in sleep medicine at the Evelina London Children's Hospital, he also helped set up the NHS Rainbow badge scheme. Greta McLachlan is a general surgical trainee, and member of the Royal College of Surgeon's Pride in Surgery Forum