Medicine and Science from The BMJ

Life Support - Being a compassionate colleague

In this episode of Doctor Informed, Clara Munro is joined by Ayisha Ashmore - and they're getting to grips with being a compassionate colleague.
While the topic might seem warm and fuzzy, there's some good hard science to suggest that compassionate leadership at every level of healthcare can make a huge difference to staff, and improve patient outcomes.
Most people innately have the skills need to be compassionate colleagues - but often the pressures of the job can make it the lowest of priorities in our everyday interactions.
Our two guests this week think that's wrong though - and say that compassionate leadership is one of the most important things to get right.
Joining us are, Michael West, senior fellow at The King's Fund and professor of Work and Organisational Psychology at Lancaster, and Bob Klaber, consultant general paediatrician and director of strategy, research and innovation at Imperial College Healthcare NHS Trust
Michael has written the book on compassionate leadership in health and social care - https://tinyurl.com/vh55mker.
You can read more about Bob's work in his blog - https://www.imperial.nhs.uk/about-us/blog/how-acts-of-kindness-can-improve-care-and-strengthen-teams
Ayisha has written about putting some of this all into practice in a maternity setting - https://bmjleader.bmj.com/content/early/2021/11/25/leader-2021-000449

Wellbeing - feeling addicted to your phone?

In the wellbeing podcast, the dread topic of phone usage has come up again - how social media, and an "always on" culture can affect our wellbeing.
But knowing that, and changing our behaviour are two different things - so to give some advice on reducing our reliance on phones, Abi and Cat are joined by Nidhi Gupta, assistant professor of pediatrics at Vanderbilt University Medical Center, who's been using techniques from behavioural addiction to help with device usage.
For more from Nidhi, visit https://phreedom.net/
Some of the research that Nidhi mentions
https://publications.aap.org/pediatrics/article/138/5/e20162591/60503/Media-and-Young-Minds
A randomized trial of the effects of reducing television viewing and computer use on body mass index in young children
https://pubmed.ncbi.nlm.nih.gov/18316661/
Distraction: an assessment of smartphone usage in health care work settings
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437811/
Treatment Considerations in Internet and Video Game Addiction
https://pubmed.ncbi.nlm.nih.gov/29502754/
The Smartphone Addiction Scale: Development and Validation of a Short Version for Adolescents
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0083558

Doctor Informed - The patterns which emerge

When you hear the reports from a major patient safety issue, it will be shocking to hear how they have played out - but the patterns in behaviour, of people and institutions which have gone disastrously wrong, can be seen throughout healthcare.
As this first series of Doctor Informed unfolds, we'll be exploring these patterns, and bring you evidence and expertise on tackling them - Doctor Informed is about going beyond medical knowledge to make you the best doctor you can be.
In this first episode we're talking to experts who have seen these patterns firsthand, and whose work is all about tackling them;
Bill Kirkup is a clinician turned investigator - he's led investigations into failings at a maternity and neonatal unit in Morcambe Bay, into the Oxford paediatric cardiac surgery unit and into Jimmy Savile’s involvement with Broadmoor Hospital. He was also a member of the Hillsborough Independent Panel
Mary Dixon-Woods is director of THIS Insitute, and a Health Foundation Professor of Healthcare Improvement Studies in the Department of Public Health and Primary Care at the University of Cambridge. Her work is concerned with generating a high quality evidence-base to support the organisation, quality and safety of care delivered to patients.

Talk Evidence - Bones, nutrition, pain relief, and overdiagnosis.

In this month’s Talk evidence, we’re going back to our roots and avoiding covid - so sit back and listen to Helen Macdonald and Joe Ross discuss a new nutrition study to prevent fractures in older adults by eating dairy, and a meta-analysis which helps you choose pain relief medications for management of osteoarthritis.
We’ll hear from Steven Woloshin about the virtual Overdiagnosis conference, and why he’s so excited about a new category in the National Library of Medicine.
Finally, we have a study on urinary retention and risk of cancer that has been over 25 years in the making.
Reading list;
Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care
https://www.bmj.com/content/375/bmj.n2364
Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis
https://www.bmj.com/content/375/bmj.n2321
To access the webinars Steven was talking about.
https://www.preventingoverdiagnosis.net/
Acute urinary retention and risk of cancer
https://www.bmj.com/content/375/bmj.n2305
Podcast listener survey. Please let us know how we could improve the podcasts for you, and your specialty - https://linktr.ee/BMJsurvey

Introducing Doctor Informed

Doctor Informed is a new podcast for hospital doctors, from The BMJ - created in collaboration with THIS Institute, and sponsored by Medical Protection.
Medical expertise is fundamental to the practice of medicine. But other skills and knowledge are important too. Doctor Informed gives the inside story on the evidence about giving the best care and having positive relationships with patients and colleagues.
In this trailer, meet two of the hosts of Doctor Informed - Clara Munro, a surgical trainee in the North East Deanery, and Jenni Burt, senior social scientist at THIS Institute.
www.bmj.com/podcasts/doctorinformed

Wellbeing - QI approach to improving your wellbeing

It's easy to decide to do something like exercise, or a hobby to improve your wellbeing, but actually following through and make that a regular part of your week can be much harder.
In this podcast, Pedro Delgado, vice president of the Institute for Healthcare Improvement, joins Abi and Cat to explain how he turned some of the QI methodology he's been taught over the years on himself, and improved his wellbeing during the pandemic.
www.bmj.com/wellbeing

Covid in south Asia - India and Nepal

In this podcast series, Kamran Abbasi, executive editor of The BMJ will convene experts from South Asia to discuss how the pandemic has affected the region, how measures like lock-down and vaccination have been handled, and the impact of the pandemic on the social determinants of health.
In this first podcast, we're focussing on India and Nepal, and are joined by;
Srinath Reddy, president of the Public Health Foundation of India.
Biraj Swain, who works in global development in Asia and East Africa, is a senior media critic
and Buddha Basnyat, director of the Oxford University Clinical Research Unit in Nepal.
For more covid coverage
www.bmj.com/coronavirus

Talk Evidence - testing for respiratory tract infections, cannabis for pain, & covid outcomes

This week our regular panelists, Helen Macdonald and Joe Ross, are joined by Juan Franco, editor in chief of BMJ Evidence Based Medicine - to take a primary care focussed look at what's been happening in the world of evidence.
On this week’s episode.
As kids go back to school, winter bugs surge and pressure mounts on health services we look at two trials which aimed to use reduce antibiotic prescribing for respiratory tract infections in nursing homes and primary care
Juan brings us an update on prescribing medicinal cannabis for pain, based on a recent BMJ rapid recommendation article and linked systematic review and meta-analysis
And finally, in covid news, how likely are you to be admitted or die from covid after one or two SARS-CoV 2 vaccinations?
Reading list
Effect of C reactive protein point-of-care testing on antibiotic prescribing for lower respiratory tract infections in nursing home residents - https://www.bmj.com/content/374/bmj.n2198
Procalcitonin and lung ultrasonography point-of-care testing to determine antibiotic prescription in patients with lower respiratory tract infection in primary care - https://www.bmj.com/content/374/bmj.n2132
Medical cannabis or cannabinoids for chronic pain - https://www.bmj.com/content/374/bmj.n2040
Risk prediction of covid-19 related death and hospital admission in adults after covid-19 vaccination - https://www.bmj.com/content/374/bmj.n2244

Wellbeing - tired or fatigued, and why the difference might matter

There has been a lot of work on the way in which surgeon's are affected by tiredness - and the whole medical workforce can probably relate to their experience.
But there's a difference between tiredness and fatigue, and that difference might be important in understanding what's happening in your own life.
Dale Whelehan is a physiotherapist, and PhD candidate at Trinity college Dublin, where he is investigating behavioural psychology and the effect of tiredness and fatigue on surgeons - in this podcast he describes how he thinks about those two things, what we know about the effect on wellbeing, and some strategies which might help manage them.

The future of Afghan healthcare

The infrastructure of Afghanistan healthcare is under threat, as international agencies who run clinics withdraw from the country. At the same time, some of the healthcare workforce are leaving the country, while those who remain face the prospect of their wages drying up as the economy of the country collapses.
But there remain people dedicated to providing healthcare, and in this podcast we hear from, Wais Mohammad Qarani, president of the Afghanistan Midwifery and Nurses Council, about what changes might be seen under the new regime, and what needs to be done to support care in the country.