Medicine and Science from The BMJ

Wellbeing - Humanising medicine

In medicine, a lot of work has been done to encourage person centred care - but can that maxim be extended to the people working within the healthcare system?
Subodh Dave has just been elected as dean of the Royal College of Psychiatrists, and joins us fresh from talking at the International conference on physician health to speak about his ambition to humanise medicine.
In this podcast, Subodh, Abi and Cat discuss what lessons from the pandemic need to remain, why at this time it's really important to look out for your colleague with family overseas, and how ice cream trucks meant much more than a cold treat.
www.bmj.com/wellbeing

Wellbeing - After shielding

On this wellbeing podcast, Abi and Cat are joined by Emma Lishman, a clinical psychologist and part of the North Bristol NHS Trust's staff wellbeing team.Emma helps doctors return to training after a break - be that for maternity leave, or covid-19.
Emma describes some of the fears that doctors who have been shielding have expressed coming back onto the ward, the ways in which teams may inadvertently make those worse, and the problems with complying with risk assessments in the face of staffing pressures.
Wellbeing podcasts have focused a lot on the importance of openness about mental health in the NHS, but in this podcast, you'll also hear how reluctant clinicians are to discuss physical health problems - and why the taboo around all aspects of illhealth needs to be tackled.
For more wellbeing
https://www.bmj.com/wellbeing

Coronavirus second wave - headaches abound

Recorded on Tuesday 13th of April, as the shops open in the UK, and England is heading to the beer gardens. The roll out of the vaccination programme has completed its first phase, and second doses have been given to the most vulnerable people - and now the under 50s are starting to get their first doses.
In this podcast, Duncan Jarvies, multimedia editor for The BMJ, talks to; Partha Kar, consultant in diabetes and endocrinology in Portsmouth, Matt Morgan, a consultant in a intensive care medicine in Cardiff, and Helen Salisbury, GP in Oxfordshire.
The genomicc trial Matt mentions is still recruiting - if you're interested more detail is available here https://genomicc.org/

Measure the broader impacts of healthcare

The synergistic linking of increasing health and wealth is broadly accepted - it's an integral part of the thinking between the Sustainable Development Goals, and the World Bank's call for universal healthcare as a way of boosting a country's economy.
But the quantification of that link - the extent to which a particular health intervention, has broader economic impacts, is actually pretty poorly understood.
In this podcast, we hear from some economists, who have an idea about how we could - fairly easily - measure those impacts at the same time we measure clinical efficacy.
Joining us are, Dean Jamison, professor emeritus of global health at the University of Washington
Osondu Ogbuoji, assistant research professor at Duke Global Health Insitute.
Till Bärnighausen, director of the Heidelberg Institute of Global Health
Sebastian Vollmer, professor of development economics at the University of Göttingen
The collection that prompted this discussion is "Health, Wealth and Profits" - https://www.bmj.com/health-wealth-profits

Talk Evidence - children and covid, varients of concern, ivormectin update

The evidence geekery continues, and this week Helen Macdonald and Duncan Jarvies are joined again by Joe Ross, The BMJ's US research editor, and professor of medicine and public health at Yale.
This week we update you on treatment - the WHO's guidelines for covid and ivermectin, and why they're not ready to recommend it's use in treatment, and prophylactic anticoagulation treatment.
We hear about two papers from the UK and Switzerland which look at children and covid, and we pick up on varients of concern and long covid.
Reading list.
Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England
https://www.bmj.com/content/372/bmj.n628
Clustering and longitudinal change in SARS-CoV-2 seroprevalence in school children in the canton of Zurich, Switzerland: prospective cohort study of 55 schools
https://www.bmj.com/content/372/bmj.n616
Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study
https://www.bmj.com/content/372/bmj.n579
Early initiation of prophylactic anticoagulation for prevention of coronavirus disease 2019 mortality in patients admitted to hospital in the United States: cohort study
https://www.bmj.com/content/372/bmj.n311
Editorial - Prophylactic anticoagulation for patients in hospital with covid-19
https://www.bmj.com/content/372/bmj.n487
Living with Covid19 – Second review - Informative and accessible health and care research
https://evidence.nihr.ac.uk/themedreview/living-with-covid19-second-review/

Coronavirus second wave - vaccination roll out changes, uncertainty about long covid

In the UK, phase 2 of our coronavirus vaccination strategy may be delayed by supply problems, at the same time many GPs, who carried out the majority of the first vaccination phases, are declining to take on the addition burden and are trying to return to normal clinical work.
In this podcast, Duncan Jarvies, multimedia editor for The BMJ, talks to the full panel; Partha Kar, consultant in diabetes and endocrinology in Portsmouth, Matt Morgan, a consultant in a intensive care medicine in Cardiff, Helen Salisbury, GP in Oxfordshire, and Nisreen Alwan, public health consultant in Southampton.

Wellbeing - Put yourself first

In this Wellbeing podcast, sponsored by medical protection, Abi Rimmer and Cat Chatfield talk to Susanna Petche and Reina Popat, GPs and members of First You - an organisation of healthcare workers, promoting wellbeing in the NHS.
They discuss why it is that clinicians learn to subjugate their own wellbeing to their patients', and the ways in which working in the healthcare system perpetuate that. They discuss how systemic change can come through individual action, and how peers can band together to support each other.

What should ”following the science” mean for government policy?

This round table, recorded at the nuffield summit 2021, asks what does following the science actually mean - do ministers understand the nuance of the science in the pandemic, and how does uncertainty get interpreted through the lens of ideology and the power of compelling stories.
Taking part are:
Kamran Abassi, executive editor of The BMJ
Partha Kar, consultant in diabetes and endocrinology
Deborah Cohen, health correspondent for BBC Newsnight
Tom Sasse, associate director at the Institute for Government
Christina Pagel, professor of Operational Research at University College London
Matt Morgan, intensive care consultant
Andy McKeon, chair of the Nuffield Trust
Isobel Hardman, assistant editor of The Spectator
Mary Dixon-Woods, director of This Institute
Ben Page, chief executive of Ipsos MORI
Alexandra Freeman, executive director of the Winton Centre for Risk & Evidence Communication
Will Moy, chief executive of Full Fact
Nigel Edwards, chief executive of the Nuffield Trust

Talk Evidence - Inside the JCVI, and the key to grading evidence

In a slightly different talk evidence, Helen Macdonald and Duncan Jarvies are bringing you a couple, of in depth interviews,
Firstly, Anthony Harnden, GP, academic and member of the UK's Joint Committee on Vaccination and Immunisation takes us inside their decision making, and explains what evidence they look at, how they assess it, and what the next year of vaccination may look like.
Also in this episode, Gordon Guyatt, one of the founders of EBM, joins us to talk about Grade - the framework in which evidence for guidelines can be assessed - and explains why the most important thing is not the RCTs, but being very clear about what the guideline is supposed to achieve.
https://www.gov.uk/government/groups/joint-committee-on-vaccination-and-immunisation
https://www.gradeworkinggroup.org/

Stephen Thomas - Behind the scenes in the Pfizer vaccine trial

Never has the spotlight been as strong on a clinical trial as that on the Pfizer BioNTech vaccine, the first approved for covid-19.
In this interview, Joanne Silberner spoke to its lead principal investigator, Stephen Thomas chief of infectious diseases at SUNY Upstate Medical University, New York, became the lead principal investigator for one of the most closely watched clinical trials in history.
They discuss the moment the positive results came through, what will happen to the people who are still enrolled in the trial, but got a placebo dose, and why the trial was designed in the way it was.
www.bmj.com/coronavirus