Medicine and Science from The BMJ

Deep Breath In - EUPD with Leisha Davies, Soumitra Burman-Roy and Marie Stella McClure

Personality disorder is often referred to as the “Cinderella” diagnosis of mental health. Around 1 in 20 people is estimated to have a personality disorder, and it is a neglected and under-resourced area of our healthcare system. In this week’s episode, we discuss the stigma surrounding personality disorder, which can often manifest itself in high levels of anxiety for both patients and GPs, when it comes to diagnosing and managing it, and how to help a patient come to terms with their diagnosis.
With suicidal ideation being experienced by many people with a personality disorder on a regular basis, we also talk about how we may best manage a situation of a patient in crisis presenting in primary care.
Our guests:
Leisha Davies is a clinical psychologist, originally from South Africa, who currently works in private practice.
Soumitra Burman-Roy is a consultant psychiatrist at the South London and Maudsley NHS Foundation Trust. He also works for Maudsley Learning, an organisation which provides mental health training for primary care.
Marie Stella McClure, who was diagnosed with borderline personality disorder at the age of 38, is the author of ‘Borderline: a Memoir’, a book about her life and experiences of BPD.

Second wave updates - How it’s affecting practice now

As the second spike in covid-19 cases grows, we want to take stock of what's happening in the NHS. In these second wave updates, clinicians from primary care, secondary care, and public health, discuss what is happening in their field, and put questions to experts.
In this podcast, Fiona Godlee, editor in chief of The BMJ talks to Matt Morgan, consultant in intensive care medicine in Cardiff and Helen Salisbury, GP in Oxfordshire - they discuss how full hospitals are getting, how many covid-19 cases are presenting in primary care, and how treating patients has fared as the pandemic hots up.
For more on covid-19 visit https://www.bmj.com/coronavirus

Wellbeing - Dreading the second wave

The "second wave" of covid is hitting the UK, and clinicians are anticipating a spike in demand in the NHS. The inevitability of that is weighing on NHS staff's minds.
In this podcast, Cormac Doyle, a retired senior army officer, who specialises in military mental health/ veterans and support other with psychological trauma, returns to the podcast to talk about his experience of deployment in the military, and how individuals and their employers can make the inevitability of a second wave less daunting.
For more wellbeing from The BMJ - https://www.bmj.com/wellbeing

Economics for Drs - what you need to know to understand UBI and a jobs guarantee

As the economic fall out of covid-19 starts to bite, attention is turning to how the state can support everyone - especially if the pandemic turns into a depression.
Universal basic income, and a jobs guarantee are two of the potential mechanisms a country could deploy, both with different effects on people's health and wellbeing.
In this podcast, Martin Hensher, associate professor of health system financing and organisation at Deakin university in Australia, and author of the new analysis "Covid-19, unemployment, and health: time for deeper solutions?" joins us to get you up to speed on the economic thought behind these two schemes.
Read the full analysis;
https://www.bmj.com/content/371/bmj.m3687

Coughing kids with Tim Spector and Edward Snelson

Persistent coughing in children is always a challenge, both for parents trying to describe and measure the cough, and for doctors making a diagnosis. In the current climate, this is all the more difficult, seeing as a continual cough is one of the major symptoms of COVID-19. UK Government guidance advises that anyone with a persistent cough should get a coronavirus test. But with the reopening of schools and the beginning of the cold & flu season both coinciding with a national shortage of tests available, should we all err on the side of caution and try to get a test at the first sign of a cough or sniffle, or can the data on cold virus symptoms help parents and GPs make an informed judgement on the likelihood that their child’s cough indicates COVID?
Our guests:
Tim Spector is a professor of Genetic Epidemiology, and director of the TwinsUK Registry, at King’s College London.
Edward Snelson is a paediatrician in the paediatric emergency department at Sheffield Children’s Hospital.

Talk Evidence covid-19 update - antigen testing and developing non drug evidence

In this Talk Evidence covid-19 update, Jon Deeks, professor of biostatistics at the University of Birmingham gives us an update on testing technology. Will the point of care tests make a different to big live events, and how research and regulation need to change to tame the testing wild west.
Paul Glasziou, professor of evidence based practice at at Bond University has set up a new collaboration to try and get better at creating evidence for non-drug/vaccine control of pandemics - and ponders why we're good at drug research, but terrible at other kinds.

A way for healthcare to become net-zero for carbon

David Pencheon, Renee Salas and Ed Maibach join us to talk about how healthcare can, and should, take leadership on climate change.
With a few exceptions, the healthcare industry lags behind in efforts to reduce carbon emissions - in this podcast, we'll discuss why that is, why now is the time to take decarbonisation seriously, and why Covid-19 is a hindrance, but also a potential pivot point for change.
A pathway to net zero emissions for healthcare
https://www.bmj.com/content/371/bmj.m3785
For more on health and climate change
https://www.bmj.com/campaign/climate-change

’Flu vaccine season - with Nikki Turner and Jeff Kwong

With the annual flu season looming, GPs are anticipating a frenzy of vaccinations, perhaps more so than ever this year.
As so many 'flu and respiratory viruses circulate every year, and as the 'flu vaccine is for one strain of influenza only, is the vaccine worth getting, and what are the risks associated with vaccinating vs. not vaccinating?
In this week’s episode, we discuss the high vaccine uptake in New Zealand, and the role that social distancing for COVID-19 may have played in their low numbers of seasonal flu.
We also talk about whether or not the message we give to patients about the benefits and risks of vaccination is transparent enough, and how we might communicate better with them to allow them to make an informed decision.
We feel pressure to increase vaccination rates, because we believe we are protecting people, but does the evidence support that?
Our guests:
Nikki Turner is the director of the Immunisation Advisory Centre (IMAC) at the university of Auckland. She is an academic general practitioner, and a professor at the university.
Jeff Kwong is a professor at the University of Toronto, and the interim director of the Centre for Vaccine Preventable Diseases at the university’s Dalla Lana School of Public Health.

Talk evidence covid-19 update - covid in kids, and the winter cold season

This episode was recorded on 18 September - just before the news came out about the new lockdown measures. We’ll hear Carl and Helen’s thoughts, but we also want to hear a broad range of views - so get in touch at bmj.com/podcasts.
(1.15) The kids are back in school, and people are worried about the infection spreading. Helen takes us through the ISCARIC data on children's symptoms and outcomes from covid-19.
(5.50) David Ludwig, professor of pediatrics at Harvard Medical School and BMJ editor, joins us to give an overview of paediatric covid.
(15.30) Carl has thoughts about the spread of covid, and how it seems to be mirroring other respiratory illnesses.
(18.00) We wonder about the evidence for the "rule of six"

Nudge it

Nudging seemed to be all the rage a few years ago - a way of changing individual behaviours to help people make better choices, about their diet, exercise and other habits.
A lot of hype ensued, the UK government under Tony Blair even set up a “nudge unit” - but questions were asked about the efficacy of the approaches used, confusion about what a nudge actually was, and how to turn it into actual scalable change have followed the discipline.
In this podcast Craig Fox, behavioural scientist at UCLA, and author of a new analysis “Details matter: predicting when nudging clinicians will succeed or fail” joins us to explain why he thinks nudging could work in medicine.
https://www.bmj.com/content/370/bmj.m3256
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