Medicine and Science from The BMJ

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
To register for your free online place at BMJ Live 2020 visit
https://live.bmj.com/

Anthony Fauci - on changing science, long-covid, and political intrusion into health agencies

Dr Anthony Fauci needs no introduction, as head of the NIAID for almost four decades, and the U.S. government's leading advisor on infectious diseases, and leader in the country's response to Covid-19.
In this interview with The BMJ, Dr Fauci covers parallels in his experience in the HIV/AIDS crisis with this latest public health emergency. He talks about how his understanding of Covid-19 has changed.
We also tackle the reports of political intrusion into the CDC and, address worries about the rush toward a vaccine in time for the November elections.
For more from The BMJ's covid coverage, all available for free
https://www.bmj.com/coronavirus

Talking about obesity with Stephanie deGiorgio and Naveed Sattar

Fatphobia has been described as society’s last ‘ism’. Whilst our understanding of weight and health has changed over time, there is still a stigma towards people who are overweight or obese, and an assumption that they must be unhealthy, and unhealthy by choice. However, the correlation between weight and health may not be as clear cut as our societal biases would lead us to believe, and, therefore, the challenge for GPs is to make a conscious efforts to overcome our preconceptions so that they may provide the best support for our obese patients. This week, we discuss the need for a zero tolerance towards fat shaming at an organisational level, and how we can make GP practices more accessible for this group of patients. We also talk about retraining the palette in order to sustain weight loss, and our duty to lobby for better community-based weight management services.
Our guests:
Stephanie deGiorgio is a GP, and the clinical lead in the UTC at Queen Elizabeth The Queen Mother Hospital, Margate. She has a special interest in obesity.
Naveed Sattar is a professor of Metabolic Medicine at the University of Glasgow. His main research concerns investigating the prevention, causes and management of diabetes, heart disease and obesity.

Wellbeing - Mask shaming

The social norms that guide our behaviour in the world aren’t often quick to change - but the imperative to wear a mask in public has rapidly taken hold, establish by law, but policed by the public.
Mask shaming is a new phenomenon, but in this podcast, Brandy Schillace, author, historian and editor in chief of Medical Humanities (a BMJ journal) joins Cat and Abi to discuss how ineffective shaming is as a tool for behaviour change, and what mask-shaming reveals about the ways in which society treats those who are seen as non-conforming.
For more on The BMJ’s wellbeing campaign
www.bmj.com/wellbeing

Talk Evidence Covid-19 Update - Lockdown, a spoonful of honey, and weight loss

There are have been local lockdowns in the UK, in places such as Oldham, Birmingham, Manchester – but what is the criteria for making that decision?
In the non-Covid world: does honey alleviate symptoms in upper-respiratory tract infections? When does unexpected weight-loss warrant further investigation for cancer in primary care?
Plus, in the light of findings from the Cumberlege review of safety in medical devices, the team discuss the issue of doctors’ declaration of interests.

Time For A Pill Check With Anne McGregor And Tara Stein

Contraceptive pill check-up appointments used to be simple and straightforward for GPs, and frequently felt like a welcome reprieve from more complex consultations. However, there’s often more to them these days, especially given the rise in tailored regimens, with more and more women moving away from the standard of 21 pills followed by a 7-day break.
In this week’s episode, we discuss common misconceptions around the pill cycle compared with a woman’s natural cycle, the various side effects caused by taking an oestrogen-dominant versus a progesterone-dominant pill, and the purely arbitrary nature of the standard regimen. How do we ensure that our patients are able to make an informed choice on their method of contraception, and how do we avoid the risk of contraceptive coercion?
Our guests:
Anne MacGregor is a professor, working in Secual ans Reproductive Healthcare at Barts Health NHS Trust. She is a specialist in women’s health, and also in headaches and migraines.
Tara Stein is a Family Medicine doctor at Montefiore Medical Center, and the Clinical Curriculum Manager for RHEDI – Reproductive Health Education in Family Medicine.