Medicine and Science from The BMJ

Retracting abortion papers, deafness in the clinic, and 70 years of a medical orchestra

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 However, those papers are contested (including a paper published by BMJ), and some have been retracted already - Julia Littell and Antonia Biggs tell us how that science is being used in court, and why retraction is essential.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
 

Heidi Larson on misinformation, the right exercise to reduce depression, and Breathtaking TV

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
 
 
 

A health and care emergency, the US constitutional weakness for pandemic response, ActionAid in conflict zones

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

Christmas 2023 - performing medicine, and prescribing nature

 
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 Podcast00:36 Exploring the Themes of the Christmas Edition01:38 The Intersection of Medicine and Performance02:33 The Art and Science of Performance in Medicine05:04 The Role of Performance in Music06:29 The Similarities Between Medicine and Music08:06 The Role of Experiential Learning in Performance14:11 The Impact of Audience on Performance19:04 The Benefits of Nature and Green Prescribing24:52 The Challenges of Measuring the Impact of Nature Prescribing30:37 The Community's Engagement with Nature Prescribing33:01 Conclusion and Farewell

Oxytocin, clinical outcomes, and patient choice, in resource constrained settings

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

Social connection is essential for health; supporting adolescent health and wellbeing

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

Give children control; supporting adolescent health and wellbeing

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

It’s time for an educational revolution; supporting adolescent health and wellbeing

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

Insulin without refrigeration and the complexities of consent

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

The future of the winter ’flu season

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.