Medicine and Science from The BMJ

Low carb and cancer screening

Each episode of Talk Evidence we take a dive into an issue or paper which is in the news, with a little help from some knowledgeable guests to help us to understand what it all means for clinical care, policy, or research. 
 
In this episode:
Helen Macdonald take a deep dive into cancer screening tests, prompted by a paper in JAMA which showed most have no effect on all cause mortality, and news that the NHS is evaluating a single test which screens for 50 common cancers - we ask Barry Kramer, former director of the Division of Cancer Prevention, at the U.S. National Cancer Institute to help explain how to hold those two pieces of knowledge.
Juan Franco has been looking into diet and obesity, prompted by new research in The BMJ and a new Cochrane review, looking at the role of low glycemic index foods in weightloss - we ask Khadidja Chekima, nutritional researcher at Taylor’s University in Malaysia, to define low GI foods, and why it’s so hard to research their role in diet and weightloss 
 
Reading list;
JAMA research - Estimated Lifetime Gained With Cancer Screening Tests; A Meta-Analysis of Randomized Clinical Trials
The BMJ news - Clinicians raise concerns over pilot of blood test for multiple cancers
The BMJ research - Association between changes in carbohydrate intake and long term weight changes: prospective cohort study
Cochrane review - Low glycaemic index or low glycaemic load diets for people with overweight or obesity

Decolonising health and medicine: Episode 5 - Getting our house in order: Decolonising the British Medical Association

Organisational and student leaders explore the responsibilities of the British Medical Association and The BMJ to understand and respond to its colonial history.
Our panel
Kamran Abassi, editor in chief, The BMJ, London, UK
Omolara Akinnawonu, Foundation year doctor, Essex, UK, and outgoing co-chair of the BMA medical students committee
Latifa Patel, elected chair of the UK BMA's Representative Body and BMA EDI lead
Host - Navjoyt Ladher, clinical editor for The BMJ
 

Decolonising health and medicine: Episode 4 - How to transform global health institutions born of colonial eras

Leaders from academic and funding organisations discuss the transformative change required to overcome extractive and inequitable research practices in global health, and the need for examining power and privilege within traditional research institutions.
Our panel
Samuel Oti, senior program specialist, International Development Research Centre, Ottawa, Canada, and member of the Global Health Decolonization Movement in Africa (GHDM-Africa)
Muneera Rasheed, clinical psychologist and behaviour scientist and former faculty, Aga Khan University, Karachi, Pakistan
Liam Smeeth, professor of clinical epidemiology and director of the London School of Hygiene and Tropical Medicine, London, UK
Angela Obasi, senior clinical lecturer, Liverpool School of Tropical Medicine, UK
Seye Abimbola, editor of BMJ Global Health, and health systems researcher from Nigeria currently based at the University of Sydney, Australia
Jocalyn Clark, international editor, The BMJ, London, UK
Host - Navjoyt Ladher, clinical editor for The BMJ
 

Decolonising health and medicine: Episode 3 - Common terrains of anti-colonial and feminist approaches to the politics of health

International health leaders discuss how feminist and decolonial advocates in health face similar resistance and attempts to sow divisiveness, and how they can join forces to promote health equity and justice for all.
Our panel
Raewyn Connell, sociologist and professor emerita at the University of Sydney, Australia
Sarah Hawkes, professor of global public health and director of the Centre for Gender and Global Health, University College London, UK
Sanjoy Bhattacharya, head of the school of history and professor of medical and global health histories, University of Leeds, UK
Asha George, professor and South African research chair in health systems, complexity, and social change, University of the Western Cape, South Africa
Host - Navjoyt Ladher, clinical editor for The BMJ
 

Decolonising health and medicine: Episode 2 - Looking back to move forward: missing histories of the decolonisation agenda

Experts discuss how failing to confront colonial pasts is linked to present lack of progress in global health equity, why health leaders need historical educations, and how, for Indigenous peoples, it’s not just a colonial history but a colonial present.
Our panel
Seye Abimbola, editor of BMJ Global Health, and health systems researcher from Nigeria currently based at the University of Sydney, Australia
Catherine Kyobutungi, Ugandan epidemiologist and executive director of the African Population and Health Research Center, Nairobi, Kenya
Sanjoy Bhattacharya, head of the school of history and professor of medical and global health histories, University of Leeds, UK
Chelsea Watego, professor of Indigenous Health at Queensland University of Technology, Australia
Host - Navjoyt Ladher, clinical editor for The BMJ

Decolonising health and medicine: Episode 1 - The colonial legacy in clinical medicine

Healthcare leaders discuss the ways in which colonial-era bias and eugenics persist in today’s medical education and clinical practice in the UK and beyond, and what meaningful change is required to overcome racial and other healthcare inequalities
Our panel
Annabel Sowemimo, sexual and reproductive health registrar and part-time PhD student and Harold Moody Scholar at King’s College London, UK
Thirusha Naidu, head of clinical psychology, King Dinuzulu Hospital, and associate professor, Department of Behavioural Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
Subhadra Das, UK based researcher and storyteller who specialises in the history and philosophy of science, particularly scientific racism and eugenics
Amali Lokugamage, honorary associate professor, Institute of Women's Health, University College London, and consultant obstetrician and gynaecologist, Whittington Hospital, London, UK
Host - Richard Hurley, collections editor at The BMJ

Planet centred care - How to talk about this stuff

We’ve heard throughout the series from people who have a passion for sustainability, and have successfully made changes in their organisations to reduce the planetary impact of their work. In doing so, they will have recruited other people who have a similar outlook - but they will have also convinced people who aren’t prioritising sustainability.
 
In this last podcast of the series, we’re delving into that - how to talk to colleagues and patients, in ways which connect with their own needs and preferences.
 
To help with that, we’re joined by David Pencheon, director of the Sustainable Development Unit for NHS England, who’s been successfully talking about these issues for years, and Kate Wylie, executive director of Doctors for the Environment Australia.

Planet centred care - Why doing less can be hard

One element of sustainable healthcare is simply reducing the amount of healthcare you’re doing by not doing the things that are of no value to patients. However, how do we do this in practice? And why is it often so hard? What is the role of fear in this discussion? These are all questions we will discuss in this episode.  
 
To help us with this we’ll be joined by Prof Ben Newell (cognitive psychologist from University of New South Wales, whose research interest includes judgement and decision making). and Dr Lucas Chartier,  emergency medicine physician at the University Health Network in Toronto.
Ben Newell also has also recently released a book, Open Minded, co-authored with David Shanks on the role of the unconscious mind in our decisions making 

Planet centred care - Sustainable healthcare is better for patients

Acting on climate change is often framed as having to give stuff up, to cost more money, to make sacrifices. Yet in healthcare we find the opposite can often be true: there are many actions we can take which reduce the carbon footprint of healthcare which actually end up with better outcomes for our patients. In this episode, we hear from two examples of that.
Singing for breathing is a type of social prescribing to help people with chronic lung disease manage their breathlessness, reducing their need to be reliant on healthcare to do this, while also finding joy and a sense of community. Stephen is one patient who has benefited from this service, and will tell us more about the impact it had on his life.
In another example, Lynn Riddell, an HIV consultant will tell us how a change in their clinical pathway helped a cohort of patients reduce the amount of travelling to and from the clinic, still manage their condition safely and give them back precious time and control. 
 
https://www.bartscharity.org.uk/our-news/singing-sessions-to-improve-patients-lung-health/

Planet centred care - Sustainable healthcare is good for staff

Ooops! If you listened to episode 3 when it first came out you may have realised that the title didn't quite match the content. We've just updated the title and the show notes below, and stay tuned for when we'll be soon releasing an episode on how sustainable healthcare can be good for patients.
 
In a system where healthcare workers are continually described as overworked and burnt out, how can we expect them to find the time to act on the climate? In this episode we turn that assumption on its head, and, in fact, show how acting to reduce the environmental impact of healthcare can help staff find joy in their work again. Our two guests today are Tracy Lyons, founder of Pharmacy Declares and medicines optimisation pharmacist in Dorset, UK, and David Smith, general surgeon at North York General Hospital in Toronto, Canada.
 
The very worst thing is sometimes to have a problem you feel you can’t solve, and action mitigates anxiety: these are two of the many lessons that came out of today’s episode. We also touch on the different levels that you can start to take action at: from the small and tangible to influencing change at a system level. 
 
Related links:
https://cascadescanada.ca/ 
https://www.pharmacydeclares.co.uk/ 
https://twitter.com/TLyons00