Medicine and Science from The BMJ

Terence Stephenson - looking back at chairing the GMC

Terence Stephenson is a consultant paediatrician who became been chair of the General Medical Council in 2015.
His 4 year tenure has now come to an end, but during his time with the regulator the medical profession faced a number of challenges - the case of Hadiza Bawa Garba and a growing recruitment crisis in the NHS - the GMC is the gatekeeper for foreign doctors who who wish to work here. As the rules on EU doctors change, the GMC’s regulatory practice may have to change too.
In this podcast, Abi Rimmer, a report and editor for The BMJ, went to Terrence’s office to talk to him about his career at the GMC, and his perspective on how the organisation has responded to those challenges.
Read the related article:
https://www.bmj.com/content/363/bmj.k5402

How Coca-Cola shaped obesity science and policy in China

Susan Greenhalg is a research professor of chinese society in Harvard’s department of anthropology - not a natural fit for a medical journal you may think, but recently she has been looking at the influence of Coca Cola on obesity policy in China.
She has written up her investigation in an article published on bmj.com this week, and joins us in the podcast to talk about why a communist country would embrace a message from an icon of capitalism, and what attitudes toward financial conflicts of interest exist in the country.
Read the full feature:
https://www.bmj.com/content/364/bmj.k5050
Accompanying editorial:
https://www.bmj.com/content/364/bmj.l4

Coding at Christmas

For many of you Christmas is over and, you’re back to work. Admin piled up over christmas? Feeling resentful for all those forms, and the weird codes they make you put in them?
In this podcast I hope we can explain why that’s important, with 17th century death, the esoteria of reed codes, and why the WHO cares about spaceship accidents.
Consumption, flux, and dropsy: counting deaths in 17th century London
https://www.bmj.com/content/363/bmj.k5014
Christmas guide to clinical coding
https://www.bmj.com/content/363/bmj.k5209

Women in medicine at Christmas

2018 will go down in history as a year of reckoning as the year that that some men’s behaviour came back to bite them. The continuing impact of #MeToo across the world has prompted another round of thinking about women’s experiences in medicine, which can be seen this year’s christmas journal
In this podcast, Esther Choo and Eleni Lenos, join us to discuss their research into mother's experiences of being doctors - and how discrimination is still rife against them.
Also Sarah Lowry, from the Royal College of Physicians brings us some other women's voices - this time from the RCP exhibition "This vexed Question: 500 years of women in medicine"
Visit the exhibition:
https://www.rcplondon.ac.uk/events/vexed-question-500-years-women-medicine
Physician mothers’ experience of workplace discrimination: a qualitative analysis
https://www.bmj.com/content/363/bmj.k4926
A lexicon for gender bias in academia and medicine
https://www.bmj.com/content/363/bmj.k5218

Christmas Food 2018

the Christmas BMJ season is upon us - if you’re to go to our website now, you’ll see that it’s been a bumper year. In the podcast, we’re going to be bringing you a select few - we’ll be looking at motherhood. Trying to figure out what 17th Century causes of death were, and - as it’s christmas - in this pod we’ll be looking at food.
We talk to Frances Mason and Amanda Farley, from the University of Birmingham, about their RCT examining the “Effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period"
https://www.bmj.com/content/363/bmj.k4867
We also have Eric Robinson from the University of Liverpool explains how calorific restaurant food from his observational study,
"(Over)eating out at major UK restaurant chains"
https://www.bmj.com/content/363/bmj.k4982

Talk Evidence - Devices and facebook vaccines

In the second of our EBM round-ups, Carl Heneghan, Helen Macdonald and Duncan Jarvies are joined by Deborah Cohen, investigative journalist and scourge of device manufacturers.
We're giving our verdict on the sensitivity and specificity of ketone testing for hyperemesis, and the advice to drinking more water to prevent recurrent UTIs in women.
Deb joins us to talk about the massive, international, investigation into failing regulation for implantable devices - and shares some of the stories where these have harmed patients.
Finally, Carl is excised about antivaxer ads on facebook - but Helen has seen some pro-vaccine ones which are poor science too.
Reading list:
Diagnostic markers for hyperemesis gravidarum
https://www.ncbi.nlm.nih.gov/pubmed/24530975
Effect of Increased Daily Water Intake in Premenopausal Women With Recurrent Urinary Tract Infections
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2705079
The great implant scandle
https://www.bbc.co.uk/iplayer/episode/b0btjr55/panorama-the-great-implant-scandal
Facebook antivaccine ads
https://www.independent.co.uk/news/uk/home-news/anti-vaccination-antivaxxers-uk-advert-banned-facebook-post-vaccines-kill-babies-a8620831.html

Making multisectoral collaboration work

A new collection of articles published by The BMJ includes twelve country case studies, each an evaluation of multisectoral collaboration in action at scale on women’s, children’s, and adolescent’s health.
Collectively these twelve studies inform an overarching synthesis and accompanying commentaries, drawing together lessons learned in achieving effective multisectoral collaboration.
In this podcast, Wendy Graham, professor of obstetric epidemiology at the London School of Hygiene and Tropical Medicine, and Shyama Kuruvilla, senior strategic advisor to the World Health Organisation, join us to discuss what can be learned from those case studies.
Read all the case studies:
https://www.bmj.com/multisectoral-collaboration

Trojan Milk

Infant formula manufacturers were made pariah in the 70s, because of their marketing practices - this lead to “The Code”, adopted by the WHO, which set out clear guidelines about what those practices should be.
Now an investigation on bmj.com by Chris Van Tulleken, honorary senior lecturer at University College London, examines the practices associated with the marketing of specialist milk formula for children with cow’s milk protein allergy, and asks whether doctors organisations should be receiving money from that industry.
Read the full investigation:
https://www.bmj.com/content/363/bmj.k5056

The bone crushing nausea of hyperemesis

Nausea and vomiting in pregnancy affects around 70% of pregnancies. It is mild for around 40% of women, moderate for 46%, and severe for 14%.
By contrast, hyperemesis gravidarum is a complication of pregnancy rather than a normal part of it and occurs in around 1.5% of pregnancies. The psychosocial burden of HG can be heavy for women and their families.
In this podcast, Caitlin Dean Phd Candidate, Gillian Ostrowski, general practitioner, Rebecca C Painter, consultant obstetrician join us to explain what hyperemesis is like for those who experience it, and discuss what treatment options are available.
Read the full article:
https://www.bmj.com/content/363/bmj.k5000

God is in Operating Room 4

Healthy self confidence has an important role in surgery, but what came first - the surgeon or the ego?
In this conversation, Christopher Myers, Yemeng Lu-Myers, and Amir Ghaferi join us to talk about the (very few) surgeons who behave badly in theatre, and why that behaviour has persisted, and can be detrimental.
Read their full analysis:
https://www.bmj.com/content/363/bmj.k4537