Medicine and Science from The BMJ

Christmas 2016 - War

In this year's Christmas BMJ 2016 podcasts, we’ve been discussing morality, compassion, truth. In this final one, it's time for war.
After the second world war, there was an attempt to bring a moral sense to conflict - and Julian Sheather, specialist adviser on ethics and human rights to the BMA, and author of the christmas editorial “medicine under fire” is worried about the retrenchment of those ideals.
http://www.bmj.com/content/355/bmj.i6464
Peter Wever is a doctor in The Netherlands, and has been uncovering the story of the number 10 stationary hospital, in st-omer in northern france - a British army hospital that was targeted and destroyed during the first world war.
http://www.bmj.com/content/355/bmj.i6509

Christmas 2016 - truth, post truth, nothing like the truth

In response to the turmoil of 2016, with political campaigns being run on, and won on, misinformation - many commentators are disparing that we’ve become a post-truth society. And what is truth anyway?
Tracy Brown, director of Sense about Science, the charity set up to champion evidence in everyday life, is less pessimistic about the public's appetite for evidence.
http://www.bmj.com/content/355/bmj.i6467
Anders Huitfeldt, a postdoctoral scholar at Stanford University School of Medicine, and has been trying to puzzle out “Is caviar a risk factor for being a millionaire?”
http://www.bmj.com/content/355/bmj.i6536

Christmas 2016 - Health and happiness

Underneath all of our civilisation and science, we’re still primates - and the connection between patient and doctor can be reinforced by simply taking a hand.
Robin Youngson, cofounder of hearts in healthcare, and Mitzi Blennerhassett, who has written extensively on patient engagement, have co-authored an editorial calling for the humanisation of medicine, and we talk to them about the power of touch.
Read the editorial:
www.bmj.com/content/355/bmj.i6262
Andrew Steptoe is the British Heart Foundation professor of psychology, at University College London. He and colleagues have been using a large cohort study to measure the link between overall happiness and health.
Read the full research:
www.bmj.com/content/355/bmj.i6267

Christmas 2016 - ideologies and moralities

In an ideal world, policies would be evidence based - but governments are made of humans, who have positions and ideologies and moral bases.
In this podcast Anthony Painter, from the RSA will be talking about why universal basic income may work, but who’s proponents cross ideological barriers, and writer and philosopher AC Grayling explains how economic arguments become moral crusades.
A universal basic income: the answer to poverty, insecurity, and health inequality?
http://www.bmj.com/content/355/bmj.i6473
Morality and non-medical drug use
http://www.bmj.com/content/355/bmj.i5850

Education round up - November

The BMJ publishes a variety of education articles, to help doctors improve their practice. Often authors join us in our podcast to give tips on putting their recommendations into practice.
In this new monthly audio round-up The BMJ’s clinical editors discuss what they have learned, and how they may alter their practice.
In our second audio edition, GPs Sophie Cook and Helen Macdonald, surgical trainee Jessamy Baganel, and internalist and methodologist Reed Siemieniuk, talk about the evidence for vitamin D supplements.
http://www.bmj.com/content/355/bmj.i6201
The new Rapid Recommendation series in the BMJ
http://www.bmj.com/content/354/bmj.i5085
Communication with patients who have learning difficulties, or others who have experienced torture.
http://www.bmj.com/content/355/bmj.i5296
http://www.bmj.com/content/355/bmj.i5019
And safety netting of people with low, but not no, risk of cancer.
Can safety-netting improve cancer detection in patients with vague symptoms?

Caring for renal transplant patients

Renal transplantation improves quantity and quality of life compared with chronic dialysis. A UK general practice with 8000 patients will have around four patients with a functioning renal transplant, one patient on the transplant waiting list, and several under consideration for transplantation.
Many medical problems in renal transplant recipients will be managed by non-specialist clinicians, and this article provides advice for the non-specialist on managing renal transplant patients.
In this podcast, Tom Nieto, and Paul Cockwell from the Renal Services unit in the, College of Medical and Dental Sciences at the University of Birmingham, join us to discuss how non-specialists can spot problems early, and when it’s appropriate to talk about the potential for transplantation.
Read their full clinical update:
http://www.bmj.com/content/355/bmj.i6158

Margaret McCartney wants to fix the NHS

Glasgow GP, writer, broadcaster, and The BMJ's weekly columnist Margaret McCartney joins us to talk about her new book "The State of Medicine: Keeping the Promise of the NHS".
Read all of Margaret's columns:
goo.gl/iKmmie

Evidence for vitamin D supplimentation

Despite high quality systematic reviews reporting ineffectiveness, many guideline groups continue to recommend vitamin D supplementation (with or without calcium) for fall or fracture prevention. Recently Public Health England recommended that everyone needs vitamin D equivalent to an average daily intake of 10 μg (400 IU) to protect bone and muscle health,
In this podcast, Andrew Grey, associate professor of medicine at the University of Aukland joins us to discuss what the evidence says for who should, and who shouldn't take vitamin D supplimentation.
Read the full uncertainties article:
http://www.bmj.com/content/355/bmj.i6201

Blinding the randomisation

Allocation concealment - blinding which arm of a trial a patient is randomised to - is being questioned in an analysis published on thebmj.com.
David Torgerson, director of the York Trials Unit at the university of York and colleagues have been looking at the way in which trials do this randomisation, and how they subsequently report it - and have found both lacking.
Read the full analysis:
http://www.bmj.com/content/355/bmj.i5663

What to do after a concussion

Concussion is a clinical diagnosis made after a head injury with consequent associated signs, symptoms, and neurological or cognitive impairment (infographic - http://bmj.co/conrecG). In the absence of strong evidence, most recommendations on the management and recovery from concussion are based on international expert consensus.
In this podcast John Brooks, academic clinical fellow in general practice, and Simon Kemp, chief medical officer for the Rugby Football Union take us through the process of guiding a patient through recovery and back into everyday life, including sport.
Read the full 10 minute consultation:
http://www.bmj.com/content/355/bmj.i5629