Medicine and Science from The BMJ

Non-drug treatments for chronic insomnia

Between 13 & 33% of the adult population have regular difficulty in getting to sleep, or staying asleep. It's important to recognise the difference between acute and chronic insomnia, as treatment strategies differ.
David Cunnington, director of the Melbourne Sleep Disorders Centre, joins us to explain what non-drug interventions are available to help those with chronic insomnia.
Read the full clinical review:
http://www.bmj.com/content/355/bmj.i5819

Cancer drugs, survival, and ethics

Despite considerable investment and innovation, chemotherapy drugs have had little effect on survival in adults with metastatic cancer.
In this podcast, Navjoyt Ladher, clinical editor for The BMJ, talks to Peter Wise, former consultant physician and senior lecturer Imperial College School of Medicine, and author of a recent analysis on TheBMJ.com
Read the full analysis:
http://www.bmj.com/content/355/bmj.i5792

Advertising junk food to children

In the UK, junk food advertising is banned on children’s TV - but manufactures are still able to target children in other ways.  A recent report from the WHO  "Tackling food marketing to children in a digital world", takes a look at the issue.
In this podcast we're joined by João Breda, programme manager for nutrition physical activity and obesity at the regional office for Europe of the World Health Organisation, and Mimi Tatlow-Golden, lecturer in childhood studies and developmental psychology at the open university, and the lead author on the report.
Read the full report:
http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/publications/2016/tackling-food-marketing-to-children-in-a-digital-world-trans-disciplinary-perspectives-2016

Research before researching

To avoid waste of research, no new studies should be done without a systematic review of existing evidence. That argument has been made for 20 years, yet the lack of reference to a systematic review before designing new studies is still a problem.
Hand Lund, professor at the University of Southern Denmark joins us to explain why research before researching is still an issue.
Read the full analysis:
http://www.bmj.com/content/355/bmj.i5440

Rapid Recs - patient preference in heart valve replacement

In patients with symptomatic severe aortic stenosis but at lower risk of perioperative death, how do minimally invasive techniques compare with open surgery? Prompted by a recent trial, an expert panel produced these recommendations based on three linked rapid systematic reviews.
In this podcast we talk to Michael Shapiro who was a patient representative on that panel about what matters to patients, and how he found taking part in creating the recommendation.
Read the recommendation in full:
http://www.bmj.com/content/354/bmj.i5085

Catherine Calderwood’s realistic medicine

Catherine Calderwood has been chief medical officer for Scotland since March 2015 - her first CMO report, which she titled “Realistic Medicine” has created a stir beyond the borders of Scotland. The BMJ, sat down with Catherine at a the Preventing Overdiagnosis conference to find out what she intended with that report.
Read more:
http://www.bmj.com/content/355/bmj.i5455

Middle East respiratory syndrome

Middle East respiratory syndrome (MERS) is an acute viral respiratory tract infection caused by the novel betacoronavirus.
Cases have been limited to the Arabian Peninsula and its surrounding countries, and to travellers from the Middle East or their contacts.
The clinical spectrum of infection varies from no symptoms or mild respiratory symptoms to severe, rapidly progressive pneumonia, acute respiratory distress syndrome, septic shock, or multiorgan failure resulting in death.
In this podcast Sarah Shalhoub, infectious diseases consultant at King Fahad Armed Forces Hospital, in Saudi Arabia joins us to discuss the history of the disease, clinical presentation, and what can be done to support those infected.
Read the full clinical update:
http://www.bmj.com/content/355/bmj.i5281

Beyond data sharing - ”It was me who got my research team out of jail... that’s my data”

Elizabeth Pisani, visiting senior research fellow at King's College London, collects data on sex workers and injecting drug users in low and middle income countries.
For years she has been sharing her data, and joins us to explain why she went from being protective of her research to to making it freely available - and talk about some of the practicalities of keeping participants anonymous.
Read the full analysis:
http://www.bmj.com/content/355/bmj.i5295

Head to head - Should all GPs be NHS employees?

Independent contractor status creates unnecessary stress, argues Azeem Majeed, GP partner and professor of primary care at Imperial College London.
Laurence Buckman, GP partner and former head of the BMA GP committee, values his autonomy and distance from a non-benign employer.
Read the full head to head:
http://www.bmj.com/content/355/bmj.i5064
We also hear from former columnist and current partner in a federated practice, Des Spence, who thinks that the days of small GP surgeries are numbered.
Independent or employed? There is a third way. . .
http://www.bmj.com/content/355/bmj.i5329

Preventing Overdiagnosis In Barcelona

The Preventing Overdiagnosis conference is part of The BMJ's campaign against Too Much Medicine.
Helen Macdonald clinical editor for The BMJ was at the conference, and talked to some of the key speakers there about what they believe the key issues are, and what's being done to roll back the harms of too much medicine.
http://www.bmj.com/too-much-medicine
http://www.preventingoverdiagnosis.net/