Medicine and Science from The BMJ

Sarah Wollaston - obesity, not a sugary drinks tax, is regressive

The UK Parliament's Health Select Committee's recent report on childhood obesity says 1 in 5 children are obese by the time they leave school. The committee calls for legislation to turn the tide by taxing sugary drinks, a pre-watershed ban on junk food advertising, and investment in public health.
We joined Sarah Wollaston, conservative MP for Totnes, and chair of the committee for lunch (thai chicken soup) to discuss their recommendations.

The diagnosis and treatment of post-traumatic stress disorder

PTSD may develop after exposure to exceptionally threatening or horrifying events. About 3% of the adult population has PTSD at any one time, and more than 50% in survivors of rape.
In this podcast Jonathan Bisson, professor of psychiatry at the School of Medicine in Cardiff joins us to talk about the evidence for diagnosis and treatment, and Sarah Cosgrove, the patient author of the paper, discusses her experience of treatment.
Read the full clinical review:
http://www.bmj.com/content/351/bmj.h6161

The evidence on doctors strikes and patient harm

Doctors considering strike action may worry about the effect on patients. David Metcalfe and colleagues examine the evidence and find that “patients do not come to serious harm during industrial action provided that provisions are made for emergency care.”
Read the full analysis:
http://www.bmj.com/content/351/bmj.h6231

Revisiting the bridge

In the podcast, we’ll hear from Kevin Hines the survivor of such an attempt, and Alys Cole-King, a psychiatrist who wants to break down the stigma of suicide.
Originally broadcast in 2010
For more on suicide risk assessment and prevention, read our latest clinical review:
http://www.bmj.com/content/351/bmj.h4978

Unexpected findings, with uncertain implications, in research imaging

When healthy volunteers are scanned as part of a research project, unexpected findings, with uncertain implications, can be thrown up.
Joanna Wardlaw, professor of applied neuroimaging and honorary consultant neuroradiologist at the University of Edinburgh, joins us to discuss how her group deals with these incidental findings, and what volunteers and patients want to happen when they are found.
Read the full analysis:
http://www.bmj.com/content/351/bmj.h5190

This house believes that medicine is the best career in the world.

Medicine has long been a rewarding career, but doctors say the profession needs to overcome the frustrations of working in the NHS to ensure it remains so.
During the Big Debate at BMJ Live in London last week six speakers argued for and against the motion, “This house believes that medicine is the best career in the world.” After presentations from the six speakers and questions from the floor, the audience voted in favour of the motion.
Arguing the motions are:
Jennie Watson, medical student, Imperial College (for)
Janis Burns, junior clinical fellow, Royal Brompton and Harefield NHS Foundation Trust (against)
Helgi Johannsson, anaesthetic consultant, Imperial College Healthcare NHS Trust(for)
Pete Deveson, GP, Epsom, Surrey(against)
Clare Gerada, medical director, Practitioner Health Programme(for)
Partha Kar, diabetes and endocrinology consultant, Portsmouth Hospitals NHS Trust(against)
edit: To see Pete Devesons slides - check out https://www.youtube.com/watch?v=cfRezS1dZJY

Diagnosis and treatment of diabetic ketoacidosis in adults

Shivani Misra, clinical research fellow and specialist trainee in metabolic medicine from Imperial College London, joins us to discuss diagnosis and management of diabetic ketoacidosis in adults. She talks us through UK and US guidelines, and explains what the latest evidence tells us about prescribing fluid and insulin.
Read the full clinical review:
http://www.bmj.com/content/351/bmj.h5660

Europe’s impending syrup tsunami

Europe's common agricultural policy (CAP) on sugar is due to change, and Emilie Aguirre, from the UKCRC Centre for Diet and Activity Research at the University of Cambridge, argues that an influx of cheap high fructose corn syrup (HFCS, isoglucose) into the European market will have a negative effect on on the health of the continent.
Read the full analysis here:
http://www.bmj.com/content/351/bmj.h5085

Mark Britnell - You have to value your workforce

“The people of the UK are right to treasure their NHS,” writes Mark Britnell in his new book In Search of the Perfect Health System (Palgrave Macmillan). Currently chairman of KPMG Global Health, Britnell has worked in healthcare systems in over 60 countries. For his book he analysed 25 healthcare systems in search of what was working and what wasn’t in times of challenging demographic and economic change. He doesn’t find perfection, but against the others the NHS measures up pretty well.
Buy the book:
http://www.amazon.co.uk/In-Search-Perfect-Health-System/dp/1137496614

The junior doctor protest

Thousands of NHS staff have demonstrated against the government’s threatened “imposition” of an “unsafe and unfair” contract for junior doctors.
At a London rally on Saturday 17 October junior doctors and supporters noisily defended their trade union, as speakers accused England’s health secretary, Jeremy Hunt, of misleading the public about research evidence on weekend mortality rates in hospitals and the nature of contract negotiations.
Matt Limb was there for the BMJ, finding out why junior doctors are so angry.
Read more:
http://www.bmj.com/content/351/bmj.h5572