Medicine and Science from The BMJ

In this episode, we speak to the doctor overseeing the WHO’s emergency response for the eastern mediterranean region - including Gaza, Lebanon, Sudan and Yemen. Richard Brennan joins us to talk about protecting health services, and workers, in the escalating armed conflicts that are affecting the region.

Menaka Paranathala and Emma Rourke, from The BMJ, are on to talk about improving research into women’s health. A new UK project, MESSAGE, aims to give consideration to sex and gender in life science research.

Palliative care is not just for end-of-life, and rethinking how it’s integrated into every speciality is the key to improving care for patients, argue Richard Harding, Anna Peeler, and Oladayo Afolabi from the Cicely Saunders Institute.

Links

• WISH report - Protecting Health in Armed Conflict

It’s an often cited statistic that if healthcare was a country, it would be the fifth largest carbon emitter. At The BMJ we want to change that, and move healthcare towards a more sustainable future. 

In this week’s episode, we’ll hear about our annual climate edition from two of The BMJ’s editors, Sophie Cook and Juliet Dobson. 

We’ll be diving into Cli-Fi and asking how climate fiction can galvanise our collective response to climate change. Our panel includes Howard Frumkin, professor emeritus at University of Washington. Lakshmi Krishnan, internist and Director of Medical Humanities at Georgetown university, and Sarah Grossman, journalist and author of Fire So Wild.

And Finally, Tereza Kasaeva, director of the WHO’s Global Tuberculosis Programme, explains how migration and food insecurity, exacerbated by climate change, are affecting TB - and why, despite effective treatment, there are still over a million deaths from the disease annually. 

Our panel's cli-fi book recommendations

• A Fire So Wild - Sarah Grossman

Links

• The BMJ’s annual climate issue

Lakshmi’s references

• Fundamental Role of Arts and Humanities in Medical Education 

How science can be transformed into policy?

One of the seemingly intractable issues when it comes to legislative change in the US is gun control.  One reason policy change is so difficult, is the US specific evidence vacuum, but that’s beginning to change.

We're joined by Louis Klarevas, an academic at the University of Colombia and author of the book “Rampage Nation, securing america from gun violence" and Shannon Watts, from Moms Demand Action which is a grassroots movement of Americans fighting for public safety measures that can protect people from gun violence.

Even when there is evidence, the trade-offs needed for legislative change can still paralyse policy makers. Citizen assemblies, a form of democratic participation that asks the public for their views, has helped clarify some key healthcare issues, from assisted dying in Jersey, to abortion access in Ireland.

Rebecca McKee from the Institute of Government argues they could be used to fix the NHS, and joins us to explain how.

Reading list

More gun regulation, less firearm harm

Citizens’ assemblies, health, and health policy

Under-nutrition harms health, but so does over-nutrition.

The Bill and Melinda Gate’s foundation has just released their Goalkeepers' report - highlighting the detrimental impact that poor nutrition is having on children’s health.  Rasa Izadnegahdar, director of Maternal, Newborn, Child Nutrition & Health at the foundation joins us to explain how they are targeting nutritional interventions.

Also this week, a new investigation in The BMJ has found that the UK government’s  Scientific Advisory Committee on Nutrition - the people who help guide the UK’s nutrition policy - have competing interests with the food industry. We hear from Chris van Tulleken, University College London; Rob Percival, the Soil Association; and Alison Tedstone, chair of the Association for Nutrition.

Reading list:

Goalkeepers Report 2024

UK government’s nutrition advisers are paid by world’s largest food companies, BMJ analysis reveals

The news that GPs in England have voted for industrial action has spooked the healthcare system - Katie Bramall-Stainer, the chair of the BMA's General Practice Committee explains what's lead to this, and why trust in the government has gone.

After the games, olympians and paralympians return to their normal lives - but what does that mean for their healthcare, especially in the US where insurance is expensive? Jonathan Finnoff, chief medical officer for the US Olympic and Paralympic committee joins us to explain how athletes are supported outside the games.

Reading list;

GP leader: “If general practice is the bedrock of the NHS, then the NHS is collapsing”

This week we're questioning the effectiveness of the Galleri Test for early cancer detection with investigation authors Margaret McCartney and Deborah Cohen. They delve into the decision-making and politics behind this test's introduction in the UK.

The episode also covers the growing NHS waiting list crisis and how Imran Ahmed and his team at Guy's and St. Thomas' NHS Trust are using high intensity theatre (HIT) lists to increase surgical throughput - and what other teams need to know, if a national rollout of this model is to happen.

Reading list

Galleri promises to detect multiple cancers—but new evidence casts doubt on this much hyped blood test

Are surgical HIT lists the answer to bringing down NHS waiting times?

The Paris games have just started - and France has made a concerted effort to ensure that this year's Olympics will have a legacy of physical activity for the whole population.

However, mega sporting events don't always have that effect, and Fiona Bull, head of physical activity for the WHO, joins us to explain why it's increasingly important that they do.

We'll also hear from Professor Sir Denis Perera Gray about how a lifetime of general practice, and why continuity needs to be at the heart of any improvement to primary care.

Finally, Harry Brunjes went from being a village GP to the chair of English National Opera, and explains what the two careers have in common.

Reading list

Olympic Games: linking sports mega events to population physical activity

We celebrate 10 years of patient and public partnership strategy at The BMJ with a patient-centred podcast.

Highlights:

01:52 - The Patient "takeover"

Women's Health, breast cancer screening, epidurals, and GP voices

New U.S. guideline on breast cancer screening  have been extended to women in their 40s -  Katy Bell, from the University of Sydney, and Stacy Carter, from the University of Wollongong explain why the good intention of that change wont be mirrored in outcomes - and may even induce harm.

Research in The BMJ shows epidurals during labour can reduce severe maternal morbidity Rachael Kearns describes why analgesia may improve those outcomes, and why some myths about epidurals may be reducing their usage.

Lastly,  a GP confronts the Prime Minister on the disintegration of the NHS and its effects on general practitioners.

02:23 Breast cancer screening guidelines

14:00 Epidurals and maternal morbidity

26:42 A GP confronts the Prime Minister 

Reading list:

Breast cancer screening from age 40 in the US

Epidural analgesia during labour and severe maternal morbidity: population based study

GP who confronted Rishi Sunak received “hundreds” of supportive messages from doctors