We were accepting of an increase in deaths every winter 'flu season, but Ashish Jha thinks that is not longer a tenable position.

Lessons he learned during his time as the White House Covid-19 coordinator have convinced him we should be taking a different approach to the winter season.

In this interview with Mun-Keat Looi, The BMJ's international features editor, we hear about living with COVID, the future of antivirals, vaccines, and surveillance. They talk about long COVID, the investment required to fight future outbreaks effectively, and the role of the US in the global health response.

Each episode of Talk Evidence we take a dive into an issue or paper which is in the news, with a little help from some knowledgeable guests to help us to understand what it all means for clinical care, policy, or research. 

In this episode:

Helen Macdonald take a deep dive into cancer screening tests, prompted by a paper in JAMA which showed most have no effect on all cause mortality, and news that the NHS is evaluating a single test which screens for 50 common cancers - we ask Barry Kramer, former director of the Division of Cancer Prevention, at the U.S. National Cancer Institute to help explain how to hold those two pieces of knowledge.

Juan Franco has been looking into diet and obesity, prompted by new research in The BMJ and a new Cochrane review, looking at the role of low glycemic index foods in weightloss - we ask Khadidja Chekima, nutritional researcher at Taylor’s University in Malaysia, to define low GI foods, and why it’s so hard to research their role in diet and weightloss 

Reading list;

JAMA research - Estimated Lifetime Gained With Cancer Screening Tests; A Meta-Analysis of Randomized Clinical Trials

The BMJ news - Clinicians raise concerns over pilot of blood test for multiple cancers

The BMJ research - Association between changes in carbohydrate intake and long term weight changes: prospective cohort study

Cochrane review - Low glycaemic index or low glycaemic load diets for people with overweight or obesity

Organisational and student leaders explore the responsibilities of the British Medical Association and The BMJ to understand and respond to its colonial history.

Our panel

• Kamran Abassi, editor in chief, The BMJ, London, UK

Leaders from academic and funding organisations discuss the transformative change required to overcome extractive and inequitable research practices in global health, and the need for examining power and privilege within traditional research institutions.

Our panel

• Samuel Oti, senior program specialist, International Development Research Centre, Ottawa, Canada, and member of the Global Health Decolonization Movement in Africa (GHDM-Africa)

International health leaders discuss how feminist and decolonial advocates in health face similar resistance and attempts to sow divisiveness, and how they can join forces to promote health equity and justice for all.

Our panel

• Raewyn Connell, sociologist and professor emerita at the University of Sydney, Australia

Experts discuss how failing to confront colonial pasts is linked to present lack of progress in global health equity, why health leaders need historical educations, and how, for Indigenous peoples, it’s not just a colonial history but a colonial present.

Our panel

• Seye Abimbola, editor of BMJ Global Health, and health systems researcher from Nigeria currently based at the University of Sydney, Australia

Healthcare leaders discuss the ways in which colonial-era bias and eugenics persist in today’s medical education and clinical practice in the UK and beyond, and what meaningful change is required to overcome racial and other healthcare inequalities

Our panel

• Annabel Sowemimo, sexual and reproductive health registrar and part-time PhD student and Harold Moody Scholar at King’s College London, UK

We’ve heard throughout the series from people who have a passion for sustainability, and have successfully made changes in their organisations to reduce the planetary impact of their work. In doing so, they will have recruited other people who have a similar outlook - but they will have also convinced people who aren’t prioritising sustainability.

In this last podcast of the series, we’re delving into that - how to talk to colleagues and patients, in ways which connect with their own needs and preferences.

To help with that, we’re joined by David Pencheon, director of the Sustainable Development Unit for NHS England, who’s been successfully talking about these issues for years, and Kate Wylie, executive director of Doctors for the Environment Australia.

One element of sustainable healthcare is simply reducing the amount of healthcare you’re doing by not doing the things that are of no value to patients. However, how do we do this in practice? And why is it often so hard? What is the role of fear in this discussion? These are all questions we will discuss in this episode.  

To help us with this we’ll be joined by Prof Ben Newell (cognitive psychologist from University of New South Wales, whose research interest includes judgement and decision making). and Dr Lucas Chartier,  emergency medicine physician at the University Health Network in Toronto.

Ben Newell also has also recently released a book, Open Minded, co-authored with David Shanks on the role of the unconscious mind in our decisions making 

Acting on climate change is often framed as having to give stuff up, to cost more money, to make sacrifices. Yet in healthcare we find the opposite can often be true: there are many actions we can take which reduce the carbon footprint of healthcare which actually end up with better outcomes for our patients. In this episode, we hear from two examples of that.

Singing for breathing is a type of social prescribing to help people with chronic lung disease manage their breathlessness, reducing their need to be reliant on healthcare to do this, while also finding joy and a sense of community. Stephen is one patient who has benefited from this service, and will tell us more about the impact it had on his life.

In another example, Lynn Riddell, an HIV consultant will tell us how a change in their clinical pathway helped a cohort of patients reduce the amount of travelling to and from the clinic, still manage their condition safely and give them back precious time and control. 

https://www.bartscharity.org.uk/our-news/singing-sessions-to-improve-patients-lung-health/