The BMJ Podcast

Around half of people aged over 75 meet the diagnostic criteria for chronic kidney disease (CKD), but there is debate about what this means for patients as only a proportion of elderly people with CKD will have clinically important outcomes as a result.

In this podcast, Dr Arif Khwaja argues that for CKD in the elderly, we should focus on patient centered outcomes rather than applying population risks.

Read the full Analysis article: http://www.bmj.com/content/352/bmj.h6559

The claim that cancer screening saves lives is based on fewer deaths due to the target cancer. Vinay Prasad, assistant professor at Oregon Health and Science University, joins us to argue that reductions in overall mortality should be the benchmark and call for higher standards of evidence for cancer screening.

Read the full analysis:

http://www.bmj.com/content/352/bmj.h6080

Despite what hollywood says, science has proven that British teeth are actually better than American. Richard Watt, head of the Research Department of Epidemiology and Public Health at UCL explains how they came to that conclusion.

Read the full research:

http://www.bmj.com/cgi/doi/10.1136/bmj.h6543

Larger portions of food increase consumption. Theresa Marteau, director of the Behaviour and Health Research Unit at the University of Cambridge, joins us to discuss how government action to tackle portion size and packaging could help reset our appetites and make us thinner.

Read the full analysis:

http://www.bmj.com/content/351/bmj.h5863

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

The current orthodoxy is that home is the best and preferred place of death for most people, but in this podcast, Kristian Pollock a sociologist from Nottingham University questions these assumptions and calls for greater attention to improving the experience of dying in hospital and elsewhere.

Read the full analysis:

http://www.bmj.com/content/351/bmj.h4855

Following on from the clinical review "Caring for sex workers", we spoke to the team at Open Doors, a sex worker outreach clinic in east London, run from the Homerton University Hospital NHS Foundation Trust.

Kim Leveret and Anca Doczi join us to give practical advice on reaching out to sex workers, what barriers exist to them accessing care, and how to take a sex worker sexual history.

Listen to the author of the clinical review, Michael Rekart, talk about the infectious disease side of sex worker health in our accompanying podcast:

https://soundcloud.com/bmjpodcasts/sex-worker-health

Read the full review:

http://www.bmj.com/content/351/bmj.h4011

Practical advice for sex workers and health professionals, including links to Ugly Mugs:

http://www.opendoors.nhs.uk/

The historic reasons for high abortion rates in Romania, from the journal of family planning and reproductive healthcare:

https://soundcloud.com/bmjpodcasts/romanian-womens-fertility

Hepatic encephalopathy constitutes a spectrum of neuropsychiatric abnormalities, beginning with subtle psychomotor changes and progressing to confusion with asterixis, somnolence, and then coma, arising in patients with impaired liver function.

In this podcast, Tim Cross, a consultant hepatologist from the Royal Liverpool University Hospital, describes how to diagnose and manage the condition.

We're also joined by Ralph Crawford, who suffers from hepatic encephalopathy, to talk about the burden of the disease and the treatment from a patient's perspective.

Read the full review:

http://www.bmj.com/content/351/bmj.h4187

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has been examining the treatment of acute GI bleeds in England's NHS.

Two of the authors, Martin Sinclair, consultant surgeon, and Simon McPherson, consultant vascular radiologist, join us to talk about their findings.

Read the full report:

http://www.ncepod.org.uk/gih.htm

Read The BMJ news story:

http://www.bmj.com/content/351/bmj.h3488

Cervical screening programmes in many countries stop at around the age of 65 and much of the focus is often on younger women. However, comparatively little attention has been given to older women despite the fact that they account for about a fifth of cases each year and half of deaths.

In this podcast Susan Sherman, a senior lecturer in psychology at Keele University, and Esther Moss, consultant gynaecological oncologist at University Hospitals of Leicester NHS Trust, argue that the upper age limit for cervical screening needs revisiting and call for awareness campaigns to target older as well as younger women.

Read the full analysis:

http://www.bmj.com/content/350/bmj.h2729