Effective, efficient, patient-centred and safe healthcare is what we all want to see, and what the field of quality improvement is all about.

In these podcasts, Harriet Vickers talks to doctors and other healthcare professionals about how they’ve gone about improving care for their patients, and explores the ideas and techniques behind making change happen.

http://quality.bmj.com
 

Making the difference

The BMJ Best Practice podcast publishes interviews with clinical experts, aimed at healthcare professionals and students with an interest in keeping up to date with the latest scientific developments, evidence-based medicine and guidelines. 

BMJ Best Practice is ranked one of the best clinical decision support tools for health professionals worldwide.* Structured around the clinical workflow and updated daily, BMJ Best Practice uses the latest evidence-based research, guidelines and expert opinion to offer step-by-step guidance on diagnosis, prognosis, treatment and prevention.

bestpractice.bmj.com

*Kwag KH, González-Lorenzo M, Banzi R, Bonovas S, Moja L. Providing Doctors With High-Quality Information: An Updated Evaluation of Web-Based Point-of-Care Information Summaries

The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

BMJ Best Practice Podcast

Heart is an international, peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease. Each issue contains original research, accompanying editorials and reviews.
* The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Heart podcast

For 50 years, Drug and Therapeutics Bulletin (DTB) has provided rigorous and independent evaluations of, and practical advice on, individual treatments and the overall management of disease for doctors, pharmacists and other healthcare professionals. DTB has always been wholly independent of the pharmaceutical industry, Government and regulatory authorities. DTB is also free of advertising and other forms of commercial sponsorship.
Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page - https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309.
* The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

DTB podcast

Frontline Gastroenterology publishes articles that accelerate adoption of innovative and best practice in the fields of gastroenterology and hepatology. Frontline Gastroenterology is especially interested in articles on multidisciplinary research and care, focusing on both retrospective assessments of novel models of care as well as putative future directions of best practice. Specifically Frontline Gastroenterology publishes articles in the domains of clinical quality, patient experience, service provision and medical education.
Listen to our regular podcasts and subscribe in Apple Podcasts, Google Podcasts, Stitcher and Spotify.
* The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

FG podcast

In this podcast, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) review the May issue of DTB. In light of the "First do no harm" report, the editorial discusses the need for a mandatory register of payments made by pharmaceutical and medical device companies to healthcare professionals, healthcare organisations and patient support organisations (https://dtb.bmj.com/content/59/5/66).  The editors talk about the BTS guideline on long-term use of macrolides (https://dtb.bmj.com/content/59/5/67). The main article explores the use of CAR T-cell therapy (https://dtb.bmj.com/content/59/5/73) and the case report is of a patient who developed quinidine hypersensitivity (https://dtb.bmj.com/content/59/5/77).
Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). Thank you for listening.

May 2021 - Time for transparency

Giant cell arteritis is a common form of vasculitis in people aged 50 years or older. The extracranial branches of the carotid artery are usually affected.

Kenneth J. Warrington, Professor of Medicine, Mayo Clinic College of Medicine, gives us an overview of the condition.

For more on giant cell arteritis, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/177

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The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Giant cell arteritis

In this podcast, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) review the June issue of DTB. 
The list of articles mentioned in this podcast:
The Editorial “COVID-19 vaccination in pregnancy” - https://dtb.bmj.com/content/59/6/82
DTB select “Stepping down asthma treatment” - https://dtb.bmj.com/content/59/6/85
Review “Prescribing for pregnancy: managing diabetes” - https://dtb.bmj.com/content/59/6/88
Republished case report “Euglycaemic diabetic ketoacidosis in a 43-year-old woman with type 2 diabetes mellitus on SGLT-2 inhibitor (empagliflozin)” - https://dtb.bmj.com/content/59/6/93
Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). Thank you for listening.

June 2021 - COVID-19 vaccination in pregnancy

Today Brooke Patterson (@Knee_Howells) speaks with Dr Nonhlanhla Mkumbuzi (@DrNoeMkumbuzi). Dr Mkumbuzi is a physiotherapist, and completed her PhD in 2020 on the association of genetic risk factors with nociception and pain in chronic painful achilles and patellar tendinopathies. She is a post-doctoral research fellow at the University of Cape Town. Dr Mkumbuzi shares some eye-opening experiences as head physiotherapist for Zimbabwe National Rugby Teams. We discuss her recent editorial (https://bjsm.bmj.com/content/early/2021/05/10/bjsports-2021-104202) and the broad consideration of race, culture, gender, and economics in sport and exercise medicine. She shares some personal experience and advice for marginalised athletes, clinicians, and academics. Brooke discusses the opportunity to get involved in the BJSM global mentoring program (https://bjsm.bmj.com/pages/wp-content/uploads/sites/17/2021/03/BJSM-Global-SEM-Mentoring-Program.pdf). Mentors can submit a short statement of interest with your areas of expertise to bjsmglobalmentoring@bmj.com. Mentees can submit a short description of the proposed study, and the specific areas you could use assistance.

Out of sight, out of mind: the invisibility of female African athletes in SEM research. Ep #480

In this Talk Evidence, Helen Macdonald, Joe Ross and Duncan Jarvies discuss what's going on in the world of EBM.

Firstly, a while ago on the podcast, we concluded that excess mortality would be the best way to measure the impact of the pandemic - and now a new paper looks at different country's excess mortalitites over the past year. We're joined by author Nazrul Islam Physician-Epidemiologist at the University of Oxford (and a research editor for The BMJ) to talk about why comparisons may still not be sensible.

Read the full research here - https://www.bmj.com/content/373/bmj.n1137

The Delta variant is dominating headlines, and infections in the UK now - but until recently the Alpha one was ascendent, and new research has helped characterise how the mortality rate of that variant differed from previous viruses.  We discuss how that research was done.

Read the full research - https://www.bmj.com/content/372/bmj.n579

GP data in the UK - the planned cut-off for granting access to your GP data for researchers has been extended, but there are still a lot of questions remaining. Helen has tried to find out some basic answers, and is still confused.

Finally, the FDA has approved a new drug for treatment of dementia - and researchers (and the FDA's own panel of experts) are up in arms. Joe Ross tells us why he thinks the decision was the wrong one, and why patients may be harmed because of it. 

https://edition.cnn.com/2021/06/17/opinions/biogen-alzheimers-drug-opinion-ramachandra-ross/index.html

Talk Evidence - GP data, excess mortality and FDA approval

The highlights of this edition brought to you by the Editor-in-Chief of Frontline Gastroenterology Mark Beattie.
Read the UpFront of the July issue of Frontline Gastroenterology: https://fg.bmj.com/content/12/4/261
The full issue is now online: https://fg.bmj.com/content/12/4
Listen to our regular podcasts and subscribe in Apple Podcasts, Google Podcasts, Stitcher and Spotify.

Mark Beattie's UpFront July 2021

In this podcast, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) provide an overview of the July issue of DTB. The editors catch up on developments with proposals for all doctors in the UK to provide financial and non-financial declarations of interest. They discuss the problem of boron in chloramphenicol eye drop products and the impact on treating children aged under 2 years (https://dtb.bmj.com/content/59/7/98).  The editors also talk about PPIs for persistent throat symptoms (https://dtb.bmj.com/content/59/7/102), the dose of folic acid for use with methotrexate (https://dtb.bmj.com/content/59/7/103) and a case of a patient who developed severe hypophosphataemia with an oral bisphosphonate (https://dtb.bmj.com/content/59/7/107).
Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). Thank you for listening.

July 2021 - Chloramphenicol eye drops, boron, infants and fertility

It's been 25 years since the declaration on the rights of women, was signed in Beijing - and in that time the landscape of health car inequity has changed. To celebrate we created 3 podcasts, in collaboration with The WHO and UN University, as part of the collection on Women’s Health and Gender Inequalities

https://www.bmj.com/gender

In these podcasts we'll be hosting conversations between women early in, and some who are more advanced in, their careers - doctors, researchers, legislators and campaigners, all working towards building a future in which women can thrive.

As well as these in depth discussions, you will hear some shorter interviews from experts who have written for the collection. These give you a flavour of the bigger discussions going on in global health when it comes to gender equity - so keep an ear out for those during the discussions.

In this first podcast, Adrienne Germaine talks to Fila Magnus.

Adrienne starter her career as an activist for women's health in the 1970s, and went on to become president of the  International Women's Health Coalition

Fila Magnus is Director of Communications at the International Youth Alliance for Family Planning, and was born in the same year as the Declaration was signed.

Fila and Adrienne discuss campaigning, now and then, and how the work that led to the declaration can be built on, but is never over...

The additional interviews are from; Emma Fulu, Sheena Hadi, Oswaldo Montoya, and Claudia Garcia-Moreno.

Women's health and gender inequalities - Campaigning for change

Bulimia nervosa is an eating disorder, characterised by severe preoccupation about weight and body shape. Includes recurrent episodes of binge eating with compensatory mechanisms, such as self-induced vomiting, to prevent weight gain.

Debra Safer, Associate Professor, Co-Director of Stanford Eating and Weight Disorders Program, Stanford University School of Medicine, gives us an overview of the condition.

For more on bulimia nervosa, see BMJ Best Practice: https://bestpractice.bmj.com/topics/en-gb/441

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The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Bulimia nervosa

This month Dr Sunny Raju is joined by the fantastic Dr Jenny Epstein, a leading paediatric gastroenterologist and paediatric endoscopist, based in West London to learn about recent advances and how to practically manage Eosinophilic oesophagitis. Read the full article at https://fg.bmj.com/content/early/2020/09/06/flgastro-2019-101313 now.

Eosinophilic oesophagitis: recent advances and practical management

In this episode of the Heart podcast, James Rudd is joined by Professor Salim Virani and Dr Dhruv Mahtta from Baylor College of Medicine, Houston, Texas. They discuss their recent paper entitled "Recreational substance use among patients with premature atherosclerotic cardiovascular disease".

If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Link to published paper: https://heart.bmj.com/content/107/8/650

Recreational drugs and vascular health - a hidden epidemic

We know the pandemic has disproportionately affected the NHS workers who come from a ethnic minorities, we also know that doctors from an ethnic minority face additional barriers to accessing support - so how well have the various support schemes put in place during the pandemic helped those doctors from ethnic minorities?

Dammie Olubawale, medical student and grants and partnerships manager at Melanin Medics, joins us to talk about a fund they've created specifically to help doctors of black African and Caribbean heritage, to access support tailored to them.

Dammie explains some of the reasons which doctors, particularly from that heritage, may be more reluctant to access support - and how organisations large and small need to think about tailoring their wellbeing initiatives to include all staff.

To access the melanin medics wellbeing fund visit
https://www.melaninmedics.com/wellbeing-fund

Wellbeing - the need for culturally aware support

This week Nikki and Issy are joined by general surgical registrar Clara Munro, and author and co-founder of the Impostor Syndrome Institute, Valerie Young to talk about imposter syndrome in medicine. 

Article mentioned: https://hbr.org/2021/02/stop-telling-women-they-have-imposter-syndrome

Valerie’s website: https://impostorsyndrome.com/

Imposter Syndrome

In this episode of the Heart podcast, James Rudd is joined by Professor Chris Packard from the University of Glasgow. They discuss recent guideline changes in LDL targets and how these might be achieved in clinical practice.
If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2
Link to published paper: https://heart.bmj.com/content/early/2021/03/31/heartjnl-2020-318760

LDL cholesterol - how low should we go?

It's been 25 years since the declaration on the rights of women, was signed in Beijing - and in that time the landscape of health car inequity has changed. To celebrate we created 3 podcasts, in collaboration with The WHO and UN University, as part of the collection on Women’s Health and Gender Inequalities

www.bmj.com/gender

In these podcasts we'll be hosting conversations between women early in, and some who are more advanced in, their careers - doctors, researchers, legislators and campaigners, all working towards building a future in which women can thrive.

As well as these in depth discussions, you will hear some shorter interviews from experts who have written for the collection. These give you a flavour of the bigger discussions going on in global health when it comes to gender equity - so keep an ear out for those during the discussions.

In this first podcast, Lulit Yonas Mengesha talks to Cara Tannenbaum

Lulit Yonas Mengesha is right at the beginning of her medical career, she's a medical student in Ethiopia, but has already become passionate about woman's health

Cara Tannenbaum is is Scientific Director of the Institute of Gender and Health at the Canadian Institutes of Health Research.

Lulit and Cara discuss how women have been excluded from healthcare research - and how that affects practice today, how there are gaps in our understanding of basic biology, as well as how different life experiences affect outcomes.

The additional interviews are from; Lavanya Vijayasingham, Claudia Lopes, and Claire Wenham

Women’s health and gender inequalities - The science of women's health

What is a weighted ball velocity throwing program? Do they work, and what is the evidence of benefit? What are the risks involved and common injury patterns seen? Host Dr. Devin McFadden, MD is joined by Dr. Jason Zaremski, MD to explore these topics and more on the AMSSM Sports Medcast.

Dr. Zaremski is a clinical associate professor holding a joint appointment from the Departments of Physical Medicine and Rehabilitation and the, Department of Orthopaedics and Rehabilitation at the University of Florida. In addition he is the Co-Medical Director of the Adolescent and High School Outreach Program at the University of Florida. He is  a past participant in the AMSSM International Travelling Fellowship program, is a Co-Chair of the AMSSM Fellowship Committee and currently serves on the Board of Directors for the AMSSM.

 In this 17 minute conversation Dr. Zaremski addressed the following topics:
Defining a weighted ball velocity program
Considering the risks and benefits of their use
Determining what populations should not use these programs and how to safely implement them if athletes decide to pursue one.

 Zaremski JL. Weighted Ball Velocity Throwing Programs Are Effective. Are the Benefits Worth the Risk? Clin J Sport Med. 2020 Mar 11. doi: 10.1097/JSM.0000000000000822. Epub ahead of print. PMID: 33914497.
 Caldwell JE, Alexander FJ, Ahmad CS. Weighted-Ball Velocity Enhancement Programs for Baseball Pitchers: A Systematic Review. Orthop J Sports Med. 2019 Feb 12;7(2):2325967118825469. doi: 10.1177/2325967118825469. PMID: 30800693; PMCID: PMC6378453.
 Melugin HP, Smart A, Verhoeven M, Dines JS, Camp CL. The Evidence Behind Weighted Ball Throwing Programs for the Baseball Player: Do They Work and Are They Safe? Curr Rev Musculoskelet Med. 2021 Feb;14(1):88-94. doi: 10.1007/s12178-020-09686-0. Epub 2021 Jan 6. PMID: 33403626; PMCID: PMC7930148.

Weighted Ball Velocity Throwing Programs: Injury Risk or Competitive Edge? EP #481

Chronic sinusitis is inflammation of the paranasal sinuses lasting more than 12 weeks.

Symptoms include facial pressure, rhinorrhoea, postnasal drainage, congestion, and general malaise.

Raj Sindwani, Section Head of Rhinology, Sinus, and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic Foundation, gives us a clinical overview of the condition.

For more on chronic sinusitis, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/15

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The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Chronic sinusitis

The 19th of July in the UK saw the relaxation of covid rules that have been in place for 18 months - social distancing requirements in venues, mask wearing in public will no longer be legally mandated.

There are a lot of questions about what this will mean for the pandemic, and in this episode of Talk Evidence Helen MacDonald, Joe Ross and Duncan Jarvies are joined by Iain Buchan, professor of public health in Liverpool, who has been involved in 2 key studies on covid transmission. 

Firstly, lateral flow tests - the big questions has been how well do they work in the wild - and how well do they have to work, to be useful in test trace and isolate? Iain tells us about new research into the innova test.

Secondly, events - the football has shown that events can still be a big source of transmission, and the UK government put in place a number of trial events, all carefully monitored by public health researchers - Iain tells us about one nightclub test in Liverpool, and what we can glean from it.

Reading list;

Performance of the Innova SARS-CoV-2 antigen rapid lateral flow test in the Liverpool asymptomatic testing pilot: population based cohort study
https://www.bmj.com/content/374/bmj.n1637

The UK government's events programme
https://www.gov.uk/government/publications/events-research-programme-phase-i-findings/events-research-programme-phase-i-findings#findings
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/979461/S1195_Science_framework_for_opening_up_group_events.pdf

Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data
https://www.bmj.com/content/373/bmj.n1343

Optimizing Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older Adults (OPERAM): cluster randomised controlled trial
https://www.bmj.com/content/374/bmj.n1585

Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis
https://www.bmj.com/content/374/bmj.n1446

Talk Evidence - Freedom Day

In this podcast, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) provide an overview of the August issue of DTB (https://dtb.bmj.com/content/59/8). The editors talk about the MHRA's decision to reverse the EMA's decision and allow boron-containing chloramphenicol eye drops to be used in children aged below 2 years. They discuss a scheme in England that allows hospital staff to refer patients who would benefit from extra guidance around their medicines regimen for support from a community pharmacy (https://dtb.bmj.com/content/59/8/114). They also highlight the risk from concurrent opioid and benzodiazepine use (https://dtb.bmj.com/content/59/8/116), and talk about home blood pressure monitoring (https://dtb.bmj.com/content/59/8/119).
Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). Thank you for listening.

August 2021. Community pharmacy discharge medicines service: a step towards improved patient safety?

Kieran Walsh, clinical director at BMJ, asks editors from BMJ Learning and BMJ Best Practice to summarise the latest clinical guidance related to Covid-19.

Abigail Davis, GP and section editor, covers the latest evidence around vaccine immunogenicity in different immunosuppressed populations, as well as the use of interleukin-6 inhibitors in COVID-19 patients.

And Emma Scott, section editor, updates us on mucormycosis, or black fungus infection in COVID-19 patients.

For more, see:

BMJ Best Practice's topic on COVID-19: bestpractice.bmj.com/topics/en-gb/3000168

BMJ Learning module on COVID-19 rapid guideline on critical care (NICE): new-learning.bmj.com/course/10065100

BMJ Learning COVID-19 in primary care module: new-learning.bmj.com/course/10065230

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00676-0/fulltext

Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19: https://www.nejm.org/doi/full/10.1056/NEJMoa2100433

WHO Therapeutics and COVID-19: living guideline: https://app.magicapp.org/#/guideline/nBkO1E/section/LrV7OL

Indian Council of Medical Research advice on mucormycosis: https://www.icmr.gov.in/pdf/covid/techdoc/Mucormycosis_ADVISORY_FROM_ICMR_In_COVID19_time.pdf

COVID-19: Vaccine immunogenicity, interleukin-6 inhibitors, mucormycosis

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Drs Ferro and Khazi from Beth Israel Deaconess Medical Center in Boston. They discuss how new drugs are evaluated for cost-effectiveness and how we determine if they are affordable for both patients and healthcare systems.
If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2
Link to published paper:
https://heart.bmj.com/content/107/15/1267

How are novel cardiovascular drugs costed and paid for?

In the wellbeing podcast, we have had a lot of personal experience of the pandemic, and schemes to support staff - but always we've wanted to know if there's research which can tell us how universal those experiences have been.

In this podcast, Abi and Cat are joined by Danielle Lamb, senior research fellow at University College London, and Sam Gnanapragasam, clinical fellow in psychiatry at South London and the Maudsley NHS Trust. Danielle and Sam are both investigators on NHS Check - a representative survey of NHS staff about their mental wellbeing during covid-19.

https://nhscheck.org/

Wellbeing - surveying the mental health of NHS staff

Dr Philip Smith, Social Media and Associate Editor of FG and Consultant Gastroenterologist at the Royal Liverpool Hospital, Liverpool, UK interviews members of the UK ‘Green Endoscopy’ group, Dr James Maurice, Hepatology registrar at St Mary's Hospital in London, Dr William Stableforth, Hepatologist and Gastroenterologist at the Royal Cornwall Hospital, and Dr Bu Hayee Consultant Gastroenterologist, King’s College Hospital, London. This podcast focuses on the groups' work to date and the paper 'Green endoscopy: using quality improvement to develop sustainable practice' which was published online in Frontline Gastroenterology in 2021.
Related article: https://fg.bmj.com/content/early/2021/06/07/flgastro-2021-101874

Green endoscopy: using quality improvement to develop sustainable practice

Dan is a podiatrist and a senior lecturer at La Trobe University. He completed a PhD in 2019, where he investigated the use of foot orthoses for the prevention of injury in military recruits. In this episode, Brooke Patterson discusses with Dan the key considerations for clinicians when helping athletes make footwear choices. They discuss the role of performance and sponsorship, and Dan provides his opinion on Nike’s super spike in the lead up to the Tokyo Olympics. The role of injury, comfort, gender, and foot shape, and research in footwear design is discussed. 
Twitter:
@DanielRBonanno

Superspikes FTW? Footwear choice for athletes with Dr Dan Bonanno. Ep #482

It's been 25 years since the declaration on the rights of women, was signed in Beijing - and in that time the landscape of health car inequity has changed. To celebrate we created 3 podcasts, in collaboration with The WHO and UN University, as part of the collection on Women’s Health and Gender Inequalities

www.bmj.com/gender

In these podcasts we'll be hosting conversations between women early in, and some who are more advanced in, their careers - doctors, researchers, legislators and campaigners, all working towards building a future in which women can thrive.

As well as these in depth discussions, you will hear some shorter interviews from experts who have written for the collection. These give you a flavour of the bigger discussions going on in global health when it comes to gender equity - so keep an ear out for those during the discussions.

In this podcast, we're joined by lawyer and activist Hina Jilani, who has been campaigning for women's rights in her native Pakistan for her whole life. 

She and her sister set up the first female law firm in the country, she established a refuge for women who were fleeing violence and abuse, she was one of the founders of the Human Rights Commission of Pakistan, and is now an advocate on the country's Supreme Court. She is also one of The Elders.

Hina talks about her career, how she has pulled the various levers of change - lobbying for legislation, legal challenge, and protest - to improve the lives of women in Pakistan.

The additional interviews are from; Lia Quatrapella, Asha George, and Veloshnee Govender

Women’s health and gender inequalities - Legislating for change

This week Nikki and Anna are joined by Professor Doug Corfield from The University of Manchester Medical School to talk all things intercalation. From why to take a year out to all of the logistics involved, listen to find out more about doing an intercalated degree during your medical studies.

Should I intercalate?

Rota gaps are a big problem when it comes to loading stress on the medical workforce, and there is big pressure to spread the workforce as evenly as possible across wards and shifts.

However the tyranny of the rota - especially when changing rotations or working across multiple sites, means that often doctors personal wishes, or big life events are not taken into account.

The dehumanising status of becoming just a number in the system is not helping people have the kind of fulfilling careers that encourages people to stay within the workforce, and helps guard them from burnout.

So how do we square that circle? Anas Nader, CEO of Patchwork Health, joins us to talk about why his own burnout lead him to try and fix the rota problem - and where he has got to now.

Findout more at: https://www.patchwork.health/

Note - BMJ company has invested in patchwork health

Wellbeing - scheduling and burnout

The mental health of athletes has been in the spotlight throughout this summer, as high-profile athletes such as Naomi Osaka and Simone Biles have spoken out about the importance of prioritizing their physical, and especially their mental, well-being.

In this episode, host Dr. Giselle Aerni, MD is joined by AMSSM Past Presidents Dr. Cindy Chang, MD and Dr. Margot Putukian, MD to discuss the AMSSM Position Statement on Mental Health Issues and Psychological Factors in Athletes, which Dr. Aerni also co-authored.

In this 33-minute conversation, they address the following topics:
The importance of a position statement on the mental health of athletes and the novel aspects addressed in the document
The team-based approach to mental health care and why it’s a crucial component for the well-being of athletes
How the acceptance of mental health issues has evolved in recent years and the impact social media has on those perceptions
The impact of the COVID-19 pandemic on athletes’ mental health and how it reinforces the need for conversations about this vital issue

Resources:
Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement (https://bjsm.bmj.com/content/54/4/216.full)
Madam Athlete Podcast (https://madamathlete.com/)

The Importance of Mental Health in Athletes with Two AMSSM Past Presidents EP #483

In this podcast, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) provide an overview of the September issue of DTB. They discuss the US FDA's controversial decision to license aducanumab for Alzheimer's disease (https://dtb.bmj.com/content/59/9/130) and consider barriers to prescribing shorter courses of antibiotics in primary care (https://dtb.bmj.com/content/59/9/131). The editors also highlight the impact that some medicines have on oral health and dental treatment (https://dtb.bmj.com/content/59/9/135).
Before all of that though, the recent NICE's guideline on shared decision making. 
Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). Thank you for listening.

September 2021: Aducanumab for Alzheimer's, antibiotics, shared-decision making, and dental health

The Midlands Charter, is a set of principles that hospitals in the midlands region of England have signed up to, to improve the health and wellbeing of trainees working in the area. It was created in a huge collaboration of  trainees, NHS England, Health Education England and the GMC. 

Dan Smith is a junior doctor at Nottingham University Hospitals NHS Trust, and one of the authors of that charter. He joins us to explain how they're QI thinking to improve doctors wellbeing, and how other areas can follow their lead.

Read the full charter:
https://www.england.nhs.uk/midlands/information-for-professionals/nhs-midlands-charter/

To join the collaborative
https://future.nhs.uk/MidlandsCharter/grouphome

Junior doctors improving hospital wellbeing

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Clare Taylor from the University of Oxford. They discuss the high risk of events associated with an elevated BNP and how pathways to the diagnosis of heart failure might be improved.

If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2

Link to published paper:
https://heart.bmj.com/content/early/2021/06/28/heartjnl-2021-319196

BNP levels and risk of subsequent death and hospitalisation - an interview with Dr Clare Taylor

This week the panel discusses their tips for clinical years. From the logistics of commuting and hospital accommodation to speaking to your first patient - tune in to hear the panel's reflections and advice

Tips for clinical years

In this month's Talk Evidence, Helen Macdonald and Joe Ross are back with a wry look at the world of Evidence Based Medicine.

They give us a round up of real world data emerging to address various uncertainties about vaccinations against covid

Helen has an update on NHS Digital’s project to extract GP coding for planning of healthcare and research, and talks to Natalie Banner from Understanding Patient Data, to find out what the public really cares about.

Finally, as routine care must go on a clinical review on cardiovascular disease in older adults introduces us to geroscience.


Reading list

Vaccines;
Effectiveness of BNT162b2 and mRNA-1273 covid-19 vaccines against symptomatic SARS-CoV-2 infection and severe covid-19 outcomes in Ontario, Canada: test negative design study - https://doi.org/10.1136/bmj.n1943 

Effectiveness of the CoronaVac vaccine in older adults during a gamma variant associated epidemic of covid-19 in Brazil: test negative case-control study -  https://doi.org/10.1136/bmj.n2015

Associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 in nursing homes and healthcare workers in Catalonia: prospective cohort study
https://doi.org/10.1136/bmj.n1868

Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study - https://doi.org/10.1136/bmj.n1931 

CVD
Cardiovascular care of older adults - https://doi.org/10.1136/bmj.n1593

Talk Evidence - real world vaccine data, GP records and CVD

The highlights of this edition brought to you by the Editor-in-Chief of Frontline Gastroenterology Mark Beattie.
Read the UpFront of the September 2021 issue of Frontline Gastroenterology: https://fg.bmj.com/content/12/5/359
The full issue is now online: https://fg.bmj.com/content/12/5
Listen to our regular podcasts and subscribe in Apple Podcasts, Google Podcasts, Stitcher and Spotify.

Mark Beattie's UpFront September 2021

The final evacuation planes have left Kabul airport, and Afghanistan’s government have ceded power to the Taliban. 

Amongst the international community, worries about what that transition of power means for the people of Afghanistan have centred around the rights of women, access to education for the whole population, and the continuing prosperity of the country… However what this means for health is still uncertain.

Nadia Akseer is an Afghan scientist and epidemiologist, now working at John's Hopkins Bloomberg School of Public Health and who has published extensively the health of her home country 

Reading list;
Achieving maternal and child health gains in Afghanistan
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30002-X/fulltext

Association of Exposure to Civil Conflict With Maternal Resilience and Maternal and Child Health and Health System Performance in Afghanistan
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2754253

Coverage and inequalities in maternal and child health interventions in Afghanistan
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3406-1

Geospatial inequalities and determinants of nutritional status among women and children in Afghanistan
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30025-1/fulltext

Healthcare In Afghanistan Now

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Alastair Moss from the University of Leicester. They discuss the paradoxical effect of exercise on coronary artery calcification.
If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2
Link to published paper: https://heart.bmj.com/lookup/doi/10.1136/heartjnl-2021-319868

Is exercise bad for your calcium score?

This podcast is focused on the paper "Anorexia nervosa and the gastrointestinal tract”, published online in Frontline Gastroenterology in August 2021.
Dr Philip Smith, Social Media and Associate Editor of FG and Consultant Gastroenterologist at the Royal Liverpool Hospital interviews Dr Wisam Jafar, Consultant Gastroenterologist and Nutrition Lead at Stepping Hill Hospital, Stockport, Greater Manchester, UK. 
Read the paper: https://fg.bmj.com/content/early/2021/08/19/flgastro-2021-101857

Anorexia nervosa and the gastrointestinal tract

Today, Brooke Patterson hosts Annie Strauch and Catherine Etty-Leal, both experienced Australian physiotherapists with a Masters in Sports Physio and Musculoskeletal Physio. Annie’s passion for performance physiotherapy started in London’s West End where she managed performers in over 30 productions. After that, Performance Medicine (https://performancemedicine.com.au/) was born, a multidisciplinary clinic to provide singers, dancers and performers with tailored physiotherapy treatment.  Annie and Catherine both specialise in vocal physiotherapy, and provide some tips for online public speaking. They discuss injury management and prevention for performing artists, and the cultural considerations. Sports medicine professionals have a big role to play in the performing arts industry, and Annie and Catherine share some tips for getting involved in the field. 
 
Links 
International Association of Dance Medicine and Science (IADMS) - https://protect-au.mimecast.com/s/Cu1_CMwv0QUOKzGqCwWvfG?domain=iadms.org/ 
 
Australian Society of Performing Arts & Healthcare (ASPAH)-https://protect-au.mimecast.com/s/RieBCNLwP9UlKj10c4VDDt?domain=aspah.org.au/
 
Australian Voice Association (AVA)- https://protect-au.mimecast.com/s/7-noCOMxQyURVvopTkxo26?domain=australianvoiceassociation.com.au/
 
Medical Problems in Performing Artists (MPPA) - https://protect-au.mimecast.com/s/5dXICP7yRZiGY3qKSjiL2U?domain=sciandmed.com
 
RETURN TO DANCE post COVID  - Webinar about how dance teachers, dance professionals and dance clinicians can assist their dance students return to the studio in a safe way. -https://protect-au.mimecast.com/s/-ILGCROAWocm958vSoFlgP?domain=performancemedicine.com.au/

Playing your part: SEM for the Performing Arts with Annie Strauch and Catherine Etty-Leal. Ep #484

The infrastructure of Afghanistan healthcare is under threat, as international agencies who run clinics withdraw from the country. At the same time, some of the healthcare workforce are leaving the country, while those who remain face the prospect of their wages drying up as the economy of the country collapses.

But there remain people dedicated to providing healthcare, and in this podcast we hear from, Wais Mohammad Qarani,  president of the Afghanistan Midwifery and Nurses Council, about what changes might be seen under the new regime, and what needs to be done to support care in the country.

The future of Afghan healthcare

Have you ever had a question you thought … “OOOO! That’s an Archimedes in waiting that is!”. Well, join in the footsteps of those who have climbed the craggy path through submission, review, Editorial Board and onwards to the sunny pastures of ‘Online First’ and eventually the Paper Journal (where, like one of our colleagues, your Gran can try and order one from the newsagents because she’s so proud of you).
The Grannies being delighted this month will be able to learn all about if their migrainous adolescent grandchildren will benefit from magnesium to reduce their headache frequency of severity (https://adc.bmj.com/content/106/10/1027), and far from benign taught to suck eggs they may have their perception of weaning foods challenged when it comes to egg introduction to the diet of four month olds (https://adc.bmj.com/content/106/10/1024.1). Their wisdom will be already full of the knowledge that just because something’s always been this way doesn’t make it right, but they may like to hear about how we think momentum and inertia apply in medicine too (and here’s the ship-related podcast that’s mentioned: https://timharford.com/2019/11/cautionary-tales-ep-1-danger-rocks-ahead/)
https://adc.bmj.com/content/106/10#Archimedes
https://adc.bmj.com/content/106/10/1024.2

Archimedes October 2021: Metal heads, egg building and ship steering

What do med students have in common with Luke Skywalker and Harry Potter?

Luke Skywalker had Obi Wan to guide him through Jedi training. Harry Potter had Prof Dumbledore who gave him advice in surviving at Hogwarts and beyond. 

Whether officially or unofficially, we have all had mentors who guided us through the non-straightforward journey known as medical school. They could come in the form of medic parents or a mentor whom you were matched to through a formal scheme - or anyone who helped you during your medical school journey.

In this episode, we address the questions:

Why would you want a mentor
What are the different types of mentor
How to find a mentor
How to make the most of a mentoring relationship

Our expert guest:
Dr Georgia Winnett is a consultant renal physician at Basildon Hospital, senior lecturer at Anglia Ruskin School of Medicine and an associate postgraduate dean for Health Education East of England. 

While you are here, do check us out on social media:
Twitter: https://twitter.com/BMJStudent 
Instagram: https://www.instagram.com/bmj_student/
Facebook: https://www.facebook.com/BMJStudent/

Do you have a mentor?

There has been a lot of work on the way in which surgeon's are affected by tiredness - and the whole medical workforce can probably relate to their experience.

But there's a difference between tiredness and fatigue, and that difference might be important in understanding what's happening in your own life.

Dale Whelehan is a physiotherapist, and PhD candidate at Trinity college Dublin, where he is investigating behavioural psychology and the effect of tiredness and fatigue on surgeons - in this podcast he describes how he thinks about those two things, what we know about the effect on wellbeing, and some strategies which might help manage them.

Wellbeing - tired or fatigued, and why the difference might matter

In this podcast, we’re joined by Dr Yetsa Tuakli-Wosornu, Lead Author of the BJSM #SportsEquity e-Edition and Dr Jane Thornton, one of the BJSM’s editors.
We cover: 

How this e-Edition came about
The difference between equity and equality
Why this issue is so important 
How people can use this e-edition in their personal and professional
   
Links:
E-Edition: https://bjsm.bmj.com/pages/bjsm-e-edition-sportsequity/
Editorial: https://bjsm.bmj.com/content/early/2021/09/09/bjsports-2021-104874

Why the SportsEquity e-Edition is a must read for all working in SEM. EP #485

Doctors are taught from medical school about the benefits of IUD, and are often advocates of them to patients.

However, recent media attention on the pain that some women suffer when having their IUD's fitted have started conversations about the need for cervical blocks, and more honest counselling of women about the procedure.

Rebekah Fenton, adolescent medicine fellow at Lurie Children's Hospital of Chicago joins us to talk about how she councils her patients, and why the most important thing is to make sure women are in charge of their reproductive healthcare decisions.

Fitting IUDs with Rebekah Fenton

"Those who do not study the past are doomed to repeat it." 

At the International Forum on Quality and Safety in Healthcare, in Gothenburg in April, Don Berwick spoke on the scientific foundations of improvement. This is the full audio of his talk.

Don Berwick is president emeritus and senior fellow, Institute for Healthcare Improvement. On twitter, he's @donberwick.

Extra: Don Berwick on the science of improvement

Fiona Moss, dean at the Royal Society of Medicine, gives us an overview of quality improvement, and it's underpinnings.

This interview was recorded at the International Forum on Quality and Safety in Healthcare, Gothenburg, April 2016.

Find Fiona Moss on twitter, @FiMoss.

Extra: Fiona Moss on the science of improvement

This week, we look at medication reconciliation.

Joshua Pevnick, health services researcher and hospital physician at Cedars-Sinai Hospital, LA, US, talks us through what it is and why it can be so hard to get right. 

And Emma Iddles, a junior doctor in general surgery at Hairmyres Hospital, Lanarkshire, UK, explains how her project improved medicines reconciliation in the surgical admissions unit of the hospital.

For more, read Joshua's full paper, http://goo.gl/O59BWo, and Emma's project write up http://goo.gl/znrNGQ.

What are they on?

How can asking patient to tell us their story improve healthcare? Helen Morant, content lead at BMJ, talks us through her project getting healthcare professionals to sit down with patients and record their conversations, and what on earth this has to do with quality improvement.

We also hear some of the recordings she has gathered through the project.

Here are links to the other podcasts and projects Helen mentions:

Story Corps - https://storycorps.org/

The Listening Project - http://goo.gl/3auSHX

Beautiful stories from anonymous people - http://goo.gl/78QSjU

Tell me a story

Is efficiency the enemy of innovation and improvement? Are efficiency programmes oppressive, leaving healthcare staff no time to be creative and piling on burdensome bureaucracy, or are efficiency, innovation and improvement positively correlated?

These questions were debated at the International Forum on Quality and Safety in Healthcare, in Gothenburg in April, and here we dip into that debate and pick out the key arguments.

Featuring contributions from: 

Jason Leitch, national clinical director, Healthcare Quality and Strategy, Scottish Government.

Frank Federico, executive director, Institute of Healthcare Improvement.

Mohsin Choudry, national medical director's clinical fellow, Royal College of Physicians.

Robbert Huijsman, professor of management and organisation of elderly care, Erasmus University, Rotterdam.

For more on the Forum, see http://internationalforum.bmj.com/.

This episode is the last in the first series of the Making the difference podcast. We'll be back in a month with series two.




 


Efficiency vs innovation and improvement

Childhood constipation is typically characterised by infrequent bowel evacuations, large stools, and difficult or painful defecation.

Symptoms may result from low fibre, poor nutrient, and/or insufficient water intake, which leads to excessive hardening of the stool. This often starts as an acute problem but can progress to faecal impaction and chronic constipation.

Claire Zar-Kessler, Instructor in Pediatric Gastroenterology, Massachusetts General Hospital for Children, Boston gives us a clinical overview of the condition.

Please always check the licensed indications for medications in your own country.

For more on constipation in children, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/784

-

The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

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