Medicine and Science from The BMJ

How can you treat a young person who is exhibiting the first signs of psychosis? Mabel Chew talks to Professor Tim Kendall a consultant psychiatrist and director of the National Collaborating Centre for Mental Health at the Royal College of Psychiatrists. Professor Kendall is co-author of both a systematic review and meta-analysis into early treatments to prevent psychosis, and co-author of a new...

In this practice special podcast, Timothy Wilt, professor of medicine at Minneapolis VA Center for Chronic Disease Outcomes Research, explains how to talk to patients about prostate cancer screening. Benjamin C Thomas, senior clinical fellow at Addenbrooks Hospital in Cambridge then talks us through androgen deprivation therapy.

The Francis report into care standards at Mid Staffordshire NHS Foundation Trust was published this week. Triggered by deaths at a hospital in England, Robert Francis QC was appointed by the government to look into why the quality of care in some wards was so low, and what can be done to make sure that this doesn’t happen in other hospitals. Also this week, research has unearthed data hidden for 4...

The BMJ held a round table in January 2013 to discuss the future of primary care in England and Wales. The wide ranging topics included out of hours care, commissioning, education, time management, and integration. This is the full version, lasting one hour and 20 minutes. Edited highlights are available in this week's podcast. Chair: Domhnall MacAuley, primary care editor, BMJ. Participants: Hele...

How involved are doctors in the non medical aspects of patient care? An analysis on bmj.com this week examines the problem of nutrition and fluid balance in hospitalised patients. Helen Macdonald, a junior doctor and editor at the BMJ, asks Richard Leach, clinical director of Guy's and St Thomas' NHS Foundation Trust, about how it should best be handled. Also this week, a summary of the BMJ round...

Of the myriad of clinical decision support tools, what features actually improve patient outcomes? Pavel Romanov, medical student at Western University in Canada, discusses his research. Also this week: Is it feasible to get governments to consider the public health impact of every policy decision they make? Politicians in Wales have drafted legislation to make the devolved nation the first in the...

In the wake of the Francis report, the BMJ gathered experts to discuss compassion in the health service. This is the discussion in full. Taking part are: Domhnall MacAuley, BMJ primary care editor Anthony Silverstone, consultant at UCH Peter Carter, chief executive for the Royal College of Nursing Jocelyn Cornwall, director, The Point of Care programme, The King's Fund Joanne Watson, consultant at...

If patients living in one area have more diagnoses than those living in another, use more care, but have similar mortality rates, you would think they were simply sicker, but that the extra care they were receiving must be good and making them better. Not so, says new research published on bmj.com. John Wennberg, emeritus professor of community and family medicine at the Dartmouth Institute in the...

Andrew Witty is the CEO of GlaxoSmithKline. He’s been credited with taking on a pharma company with a history of behaving badly in the past – as shown by a record $3bn fine levied by the US government last year. How much is he able or willing to change the culture of an industry, which is under pressure to alter its practices? Rebecca Coombes finds out. Also this week, Michael Dowling, president a...

Recorded at the recent Nuffield health policy summit, this round table asks how to impliment the Francis reports recommendations. Taking part were: Robert Francis, chair of The Mid Staffordshire NHS Foundation Trust Public Enquiry Simon Stevens, president of global health at the UnitedHealth Group Sam Barrell, chief clinical officer of South Devon and Torbay CCG Niall Dickson, CEO of the General M...

Are all calories equal? Thermodynamics would say that energy is energy, be it derived from carbohydrate, fat, or protein. But things get more complicated when appetite is taken into consideration , says Robert Lustig, professor of pediatric endocrinology at the University of California, San Francisco. Also this week, life expectancy in Europe is increasing, but at the same time health inequalities...

A clinical review this week looks at the diagnosis and treatment of carotid atherosclerosis, including when to screen and the threshold for intervention. Alun Davies, professor of vascular surgery at Imperial College London, also answers how useful or harmful screening offered commercially is. Also this week, the BMJ’s editorial board met to discuss how patient participation should be represented...

The issues of hidden data are well known, and the BMJ’s open data campaign page documents some of the problems which have arisen as a result of clinical trial data remaining undisclosed. At Evidence Live 2013 in Oxford this week, Fiona Godlee, BMJ editor in chief, convened a group of those closely involved with the AllTrials campaign, to discuss where we are now and what still needs to be done

The World Health Organization has chosen hypertension as the public health threat it will focus on for the next year. The problem is particularly pressing in India, and Anita Jain, the BMJ's India editor, spoke to François Decaillet, Coordinator for Health Programs, WHO India, about what needs to be done to tackle hypertension in the country's population.

Delirium is often missed in primary and secondary care. Edison Vidal, assistant professor in internal medicine at the Universidade Estadual Paulista, Brazil, advises on diagnosing and managing the condition. Rheumatoid arthritis, non-biological drug treatments, or both, might suppress tumour surveillance and in theory increase the risk of melanoma. Pauline Raaschou, consultant in clinical pharmaco...

This week, we discuss how Australia’s national human papillomavirus (HPV) vaccination programme has caused a dramatic drop in genital warts. Does this foretell elimination of all disease caused by HPV in the country? And some advice on how to diagnose and manage pulmonary hypertension.

Patients are increasingly going online to find and discuss information about their condition. What are they getting on the web that they’re not getting from clinicians, and how is this changing healthcare? Also, how to care for a dying patient in hospital.

Mabel Chew, practice editor at the BMJ, talks to Tushar Kotecha, a cardiology specialist registrar at Charing Cross Hospital in London, about when to suspect heart failure, and how to diagnose the condition.

The BMJ Awards were held last Thursday. Fiona Godlee, the BMJ's editor in chief, announced that the Britain Nepal Otology Service (BRINOS) was named Medical Team of the Year. BRINOS (brinos.org.uk) started out in 1988 by setting up joint British and Nepalese surgical camps to treat ear disease among patients living outside the reach of hospitals in the capital of Kathmandu. A national survey in 19...

In a drive to improve safety, many cyclists now wear helmets. But how useful is legislation that mandates their use when compared with all the other safety initiatives available? Jessica Dennis, a PhD candidate from the Dalla Lana School of Public Health at the University of Toronto, tells us about her research into accident trends. Also this week, doctors play a key role in spotting when a vulner...

Until now, the increased risk of cancer from CT scans has been modelled from the data gathered from survivors of the Hiroshima and Nagasaki bombings. However, new BMJ research, based on a large Australian cohort, offers new evidence to support the modelling. John Matthews, from the university of Melbourne, joins us to explain what they found. Also this week, social media is relatively new – but di...

This month the UK parliament has been looking at the big accountancy firms' involvement in drafting tax laws. Conversely, the Department of Health has hidden the involvement of tobacco lobbyists in proposed plain packaging legislation. Jeff Collin, professor of global health policy at the University of Edinburgh, argues that this culture of industry participation is worrying, but the lack of trans...

Despite repeated calls to prohibit or limit conflicts of interests among authors and sponsors of clinical guidelines, the problem persists. Jeanne Lenzer explains what's going wrong. And is giving birth at home as safe for the mother as giving birth in hospital? New research from the Netherlands suggests that it is, and that risk assessment is key.

This week, the World Health Organisation called for healthcare providers to be more aware of intimate partner and sexual violence against women, calling it a "global health problem of epidemic proportions." We look into what doctors need to know. And we discuss advice on diagnosing and treating first trimester miscarriage.

Recent research shows that some non-steroidal anti-inflammatory drugs increase cardiovascular risk in some patients. Given their widespread use, and breadth of indications for prescription, should clinicians be more circumspect about their practice? In this podcast, Mabel Chew BMJ's practice editor, talks to Richard O'Day, professor of clinical pharmacology at the University of New South Wales and...