Medicine and Science from The BMJ

Richard Brennan, WHO Emergency Director for the Eastern Mediterranean, discusses the dire impact of armed conflict on healthcare access in regions like Gaza and Lebanon. He highlights the brave efforts of healthcare workers amidst escalating violence. Menaka Paranathala, a clinical editor at The BMJ, focuses on addressing gender inequity in medical research, emphasizing the historical neglect of women's health issues. The conversation also touches on the critical role of palliative care and the need for its integration across all medical specialties for improved patient outcomes.

Lakshmi Krishnan, a physician and cultural historian of medicine, discusses the pressing link between climate change and healthcare. The conversation highlights how healthcare is a significant carbon emitter, urging immediate action for sustainability. Krishnan explores the genre of climate fiction ('cli-fi') as a tool for advocacy, sharing book recommendations to inspire action and hope. Additionally, the panel examines the effects of climate change on migration and tuberculosis, emphasizing the need for enhanced nutritional support to tackle this global health crisis.

Louis Klarevas, a research professor at Columbia University and author of "Rampage Nation," dives deep into the intricacies of gun control policy. He discusses the historical evidence vacuum in the U.S. and how grassroots movements are driving change. Klarevas emphasizes the power of data in advocacy while revealing challenges posed by misinformation and lobby influences. The conversation highlights the potential of citizens' assemblies to inform pivotal debates in gun regulation and NHS reform, illuminating a path forward for evidence-based 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    

Improving healthcare quality relies heavily on robust data collection, especially in resource-challenged areas. Innovative projects like the Clinical Information Network in Kenya showcase how to navigate data challenges. A collaboration across 85 hospitals in Latin America dramatically improved timely antibiotic administration for children with cancer. The journey towards better health systems requires a motivated workforce and a clear understanding of patient needs, driving meaningful changes in care quality worldwide.

Katie Bramall-Stainer, chair of the BMA's General Practice Committee, discusses the recent vote for industrial action among GPs in England, highlighting the declining trust in the government and urgent stability needed in healthcare. Jonathan Finnoff, chief medical officer for the US Olympic and Paralympic Committee, addresses the complex healthcare needs of athletes post-Olympics, including mental health support initiatives and the unique challenges they face with insurance in the U.S., ensuring their well-being remains prioritized.

Margaret McCartney, an author scrutinizing early cancer detection tests, and Deborah Cohen, who examines health test decision-making, interrogate the controversial Galleri Test's effectiveness. They explore political influences in healthcare, emphasizing the need for rigorous evaluation. Imran Ahmed from Guy's and St. Thomas' NHS Trust unveils an innovative HIT model aimed at tackling the NHS waiting list crisis, highlighting how prioritizing surgical procedures can optimize efficiency and improve staff morale.

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. We ask how should the new Labour government engage patients in shaping the future of the NHS. We also dive into the concepts of social care and peer support, and learn from Brazil's experience in social participation. Highlights: 01:52 - The Patient "takeover" 05:43 - Social care with Charlotte Augst 19:53 - Peer support groups with Claire Reid and Partha Kar 31:48 - WHO’s resolution on social participation with Mark Barone Reading: Editor's Choice - Listening to patients at all levels of healthcare, Emma Doble, patient editor

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