Medicine and Science from The BMJ

The BMJ has published a series of articles, taking an in-depth look at health in South Asia. In this collection, authors from India, Pakistan, Nepal, Bangladesh, Sri Lanka, and Afghanistan collaborate to identify evidence-based solutions to shape health policy and interventions, and drive innovations and research in the region. In this podcast, two of the driving forces behind the series - Dr Zulfiqar Bhutta, from Aga Khan University, and Dr Samiran Nundy from the Ganga Ram Postgraduate institute for Medical Education and research - join Anita Jain to discuss the key issues affecting the region now. Read all of the open access articles: http://www.bmj.com/health-in-south-asia

The NHS Delivery Plan - setting out what’s in store of the English NHS in the coming years, has been delivered by Simon Stevens the chief executive. Key to those are the sustainability and transformation plans (STPs) which have been made in 44 areas, and yet again reorganise care - crucially, this time, with social care included in the mix. In this podcast Hugh Alderwick, senior policy advisor at the King’s Fund explains what STPs are, and what they're planning, and crucially, the cash involved. Read the full analysis: http://www.bmj.com/content/356/bmj.j1541

Around 1 in 10 children and young people worldwide have mental health difficulties that substantially affect their lives. Child mental health services often concentrate on risk reduction, at the expense of the wider aspects of a child's wellbeing. As part of the high integrity healthcare series, this podcast focuses on novel ways of providing support to children and adolescents, and particularly Pause - a city centre drop in centre in Birmingham, England. Read the full analysis: http://www.bmj.com/content/357/bmj.j1500

This week, a new series starts in The BMJ - the aim is to rethink how hospitals, clinics, community services and public health work - with the aim of stopping the perverse blocks and incentives that prevent doctors, and other healthcare professionals, from providing the care that patients want and need. Talking to Navjoyt Ladher, are Albert Mulley - professor of medicine at the Dartmouth Institute, and Jane Druce, an evaluations manger, and Donal Collins, a GP - both of whom work in an NHS Vanguard area, where new ways of delivering care are being tested. Read the full analysis: http://www.bmj.com/content/356/bmj.j1401

Transient symptoms of depersonalisation and derealisation - feeling detached from the world, and feeling as if you are watching events at a remove - are common. However for some, persistent symptoms can make the disorder extremely distressing. In this podcast, Kate Adlington is joined by Elaine Hunter, consultant clinical psychologist, Anthony David, professor of cognitive neuropsychiatry, and by Jane Charlton and Fiona Godlee - who have both experienced depersonalisation/derealisation over a number of years. Read the full education article: http://www.bmj.com/content/356/bmj.j745

For seven years, Republicans have vowed to repeal the Affordable Healthcare Act (Obamacare), and that promise took a central place in President Trump's campaign. The first major vote to replace it was due to happen last week, but was cancelled at the 11th hour. In advance of the potential vote, The BMJ published a debate asking "Should US doctors mourn for Obamacare?". Now we're asking the authors of that debate, what next? Joining Peter Doshi are Adam Gaffney, from Harvard Medical School and Saurabh Jha from the Hospital of the University of Pennsylvania. Read their original debate: http://www.bmj.com/content/356/bmj.j1441

Lady-Jacqueline Aster lives on a 72 foot canal boat. She's been diagnosed with adrenocortical cancer, and is receiving palliative care and is planning to die in the home she loves. In this interview The BMJ's patient editor, Rosamund Snow, talks to Lady-Jacqueline about her cancer, her care and her funeral plans - and why planning one's own death can be fun. Read more about healthcare on the water http://www.bmj.com/content/356/bmj.j245 Since this recording, Rosamund died by suicide, making these discussions about planning for death more poignant. You can read more about Rosamund's life and work in her obituary. http://www.bmj.com/content/346/bmj.j850

The BMJ publishes a lot of educational articles, and in an attempt to help you with your CPD, we have put together this round-up. Our authors and editors will reflect on the key learning points in the articles we discuss, and explain how they may change their practice in light of that new understanding. In this week's round up we're discussing: The offer of an HIV screen for an asymptomatic adult http://www.bmj.com/content/356/bmj.i6656 Two articles on legal highs Novel psychoactive substances: types, mechanisms of action, and effects http://www.bmj.com/content/356/bmj.i6848 Novel psychoactive substances: identifying and managing acute and chronic harmful use http://www.bmj.com/content/356/bmj.i6814 and how to become better at supporting relatives and carers at the end of a patient’s life http://www.bmj.com/content/356/bmj.j367

Viral exanthema can cause rash in a pregnant woman and should be considered even in countries that have comprehensive vaccination programmes. Measles and rubella can cause intrauterine death. Intrauterine infection with rubella can lead to congenital rubella syndrome in the liveborn baby. In this podcast, Jack Carruthers, honorary clinical research fellow at Imperial College London joins us to discuss spotting a viral rash, what steps to take to assess cause, and what advice to give a worried parent. Read the full clinical review: http://www.bmj.com/content/356/bmj.j512

As the NHS strains under pressure from rising patient activity, an ageing population, and financial constraints, The BMJ hosted a discussion on how clinicians should be helping to manage demand at last week’s Nuffield Trust health policy summit. Taking part are: - Eileen Burns, president of the British Geriatrics Society - Andrew Fernando, GP and medical director of North Hampshire Urgent Care - Candace Imison, director of policy at the Nuffield Trust - Martin Marshall, vice chair of the Royal College of General Practitioners - Amanda Philpott, chief officer of two clinical commissioning groups - Maxine Power, director of innovation and improvement science at Salford Royal NHS Foundation Trust - Jeremy Taylor, chief executive of the charities’ coalition National Voices - Judith Smith, director of the Health Services Management Centre - Ashok Soni, chair of NHS England’s local professional network for pharmacy in London Listen to all of our other Nuffield Summit Roundtables: http://www.bmj.com/nuffieldsummit