Medicine and Science from The BMJ

Demand for better access to primary care is ever rising, but is email the answer? In this podcast, Elinor Gunning, a clinical teaching fellow in London says that patients want it and that careful planning can mitigate worries about safety and security. Emma Richards, trainee academic GP, is not so sure and thinks clearer guidance and resourcing are needed first. Read the head to head online: http://www.bmj.com/content/349/bmj.g5338

David Heymann, professor of infectious disease epidemiology, and head and senior fellow, at the Chatham House Centre on Global Health Security was sent to investigate the first outbreaks of Ebola in 1976. In this podcast he gives a longer term perspective on the disease, and talks about the importance and challenges of introducing novel treatments. For more information on ebola virus disease, including working in a front line clinic, visit bmj.com/ebola David Heymann's analysis article, Prevention is better than cure for emerging infectious diseases: http://www.bmj.com/content/348/bmj.g1499

A new rational testing article, published on thebmj.com, looks at how to diagnose an immediate food allergy. Mabel Chew, The BMJ's practice editor, is joined by Cathal Steele from the Belfast Trust Regional Immunology Service - they discuss which tests are appropriate, and the common pitfalls in diagnosis. Read the full article: http://www.bmj.com/content/349/bmj.g3695

Management of spasticity requires a balanced approach, weighing the benefits of treatment against the usefulness of the spasticity. Current interventions to treat spasticity lack a robust evidence base, and guidelines often depend on expert recommendations. A new clinical review published on thebmj.com discusses the assessment and treatment of spasticity in adults. In this podcast we're joined by one of the authors of that review, Siva Nair, from the Department of Neurology at The Royal Hallamshire Hospital, and by a patient with spasticity, Ian, who is chairman of the Hereditary Spastic Paraplegia (HSP) Support Group. Read the clinical review: http://www.bmj.com/content/349/bmj.g4737 For more information on HSP visit http://hspgroup.org/

Global endorsement as a WHO essential medicine is big step. But Corrado Barbui, from the Department of Public Health and Community Medicine at the University of Verona, has found that the quality of applications for antidepressants and antipsychotics is poor and calls on applicants and WHO to raise standards. Read the analysis article: http://www.bmj.com/content/349/bmj.g4798

Pre-diabetes is an umbrella term and the most widely used phrase to describe a blood concentration of glucose or glycated haemoglobin (HbA1c) that lies above normal but below that defined for diabetes. John S Yudkin, emeritus professor of diabetes at University College London, thinks this is over-medicalisation and will only increase the burden on individuals and the health system. Read the full analysis article: http://www.bmj.com/content/349/bmj.g4485

Research fraud, the deliberate falsification of research data, undermines science and can lead to horrible outcomes, as exemplified by Andrew Wakefield and the MMR/Autism scandal. A new Head to Head in The BMJ sets out the case for and against making research fraud a crime. Arguing yes is Prof. Zulfiqar Bhutta, from the Hospital for Sick Children in Toronto, who says that criminal sanctions are necessary to deter growing deliberate research misconduct, which can ultimately harm patients. Prof. Julian Crane, from the University of Otago Wellington, disagrees: he doubts that sanctions will have any deterrent effect and worries that criminalisation would undermine trust. Read the full debate: http://www.bmj.com/content/349/bmj.g4532

HIV testing is now being routinely offered in increasingly diverse health settings, including primary care. In this podcast we talk to HIV consultant Mike Rayment, from Chelsea and Westminster NHS Foundation Trust, and Paul, a patient diagnosed with HIV infection 4 years ago. They discuss how to go about offering testing, and what matters to patients when they receive the diagnosis. Read the clinical review discussed: http://www.bmj.com/content/349/bmj.g4275

Devi Sridhar, population health researcher and lecturer, joins us to discuss why an independent organisation to co-ordinate international health concerns is absolutely necessary. Read more in her analysis article, Global rules for global health: Why we need an independent, impartial WHO

Whichever country hoists aloft the World Cup trophy on 13 July, the real winner will be the alcohol industry. In this podcast Jonathan Gornall explains why FIFA promotes the interests of the alcohol industry, and the extraordinary demands countries comply with in order to host the World Cup. World Cup 2014: festival of football or alcohol? http://www.bmj.com/content/348/bmj.g3772