Medicine and Science from The BMJ

This year The BMJ has chosen Doctors of the World as it's Christmas appeal. This week we hear about the charity's international work. Deputy magazine editor Richard Hurley talks to some of the doctors who are working in Syria and the camps surrounding the stricken country. Also this week, a clinical review on BMJ.com looks at polymyalgia rheumatica. Clinical reviews editor Sophie Cook asks Sarah Mackie, from the Leeds Institute of Rheumatic and Musculoskeletal Medicine, how she explains this difficult condition to patients. After the typhoon: how volunteer doctors are bringing medical care to those most in need http://www.bmj.com/content/347/bmj.f7193 Polymyalgia rheumatica http://www.bmj.com/content/347/bmj.f6937

Professor Sir John Oldham, from the Institute of Global Health Innovation at Imperial College London, talks about reforming reform, and why he worries that research agendas are more influenced by career aspirations than patient care. Tom Kenny, director of external relations at the Evaluation, Trials, and Studies Coordinating Centre at the National Institute for Health Research, explains how the NIHR is trying to put patients at the centre of the research it funds. Finally doctors' health - Michael Peters from the BMA's Doctors for Doctors Unit, explains why life's everyday struggles are hard for doctors to cope with. See also: Reform reform: an essay by John Oldham http://www.bmj.com/content/347/bmj.f6716 Doctors’ health: taking the lifecycle approach http://www.bmj.com/content/347/bmj.f7086

The latest NCEPOD (National Confidential Enquiry into Patient Outcome and Death) report examines the management of aneurysmal subarachnoid haemorrhage, in England's National Health Service. Two of the report's clinical co-ordinators, Mike Gough, a vascular surgeon at Leeds General Hospital, and Alex Goodwin, anaesthetist at the Royal United Hospital in Bath, join us to discuss the reports findings and recommendations. Read the full report: http://www.ncepod.org.uk/sah.htm

The population timebomb: The idea that an ageing population is making it harder and harder to fund pensions, social care, and healthcare, as the number of older people grows in proportion to the working population. Jeroen Spijker, senior research fellow at the School of Social and Political Science in the University of Edinburgh, explains why he thinks the risk has been overblown. Also, Michael Kidd, current president of WONCA – the world organisation of family doctors - talks about the pressures on primary care, and how he would like to attract the best medical talent to the specialty. http://www.bmj.com/content/347/bmj.f6598

A modelling study on bmj.com suggests that a 20% tax on sugar sweetened drinks would reduce the number of obese adults in the UK by 1.3%, and by 0.9 for those who are overweight. The health gains are fairly similar across all income groups. Oliver Mytton, one of the study's authors, describes why a 20% figure was chosen and how the modelling was done. Also, liver function tests follow a different normal range during pregnancy. Catherine Williamson, professor of women’s health at King's College London, explains why. Read the articles: Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK - http://www.bmj.com/content/347/bmj.f6189 Abnormal liver function tests in pregnancy - http://www.bmj.com/content/347/bmj.f6055

Professor Michael Marmot has spearheaded WHO Europe’s Health 2020 report, which looks at the disparity in the social determinants of health across the region. He joins us to explain why he’s hopeful for change. Also, Spencer Ellis, consultant rheumatologist at Lister Hospital in Stevenage, explains when and why to order antinuclear antibody (ANA) tests.

NB: In our interview about statins, Abramson quotes the figure of an 18% relative increase in risk of adverse effects of statins. This figure should be couched in uncertainty, and a correction has been posted on bmj.com to reflect that - http://www.bmj.com/content/348/bmj.g3329 -------------------------------------------------------------------- It may soon be recommended that statins are prescribed to patients with a low risk of cardiovascular disease. John Abramson from the Department of Health Care Policy at Harvard Medical School explains why the risks associated with taking the drug may have been underplayed. Also this week, interviews with Steve Field, the new chief inspector of hospitals, and Richard Vautry, deputy chairman of the BMA's GP committee, recorded at the National Association of Primary Care's annual Best Practice conference. See also: Should people at low risk of cardiovascular disease take a statin? http://www.bmj.com/content/347/bmj.f6123

The BMJ, BMJ Open, Heart, Thorax, and Tobacco control – all journals in BMJ’s stable, have announced they will no longer carry research funded in part, or in whole, by the tobacco industry. Fiona Godlee, BMJ Editor in chief, explains what that means, and Allen Brandt, professor of the history of science at Harvard University, gives us a potted history of the way in which the tobacco industry has manipulated science. Also this week, Sebastian Brandner, professor of neuropathology at UCL, explains his research into the population prevalence of the prion which causes vCJD. See also Prevalent abnormal prion protein in human appendixes after bovine spongiform encephalopathy epizootic http://www.bmj.com/content/347/bmj.f5675 Journal policy on research funded by the tobacco industry http://www.bmj.com/content/347/bmj.f5193

There are many overlapping classifications for bowel polyps. Geir Hoff, professor of gastroenterology at the University of Oslo, explains why he fears screening for one type has lead to overtreatment of another. Also, Sophie Wilne, consultant paediatric oncologist at Nottingham University Hospitals NHS Trust, discusses the clinical signs of brain tumours in children and young adults, and what treatment should follow. See also: Identifying brain tumours in children and young adults www.bmj.com/content/347/bmj.f5844 New polyps, old tricks: controversy about removing benign bowel lesions www.bmj.com/content/347/bmj.f5843

As Clare Gerada's stint as RCGP chair comes to a close, she gives BMJ news reporter Gareth Iacobucci a typically honest exit interview. And David Loxterkamp, a primary care physician in Belfast, Maine, tells us why he thinks metrics are obscuring humanism in medical care. See also: Clare Gerada: “It’s like the wild west in healthcare” http://goo.gl/SiWZ5y Humanism in the time of metrics—an essay by David Loxterkamp http://goo.gl/FRD0xC