Medicine and Science from The BMJ

For the last year a group commissioned by the UK government has been looking at whether making all published research freely available is attainable or not. BMJ editor Fiona Godlee speaks to Dame Janet Finch, the group's chair, about its conclusions. We also bring you highlights from a BMJ hosted round table on what the landscape of research publishing could, and should, look like in the future.

With changes to the NHS such as cuts, competition and tendering, secondary care will need to adapt. Joining BMJ features editor Rebecca Coombes to discuss how, are: Yi Mien Koh, chief executive of Whittington Health, London Jan Filochowski, chief executive of West Hertfordshire Hospitals NHS Trust Fergus Gleeson, divisional director of Critical Care, Theatres, Diagnostics and Pharmacy at Oxford University Hospitals Nigel Edwards, senior fellow at the King’s Fund Derek Greatorex, chair of the South Devon and Torbay Clinical Commissioning Group Kate Hall, policy advisor, Monitor, London This is the full version of the roundtable. See the podcast above for highlights.

The healthcare landscape in the England is shifting, with cuts, competition and tendering some of the major changes. Secondary care must adapt to these, but how? Joining BMJ features editor Rebecca Coombes to discuss the issues are: Yi Mien Koh, chief executive of Whittington Health, London Jan Filochowski, chief executive of West Hertfordshire Hospitals NHS Trust Fergus Gleeson, divisional director of Critical Care, Theatres, Diagnostics and Pharmacy at Oxford University Hospitals Nigel Edwards, senior fellow at the King’s Fund Derek Greatorex, chair of the South Devon and Torbay Clinical Commissioning Group And BMJ practice editor Mabel Chew talks to Ruth Reed (specialty registrar in child and adolescent psychiatry, Warneford Hospital, Oxford) and Mina Fazel (postdoctoral research fellow, Warneford Hospital Oxford) about why post-traumatic stress disorder is easily missed, and what clinicians should look out for.

Barack Obama saw his Affordable Care Act remain law last week, as the US Supreme Court ruled it is constitutional. Ed Davies (BMJ US news and features editor) talks to Janice Hopkins Tanne (freelance journalist based in New York) about the ruling’s implications. And what are the options for tackling childhood obesity? Li Ming Wen (research and evaluation manager at Sydney University) believes intervention needs to be early, and has demonstrated that giving new mothers simple nutrition messages reduces their child’s BMI at age two. BMJ assistant editor Helen MacDonald speaks to him.

It seems the race to implement telehealth is on – the UK government’s response to its Whole System Demonstrator pilot has been very positive. But has it been over-hyped? We find out from Jennifer Dixon, Director of the Nuffield Trust, which has evaluated the pilot. Also, alcohol: beneficial or detrimental? Evidence shows it depends on what aspects of health you look at. Research published on bmj.com this week adds to the picture by looking at the association between alcohol consumption and the risk of developing arthritis. Alicja Wolk, professor of nutritional epidemiology at the Karolinska Institutet, explains her study.

It has been almost exactly a year since Anders Breivik bombed government buildings in Oslo, and then carried out a mass shooting on the island of Utøya, where he killed 69 people, mostly teenagers. In that time there has been much discussion about his mental state. Vivienne Nathanson and Julian Sheather from the BMA join us to discuss the moral and ethical problems that a diagnosis of insanity bring to the case. Also this week, seven articles on bmj.com look at the science behind sports product adverts. We hear from Matthew Thompson, from the Centre for Evidence Based Medicine in Oxford, who criticises the quality of the evidence submitted to the European Food Safety Authority to back these claims

Daniel Hackam, associate professor at Western University in Canada, explains how shift patterns can have a detrimental effect on the vascular health of workers. Also this week Seena Fazel, Wellcome Trust senior research fellow in clinical science at the University of Oxford, queries the predictive value of the risk assessment tools routinely used to predict violent behaviour

A feature this week asks "Should patients be able to control their own records?". The website renalpatientview.org allows patients to do exactly that. Neil Turner, a professor of nephrology at Edinburgh Royal Infirmary, explains how he and colleagues developed the resource. Also Steven Woloshin and Lisa Schwartz, authors of the "Not So Stories" column have turned their statistical scrutiny onto a recent advert by Susan G. Komen for the Cure®, the breast cancer charity. They explain how the case for mammography has been massively oversold.

This week we’ll hear why Donald Light, professor of comparative health systems research at the University of Medicine and Dentistry of New Jersey, thinks the innovation crisis in the development of drugs is more marketing rhetoric than reality. Also this week, a research paper on bmj.com looks at how subclinical psychological distress affects mortality. Tom Russ, Alzheimer Scotland clinical research fellow at the University of Edinburgh and one of the paper's authors, explains what they found.

Marion Nestle is the Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University. She has written widely about food and nutrition, and is an iconoclast in the world of food politics. In this podcast she explains how economic forces have changed the food industry, and how that change is fuelling the obesity epidemic.