Medicine and Science from The BMJ

Over the decades public health has had many incarnations. Geof Rayner and Tim Lang (Center for Food Policy) argue that public health today needs an overhaul, and to focus on our co-existence with nature and relationships with each other. They explain why, and how. Many of the issues Dr Rayner and Professor Lang are concerned about are being taken up by the People's Health Movement. Member Jonny Currie explains what he wants the movement to achieve, and others involved talk about actions they are taking.

In 2008 the rates of suicide in the UK began to increase. Is it a coincidence that this was also when the financial crisis hit? Ben Barr, research fellow in the department of Public Health and Policy at the University of Liverpool, explains what his study found. Those who've attempted to kill themselves once are at high risk of doing so again, but interventions to prevent this have been hard to find. Merete Nordentoft, professor at the Mental Health Centre Copenhagen, University of Copenhagen, talks us through the results of her study examining a promising candidate.

It's increasingly obvious that acutely ill patients have received less than gold standard care. Deficiencies in training are often blamed. Paul Frost, consultant in intensive care medicine at the University Hospital of Wales, takes us through the admission of an acutely ill patient. Also this week, BRCA mutations and ionising radiation both increase the risk of developing cancer, but how do these risk factors combine? Anouk Pijpe, an epidemiologist at the Netherlands Cancer Institute, explains the results of her retrospective cohort study.

A BMJ head to head article this week asks: "Are the causes of obesity primarily environmental?" John Wilding, Head of the Department of Obesity and Endocrinology at the University of Liverpool, and Tim Frayling, professor of human genetics at the University of Exeter, argue their cases. Also this week, David Williams, a consultant obstetric physician at University College Hospital London, explains why pre-eclampsia is easily missed.

This week we concentrate on diabetes "The difference between insulin management in type 1 and type 2 diabetes is rather like the difference between driving a sports car and driving a lorry," says Edwin Gale, emeritus professor of diabetes at the University of Bristol. He tells us why this means the newer insulins that have benefits in the treatment of type 1 diabetes may not be as good for type 2. Sripal Bangalore, director of research at the New York University School of Medicine, discusses his research into the relative effectiveness of different types of stents in diabetes patients

Schemes which reduce emergency admissions sound like a good thing, but Martin Rowland, professor of health services research, Cambridge Centre for Health Services Research, University of Cambridge, explains how they can go off track. And Mabel Chew gets some advice on the prognosis of children with acute coughs from Matthew Thompson, a senior clinical scientist in the Department of Primary Care Health Sciences, Oxford University.

A head to head article this week asks: "Does celebrity involvement in public health campaigns deliver long term benefit?”. The British Heart Foundation’s Hands Only CPR campaign, featuring Hollywood actor Vinnie Jones, seems to be having positive effects. Maura Gillespie, head of policy and advocacy at the BHF, explains why. Also this week, care for the homeless is often fragmented and transient. A team at University College Hospital in London is trying to unite the disparate agencies involved to ensure long term medical and social care for these vulnerable people. They tell us how their pilot service has improved outcomes and reduced costs.

In the US, overly aggressive treatment is estimated to cause 30 000 deaths among Medicare recipients alone each year. Reporter Jeanne Lenzer has investigated the problem for the BMJ, and explains why she thinks profit driven healthcare is to blame. And, experience of treating rare conditions can take time to build. Rej Bhumbra, a surgical trainee in orthopaedic oncology, explains how his time in India fast tracked his learning.

Bariatric surgery is under scrutiny from NCEPOD, the National Confidential Enquiry into Patient Outcome and Death, Ian Martin, NCEPOD's clinical co-ordinator for surgery, takes us through the highlights of its latest report. Also this week, Julie Paik, instructor and physician at Harvard Medical School, tells us about a new risk factor for primary hyperparathyroidism. And finally, some neuromuscular agents may lead to respiratory complications after surgery. Matthias Eikermann, director of research in the surgical intensive care unit at Massachusetts General Hospital, explains how they investigated this vexed problem.

Deborah Cohen explains how a joint BMJ and Daily Telegraph investigation helped uncover problems with device regulation in Europe. Previous research has shown smoking reduces life expectancy by about a decade, but only by four years if you are Japanese. Sarah Darby, from the University of Oxford, explains why her new research shows they are actually just as unhealthy as their British counterparts.