Medicine and Science from The BMJ

The authors of the recent meta-analysis on dietary sugar and body weight, Lisa Te Morenga, and Jim Mann, from the Departments of Human Nutrition and Medicine at the University of Otago, join us to discuss their findings. Also this week, the BMA wants doctors to be more involved in influencing policy on recreational drugs. Vivienne Nathanson, its director of professional activities, explains its new report, and how individual testimony can combine to convince governments to change policy.

An epidemiological investigation on bmj.com discusses the first probable case of human to human transmission of novel avian influenza A (H7N9). The author of the accompanying editorial, James Rudge, from the London School of Hygiene and Tropical Medicine, explains what this means for public health. Also this week, we know that standardised mortality rates are tricky and have to be interpreted carefully. David Spiegelhater, Winton Professor for the Public Understanding of Risk at the university of Cambridge, explains why a figure of 13 000 excess deaths in NHS hospitals is “number abuse”. Read the articles: http://www.bmj.com/content/347/bmj.f4730 http://www.bmj.com/content/347/bmj.f4893

US Health in International Perspective: Shorter Lives, Poorer Health produced by the National Research Council and Institute of Medicine of the National Academies, has found that on almost every comparative measure, Americans fare worse than their counterparts from other developed countries. Steve Woolf, from the Department of Family Medicine at Virginia Commonwealth University, who chaired the report, joins us to discuss its findings, and the implications.

How can you treat a young person who is exhibiting the first signs of psychosis? Mabel Chew talks to Professor Tim Kendall a consultant psychiatrist and director of the National Collaborating Centre for Mental Health at the Royal College of Psychiatrists. Professor Kendall is co-author of both a systematic review and meta-analysis into early treatments to prevent psychosis, and co-author of a new set of NICE guidelines into management of the condition.

In this practice special podcast, Timothy Wilt, professor of medicine at Minneapolis VA Center for Chronic Disease Outcomes Research, explains how to talk to patients about prostate cancer screening. Benjamin C Thomas, senior clinical fellow at Addenbrooks Hospital in Cambridge then talks us through androgen deprivation therapy.

The Francis report into care standards at Mid Staffordshire NHS Foundation Trust was published this week. Triggered by deaths at a hospital in England, Robert Francis QC was appointed by the government to look into why the quality of care in some wards was so low, and what can be done to make sure that this doesn’t happen in other hospitals. Also this week, research has unearthed data hidden for 40 years on magnetic tapes. It casts new light on the link between consumption of unsaturated fatty acids and secondary prevention of cardiovascular events. We hear from Christopher Ramsden, a clinical investigator at the US National Institutes of Health, who dug up the data.

The BMJ held a round table in January 2013 to discuss the future of primary care in England and Wales. The wide ranging topics included out of hours care, commissioning, education, time management, and integration. This is the full version, lasting one hour and 20 minutes. Edited highlights are available in this week's podcast. Chair: Domhnall MacAuley, primary care editor, BMJ. Participants: Helen Thomas, former GP partner, and current GP Strategic Health Authority lead for the south west of England Clare Gerada, chair of the Royal College of General Practitioners. Nav Chana, postgraduate dean of GP and community based education at the London Deanery. Judith Smith, director of policy at the policy think tank, the Nuffield Trust.

How involved are doctors in the non medical aspects of patient care? An analysis on bmj.com this week examines the problem of nutrition and fluid balance in hospitalised patients. Helen Macdonald, a junior doctor and editor at the BMJ, asks Richard Leach, clinical director of Guy's and St Thomas' NHS Foundation Trust, about how it should best be handled. Also this week, a summary of the BMJ round table on the future of primary care, which is available in full on the podcast page.

Of the myriad of clinical decision support tools, what features actually improve patient outcomes? Pavel Romanov, medical student at Western University in Canada, discusses his research. Also this week: Is it feasible to get governments to consider the public health impact of every policy decision they make? Politicians in Wales have drafted legislation to make the devolved nation the first in the world to implement this WHO recommendation. Adam Fletcher, senior lecturer in social science and health at Cardiff University, has written an editorial about the plan, and joins us to discuss the practicalities of enshrining public health in law.

In the wake of the Francis report, the BMJ gathered experts to discuss compassion in the health service. This is the discussion in full. Taking part are: Domhnall MacAuley, BMJ primary care editor Anthony Silverstone, consultant at UCH Peter Carter, chief executive for the Royal College of Nursing Jocelyn Cornwall, director, The Point of Care programme, The King's Fund Joanne Watson, consultant at Musgrove Park Hospital Sean O'Brien, head of the patient experience group at Musgrove Park Hospital