Podcasts about The BMJ

SomX's Belle Taylor and The BMJ's Helen Surana, dive into this week's healthtech news.00:00 - Intro02:35 - Government announces Women's Health Strategy to be renewed19:40 - Cyclana Bio raises £5m to boost women's health29:09 - Scientists develop breakthrough approach to detecting endometriosis in menstrual blood

Featuring an interview with Dr Aaron Lisberg, including the following topics: Efficacy and Safety of Datopotamab Deruxtecan (Dato-DXd) for Patients with Previously Treated EGFR-Mutated Advanced Non-Small Cell Lung Cancer (NSCLC): A Pooled Analysis of the TROPION-Lung01 and TROPION-Lung05 Trials (0:00) Ahn M-J et al. Efficacy and safety of datopotamab deruxtecan (Dato-DXd) in patients (pts) with previously-treated EGFR-mutated advanced non-small cell lung cancer (NSCLC): A pooled analysis of TROPION-Lung01 and TROPION-Lung05. ESMO Asia 2024;Abstract LBA7 Ahn M-J et al. A pooled analysis of datopotamab deruxtecan in patients with EGFR-mutated NSCLC. J Thorac Oncol 2025;[Online ahead of print]. Abstract Sacituzumab Tirumotecan for Previously Treated Advanced EGFR-Mutated NSCLC: Results from the Randomized OptiTROP-Lung03 Study (7:08) Fang W et al. Sacituzumab tirumotecan versus docetaxel for previously treated EGFR-mutated advanced non-small cell lung cancer: Multicentre, open label, randomised controlled trial. BMJ 2025;389:e085680. Abstract Zhang L et al. Sacituzumab tirumotecan (sac-TMT) in patients (pts) with previously treated advanced EGFR-mutated non-small cell lung cancer (NSCLC): Results from the randomized OptiTROP-Lung03 study. ASCO 2025;Abstract 8507. Combination of Dato-DXd and Immunotherapy as First-Line Therapy for Patients with Advanced NSCLC (13:12) Cuppens K et al. First-line (1L) datopotamab deruxtecan (Dato-DXd) + durvalumab ± carboplatin in advanced or metastatic non-small cell lung cancer (a/mNSCLC): Results from TROPION-Lung04 (cohorts 2 and 4). ESMO Targeted Anticancer Therapies Congress 2025;Abstract 8O. Okamoto I et al. TROPION-Lung07: Phase III study of Dato-DXd + pembrolizumab ± platinum-based chemotherapy as 1L therapy for advanced non-small-cell lung cancer. Future Oncol 2024;20(37):2927-36. Abstract Levy BP et al. TROPION-Lung08: Phase III study of datopotamab deruxtecan plus pembrolizumab as first-line therapy for advanced NSCLC. Future Oncol 2023;19(21):1461-72. Abstract Aggarwal C et al. AVANZAR: Phase III study of datopotamab deruxtecan (Dato-DXd) + durvalumab + carboplatin as 1L treatment of advanced/mNSCLC. World Conference on Lung Cancer (WCLC) 2023;Abstract P2.04-02. TROP2-Targeting Antibody-Drug Conjugates as Neoadjuvant and/or Adjuvant Therapy for Patients with Resectable NSCLC (19:08) A phase III, randomised, open-label, global study of adjuvant datopotamab deruxtecan (Dato-DXd) in combination with rilvegostomig or rilvegostomig monotherapy versus standard of care, following complete tumour resection, in participants with Stage I adenocarcinoma non-small cell lung cancer who are ctDNA-positive or have high-risk pathological features (TROPION-Lung12). NCT06564844 Cascone T et al. Perioperative durvalumab plus chemotherapy plus new agents for resectable non-small-cell lung cancer: The platform phase 2 NeoCOAST-2 trial. Nat Med 2025;31(8):2788-96. Abstract CME information and select publications

Not all fats are created equal—and some can be powerful allies for your migraine-prone brain. In this episode of Migraine Heroes Podcast, we dive deep into the world of Omega-3 fatty acids and their remarkable ability to soothe inflammation, stabilize blood vessels, and support your brain's natural resilience against migraine attacks. Hosted by Diane Ducarme, who bridges neuroscience and Traditional Chinese Medicine, this conversation reveals how the right kind of fat can become medicine.You'll discover:

Un nouvel épisode du Pharmascope est disponible! Dans ce 80ème épisode, Nicolas, Sébastien et Isabelle, inspirés par une populaire série documentaire, abordent cette fois-ci l'utilisation des thérapies non-hormonales en ménopause. Les objectifs pour cet épisode sont les suivants: Discuter des mesures non pharmacologiques utiles dans la prise en charge des symptômes de la ménopause Discuter des bénéfices et des risques associés aux thérapies non-hormonales en ménopause Conseiller adéquatement une patiente sur les thérapies non-hormonales offertes dans le traitement de la ménopause Pharmascope Medecine: (Protected Content)   Ressources pertinentes en lien avec l'épisode Série documentaire Loto-Méno Produit par KOTV, 2021. Disponible sur l'EXTRA d'ICI TOU.TV Articles de revue des traitements non-hormonaux Drewe J et coll. A systematic review of non-hormonal treatments of vasomotor symptoms in climacteric and cancer patients. Springerplus. 2015;4:65. Hickey M et coll. Non-hormonal treatments for menopausal symptoms. BMJ. 2017;359:j5101. Dugré N, Bustamante H. Combattre les chaleurs sans hormone? Le Médecin du Québec. 2020;55:47-51. Études portant sur les produits naturels Franco OH et coll. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA. 2016;315:2554-63. Mohammady M et coll. Effect of omega-3 supplements on vasomotor symptoms in menopausal women: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2018;228:295-302. Études portant sur les mesures non pharmacologiques Tran S et coll. Nonpharmacological therapies for the management of menopausal vasomotor symptoms in breast cancer survivors. Support Care Cancer. 2021;29:1183-93. Cramer H et coll. Yoga for menopausal symptoms-A systematic review and meta-analysis. Maturitas. 2018;109:13-25. Stefanopoulo E, Grunfled EA. Mind-body interventions for vasomotor symptoms in healthy menopausal women and breast cancer survivors. A systematic review. J Psychosom Obstet Gynaecol. 2017;38:210-25. Befus D et coll. Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis. J Altern Complement Med. 2018;4:314-23. Ayers B et coll. Effectiveness of group and self-help cognitive behavior therapy in reducing problematic menopausal hot flushes and night sweats (MENOS 2): a randomized controlled trial. Menopause. 2012;19:759-69.

An avalanche of information besets us on what to eat. It comes from the news, from influencers of every ilk, from scientists, from government, and of course from the food companies. Super foods? Ultra-processed foods? How does one find a source of trust and make intelligent choices for both us as individuals and for the society as a whole. A new book helps in this quest, a book entitled Food Intelligence: the Science of How Food Both Nourishes and Harms Us. It is written by two highly credible and thoughtful people who join us today.Julia Belluz is a journalist and a contributing opinion writer for the New York Times. She reports on medicine, nutrition, and public health. She's been a Knight Science Journalism Fellow at MIT and holds a master's in science degree from the London School of Economics and Political Science. Dr. Kevin Hall trained as a physicist as best known for pioneering work on nutrition, including research he did as senior investigator and section chief at the National Institutes of Health. His work is highly regarded. He's won awards from the NIH, from the American Society of Nutrition, the Obesity Society and the American Physiological Society. Interview Transcript Thank you both very much for being with us. And not only for being with us, but writing such an interesting book. I was really eager to read it and there's a lot in there that people don't usually come across in their normal journeys through the nutrition world. So, Julia, start off if you wouldn't mind telling us what the impetus was for you and Kevin to do this book with everything else that's out there. Yes, so there's just, I think, an absolute avalanche of information as you say about nutrition and people making claims about how to optimize diet and how best to lose or manage weight. And I think what we both felt was missing from that conversation was a real examination of how do we know what we know and kind of foundational ideas in this space. You hear a lot about how to boost or speed up your metabolism, but people don't know what metabolism is anyway. You hear a lot about how you need to maximize your protein, but what is protein doing in the body and where did that idea come from? And so, we were trying to really pair back. And I think this is where Kevin's physics training was so wonderful. We were trying to look at like what are these fundamental laws and truths. Things that we know about food and nutrition and how it works in us, and what can we tell people about them. And as we kind of went through that journey it very quickly ended up in an argument about the food environment, which I know we're going to get to. We will. It's really interesting. This idea of how do we know what we know is really fascinating because when you go out there, people kind of tell us what we know. Or at least what they think what we know. But very few people go through that journey of how did we get there. And so people can decide on their own is this a credible form of knowledge that I'm being told to pursue. So Kevin, what do you mean by food intelligence? Coming from a completely different background in physics where even as we learn about the fundamental laws of physics, it's always in this historical context about how we know what we know and what were the kind of key experiments along the way. And even with that sort of background, I had almost no idea about what happened to food once we ate it inside our bodies. I only got into this field by a happenstance series of events, which is probably too long to talk about this podcast. But to get people to have an appreciation from the basic science about what is going on inside our bodies when we eat. What is food made out of? As best as we can understand at this current time, how does our body deal with. Our food and with that sort of basic knowledge about how we know what we know. How to not be fooled by these various sound bites that we'll hear from social media influencers telling you that everything that you knew about nutrition is wrong. And they've been hiding this one secret from you that's been keeping you sick for so long to basically be able to see through those kinds of claims and have a bedrock of knowledge upon which to kind of evaluate those things. That's what we mean by food intelligence. It makes sense. Now, I'm assuming that food intelligence is sort of psychological and biological at the same time, isn't it? Because that there's what you're being told and how do you process that information and make wise choices. But there's also an intelligence the body has and how to deal with the food that it's receiving. And that can get fooled too by different things that are coming at it from different types of foods and stuff. We'll get to that in a minute, but it's a very interesting concept you have, and wouldn't it be great if we could all make intelligent choices? Julia, you mentioned the food environment. How would you describe the modern food environment and how does it shape the choices we make? It's almost embarrassing to have this question coming from you because so much of our understanding and thinking about this idea came from you. So, thank you for your work. I feel like you should be answering this question. But I think one of the big aha moments I had in the book research was talking to a neuroscientist, who said the problem in and of itself isn't like the brownies and the pizza and the chips. It's the ubiquity of them. It's that they're most of what's available, along with other less nutritious ultra-processed foods. They're the most accessible. They're the cheapest. They're kind of heavily marketed. They're in our face and the stuff that we really ought to be eating more of, we all know we ought to be eating more of, the fruits and vegetables, fresh or frozen. The legumes, whole grains. They're the least available. They're the hardest to come by. They're the least accessible. They're the most expensive. And so that I think kind of sums up what it means to live in the modern food environment. The deck is stacked against most of us. The least healthy options are the ones that we're inundated by. And to kind of navigate that, you need a lot of resources, wherewithal, a lot of thought, a lot of time. And I think that's kind of where we came out thinking about it. But if anyone is interested in knowing more, they need to read your book Food Fight, because I think that's a great encapsulation of where we still are basically. Well, Julie, it's nice of you to say that. You know what you reminded me one time I was on a panel and a speaker asks the audience, how many minutes do you live from a Dunkin Donuts? And people sort of thought about it and nobody was more than about five minutes from a Dunkin Donuts. And if I think about where I live in North Carolina, a typical place to live, I'm assuming in America. And boy, within about five minutes, 10 minutes from my house, there's so many fast-food places. And then if you add to that the gas stations that have foods and the drug store that has foods. Not to mention the supermarkets. It's just a remarkable environment out there. And boy, you have to have kind of iron willpower to not stop and want that food. And then once it hits your body, then all heck breaks loose. It's a crazy, crazy environment, isn't it? Kevin, talk to us, if you will, about when this food environment collides with human biology. And what happens to normal biological processes that tell us how much we should eat, when we should stop, what we should eat, and things like that. I think that that is one of the newer pieces that we're really just getting a handle on some of the science. It's been observed for long periods of time that if you change a rat's food environment like Tony Sclafani did many, many years ago. That rats aren't trying to maintain their weight. They're not trying to do anything other than eat whatever they feel like. And, he was having a hard time getting rats to fatten up on a high fat diet. And he gave them this so-called supermarket diet or cafeteria diet composed of mainly human foods. And they gained a ton of weight. And I think that pointed to the fact that it's not that these rats lacked willpower or something like that. That they weren't making these conscious choices in the same way that we often think humans are entirely under their conscious control about what we're doing when we make our food choices. And therefore, we criticize people as having weak willpower when they're not able to choose a healthier diet in the face of the food environment. I think the newer piece that we're sort of only beginning to understand is how is it that that food environment and the foods that we eat might be changing this internal symphony of signals that's coming from our guts, from the hormones in our blood, to our brains and the understanding that of food intake. While you might have control over an individual meal and how much you eat in that individual meal is under biological control. And what are the neural systems and how do they work inside our brains in communicating with our bodies and our environment as a whole to shift the sort of balance point where body weight is being regulated. To try to better understand this really intricate interconnection or interaction between our genes, which are very different between people. And thousands of different genes contributing to determining heritability of body size in a given environment and how those genes are making us more or less susceptible to these differences in the food environment. And what's the underlying biology? I'd be lying to say if that we have that worked out. I think we're really beginning to understand that, but I hope what the book can give people is an appreciation for the complexity of those internal signals and that they exist. And that food intake isn't entirely under our control. And that we're beginning to unpack the science of how those interactions work. It's incredibly interesting. I agree with you on that. I have a slide that I bet I've shown a thousand times in talks that I think Tony Sclafani gave me decades ago that shows laboratory rats standing in front of a pile of these supermarket foods. And people would say, well, of course you're going to get overweight if that's all you eat. But animals would eat a healthy diet if access to it. But what they did was they had the pellets of the healthy rat chow sitting right in that pile. Exactly. And the animals ignore that and overeat the unhealthy food. And then you have this metabolic havoc occur. So, it seems like the biology we've all inherited works pretty well if you have foods that we've inherited from the natural environment. But when things become pretty unnatural and we have all these concoctions and chemicals that comprise the modern food environment the system really breaks down, doesn't it? Yeah. And I think that a lot of people are often swayed by the idea as well. Those foods just taste better and that might be part of it. But I think that what we've come to realize, even in our human experiments where we change people's food environments... not to the same extent that Tony Sclafani did with his rats, but for a month at a time where we ask people to not be trying to gain or lose weight. And we match certain food environments for various nutrients of concern. You know, they overeat diets that are higher in these so-called ultra-processed foods and they'd spontaneously lose weight when we remove those from the diet. And they're not saying that the foods are any more or less pleasant to eat. There's this underlying sort of the liking of foods is somewhat separate from the wanting of foods as neuroscientists are beginning to understand the different neural pathways that are involved in motivation and reward as opposed to the sort of just the hedonic liking of foods. Even the simple explanation of 'oh yeah, the rats just like the food more' that doesn't seem to be fully explaining why we have these behaviors. Why it's more complicated than a lot of people make out. Let's talk about ultra-processed foods and boy, I've got two wonderful people to talk to about that topic. Julia, let's start with your opinion on this. So tell us about ultra-processed foods and how much of the modern diet do they occupy? So ultra-processed foods. Obviously there's an academic definition and there's a lot of debate about defining this category of foods, including in the US by the Health and Human Services. But the way I think about it is like, these are foods that contain ingredients that you don't use in your home kitchen. They're typically cooked. Concocted in factories. And they now make up, I think it's like 60% of the calories that are consumed in America and in other similar high-income countries. And a lot of these foods are what researchers would also call hyper palatable. They're crossing these pairs of nutrient thresholds like carbohydrate, salt, sugar, fat. These pairs that don't typically exist in nature. So, for the reasons you were just discussing they seem to be particularly alluring to people. They're again just like absolutely ubiquitous and in these more developed contexts, like in the US and in the UK in particular. They've displaced a lot of what we would think of as more traditional food ways or ways that people were eating. So that's sort of how I think about them. You know, if you go to a supermarket these days, it's pretty hard to find a part of the supermarket that doesn't have these foods. You know, whole entire aisles of processed cereals and candies and chips and soft drinks and yogurts, frozen foods, yogurts. I mean, it's just, it's all over the place. And you know, given that if the average is 60% of calories, and there are plenty of people out there who aren't eating any of that stuff at all. For the other people who are, the number is way higher. And that, of course, is of great concern. So there have been hundreds of studies now on ultra-processed foods. It was a concept born not that long ago. And there's been an explosion of science and that's all for the good, I think, on these ultra-processed foods. And perhaps of all those studies, the one discussed most is one that you did, Kevin. And because it was exquisitely controlled and it also produced pretty striking findings. Would you describe that original study you did and what you found? Sure. So, the basic idea was one of the challenges that we have in nutrition science is accurately measuring how many calories people eat. And the best way to do that is to basically bring people into a laboratory and measure. Give them a test meal and measure how many calories they eat. Most studies of that sort last for maybe a day or two. But I always suspected that people could game the system if for a day or two, it's probably not that hard to behave the way that the researcher wants, or the subject wants to deceive the researcher. We decided that what we wanted to do was bring people into the NIH Clinical Center. Live with us for a month. And in two two-week blocks, we decided that we would present them with two different food environments essentially that both provided double the number of calories that they would require to maintain their body weight. Give them very simple instructions. Eat as much or as little as you'd like. Don't be trying to change your weight. We're not going to tell you necessarily what the study's about. We're going to measure lots of different things. And they're blinded to their weight measurements and they're wearing loose fitting scrubs and things like that, so they can't tell if their clothes are getting tighter or looser. And so, what we did is in for one two-week block, we presented people with the same number of calories, the same amount of sugar and fat and carbs and fiber. And we gave them a diet that was composed of 80% of calories coming from these ultra-processed foods. And the other case, we gave them a diet that was composed of 0% of calories from ultra-processed food and 80% of the so-called minimally processed food group. And what we then did was just measured people's leftovers essentially. And I say we, it was really the chefs and the dieticians at the clinical center who are doing all the legwork on this. But what we found was pretty striking, which was that when people were exposed to this highly ultra-processed food environment, despite being matched for these various nutrients of concern, they overate calories. Eating about 500 calories per day on average, more than the same people in the minimally processed diet condition. And they gained weight and gained body fat. And, when they were in the minimally processed diet condition, they spontaneously lost weight and lost body fat without trying in either case, right? They're just eating to the same level of hunger and fullness and overall appetite. And not reporting liking the meals any more or less in one diet versus the other. Something kind of more fundamental seemed to have been going on that we didn't fully understand at the time. What was it about these ultra-processed foods? And we were clearly getting rid of many of the things that promote their intake in the real world, which is that they're convenient, they're cheap, they're easy to obtain, they're heavily marketed. None of that was at work here. It was something really about the meals themselves that we were providing to people. And our subsequent research has been trying to figure out, okay, well what were the properties of those meals that we were giving to these folks that were composed primarily of ultra-processed foods that were driving people to consume excess calories? You know, I've presented your study a lot when I give talks. It's nice hearing it coming from you rather than me. But a couple of things that interest me here. You use people as their own controls. Each person had two weeks of one diet and two weeks of another. That's a pretty powerful way of providing experimental control. Could you say just a little bit more about that? Yeah, sure. So, when you design a study, you're trying to maximize the efficiency of the study to get the answers that you want with the least number of participants while still having good control and being able to design the study that's robust enough to detect a meaningful effect if it exists. One of the things that you do when you analyze studies like that or design studies like that, you could just randomize people to two different groups. But given how noisy and how different between people the measurement of food intake is we would've required hundreds of people in each group to detect an effect like the one that we discovered using the same person acting as their own control. We would still be doing the study 10 years later as opposed to what we were able to do in this particular case, which is completed in a year or so for that first study. And so, yeah, when you kind of design a study that way it's not always the case that you get that kind of improvement in statistical power. But for a measurement like food intake, it really is necessary to kind of do these sorts of crossover type studies where each person acts as their own control. So put the 500 calorie increment in context. Using the old fashioned numbers, 3,500 calories equals a pound. That'd be about a pound a week or a lot of pounds over a year. But of course, you don't know what would happen if people were followed chronically and all that. But still 500 calories is a whopping increase, it seems to me. It sure is. And there's no way that we would expect it to stay at that constant level for many, many weeks on end. And I think that's one of the key questions going forward is how persistent is that change. And how does something that we've known about and we discuss in our books the basic physiology of how both energy expenditure changes as people gain and lose weight, as well as how does appetite change in a given environment when they gain and lose weight? And how do those two processes eventually equate at a new sort of stable body weight in this case. Either higher or lower than when people started the program of this diet manipulation. And so, it's really hard to make those kinds of extrapolations. And that's of course, the need for further research where you have longer periods of time and you, probably have an even better control over their food environment as a result. I was surprised when I first read your study that you were able to detect a difference in percent body fat in such a short study. Did that surprise you as well? Certainly the study was not powered to detect body fat changes. In other words, we didn't know even if there were real body fat changes whether or not we would have the statistical capabilities to do that. We did use a method, DXA, which is probably one of the most precise and therefore, if we had a chance to measure it, we had the ability to detect it as opposed to other methods. There are other methods that are even more precise, but much more expensive. So, we thought that we had a chance to detect differences there. Other things that we use that we also didn't think that we necessarily would have a chance to detect were things like liver fat or something like that. Those have a much less of an ability. It's something that we're exploring now with our current study. But, again, it's all exploratory at that point. So what can you tell us about your current study? We just wrapped it up, thankfully. What we were doing was basically re-engineering two new ultra-processed diets along parameters that we think are most likely the mechanisms by which ultra-processed meals drove increased energy intake in that study. One was the non-beverage energy density. In other words, how many calories per gram of food on the plate, not counting the beverages. Something that we noticed in the first study was that ultra-processed foods, because they're essentially dried out in the processing for reasons of food safety to prevent bacterial growth and increased shelf life, they end up concentrating the foods. They're disrupting the natural food matrix. They last a lot longer, but as a result, they're a more concentrated form of calories. Despite being, by design, we chose the overall macronutrients to be the same. They weren't necessarily higher fat as we often think of as higher energy density. What we did was we designed an ultra-processed diet that was low in energy density to kind of match the minimally processed diet. And then we also varied the number of individual foods that were deemed hyper palatable according to kind of what Julia said that crossed these pairs of thresholds for fat and sugar or fat and salt or carbs and salt. What we noticed in the first study was that we presented people with more individual foods on the plate that had these hyper palatable combinations. And I wrestle with the term terminology a little bit because I don't necessarily think that they're working through the normal palatability that they necessarily like these foods anymore because again, we asked people to rate the meals and they didn't report differences. But something about those combinations, regardless of what you call them, seemed to be driving that in our exploratory analysis of the first study. We designed a diet that was high in energy density, but low in hyper palatable foods, similar to the minimally processed. And then their fourth diet is with basically low in energy density and hyper palatable foods. And so, we presented some preliminary results last year and what we were able to show is that when we reduced both energy density and the number of hyper palatable foods, but still had 80% of calories from ultra-processed foods, that people more or less ate the same number of calories now as they did when they were the same people were exposed to the minimally processed diet. In fact they lost weight, to a similar extent as the minimally processed diet. And that suggests to me that we can really understand mechanisms at least when it comes to calorie intake in these foods. And that might give regulators, policy makers, the sort of information that they need in order to target which ultra-processed foods and what context are they really problematic. It might give manufacturers if they have the desire to kind of reformulate these foods to understand which ones are more or less likely to cause over consumption. So, who knows? We'll see how people respond to that and we'll see what the final results are with the entire study group that, like I said, just finished, weeks ago. I respond very positively to the idea of the study. The fact that if people assume ultra-processed foods are bad actors, then trying to find out what it is about them that's making the bad actors becomes really important. And you're exactly right, there's a lot of pressure on the food companies now. Some coming from public opinion, some coming from parts of the political world. Some from the scientific world. And my guess is that litigation is going to become a real actor here too. And the question is, what do you want the food industry to do differently? And your study can really help inform that question. So incredibly valuable research. I can't wait to see the final study, and I'm really delighted that you did that. Let's turn our attention for a minute to food marketing. Julia, where does food marketing fit in all this? Julia - What I was very surprised to find while we were researching the book was this deep, long history of calls against marketing junk food in particular to kids. I think from like the 1950s, you have pediatrician groups and other public health professionals saying, stop this. And anyone who has spent any time around small children knows that it works. We covered just like a little, it was from an advocacy group in the UK that exposed aid adolescents to something called Triple Dip Chicken. And then asked them later, pick off of this menu, I think it was like 50 items, which food you want to order. And they all chose Triple Dip chicken, which is, as the name suggests, wasn't the healthiest thing to choose on the menu. I think we know obviously that it works. Companies invest a huge amount of money in marketing. It works even in ways like these subliminal ways that you can't fully appreciate to guide our food choices. Kevin raised something really interesting was that in his studies it was the foods. So, it's a tricky one because it's the food environment, but it's also the properties of the foods themselves beyond just the marketing. Kevin, how do you think about that piece? I'm curious like. Kevin - I think that even if our first study and our second study had turned out there's no real difference between these artificial environments that we've put together where highly ultra-processed diets lead to excess calorie intake. If that doesn't happen, if it was just the same, it wouldn't rule out the fact that because these foods are so heavily marketed, because they're so ubiquitous. They're cheap and convenient. And you know, they're engineered for many people to incorporate into their day-to-day life that could still promote over consumption of calories. We just remove those aspects in our very artificial food environment. But of course, the real food environment, we're bombarded by these advertisements and the ubiquity of the food in every place that you sort of turn. And how they've displaced healthy alternatives, which is another mechanism by which they could cause harm, right? It doesn't even have to be the foods themselves that are harmful. What do they displace? Right? We only have a certain amount the marketers called stomach share, right? And so, your harm might not be necessarily the foods that you're eating, but the foods that they displaced. So even if our experimental studies about the ultra-processed meals themselves didn't show excess calorie intake, which they clearly did, there's still all these other mechanisms to explore about how they might play a part in the real world. You know, the food industry will say that they're agnostic about what foods they sell. They just respond to demand. That seems utter nonsense to me because people don't overconsume healthy foods, but they do overconsume the unhealthy ones. And you've shown that to be the case. So, it seems to me that idea that they can just switch from this portfolio of highly processed foods to more healthy foods just doesn't work out for them financially. Do you think that's right? I honestly don't have that same sort of knee jerk reaction. Or at least I perceive it as a knee jerk reaction, kind of attributing malice in some sense to the food industry. I think that they'd be equally happy if they could get you to buy a lot and have the same sort of profit margins, a lot of a group of foods that was just as just as cheap to produce and they could market. I think that you could kind of turn the levers in a way that that would be beneficial. I mean, setting aside for example, that diet soda beverages are probably from every randomized control trial that we've seen, they don't lead to the same amount of weight gain as the sugar sweetened alternatives. They're just as profitable to the beverage manufacturers. They sell just as many of them. Now they might have other deleterious consequences, but I don't think that it's necessarily the case that food manufacturers have to have these deleterious or unhealthy foods as their sole means of attaining profit. Thanks for that. So, Julia, back to you. You and Kevin point out in your book some of the biggest myths about nutrition. What would you say some of them are? I think one big, fundamental, overarching myth is this idea that the problem is in us. That this rise of diet related diseases, this explosion that we've seen is either because of a lack of willpower. Which you have some very elegant research on this that we cite in the book showing willpower did not collapse in the last 30, 40 years of this epidemic of diet related disease. But it's even broader than that. It's a slow metabolism. It's our genes. Like we put the problem on ourselves, and we don't look at the way that the environment has changed enough. And I think as individuals we don't do that. And so much of the messaging is about what you Kevin, or you Kelly, or you Julia, could be doing better. you know, do resistance training. Like that's the big thing, like if you open any social media feed, it's like, do more resistance training, eat more protein, cut out the ultra-processed foods. What about the food environment? What about the leaders that should be held accountable for helping to perpetuate these toxic food environments? I think that that's this kind of overarching, this pegging it and also the rise of personalized nutrition. This like pegging it to individual biology instead of for whatever the claim is, instead of thinking about how did environments and don't want to have as part of our lives. So that's kind of a big overarching thing that I think about. It makes sense. So, let's end on a positive note. There's a lot of reason to be concerned about the modern food environment. Do you see a helpful way forward and what might be done about this? Julia, let's stay with you. What do you think? I think so. We spent a lot of time researching history for this book. And a lot of things that seem impossible are suddenly possible when you have enough public demand and enough political will and pressure. There are so many instances and even in the history of food. We spend time with this character Harvey Wiley, who around the turn of the century, his research was one of the reasons we have something like the FDA protecting the food supply. That gives me a lot of hope. And we are in this moment where a lot of awareness is being raised about the toxic food environment and all these negative attributes of food that people are surrounded by. I think with enough organization and enough pressure, we can see change. And we can see this kind of flip in the food environment that I think we all want to see where healthier foods become more accessible, available, affordable, and the rest of it. Sounds good. Kevin, what are your thoughts? Yes, I just extend that to saying that for the first time in history, we sort of know what the population of the planet is going to be that we have to feed in the future. We're not under this sort of Malthusian threat of not being able to know where the population growth is going to go. We know it's going to be roughly 10 billion people within the next century. And we know we've got to change the way that we produce and grow food for the planet as well as for the health of people. We know we've got to make changes anyway. And we're starting from a position where per capita, we're producing more protein and calories than any other time in human history, and we're wasting more food. We actually know we're in a position of strength. We don't have to worry so acutely that we won't be able to provide enough food for everybody. It's what kind of food are we going to produce? How are we going to produce it in the way that's sustainable for both people and the planet? We have to tackle that anyway. And for the folks who had experienced the obesity epidemic or finally have drugs to help them and other kinds of interventions to help them. That absolve them from this idea that it's just a matter of weak willpower if we finally have some pharmaceutical interventions that are useful. So, I do see a path forward. Whether or not we take that is another question. Bios Dr. Kevin Hall is the section chief of Integrative Physiology Section in the Laboratory of Biological Modeling at the NIH National Institute of Diabetes and Digestive and Kidney Diseases. Kevin's laboratory investigates the integrative physiology of macronutrient metabolism, body composition, energy expenditure, and control of food intake. His main goal is to better understand how the food environment affects what we eat and how what we eat affects our physiology. He performs clinical research studies as well as developing mathematical models and computer simulations to better understand physiology, integrate data, and make predictions. In recent years, he has conducted randomized clinical trials to study how diets high in ultra-processed food may cause obesity and other chronic diseases. He holds a Ph.D. from McGill University. Julia Belluz is a Paris-based journalist and a contributing opinion writer to the New York Times, she has reported extensively on medicine, nutrition, and global public health from Canada, the US, and Europe. Previously, Julia was Vox's senior health correspondent in Washington, DC, a Knight Science Journalism fellow at the Massachusetts Institute of Technology in Cambridge, and she worked as a reporter in Toronto and London. Her writing has appeared in a range of international publications, including the BMJ, the Chicago Tribune, the Economist, the Globe and Mail, Maclean's, the New York Times, ProPublica, and the Times of London. Her work has also had an impact, helping improve policies on maternal health and mental healthcare for first responders at the hospital- and state-level, as well as inspiring everything from scientific studies to an opera. Julia has been honored with numerous journalism awards, including the 2016 Balles Prize in Critical Thinking, the 2017 American Society of Nutrition Journalism Award, and three Canadian National Magazine Awards (in 2007 and 2013). In 2019, she was a National Academies of Sciences, Engineering, and Medicine Communications Award finalist. She contributed chapters on public health journalism in the Tactical Guide to Science Journalism, To Save Humanity: What Matters Most for a Healthy Future, and was a commissioner for the Global Commission on Evidence to Address Societal Challenges.

In this unique episode of RAPM Focus, Editor in Chief Dr. Brian Sites's fellow, Dr. Meredith Peck, discusses regional anesthesia fellowships with Dr. Giselle Maquoit. Fellowship applications have seen an obvious decline over the past several years due to an extremely lucrative job market. However, regional anesthesia fellowships still offer invaluable experiences for regional anesthesiologists. Meredith Peck, DO, is a current regional anesthesia and pain medicine fellow at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.  Gisselle Maquoit, MD, is a current anesthesiologist at Kennebec Anesthesia Associates, a private practice serving Maine General Hospital. She completed a regional fellowship at Duke University. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

You requested; we delivered. Lots of Science Fictions listeners have asked us to take a look into Donald Trump and RFK, Jr.'s recent claims about Tylenol (that is, paracetamol or acetaminophen—all the same thing). Does it cause autism?It turns out there's more to this than you might've thought—regardless of all the recent hype, a lot of very reputable scientists take the idea seriously. But should they? In this emergency podcast, we go through all the relevant studies.The Science Fictions podcast is brought to you by Works in Progress magazine. In the ad this week we mentioned “The Death Rays that Guard Life”, an article from Issue 20 of the magazine about far-UVC light and how—with a lot more research—it might be the next big thing for reducing the spread of germs in hospitals and classrooms. Find that and many other articles and podcasts at worksinprogress.co.Show notes* The FDA's September 2025 announcement on Tylenol and autism* The UK's Department of Health and Social Care announcement the same day* “The phrase ‘no evidence' is a read flag for bad science communication”, by Scott Alexander* 2003 theoretical paper with speculation about paracetamol and neurodevelopmental disorders* 2013 sibling control study in the International Journal of Epidemiology* “Ecological” study in Environmental Health from 2013 about circumcision rates, paracetamol, and autism* 2015 Danish seven-year follow-up study* 2019 cord blood study in JAMA Psychiatry* 2021 “consensus statement” on paracetamol and neurodevelopment* 2025 Japanese sibling-control study* 2024 very large Swedish sibling-control study* Study that sparked the current debate: the “Navigation Guide” review from Environmental Health* Description of what “Navigation Guide” is* STAT News on the evidence for a paracetamol-autism link; and on the controversy about the Dean of the Harvard School of Public Health* White House statement defending the existence of the link* BMJ article summing up the controversyCreditsThe Science Fictions podcast is produced by Julian Mayers at Yada Yada Productions. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit sciencefictionspod.substack.com/subscribe

In this solo episode, Darin pulls back the curtain on one of the most important parts of his life:  he prepares for travel. From the supplements that keep his immune system strong to hydration hacks, adaptogenic elixirs, and EMF protection, this episode is a masterclass in staying grounded and resilient on the road. Travel doesn't have to destroy your health — it can actually elevate it. With a few intentional rituals, smart packing, and awareness, you can turn every trip into an opportunity to deepen your energy, focus, and connection to yourself. What You'll Learn 00:00:00 – Why travel is stressful and how to transform it into an empowering, health-boosting experience 00:01:00 – Darin's supplement protocol: Vitamin D3/K2, probiotics, zinc, vitamin C, and glutathione for immune defense 00:03:00 – The antioxidant power of glutathione and why it's critical for long flights and radiation exposure 00:04:30 – How CBD and terpenes support stress resilience and circadian rhythm through the endocannabinoid system 00:05:20 – Why magnesium and NAD are the unsung heroes of travel recovery and energy 00:06:30 – Darin's morning elixir recipe: cacao, guarana, ashwagandha, chaga, ginseng, and monk fruit 00:08:00 – Hydration 101: how to use a manual RO filter, mineralize your water, and ditch plastic 00:10:00 – How to build nutrient density into travel days using chlorella, spirulina, Shakeology, and Barukas 00:12:00 – Travel nutrition sovereignty: packing your own snacks, fasting, and avoiding airline food 00:14:00 – Movement anywhere: Darin's “portable gym” using bungee cords and bodyweight routines 00:16:00 – The 3-hour morning ritual: NewCalm, Healing Codes, journaling, cacao, red light therapy, and breathwork 00:20:00 – How to avoid radiation scanners, mitigate EMFs, and use WaveGuard for energy field protection 00:22:00 – Why Darin microdoses nicotine for cognitive focus and immune modulation 00:23:00 – Breathing practices for immune strength: 3–4 rounds of 40 deep breaths, Wim Hof style 00:24:00 – How to pack fruit and salads in mason jars to stay hydrated and nourished on planes 00:26:00 – Grounding after flights: barefoot on the earth, morning sunlight, and re-aligning your circadian rhythm Thank You to Our Sponsors Manna Vitality: Go to mannavitality.com/ or use code DARIN20 for 20% off your order. Fatty15: Get an additional 15% off their 90-day subscription Starter Kit by going to fatty15.com/DARIN and using code DARIN at checkout. Find More from Darin Olien: Instagram: @darinolien Podcast: SuperLife Podcast Website: superlife.com Book: Fatal Conveniences Key Takeaway “Preparation is sovereignty. When you take responsibility for your nutrition, your hydration, and your energy before you travel, you're no longer surviving the trip — you're expanding through it.” Bibliography Martineau AR et al. Vitamin D supplementation to prevent acute respiratory infections: systematic review. BMJ. 2017. Goldenberg JZ et al. Probiotics for prevention of respiratory infections. Cochrane Database. 2017. Hemilä H. Vitamin C and zinc in common cold. Nutrients. 2017. Blessing EM et al. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. 2015. Morris HJ et al. Spirulina and chlorella as functional foods. Nutrients. 2022. Longo VD, Panda S. Fasting, circadian rhythms, and time-restricted feeding. Cell Metabolism. 2016. Booth FW et al. Waging war on physical inactivity. J Physiol. 2017. Balmori A. Electromagnetic pollution from radiofrequency fields. Pathophysiology. 2015. Kox M et al. Voluntary activation of sympathetic nervous system and attenuation of the innate immune response. PNAS. 2014.

SOME say UK pharma has “a slow self-regulatory process that fails to ensure compliance” (BMJ letter, Oct 23)WE say it is the PMCPA themselves bringing the industry into disrepute (evidence to be presented at conference)

In this episode of the podcast; In July this year, the Government published their 10 year health plan for England - A new analysis just published on BMJ.com takes an in depth look at the chances of that plan succeeding, and where the government needs to focus time and resources. Bob Klaber, paediatrician and director of strategy, research and innovation at Imperial College Healthcare, and Helen Salisbury, GP and columnist for the BMJ join us to discuss. Journalist Chris Stoker-Walker's grandfather suffered from delirium at the end of his life, but the journey to that diagnosis was difficult - Chris joins us to talk about the impact that had on his family, and Elizabeth Sampson, professor of liaison psychiatry from Queen Mary University of London, explains why it's under-researched. Finally, we've been reporting from Gaza for 2 years, and it's been very difficult to get accurate information out of the region. However, new research published on bmj.com has surveyed medics there, to document the patterns of wounding in the civilian population - to improve the medical response to the conflict. Omar El-Taji and Ameer Ali, resident doctors in the NHS join us to explain what they found.   Reading list: Delivering on the 10 year health plan for England Why can't we do anything about delirium? Patterns of war related trauma in Gaza during armed conflict  

Starre Ernährungspläne sehen auf dem Papier gut aus, halten dem Kontakt mit dem "echten Leben" aber oft nicht stand. Am Ende dieser Folge weißt Du, wie Du trotzdem gewinnst.Du erfährst, warum rigide Kontrolle oft zu Stress, Rückfällen und Jo-Jo-Effekt führt, während flexible Kontrolle nachweislich mit weniger Überessen, niedrigerem BMI und besserer Stimmung einhergeht.Statt Verboten bekommst Du ein praxistaugliches System: 90/10-Prinzip, kleine Hebel für jede Mahlzeit und ein Umfeld, das Dich trägt, statt Deine Willenskraft zu verbrauchen.Dabei gehen wir ganz praktisch vor. Es geht um Leitplanken, die Dir Freiheit geben und die zu Deinem Alltag passen, ohne Abwiegen und Tabellen.Marks Ziel: Am Ende der Folge hast Du einen kompakten Werkzeugkasten in der Tasche, der Dir das Dranbleiben leicht(er) macht.____________*WERBUNG: Infos zum Werbepartner dieser Folge und allen weiteren Werbepartnern findest Du hier.____________Mehr zum Thema:Das erwähnte „Buch-Geheimprojekt“: Mehr dazu im Newsletter, sobald es spruchreif ist.Artikel: Das 90/10 PrinzipErnährungs-App (Tipp): Yazio ProLiteratur:Wing, et al. (2005). Long‑term weight loss maintenance. Am J Clin Nutr, 82(1 Suppl), 222S–225S.Anderson, et al. (2001). Long‑term weight‑loss maintenance: A meta‑analysis of US studies. Am J Clin Nutr, 74(5), 579–584.Dombrowski, et al. (2014). Long term maintenance of weight loss with non‑surgical interventions in obese adults: Systematic review and meta‑analyses of RCTs. BMJ, 348, g2646.Westenhoefer, et al. (2013). Cognitive and weight‑related correlates of flexible and rigid restrained eating behaviour. Eating Behaviors, 14(1), 69–72.Hollands, et al. (2015). Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco. Cochrane Database Syst Rev, 2015(9), CD011045.Robinson, et al. (2014). A systematic review and meta‑analysis examining the effect of eating rate on energy intake and hunger. Am J Clin Nutr, 100(1), 123–151.Carrière, et al. (2018). Mindfulness‑based interventions for weight loss: A systematic review and meta‑analysis. Obes Rev, 19(2), 164–177.Teixeira, et al. (2012). Motivation, self‑determination, and long‑term weight control. Int J Behav Nutr Phys Act, 9, 22.Lally, et al. (2010). How are habits formed? Modelling habit formation in the real world. Eur J Soc Psychol, 40(6), 998–1009.Westerterp‑Plantenga, et al. (2009). Dietary protein, weight loss, and weight maintenance. Annu Rev Nutr, 29, 21–41.Robinson, et al. (2022). Calorie‑reformulation: A systematic review and meta‑analysis examining the effect that manipulating food energy density has on daily energy intake. Int J Behav Nutr Phys Act, 19, 48.Hall, et al. (2019). Ultra‑processed diets cause excess calorie intake and weight gain: An inpatient randomized controlled trial of ad libitum food intake. Cell Metab, 30(1), 67–77.e3.Mills, et al. (2017). Frequency of eating home‑cooked meals and potential benefits for diet and health: Cross‑sectional analysis of a population‑based cohort study. Int J Behav Nutr Phys Act, 14, 109.Larson, et al. (2006). Food preparation by young adults is associated with better diet quality. J Am Diet Assoc, 106(12), 2001–2007.____________Shownotes und Übersicht aller Folgen.Trag Dich in Marks Dranbleiber Newsletter ein.Entdecke Marks Bücher.Folge Mark auf Instagram, Facebook, Strava, LinkedIn. Hosted on Acast. See acast.com/privacy for more information.

In this episode we are joined by Dr. Elspeth Davies, a medical anthropologist from the University of Oxford, and Dr. Helen Salisbury, a GP and BMJ columnist, about their BMJ article: How do we talk about overdiagnosis of mental health conditions without dismissing people's suffering?Our discussion explores the fine line between validating patients' experiences and the potential harms of unnecessary diagnostic labels. We examine the influence of medicalisation, the role of diagnoses in accessing care and benefits, and the broad societal implications.The conversation also highlights the need for improved communication between doctors and patients and the importance of considering alternative approaches to understanding mental health issues.Please note that this show does not constitute medical advice and is not a replacement for seeking professional help. You can find out more about the show and get signposting to support on our website livelymindspod.comFollow @livelymindspod on social media, or see our links at  https://www.bio.link/livelyminds 00:00 Introduction to Lively Minds Podcast00:20 Introducing the Topic of Over-Diagnosis00:27 Meet the Experts: Dr. Elspeth Davies and Dr. Helen Salisbury01:28 Defining Over-Diagnosis in Mental Health02:24 The Complexity of Diagnosing Mental Health Conditions04:39 The Role of Diagnoses in Accessing Support07:36 The Impact of Diagnoses on Patients09:48 The Debate on Over-Diagnosis and Medicalization25:52 The Influence of Pharmaceutical Companies26:26 Improving Conversations Between Doctors and Patients29:11 The Political Context of Over-Diagnosis31:03 Conclusion and Final Thoughts

Gastric ultrasound can be so important in assessing aspiration risk in any number of patients preoperatively, and POCUS can be an incredibly valuable tool in this circumstance. In this episode of RAPM Focus, RAPM social media editor, Alopi Patel, MD, converses with Jacob Wrobel, MD, and Alexander Doyal, MD, MPH, FASA, following the June 2025 publication of “Developing a method for ultrasound estimation of gastric volume in patients with previous gastric sleeve.” Dr. Jacob Wrobel is a recent graduate of the University of North Carolina School of Medicine and is preparing to begin his anesthesiology residency at the University of Pittsburgh Medical Center. He has a special interest in the applications for point-of-care ultrasound in the perioperative setting and plans to continue to pursue research in this area in his career as an anesthesiologist. Dr. Alexander Doyal is an associate professor in the department of anesthesiology within the transplant and vascular anesthesia division at the University of North Carolina. He has a keen interest in POCUS, research, and education. He serves as the POCUS course director in the School of Medicine. He also leads workshops for residents, and teaches and mentors faculty at regional and national meetings. His research interests are varied, and included novel POCUS clinical applications. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

Un nouvel épisode du Pharmascope est disponible! Dans ce 79ème épisode, Nicolas, Sébastien et Isabelle, inspirés par une populaire série documentaire, abordent l'utilisation des thérapies hormonales en ménopause. Les objectifs pour cet épisode sont: Expliquer le concept d'hormones bio-identiques Discuter des bénéfices et des risques associés à l'hormonothérapie en ménopause Conseiller adéquatement une patiente sur la prise d'hormones dans le traitement de la ménopause Pharmascope Medecine: (Protected Content)   Ressources pertinentes en lien avec l'épisode Série documentaire Loto-Méno Produit par KOTV, 2021. Disponible sur l'EXTRA d'ICI TOU.TV Revues systématiques portant sur l'efficacité et l'innocuité de l'hormonothérapie Maclennan AH et coll. Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes. Cochrane Database Syst Rev. 2004;2004:CD002978. Gaudard AMIS et coll. Bioidentical hormones for women with vasomotor symptoms. Cochrane Database Syst Rev. 2016;(8):CD010407. Rubinow DR et coll. Efficacy of estradiol in perimenopausal depression: so much promise and so few answers. Depress Anxiety. 2015;32:539-49. Lethaby A et coll. Hormone replacement therapy for cognitive function in postmenopausal women. Cochrane Database Syst Rev. 2008;2008:CD003122. Boardman HMP et coll. Hormone therapy for preventing cardiovascular disease in post-menopausal women. Cochrane Database Syst Rev. 2015;(3):CD002229. Marjoribanks J et coll. Long-term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Syst Rev. 2017;1:CD004143. Études WHI Rossouw JE et coll. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 2002;288:321-33. Anderson GL et coll. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial. JAMA. 2004;291:1701-12. Manson JE et coll. Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality: The Women's Health Initiative Randomized Trials. JAMA. 2017;318:927-38. Étude WISDOM Vickers MR et coll. Main morbidities recorded in the women's international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women. BMJ. 2007;335:239. Autres références Hoibraaten E et coll. Increased risk of recurrent venous thromboembolism during hormone replacement therapy–results of the randomized, double-blind, placebo-controlled estrogen in venous thromboembolism trial (EVTET). Thromb Haemost. 2000;84:961-7. Rowe T. A Word About Bioidenticals. J Obstet Gynaecol Can. 2016;38:697-9. Plourde R, Tan R. L'hormonothérapie de remplacement. Quand, pour qui et comment? Le Médecin du Québec. 2020;55:41-6.

Chegou o momento do já tradicional episódio duplo sobre o IgNobel, que tem como missão "honrar estudos e experiências que primeiro fazem as pessoas rir e depois pensar", com as descobertas científicas mais estranhas do ano.Esta é a primeira de duas partes sobre a edição 2025 do prêmio, com as categorias Literatura, Psicologia, Nutrição, Biologia e Química.Confira no papo entre o leigo curioso, Ken Fujioka, e o cientista PhD, Altay de Souza.> OUÇA (52min 22s)*Naruhodo! é o podcast pra quem tem fome de aprender. Ciência, senso comum, curiosidades, desafios e muito mais. Com o leigo curioso, Ken Fujioka, e o cientista PhD, Altay de Souza.Edição: Reginaldo Cursino.http://naruhodo.b9.com.br*APOIO: INSIDERIlustríssima ouvinte, ilustríssimo ouvinte do Naruhodo,sabe qual a minha peça coringa no guarda-roupas?É a Camiseta Oversized T-Shirt da INSIDER.Trampo? Ela cai bem.Lazer? Ela cai muito bem.É macia.É elástica.É anti-odor.Não desbota com o tempo.Não precisa passar.Regula a temperatura corporal.Entendeu por que ela é minha peça coringa?E, em Setembro, o Mês do Cliente, você tem a melhor oportunidade para começar a comprar INSIDER: combinando o cupom NARUHODO com os descontos do site, o seu desconto total pode chegar a até 50%!Isso mesmo: sua compra pode sair até pela metade do preço.Mas tem que acessar pela URL especial:creators.insiderstore.com.br/NARUHODOOu clicar no link da descrição deste episódio:o cupom será aplicado automaticamente no carrinho.INSIDER: inteligência em cada escolha.#InsiderStore*REFERÊNCIASThe 35th First Annual Ig Nobel Ceremony (2025)https://www.youtube.com/watch?v=z1cP4xKd_L4PRÊMIO DE LITERATURA [EUA]O falecido Dr. William B. Bean, por registrar e analisar persistentemente, durante 35 anos, a taxa de crescimento de uma de suas unhas. “A Note on Fingernail Growth,” William B. Bean, Journal of Investigative Dermatology, vol. 20, no. 1, January 1953, pp. 27-31. “A Discourse on Nail Growth and Unusual Fingernails,” William B. Bean, Transactions of the American Clinical and Climatological Association, vol. 74, 1962; pp. 152-67. “Nail Growth. Twenty-Five Years' Observation,” William B. Bean, Archives of Internal Medicine, vol. 122, no. 4, October 1968, pp. 359-61. “Nail Growth: 30 Years of Observation,” William B. Bean, Archives of Internal Medicine, vol. 134, no. 3, September 1974, pp. 497-502. “Some Notes of an Aging Nail Watcher,” William B. Bean, International Journal of Dermatology, vol. 15, no. 3, April 1976, pp. 225-30. “Nail Growth. Thirty-Five Years of Observation,” William B. Bean, Archives of Internal Medicine, vol. 140, no. 1, January 1980, pp. 73-6.  Vreeman, R. C; Carroll, A. E (2007). "Medical myths". BMJ. 335 (7633): 1288–9. doi:10.1136/bmj.39420.420370.25PRÊMIO DE PSICOLOGIA [POLÔNIA, AUSTRÁLIA, CANADÁ]Marcin Zajenkowski e Gilles Gignac, por investigarem o que acontece quando você diz a pessoas narcisistas — ou a qualquer outra pessoa — que elas são inteligentes. “Telling People They Are Intelligent Correlates with the Feeling of Narcissistic Uniqueness: The Influence of IQ Feedback on Temporary State Narcissism,” Marcin Zajenkowski and Gilles E. Gignac, Intelligence, vol. 89, November–December 2021, 101595.  PRÊMIO DE NUTRIÇÃO [NIGÉRIA, TOGO, ITÁLIA, FRANÇA]Daniele Dendi, Gabriel H. Segniagbeto, Roger Meek e Luca Luiselli, por estudarem em que medida um certo tipo de lagarto escolhe comer certos tipos de pizza. “Opportunistic Foraging Strategy of Rainbow Lizards at a Seaside Resort in Togo,” Daniele Dendi, Gabriel H. Segniagbeto, Roger Meek, and Luca Luiselli, African Journal of Ecology, vol. 61, no. 1, 2023, pp. 226-227.  PRÊMIO DE BIOLOGIA [JAPÃO]Tomoki Kojima, Kazato Oishi, Yasushi Matsubara, Yuki Uchiyama, Yoshihiko Fukushima, Naoto Aoki, Say Sato, Tatsuaki Masuda, Junichi Ueda, Hiroyuki Hirooka e Katsutoshi Kino, por seus experimentos para descobrir se vacas pintadas com listras semelhantes às de zebras podem evitar ser picadas por moscas. “Cows Painted with Zebra-Like Striping Can Avoid Biting Fly Attack,” Tomoki Kojima, Kazato Oishi, Yasushi Matsubara, Yuki Uchiyama, Yoshihiko Fukushima, Naoto Aoki, Say Sato, Tatsuaki Masuda, Junichi Ueda, Hiroyuki Hirooka, and Katsutoshi Kino, PLoS ONE, vol. 14, no. 10, 2019, e0223447.  PRÊMIO DE QUÍMICA [EUA, ISRAEL]Rotem Naftalovich, Daniel Naftalovich e Frank Greenway, por experimentos para testar se comer Teflon [uma forma de plástico mais formalmente chamada “politetrafluoretileno”] é uma boa maneira de aumentar o volume do alimento e, portanto, a saciedade sem aumentar o conteúdo calórico. “Polytetrafluoroethylene Ingestion as a Way to Increase Food Volume and Hence Satiety Without Increasing Calorie Content,” Rotem Naftalovich, Daniel Naftalovich, and Frank L. Greenway, Journal of Diabetes Science and Technology, vol. 10, no. 4, July 2016, pp. 971–976. “Use of Nondigestible Nonfibrous Volumizer of Meal Content as a Method for Increasing Feeling of Satiety,” Rotem Naftalovich  and Daniel Naftalovich, U.S. Patent 9,924,736, issued March 27, 2018.  *APOIE O NARUHODO!O Altay e eu temos duas mensagens pra você.A primeira é: muito, muito obrigado pela sua audiência. Sem ela, o Naruhodo sequer teria sentido de existir. Você nos ajuda demais não só quando ouve, mas também quando espalha episódios para familiares, amigos - e, por que não?, inimigos.A segunda mensagem é: existe uma outra forma de apoiar o Naruhodo, a ciência e o pensamento científico - apoiando financeiramente o nosso projeto de podcast semanal independente, que só descansa no recesso do fim de ano.Manter o Naruhodo tem custos e despesas: servidores, domínio, pesquisa, produção, edição, atendimento, tempo... Enfim, muitas coisas para cobrir - e, algumas delas, em dólar.A gente sabe que nem todo mundo pode apoiar financeiramente. E tá tudo bem. Tente mandar um episódio para alguém que você conhece e acha que vai gostar.A gente sabe que alguns podem, mas não mensalmente. E tá tudo bem também. Você pode apoiar quando puder e cancelar quando quiser. O apoio mínimo é de 15 reais e pode ser feito pela plataforma ORELO ou pela plataforma APOIA-SE. Para quem está fora do Brasil, temos até a plataforma PATREON.É isso, gente. Estamos enfrentando um momento importante e você pode ajudar a combater o negacionismo e manter a chama da ciência acesa. Então, fica aqui o nosso convite: apóie o Naruhodo como puder.bit.ly/naruhodo-no-orelo

In today's episode: Assisted Dying moves closer to becoming UK law. The proposed legislation to allow people to end their own lives has moved through a second debate in the House of Lords. What do MPs and doctors think of the Bill as it stands? And, new ways to pull research findings from observation alone makes us question whether correlation really doesn't equal causation. We find out - what is Target Trial Emulation? The BMJ's Elisabeth Mahase speaks to Labour MP Kim Leadbeater, sponsor of the Assisted Dying Bill. Why did she propose the legislation? What has been her impression of its movement through Parliament and the opposition it has faced? We also hear from Jamilla Hussain and Gareth Owen, doctors who attended a BMJ parliamentary roundtable on the topic. Finally, the BMJ's Duncan Jarvies talks to our research editors about new ways to develop evidence from observational studies. What are the limits to this new technique of causal inference? Reading list MP behind assisted dying bill warns that terminally ill people and their families are being failed, ahead of Lords debate Assisted dying bill: Lords debate concerns over lack of safeguards Transparent reporting of observational studies emulating a target trial: the TARGET Statement

For several decades, saturated fat was wrongly blamed for heart disease, while vegetable oils quietly caused a surge in obesity, inflammation, and chronic metabolic disorders Newly appointed FDA commissioner Dr. Marty Makary is now leading efforts to revise outdated dietary guidelines that were built on cherry-picked data from Ancel Keys' Seven Countries Study A 2016 BMJ-published reanalysis found replacing saturated fat with linoleic acid-rich vegetable oils increased cardiovascular deaths, despite lowering cholesterol Investigative journalist Dr. Maryanne Demasi faced vicious backlash after exposing the flawed science behind saturated fat demonization in her documentary “Heart of the Matter” Industrial seed oils like canola and soybean are now linked to mitochondrial damage, inflammation, and chronic illness — while saturated fat is finally being recognized as metabolically supportive

This week, we're unpacking the big stories shaping food, health and how we live. We start with a major BMJ study showing that eating chips three times a week raises type 2 diabetes risk by 20% but baked or boiled potatoes don't carry the same danger. We'll share why the way you cook them matters, plus the genuine health benefits of potatoes when they're not fried. Next, a Guardian feature on “otroverts” — people who don't feel at home in groups but aren't introverts either. Psychiatrist Dr Rami Kaminski explains why this isn't a deficit, how it can be a strength, and what it tells us about solitude, loneliness and connection. And from the Times, the science of the “holiday brain-boost.” We explore how holidays can slow cognitive ageing, why even short breaks matter, and the habits from naps to mindfulness and movement that help the benefits last for weeks after you're home. Plus, the trends: Australia's world-first ban on social media for under 16s, and the UK government's plan to restrict energy drink sales to teenagers. Alongside all that, Ella shares her first weekend in the new house, picking homegrown fruit and veg and welcoming two new puppies, plus a listener story that reveals just how many ultra processed additives can be hiding in a single mini cupcake. Catch Rhi discussing UPFs and The Unprocessed Plate at Waterstones - London Gower Street and Chroleywood Library Learn more about your ad choices. Visit podcastchoices.com/adchoices

Join us for an in depth discussion on AI and evidence-based medicine using insights from a recent BMJ study on computer-aided detection in the diagnosis of polyps in adult patients.Guests: - Farid Foroutan, PhD, Ted Rogers Centre for Heart Research, Toronto- Ankita Sagar, System VP for Clinical Standards and Variation ReductionDiscussion includes: - The importance of validating AI against the evidence - Living clinical practice guidelines - Guardrails on applying AI to the bedside

In today's episode: Rethinking how we measure the harm caused by the  arms industry The life long, and multigenerational, impact of starvation in Gaza What is the appropriate focus on prevention in general practice?   The BMJ's international editor, Jocalyn Clark talks about a new series we've just published - examining the arms industry as a commercial determinant of health. Jocalyn also speaks to Mark Bellis, from Liverpool John Moores university about why he thinks it's time we take the impact of the arms industry on health seriously. The blockade on food reaching Gaza is in place again, risking more starvation. Elizabeth Mahase, clinical reporter for the BMJ, has been finding out about the acute, chronic, and generational impact on the palestinian population. She speaks to Jonathan Wells, professor of anthropology and paediatric nutrition at University College London, and Tessa Roseboom, professor of early development and health at the University of Amsterdam, Marie McGrath former head of the Emergency Nutrition Network, and Chris McIntosh, humanitarian response advisor for the charity, Oxfam. Finally, an analysis we published earlier this year made the case that "tsunami" of preventative care is destabilised the work of GPs. Helen Macdonald was at the Preventing Overdiagnosis conference and spoke to some of the authors - Minna Johansson, associate professor at University of Gothenberg, Stephen Martin, professor at UMass Chan Medical School, and Iona Heath, retired GP and former president of the RCGP.   Reading list Arms industry as a commercial determinant of health Starvation is a lifelong sentence: Gaza's civilians must be protected in accordance with international humanitarian law Sacrificing patient care for prevention: distortion of the role of general practice  

Severity of common cold symptoms fell 41% in the fittest and 31% in the most active.https://bjsm.bmj.com/content/45/12/987.abstractFlu shots in children: 5× higher risk of noninfluenza respiratory infections (incl. coronaviruses).https://pubmed.ncbi.nlm.nih.gov/22423139/Glyphosate damages gut health.https://www.mdpi.com/1099-4300/15/4/1416Adults sleeping ≤6 h/night were ~4× more likely to develop a cold after rhinovirus exposure; similar with ≤7 h + low sleep efficiency.https://pmc.ncbi.nlm.nih.gov/articles/PMC4531403/Vitamin D deficiency was common in COVID patients—41.9% overall, 80% in severe cases.https://pubmed.ncbi.nlm.nih.gov/33048028/Sea lion study:https://www.frontiersin.org/journals/marine-science/articles/10.3389/fmars.2020.602565/fullNFL player's story:https://bleacherreport.com/articles/1859740-random-things-most-nfl-fans-never-knew-football-players-almost-never-get-sickCowling 2012: Flu shots in children increased risk of noninfluenza infections 5×.https://pubmed.ncbi.nlm.nih.gov/22423139/Wolff study: Vaccinated servicemen had higher odds of coronavirus (+36%), metapneumovirus (+51%), and other noninfluenza viruses (+15%).https://www.sciencedirect.com/science/article/pii/S0264410X19313647Vaccinated kids ≤4 yrs: 4.8× higher hazard of noninfluenza infection (CI 2.88–7.99). Ages 5–17: 1.61× higher hazard (CI 0.98–2.66).https://pubmed.ncbi.nlm.nih.gov/29525279/Chris Kresser (2021): Vitamin D deficiency raised SARS-CoV-2 infection risk by 80%. Deficient patients had 1.77× higher infection risk, 2.57× more severe, 2.35× higher mortality.https://vimeo.com/530879066/e9b314a0beTom Jefferson review of 259 BMJ studies: Flu vaccines had little effect on outcomes like absences, days lost, illness, or death.https://pmc.ncbi.nlm.nih.gov/articles/PMC1626345/Pesticide research (http://ndl.ethernet.edu.et/bitstream/123456789/54884/1/Jonathan%20J.%20Li_2008.pdf#page=399):• Women with reproductive cancers had 4–6× higher pesticide levels (8.7–10.9 mg/L vs 1.9 mg/L).• Living ≤1 mile from a golf course → 126% higher Parkinson's risk; risk drops 13% per mile after 3 mi.• Shared water with golf course → nearly 2× PD risk.• Vulnerable groundwater regions → 82% higher PD risk.“These chemicals can be carcinogenic, mutagenic, teratogenic, and estrogenic (disrupting hormones).”If you need other studies, ask AI or email shortlifeadvice@gmail.com

Drs. Whitney Hartlage (@whithartlage11) and Sam Windham join Dr. Ryan Moenster to discuss updates in the diagnosis and management of community-acquire pneumonia. Hear from our guests on the role of rapid diagnostic tests such as multiplex PCR and urinary antigen tests in the inpatient and outpatient setting, considerations for initiating steroids and withholding macrolides, and when to use short antibiotic durations. Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/. Visit our website! https://breakpoints-sidp.org/ References: Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, Cooley LA, Dean NC, Fine MJ, Flanders SA, Griffin MR, Metersky ML, Musher DM, Restrepo MI, Whitney CG. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. PMID: 31573350; PMCID: PMC6812437. Chaudhuri D, Nei AM, Rochwerg B, Balk RA, Asehnoune K, Cadena R, Carcillo JA, Correa R, Drover K, Esper AM, Gershengorn HB, Hammond NE, Jayaprakash N, Menon K, Nazer L, Pitre T, Qasim ZA, Russell JA, Santos AP, Sarwal A, Spencer-Segal J, Tilouche N, Annane D, Pastores SM. 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia. Crit Care Med. 2024 May 1;52(5):e219-e233. doi: 10.1097/CCM.0000000000006172. Epub 2024 Jan 19. PMID: 38240492. Odeyemi Y, Tekin A, Schanz C, Schreier D, Cole K, Gajic O, Barreto E. Comparative effectiveness of azithromycin versus doxycycline in hospitalized patients with community acquired pneumonia treated with beta-lactams: A multicenter matched cohort study. Clin Infect Dis. 2025 May 16:ciaf252. doi: 10.1093/cid/ciaf252. Epub ahead of print. PMID: 40378193. Butler AM, Nickel KB, Olsen MA, Sahrmann JM, Colvin R, Neuner E, O'Neil CA, Fraser VJ, Durkin MJ. Comparative safety of different antibiotic regimens for the treatment of outpatient community-acquired pneumonia among otherwise healthy adults. Clin Infect Dis. 2024 Oct 23:ciae519. doi: 10.1093/cid/ciae519. Epub ahead of print. PMID: 39442057; PMCID: PMC12355227. Furukawa Y, Luo Y, Funada S, Onishi A, Ostinelli E, Hamza T, Furukawa TA, Kataoka Y. Optimal duration of antibiotic treatment for community-acquired pneumonia in adults: a systematic review and duration-effect meta-analysis. BMJ Open. 2023 Mar 22;13(3):e061023. doi: 10.1136/bmjopen-2022-061023. PMID: 36948555; PMCID: PMC10040075 Schober T, Wong K, DeLisle G, et al. Clinical outcomes of rapid respiratory virus testing in emergency departments. JAMA Intern Med. 2024;184(5):528-536. Clark T, Lindsley K, Wigmosta T, et al. Rapid multiplex PCR for respiratory viruses reduces time to result and improves clinical care: results of a systematic review and meta-analysis. J Infect. 2023;86(5):462-475. May L, Robbins EM, Canchola JA, Chugh K, Tran NK. A study to assess the impact of the cobas point-of-care RT-PCR assay (SARS-CoV-2 and Influenza A/B) on patient clinical management in the emergency department of the University of California at David Medical Center. J Clin Virol. 2023:168:105597. Cartuliares MB, Rosenvinge FS, Mogensen CB, Skovsted TA, Andersen SL, Østergaard C, et al. Evaluation of point-of-care multiplex polymerase chain reaction in guiding antibiotic treatment of patients acutely admitted with suspected community-acquired pneumonia in Denmark: a multicentre randomised controlled trial. PLoS Med. 2023;20:e1004314. doi: 10.1371/ journal.pmed.1004314. Vaughn VM, Dickson RP, Horowitz JK, Flanders SA. Community-acquired pneumonia: a review. JAMA. 2024;332(15):1282-1295. Davis MR, McCreary EK, Trzebucki AM. Things we do for no reason – ordering Streptococcus pneumoniae urinary antigen in patients with community-acquired pneumonia. Open Forum Infect Dis. 2024;11(3):ofae089. Centers for Disease Control and Prevention. Laboratory Testing for Legionella. Updated June 9, 2025. Accessed July 13, 2025. https://www.cdc.gov/legionella/php/laboratories/index.html. Jain S, Self WH, Wunderink RG. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med. 2015;373(5):415-427. Kamat IS, Ramachandram V, Eswaran H, Guffey D, Musher DM. Procalcitonin to distinguish viral from bacterial pneumonia: a systematic review and meta-analysis. Clin Infect Dis. 2020;70(3):538-542. Christ-Crain M, Jaccard-Stolz D, Bingisser R, Gencay MM, Huber PR, Tamm M, et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single blinded intervention trial. Lancet. 2004;363:600–7. doi: 10.1016/S0140- 6736(04)15591-8. Schuetz P, Christ-Crain M, Thomann R, Falconnier C, Wolbers M, Widmer I, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial. JAMA. 2009;302:1059–66. Schuetz P, Muller B, Christ-Crain M, Stolz D, Tamm M, Bouadma L, et al. Procalci- € tonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Datab System Rev. 2017;10(10):CD007498. doi: 10.1002/14651858. cd007498.pub2. Huang DT, Yealy DM, Filbin MR, Brown AM, Chang C-CH, Doi Y, et al. Procalcitonin-guided use of antibiotics for lower Respiratory tract infection. New Engl J Med. 2018;379:236–49. doi: 10.1056/NEJMoa1802670. Dequin PF, Meziani F, Quenot JP, et al. Hydrocortisone in severe community-acquired pneumonia. N Engl J Med. 2023;389(19):1623-1634. doi:10.1056/NEJMoa2215145. Gupta AB, Flanders SA, Petty LA, et al. Inappropriate diagnosis of pneumonia among hospitalized adults. JAMA Intern Med. 2024;184(5):548-556. Jones BE, Chapman AB, Ying J, et al. Diagnostic Discordance, Uncertainty, and Treatment Ambiguity in Community-Acquired Pneumonia: A National Cohort Study of 115 U.S. Veterans Affairs Hospitals. Ann Intern Med. 2024;177(9):1179-1189. doi:10.7326/M23-2505. Hartlage W, Imlay H, Spivak ES. The role of empiric atypical antibiotic coverage in non-severe community-acquired pneumonia. Antimicrob Steward Healthc Epidemiol. 2024;4(1):e214. doi:10.1017/ash.2024.453. Dinh A, Barbier F, Bedos JP, et al. Update of guidelines for management of community acquired pneumonia in adults by the French Infectious Disease Society (SPILF) and the French-Speaking Society of Respiratory Diseases (SPLF). Endorsed by the French Infectious Disease Society (SPILF) and the French-Speaking Society of Respiratory Diseases (SPLF); endorsed by the French Intensive Care Society (SRLF), the French Microbiology Society (SFM), the French Radiology Society (SFR), and the French Emergency Society (SFMU). Respir Med and Res. 2025. El Moussaoui R, de Borgie CAJM, van den Broek P, et al. Effectiveness of discontinuing antibiotic treatment after three days versus eight days in mild to moderate-severe community acquired pneumonia: randomised, double blind study. BMJ. 2006;332(7554):1355. doi:10.1136/bmj.332.7554.1355. Dinh A, Ropers J, Duran C, et al. Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia: a randomized, non-inferiority trial. Lancet. 2021;397(10280):1195-1203.

In today's podcast we talk with Eric Wong, geriatrician-researcher from Toronto, and Thiago Silva, geriatrician-researcher from Brazil, about the comprehensive geriatrics assessment.  We spend the first 30 minutes (at least) discussing what, exactly is the comprehensive geriatric assessment, including: What domains of assessment are essential/mandatory components of the comprehensive geriatrics assessment? Who performs it? Is a multidisciplinary team required? Can a geriatrician perform it alone? Can non-geriatricians perform it? Who is the comprehensive geriatrics assessment for? Who is most likely to benefit? Eric Widera suggests not as much benefit for very sick and very healthy older adults, more benefit in the vast middle. Why do the comprehensive geriatrics assessment? What are the interventions that it leads to (we cover this more conceptually, rather than naming all possible interventions) How does the comprehensive geriatrics assessment relate to the 4Ms (or 5 Ms)? How long does it take to conduct a comprehensive geriatrics assessment? What's the evidence (BMJ meta analysis) for the comprehensive geriatrics assessment?  What are the outcomes we hope for from the comprehensive geriatrics assessment?   That final point, about outcomes, bring's us to Eric Wong's study, published in JAGS, which evaluates the cost effectiveness of the comprehensive geriatrics assessment performed by a geriatrician across settings (e.g. acute care, rehab, community clinics). As an aside, as the editor at JAGS who managed this manuscript, I will say that we don't ordinarily publish cost effectiveness studies at JAGS, as the methods are opaque to our clinical audience (e.g. raise your hand if you understand what ‘CGA provided in the combination of acute care and rehab was non-dominated' means). We published this article because its bottom line is of great interest to geriatricians.  In Eric's study, geriatricians performing CGA were more cost effective than usual care in Every. Single. Setting. And of course cost effectiveness is only one small piece of the argument for why we do the comprehensive geriatrics assessment in the first place (no patient in the history of the world has ever asked for a test or treatment because it's cost effective for the health care system). I'll close with a couple of “mic drop” excerpts from Thiago's accompanying editorial: Finally, it is instructive to compare the cost-effectiveness of geriatric services and CGAs with other interventions. A recent analysis of lecanemab for early-stage Alzheimer's disease found that gaining one QALY would cost approximately $287,000 (USD). In contrast, Wong et al. estimated that adding community-based CGA would cost about $1203 (CAD) per quality-adjusted life month (QALM) (equating to roughly $10,105 (USD) per QALY, using $1 USD = $0.7 CAD), making geriatrician-led CGA nearly 30 times more cost-effective. Put simply, for each dollar spent to improve quality of life for a year through CGA, one would need to spend almost $30 to achieve the same benefit with lecanemab.  Ultimately, the question is not whether geriatricians represent a worthwhile investment (they are) but how healthcare systems can ensure that every older adult requiring specialized, comprehensive care can access it. Wong et al.'s modeling study provides a valuable contribution by showing that geriatricians placed in acute and rehabilitation settings offer the most cost-effective deployment given current workforce limitations. Despite some caveats, the overarching message remains clear: geriatric expertise not only enhances care quality but can also align with health-economic objectives, especially in high-acuity environments. However, we cannot allow an inadequate geriatric workforce to become a permanent constraint, forcing painful decisions about which older adults and which settings will miss out on optimal geriatric care. Instead, we should continue to strive to increase the number of geriatricians through robust training programs and payment model reform to ensure that cost-effective care can be provided for this large and growing vulnerable population.  -Alex Smith  

Are ADHD medications just about focus? In this week's NeuroSpicy Hot Topic from The Neurodivergent Experience, hosts Jordan James and Simon Scott break down a brand-new study from the BMJ showing that ADHD medication delivers far more than concentration boosts — with real-world life-saving benefits.From suicidal thoughts to transport accidents, and from substance misuse to criminal risk, we explore:How ADHD meds reduce impulsivity, risky behaviour, and accidentsEmotional regulation: why stimulants help us process feelings without overwhelmReal-life stories: missed trains, re-injuries, bad crowds, and chasing adrenalineWhy taking medication “only on work days” may miss its biggest benefitsThe dangerous oversimplifications of ADHD as just “distracted and hyper”Internal vs external ADHD — and why invisibility creates stereotypesHow methylphenidate helps close “open tabs” in the brain and builds better decision pathwaysThe truth about being “oversensitive” vs “hypersensitive”Whether you've been told ADHD meds are only about productivity, or you're weighing whether daily use is worth it, this conversation blends science, lived experience, and a heavy dose of neurospicy humour to show why these medications can be life-changing far beyond the desk.❤️ Support the ShowIf this episode resonated with you:✅ Follow or Subscribe to The Neurodivergent Experience⭐ Leave a quick review on Apple Podcasts or Spotify

In the era of fast-tracked surgery and same-day discharge, anesthesiologists are looking for strategies to optimize recovery without compromising safety or pain control. A long-standing debate centers around whether low-dose bupivacaine or mepivacaine is the better spinal agent to promote early ambulation after total knee arthroplasty. In this episode of RAPM Focus, RAPM Editor-in-Chief, Brian Sites, MD, explores this debate with Clinton Pillow, MD, following the May 2025 publication of “Mepivacaine versus bupivacaine spinal anesthesia for return of motor function following total knee arthroplasty: a randomized controlled trial.” This episode explores a topic faced by every anesthesiologist that manages joint replacements, especially total knee arthroplasty, has grappled with—what is the ideal spinal anesthetic when time is money and same-day discharge is the goal? Dr. Pillow is an assistant professor in the department of anesthesiology and perioperative medicine at the Medical University of South Carolina. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

ENCORE: This episode was first published in Sept. 2023.In 1998, a young Norwegian exercise physiologist found that a technique he had used to help Olympic athletes could help heart patients too. But his idea made doctors sweat. One famous cardiologist told him that if he used his technique in human heart attack patients, he "would kill them."Today's show looks at what happened when our researcher, Ulrik Wisløff, defied the experts — and built a career learning how high intensity interval training can help everyone from heart patients and ageing Baby Boomers, and possibly even Alzheimer's patients — but not in the way you might think!Today's guests are Ulrik Wisløff, Dorthe Stensvold and Atefe Tari.Here's a link to a rat on a treadmill photo. And here's a link to a transcript.Here's a list of some of the research mentioned in the podcast:Wisløff U, et al. Intensity-controlled treadmill running in rats: VO(2 max) and cardiac hypertrophy. Am J Physiol Heart Circ Physiol. 2001 Mar;280(3):H1301-10.Wisløff U,et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation. 2007 Jun 19;115(24):3086-94. doi: 10.1161/CIRCULATIONAHA.106.675041. Epub 2007 Jun 4.Rognmo, Ø et al.. Cardiovascular Risk of High- Versus Moderate-Intensity Aerobic Exercise in Coronary Heart Disease Patients Circulation. 2012;126:1436-1440. doi: 10.1161/CIRCULATIONAHA.112.123117Stensvold D, Viken H, Steinshamn S L, Dalen H, Støylen A, Loennechen J P et al. Effect of exercise training for five years on all cause mortality in older adults—the Generation 100 study: randomised controlled trial BMJ 2020; 371 :m3485 Tari AR, Nauman J, Zisko N, Skjellegrind HK, Bosnes I, Bergh S, Stensvold D, Selbæk G, Wisløff U. Temporal changes in cardiorespiratory fitness and risk of dementia incidence and mortality: a population-based prospective cohort study. Lancet Public Health. 2019 Nov;4(11):e565-e574.Tari AR, Berg HH, Videm V, Bråthen G, White LR, Røsbjørgen RN, Scheffler K, Dalen H, Holte E, Haberg AK, Selbaek G, Lydersen S, Duezel E, Bergh S, Logan-Halvorsrud KR, Sando SB, Wisløff U. Safety and efficacy of plasma transfusion from exercise-trained donors in patients with early Alzheimer's disease: protocol for the ExPlas study. BMJ Open. 2022 Sep 6;12(9):e056964. Hosted on Acast. See acast.com/privacy for more information.

How does genetic testing help doctors treat patients? How accurate are private companies like 23andMe? Does knowing your genetic risk help people lead healthier lives or is it just a waste of time and money? Sophie had a bunch of questions about how genetic testing is used in everyday medical practice and Chris was here to answer!   Become a supporter of our show today either on Patreon or through PayPal! Thank you! http://www.patreon.com/thebodyofevidence/ https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Email us your questions at thebodyofevidence@gmail.com.   Editor:    Robyn Flynn Theme music: “Fall of the Ocean Queen“ by Joseph Hackl Rod of Asclepius designed by Kamil J. Przybos Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer   Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information. References: Studies evaluating the accuracy of Direct to Consumer genetic testing companies: Ng PC, Murray SS, Levy S, Venter JC. An agenda for personalized medicine. Nature. 2009 Oct 8;461(7265):724-6. doi: 10.1038/461724a. PMID: 19812653. Imai K, Kricka LJ, Fortina P. Concordance study of 3 direct-to-consumer genetic-testing services. Clin Chem. 2011 Mar;57(3):518-21. doi: 10.1373/clinchem.2010.158220.  Studies looking at how knowing the results of genetic testing affect medical treatment and lifestyle factors. Mega JL, et al. Genetic risk, coronary heart disease events, and the clinical benefit of statin therapy: an analysis of primary and secondary prevention trials. Lancet. 2015 Jun 6;385(9984):2264-2271. doi: 10.1016/S0140-6736(14)61730-X Khera AV, Emdin CA, Drake I, Natarajan P, Bick AG, Cook NR, Chasman DI, Baber U, Mehran R, Rader DJ, Fuster V, Boerwinkle E, Melander O, Orho-Melander M, Ridker PM, Kathiresan S. Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease. N Engl J Med. 2016 Dec 15;375(24):2349-2358. doi: 10.1056/NEJMoa1605086.  The Cochrane review and MI-GENES study which showed that genetic information did not change lifestyle behavior Hollands GJ, French DP, Griffin SJ, Prevost AT, Sutton S, King S, Marteau TM. The impact of communicating genetic risks of disease on risk-reducing health behaviour: systematic review with meta-analysis. BMJ. 2016 Mar 15;352:i1102. doi: 10.1136/bmj.i1102.  Kullo IJ, et al. Incorporating a Genetic Risk Score Into Coronary Heart Disease Risk Estimates: Effect on Low-Density Lipoprotein Cholesterol Levels (the MI-GENES Clinical Trial). Circulation. 2016 Mar 22;133(12):1181-8. doi: 10.1161/CIRCULATIONAHA.115.020109  

This episode is sponsored by: My Financial CoachYou trained to save lives—who's helping you save your financial future? My Financial Coach connects physicians with CFP® Professionals who specialize in your complex needs. Whether it's crushing student loans, optimizing investments, or planning for retirement, you'll get a personalized strategy built around your goals. Save for a vacation home, fund your child's education, or prepare for life's surprises—with unbiased, advice-only planning through a flat monthly fee. No commissions. No conflicts. Just clarity.Visit myfinancialcoach.com/physiciansguidetodoctoring to meet your financial coach and find out if concierge planning is right for you._______________In this episode, host Dr. Bradley Block welcomes Jonathan Jarry to tackle the persistent myth that medical error is the third leading cause of death in the US. Jarry traces the claim to a 2000 Institute of Medicine report and a 2016 BMJ paper co-authored by Dr. Marty Makary, exposing their flawed extrapolations from small, non-representative studies. He highlights issues like erroneous assumptions, small sample sizes, and the challenge of determining causality in deaths linked to errors. Jarry explains how this inflated statistic fuels fear, drives patients toward unproven alternative treatments, and erodes trust in healthcare. He offers practical ways to push back against the myth while acknowledging the need for improved patient safety systems. This episode is essential for healthcare professionals and patients seeking clarity on medical errors and their true impact.Three Actionable TakeawaysChallenge the Statistic with Facts – When confronted with the claim that medical error is the third leading cause of death, explain that it stems from flawed extrapolations (e.g., 62% of hospital deaths attributed to errors is unrealistic) and cite more reliable estimates (0.6%–5% of hospital deaths).Promote Patient Safety Transparently – Acknowledge medical errors as a real issue but emphasize ongoing efforts to improve safety, like rigorous error reporting systems, to maintain trust without dismissing legitimate concerns.Educate on Context – Share that small, non-representative studies (e.g., Medicare patients or regional data) were misused to inflate error rates, encouraging patients to seek evidence-based care rather than unproven alternatives.About the ShowSucceed In Medicine  covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school!About the GuestJonathan Jarry is a science communicator with McGill University's Office for Science and Society (OSS), dedicated to separating sense from nonsense in science. With a background in clinical lab work and podcasting, he tackles pseudoscience and misinformation, making complex topics accessible. His work at OSS, established in 1999, focuses on debunking myths and promoting evidence-based understanding.Website: mcgill.ca/ossBlueSky: https://bsky.app/profile/jonathanjarry.bsky.socialAbout the host:Dr. Bradley Block – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. Dr. Block also hosts The Succeed In Medicine  podcast, focusing on personal and professional development for physiciansWant to be a guest?Email Brad at brad@physiciansguidetodoctoring.com  or visit www.physiciansguidetodoctoring.com to learn more!Socials:@physiciansguidetodoctoring on Facebook@physicianguidetodoctoring on YouTube@physiciansguide on Instagram and Twitter  This medical podcast is your physician mentor to fill the gaps in your medical education. We cover physician soft skills, charting, interpersonal skills, doctor finance, doctor mental health, medical decisions, physician parenting, physician executive skills, navigating your doctor career, and medical professional development. This is critical CME for physicians, but without the credits (yet). A proud founding member of the Doctor Podcast Network!Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let's grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance.

Sheila Dillon looks into claims that big food companies wield too much influence over government decisions and public health. The episode follows news from the youth-led campaign group BiteBack2030, which says its billboard campaign has been effectively silenced. The group recently organised a mock inquiry in Parliament, involving MPs, to share concerns about how junk food advertising and sponsorship are affecting the health of children in the UK.Sheila also hears from a group of protesters who marched to Downing Street this month, shouting the message “Fight Fake Food.” Organiser Rosalind Rathouse, from the Cookery School on Portland Street, says the public needs to know how the food they're eating is damaging their health. She is calling on everyone to learn to cook this summer. During the march, campaigners delivered a list of wishes to Downing Street, highlighting the changes they'd like to see in food policy.Also featured are Jennifer Richardson from The BMJ, which has been investigating the impact of commercial influence on children's health, and Cathy Cliff from the Soil Association, who submitted a Freedom of Information request to uncover the extent of food industry lobbying and its effect on government policy.Presented by Sheila Dillon Produced for BBC Audio in Bristol by Natalie Donovan

From The Simpsons' Big Book of British Smiles to Austin Powers' ochre-tinged grin, American culture can't stop bad-mouthing English teeth. But why? Are they worse than any other nation's? June Thomas drills down into the origins of the stereotype, and discovers that the different approaches to dentistry on each side of the Atlantic have a lot to say about our national values. In this episode, you'll hear from historians Mimi Goodall, Mathew Thomson, and Alyssa Picard, author of Making the American Mouth; and from professor of dental public health Richard Watt. This episode was written by June Thomas and edited and produced by Evan Chung, Decoder Ring's supervising producer. Our show is also produced by Willa Paskin, Katie Shepherd, and Max Freedman. Merritt Jacob is Senior Technical Director. If you have any cultural mysteries you want us to decode, email us at DecoderRing@slate.com or leave a message on our hotline at (347) 460-7281. Sources for This Episode Goodall, Mimi. “Sugar in the British Atlantic World, 1650-1720,” DPhil dissertation, Oxford University, 2022. Mintz, Sidney. Sweetness and Power: The Place of Sugar in Modern History, Penguin Books, 1986. Picard, Alyssa. Making the American Mouth: Dentists and Public Health in the Twentieth Century, Rutgers University Press, 2009.  Thomson, Mathew. “Teeth and National Identity,” People's History of the NHS. Trumble, Angus. A Brief History of the Smile, Basic Books, 2004. Wynbrandt, James. The Excruciating History of Dentistry: Toothsome Tales & Oral Oddities from Babylon to Braces, St. Martin's Griffin, 2000. Watt, Richard, et al. “Austin Powers bites back: a cross sectional comparison of US and English national oral health surveys,” BMJ, Dec. 16, 2015. Get more of Decoder Ring with Slate Plus! Join for exclusive bonus episodes of Decoder Ring and ad-free listening on all your favorite Slate podcasts. Subscribe from the Decoder Ring show page on Apple Podcasts or Spotify. Or, visit slate.com/decoderplus for access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

From The Simpsons' Big Book of British Smiles to Austin Powers' ochre-tinged grin, American culture can't stop bad-mouthing English teeth. But why? Are they worse than any other nation's? June Thomas drills down into the origins of the stereotype, and discovers that the different approaches to dentistry on each side of the Atlantic have a lot to say about our national values. In this episode, you'll hear from historians Mimi Goodall, Mathew Thomson, and Alyssa Picard, author of Making the American Mouth; and from professor of dental public health Richard Watt. This episode was written by June Thomas and edited and produced by Evan Chung, Decoder Ring's supervising producer. Our show is also produced by Willa Paskin, Katie Shepherd, and Max Freedman. Merritt Jacob is Senior Technical Director. If you have any cultural mysteries you want us to decode, email us at DecoderRing@slate.com or leave a message on our hotline at (347) 460-7281. Sources for This Episode Goodall, Mimi. “Sugar in the British Atlantic World, 1650-1720,” DPhil dissertation, Oxford University, 2022. Mintz, Sidney. Sweetness and Power: The Place of Sugar in Modern History, Penguin Books, 1986. Picard, Alyssa. Making the American Mouth: Dentists and Public Health in the Twentieth Century, Rutgers University Press, 2009.  Thomson, Mathew. “Teeth and National Identity,” People's History of the NHS. Trumble, Angus. A Brief History of the Smile, Basic Books, 2004. Wynbrandt, James. The Excruciating History of Dentistry: Toothsome Tales & Oral Oddities from Babylon to Braces, St. Martin's Griffin, 2000. Watt, Richard, et al. “Austin Powers bites back: a cross sectional comparison of US and English national oral health surveys,” BMJ, Dec. 16, 2015. Get more of Decoder Ring with Slate Plus! Join for exclusive bonus episodes of Decoder Ring and ad-free listening on all your favorite Slate podcasts. Subscribe from the Decoder Ring show page on Apple Podcasts or Spotify. Or, visit slate.com/decoderplus for access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

From The Simpsons' Big Book of British Smiles to Austin Powers' ochre-tinged grin, American culture can't stop bad-mouthing English teeth. But why? Are they worse than any other nation's? June Thomas drills down into the origins of the stereotype, and discovers that the different approaches to dentistry on each side of the Atlantic have a lot to say about our national values. In this episode, you'll hear from historians Mimi Goodall, Mathew Thomson, and Alyssa Picard, author of Making the American Mouth; and from professor of dental public health Richard Watt. This episode was written by June Thomas and edited and produced by Evan Chung, Decoder Ring's supervising producer. Our show is also produced by Willa Paskin, Katie Shepherd, and Max Freedman. Merritt Jacob is Senior Technical Director. If you have any cultural mysteries you want us to decode, email us at DecoderRing@slate.com or leave a message on our hotline at (347) 460-7281. Sources for This Episode Goodall, Mimi. “Sugar in the British Atlantic World, 1650-1720,” DPhil dissertation, Oxford University, 2022. Mintz, Sidney. Sweetness and Power: The Place of Sugar in Modern History, Penguin Books, 1986. Picard, Alyssa. Making the American Mouth: Dentists and Public Health in the Twentieth Century, Rutgers University Press, 2009.  Thomson, Mathew. “Teeth and National Identity,” People's History of the NHS. Trumble, Angus. A Brief History of the Smile, Basic Books, 2004. Wynbrandt, James. The Excruciating History of Dentistry: Toothsome Tales & Oral Oddities from Babylon to Braces, St. Martin's Griffin, 2000. Watt, Richard, et al. “Austin Powers bites back: a cross sectional comparison of US and English national oral health surveys,” BMJ, Dec. 16, 2015. Get more of Decoder Ring with Slate Plus! Join for exclusive bonus episodes of Decoder Ring and ad-free listening on all your favorite Slate podcasts. Subscribe from the Decoder Ring show page on Apple Podcasts or Spotify. Or, visit slate.com/decoderplus for access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

From The Simpsons' Big Book of British Smiles to Austin Powers' ochre-tinged grin, American culture can't stop bad-mouthing English teeth. But why? Are they worse than any other nation's? June Thomas drills down into the origins of the stereotype, and discovers that the different approaches to dentistry on each side of the Atlantic have a lot to say about our national values. In this episode, you'll hear from historians Mimi Goodall, Mathew Thomson, and Alyssa Picard, author of Making the American Mouth; and from professor of dental public health Richard Watt. This episode was written by June Thomas and edited and produced by Evan Chung, Decoder Ring's supervising producer. Our show is also produced by Willa Paskin, Katie Shepherd, and Max Freedman. Merritt Jacob is Senior Technical Director. If you have any cultural mysteries you want us to decode, email us at DecoderRing@slate.com or leave a message on our hotline at (347) 460-7281. Sources for This Episode Goodall, Mimi. “Sugar in the British Atlantic World, 1650-1720,” DPhil dissertation, Oxford University, 2022. Mintz, Sidney. Sweetness and Power: The Place of Sugar in Modern History, Penguin Books, 1986. Picard, Alyssa. Making the American Mouth: Dentists and Public Health in the Twentieth Century, Rutgers University Press, 2009.  Thomson, Mathew. “Teeth and National Identity,” People's History of the NHS. Trumble, Angus. A Brief History of the Smile, Basic Books, 2004. Wynbrandt, James. The Excruciating History of Dentistry: Toothsome Tales & Oral Oddities from Babylon to Braces, St. Martin's Griffin, 2000. Watt, Richard, et al. “Austin Powers bites back: a cross sectional comparison of US and English national oral health surveys,” BMJ, Dec. 16, 2015. Get more of Decoder Ring with Slate Plus! Join for exclusive bonus episodes of Decoder Ring and ad-free listening on all your favorite Slate podcasts. Subscribe from the Decoder Ring show page on Apple Podcasts or Spotify. Or, visit slate.com/decoderplus for access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's episode features guest host Michael Upshall (guest editor, Charleston Briefings) who talks with Damien Pattinson, Executive Director, eLife Sciences Publications, Ltd. Damien earned his PhD in neuroscience. After a postdoc at Kings College, London, UK, he began his career in scholarly publishing almost twenty years ago, first joining BMJ as a scientific editor, then PLOS ONE as executive director and then as editorial director, and Research Square as VP of Publishing Innovation.  Damien joined eLife in 2020. In this conversation, he talks about Open Science and the eLife publishing model.  LinkedIn: https://www.linkedin.com/in/mupshall/ https://www.linkedin.com/in/damian-pattinson-b054508/ Twitter: Keywords:  #eLife #OpenScience #OpenResearch #Research #FutureOfResearch #ResearchIntegrity #AcademicResearch #OpenAccess #OpenSource #PeerReview #HigherEducation #LibraryInnovation #Innovation #LibraryJobs #career #collaboration #scholcomm #ScholarlyCommunication #libraries #librarianship #LibraryNeeds #LibraryLove #ScholarlyPublishing #AcademicPublishing #publishing #LibrariesAndPublishers #podcasts

If you've been in a high street pharmacy or supermarket recently, chances are you'll have seen home test kits for all sorts of indications; blood sugar level, vitamin deficiencies, thyroid function, and even some forms of cancer. A new series of article in The BMJ revealing serious concerns with the reliability of these home tests, and raises questions about their regulation. Jonathan Deeks, professor of Biostatistics at the University of Birmingham, joins us to discuss what these tests are, and how his team have rated their usability. Also this week, the sad death of a child in Liverpool from measles highlights the growing outbreak in the UK - and this may be one of the first times many doctors have come across the infection. Frances Dutton, GP at the Small Heath Medical Practice reminds us how to recognise the sign of the infection.   Reading list Direct-to-consumer self-tests sold in the UK in 2023 How to recognise and manage measles

In this episode of RAPM Focus, Editor-in-Chief Brian Sites, MD, discusses the use of buprenorphine for acute pain management with Thomas Hickey, MD, MS, following the February 2025 publication of “Buprenorphine versus full agonist opioids for acute postoperative pain management: a systematic review and meta-analysis of randomized controlled trials.” Dr. Hickey is full-time staff at the West Haven VA where he is medical director of preoperative evaluation and the PACU, and site director for the anesthesiology residency. Within the VA, he is chairman of the VA New England Healthcare System committee on preoperative evaluation and ERAS, co-chair of the VA's national pain/opioid consortium for research workgroup on perioperative management of medications for opioid use disorder, and a member of the National Anesthesia Program Acute Pain Management Committee. He is board certified in both anesthesiology and addiction medicine. His research interests focus on the overlap between addiction medicine and acute pain management, particularly on the use of buprenorphine for acute pain management. He and his wife are kept busy by their three kids and all their activities. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

Professor Gillian Leng, President of the Royal Society of Medicine was asked to carry out an independent review into the role of physician and anaesthetic associates. She sits down with Kamran Abbasi, editor in chief of The BMJ, to discuss her findings. In the UK, the rollout of physician associates, NHS staff who took on some of the tasks of doctors, has been both haphazard and controversial. Originally copied from similar roles in the U.S., British PAs were introduced in the early 2000s. The level of clinical responsibility they were asked to take on began to vary around the country, driven mostly by the workforce needs of individual Trusts. The lack of clarity about their roles lead to disquiet with doctors, worry for patients, and an increasingly toxic debate on social media. 01.00 What is the Leng Review? 10:00 Recommendation one: Renaming 14:00 Recommendation two: Easier identification 16:00 Recommendation three: How to work? 20:00 Recommendation four: Diagnosis 25:00 Recommendation five: Oversight & Regulation 32:00 Prescribing and ordering ionizing radiation? 40:00 A failure of workforce planning and vision ? 49:00 The NHS 10 year plan

With Britain's resident doctors due to walk off the job tomorrow, the government is planning changes to the law that could make this kind of strike more common.This podcast was brought to you thanks to the support of readers of The Times and The Sunday Times. Subscribe today: http://thetimes.com/thestoryGuest: Eleanor Hayward, Health Editor, The Times.Host: Manveen Rana.Producer: Hannah Varrall.Read more: How much do resident doctors earn? The BMA's claims examinedClips: Labour Party, PoliticsJoe, The BMJ, BMAtv, BBC, Sky News.Photo: Getty Images.Get in touch: thestory@thetimes.com. Hosted on Acast. See acast.com/privacy for more information.

What is death anxiety?  We spend the first 15 minutes of the podcast addressing this question.  And maybe this was unfair to our guests, the fabulous dynamic duo of palliative psychiatrists Dani Chammas and Keri Brenner (listen to their prior podcasts on therapeutic presence and the angry patient).  After all, we invited them on to our podcast to discuss death anxiety, then Eric and I immediately questioned if death anxiety was the best term for what we want to discuss! Several key points stood out to me from this podcast, your key points may differ: The “anxiety” in “death anxiety” is not a pathological phenomenon or a DSM diagnosis;  it references an existential concern that is fundamental to the human experience .  To me,” awareness of mortality” might be a better term, but in fairness, the idea of “death anxiety” was coined well before the formal establishment of “anxiety disorders.” The ways in which death anxiety manifests in our patient's choices and behaviors varies tremendously, and our responses as clinicians must be individualized. There is no “one size fits all” approach. In one example Dani discusses, a pain level of 1.5/10 might be overwhelming, because for a patient  in remission from cancer any pain might signal return of cancer.  Some manifestations of death anxiety can be debilitating, others lead to tremendous personal growth, connection to others, and a drive toward finding meaning in their illness experience.   Death anxiety impacts us as clinicians, not only through countertransference, that word that I still can't define (sorry Dani and Keri!), but also through our own unexamined fears about death. As clinicians who regularly care for people who are dying, we might find ourselves becoming “used to” death. Is this a sign that we are inured to the banality of death, and less able to empathize with the death anxiety experienced by our patients or their families? Or could it reflect our acceptance of the finitude of life, prompting us to live in the present moment? Perhaps it is something else entirely. The key is that looking inwards to understanding our own unique relationship with mortality can deepen our ability to authentically accompany the experiences of our patients. I mean, don't fear the reaper, right?  Sorry, no cowbell in my version, but you do get my son Kai, home from college, on guitar for the audio only podcast version. Here are some resources for listeners wanting to learn more about this topic: Books: Yalom ID. Existential Psychotherapy. New York, NY: Basic Books; 1980. Yalom ID. Staring at the Sun: Overcoming the Terror of Death. San Francisco, CA: Jossey-Bass; 2008. Solomon S, Greenberg J, Pyszczynski T. The Worm at the Core: On the Role of Death in Life. New York, NY: Random House; 2015. Becker E. The Denial of Death. Free Press; 1973. Articles: Emanuel LL, Solomon S, Chochinov HM, et al. Death Anxiety and Correlates in Cancer Patients Receiving Palliative Care. J Palliat Med. 2023;26(2):235-243. Chochinov HM, McClement SE, Hack TF, et al. Death anxiety and correlates in cancer patients receiving outpatient palliative care. J Palliat Med. 2023;26(12):1404–1410. doi:10.1089/jpm.2022.0052. Clark D. Between hope and acceptance: the medicalisation of dying. BMJ. 2002;324(7342):905–907. doi:10.1136/bmj.324.7342.905. Vess M, Arndt J, Cox CR, Routledge C, Goldenberg JL. The terror management of medical decisions: The effect of mortality salience and religious fundamentalism on support for faith-based medical intervention. J Pers Soc Psychol. 2009;97(2):334–350. Menzies RE, Zuccala M, Sharpe L, Dar-Nimrod I. The effects of psychosocial interventions on death anxiety: A meta-analysis and systematic review of randomized controlled trials. J Anxiety Disord. 2018;59:64–73. doi:10.1016/j.janxdis.2018.09.00 Brown TL, Chown P, Solomon S, Gore G, De Groot JM. Psychosocial correlates of death anxiety in advanced cancer: A scoping review. Psychooncology. 2025;34(1):45–56. doi:10.1002/pon.70068. Tarbi EC, Moore CM, Wallace CL, Beaussant Y, Broden EG, Chammas D, Galchutt P, Gilchrist D, Hayden A, Morgan B, Rosenberg LB, Sager Z, Solomon S, Rosa WE, Chochinov HM. Top Ten Tips Palliative Care Clinicians Should Know About Attending to the Existential Experience. J Palliat Med. 2024 Oct;27(10):1379-1389. doi: 10.1089/jpm.2024.0070. Epub 2024 Mar 28. PMID: 38546453.  

According to research published in The BMJ in 2002, around 40% of people experience some age-associated memory impairment after reaching 65. Thankfully only 1% of those affected will then go on to have dementia each year. But still, it's important to be aware of how effective your memory is, whatever your age. An impairment can be a sign of cognitive decline, which becomes more likely the older we get. How does our memory actually work? What happens when we have a memory lapse then? In under 3 minutes, we answer your questions! To listen to the last episodes, you can click here: ⁠Can you really lose weight by walking?⁠ ⁠Can you improve your relationship by learning your love language?⁠ ⁠Are you spending more on groceries due to stretchflation?⁠ A podcast written and realised by Joseph Chance. First Broadcast: 11/9/2024 Learn more about your ad choices. Visit megaphone.fm/adchoices

If you're anything like me, you've probably looked back and thought, “Why didn't I know this 10 years ago?” That's exactly what today's chat is about - my top five health game-changers I wish I had embraced earlier. Whether you're 25 or 75, these insights can shift the needle in how you feel, look, and thrive. From nutrition tracking without guilt to finally getting that high-quality protein in, these tips aren't about restriction - they're about empowerment. I'm opening up about what's worked, what didn't, and why strength training, ditching the processed stuff, and even allowing yourself to be hungry can be revolutionary. This one is packed with real-life examples, scientific backing, and simple steps to get started without getting overwhelmed. What we're tackling: Track your food with intention, not shame. Ditch skinny, build strong with progressive overload. Prioritize protein without obsessing. Phase out processed foods gradually. Embrace hunger and stop snacking aimlessly. Meditation App : Simply Being App Get Weekly Health Tips:  thrivehealthcoachllc.com Let's Connect:@‌ashleythrivehealthcoach or via email: ashley@thrivehealthcoachingllc.com Podcast Produced by Virtually You! Sources: Tracking Nutrition Burke, L. E., Wang, J., & Sevick, M. A. (2011). Self-monitoring in weight loss: A systematic review of the literature. Journal of the American Dietetic Association, 111(1), 92–102. https://doi.org/10.1016/j.jada.2010.10.008 Raber, M., Patterson, M., & Jia, W. (2021). A systematic review of the use of dietary self-monitoring in behavioral weight-loss interventions: Current practices and future recommendations. Public Health Nutrition, 24(17), 5885–5913. https://doi.org/10.1017/S1368980021002381 Prioritizing High-Quality Protein Holt, S. H. A., Brand Miller, J. C., Petocz, P., & Farmakalidis, E. (1995). A satiety index of common foods. European Journal of Clinical Nutrition, 49(9), 675–690. Ortinau, L. C., Culp, J. M., & Hoertel, H. A. (2014). Effects of high-protein vs. high-fat snacks on appetite control, satiety, and eating initiation in healthy women. Nutrition Journal, 13, 97. https://doi.org/10.1186/1475-2891-13-97 Dhillon, J., Craig, B. A., Leidy, H. J., Amankwaah, A. F., Jacobs, A., Jones, B. L., & Jones, J. B. (2016). The effects of increased protein intake on fullness: A meta-analysis and its limitations. Journal of the Academy of Nutrition and Dietetics, 116(6), 968–983. https://doi.org/10.1016/j.jand.2016.01.003 Zhu, R., et al. (2021). Effect of a high-protein, low-glycemic index diet on hunger and weight maintenance: Results from the PREVIEW study. Frontiers in Nutrition, 8, 649928. https://doi.org/10.3389/fnut.2021.649928 Strength Training vs. Cardio Saeidifard, F., Medina-Inojosa, J. R., West, C. P., & Lopez-Jimenez, F. (2019). The role of resistance training in the prevention and management of chronic disease. European Journal of Preventive Cardiology, 26(5), 505–515. https://doi.org/10.1177/2047487318822333 Momma, H., et al. (2022). Muscle-strengthening activities and risk of all-cause and cause-specific mortality: A systematic review and meta-analysis of cohort studies. British Journal of Sports Medicine, 56(10), 755–763. https://doi.org/10.1136/bjsports-2021-105061 Cutting Ultra-Processed Foods Monteiro, C. A., Cannon, G., Levy, R. B., Moubarac, J. C., Louzada, M. L., Rauber, F., ... & Jaime, P. C. (2019). Ultra-processed foods: What they are and how to identify them. Public Health Nutrition, 22(5), 936–941. https://doi.org/10.1017/S1368980018003762 Srour, B., et al. (2019). Ultra-processed food intake and risk of cardiovascular disease: Prospective cohort study (NutriNet-Santé). BMJ, 365, l1451. https://doi.org/10.1136/bmj.l1451 Mindful Hunger / Fasting Bruce, L. J., & Ricciardelli, L. A. (2016). A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite, 96, 454–472. https://doi.org/10.1016/j.appet.2015.10.012 Longo, V. D., & Panda, S. (2016). Fasting, circadian rhythms, and time-restricted feeding in healthy lifespan. Cell Metabolism, 23(6), 1048–1059. https://doi.org/10.1016/j.cmet.2016.06.001

Last December, The BMJ published an investigation into the 2009 PLATO trial - exposing serious problems with that study's data analysis and reporting.  Our follow up investigation has shown that those data problems extend to other key supporting evidence in AstraZeneca's initial application to regulators. Peter Doshi, senior editor in the BMJ's Investigations unit, and Rita Redberg, cardiologist and Professor of Medicine at UCSF and former editor of JAMA Internal Medicine, join us to explain what this means for scientific integrity, and trust in the FDA's approval processes.   Also in this episode. A group of international authors are arguing that weightloss advice given in primary care might actually be doing more harm than good - it's ineffective and potentially reinforces damaging stigma.  To explain why they came to that conclusion we're joined by Juan Franco editor in chief of BMJ EBM, and a practicing GP in Germany, and Emma Grundtvig Gram, from the Centre for General Practice at the University of Copenhagen Reading list Doubts over landmark heart drug trial: ticagrelor PLATO study Ticagrelor doubts: inaccuracies uncovered in key studies for AstraZeneca's billion dollar drug Beyond body mass index: rethinking doctors' advice for weight loss

Meningitis remains a major global health threat, with an estimated 2.5 million cases each year; of these, one in six results in death and one in five in long-term disabilities. Although meningitis “can strike anyone, anywhere in the world,” outbreaks disproportionately impact low- and middle-income countries, where diagnostic and treatment resources are limited. In efforts to address this, WHO launched its first-ever guideline on meningitis diagnosis and management in April this year. In this episode of Communicable, hosts Emily McDonald and Marc Bonten are joined by two experts directly involved in creating the guideline, Lorenzo Pezzoli and Nicolò Binello (WHO), as well as Jacob Bodilsen (Aalborg University), clinician-researcher and Chair of ESCMID's Study Group for Infectious Diseases of the Brain (ESGIB). The guests offer a firsthand look behind the guideline's development, review key recommendations for diagnosis and treatment - including the use of lumbar puncture, antibiotics, and chemoprophylaxis – and discuss how these fit into various clinical settings. This episode was edited by Kathryn Hostettler and peer reviewed by Ljiljana Lukić of University Hospital for Infectious Diseases in Zagreb, Croatia. The executive producer of Communicable is Angela Huttner. TermsCRP, C-reactive proteinGDG, Guideline Development GroupLiterature WHO guidelines on meningitis diagnosis, treatment and care. April 2025. https://www.who.int/publications/i/item/9789240108042Defeating meningitis by 2030: a global road map. June 2021. https://www.who.int/publications/i/item/9789240026407Olie SE, et al. Validation and clinical implementation of cerebrospinal fluid C-reactive protein for the diagnosis of bacterial meningitis: a prospective diagnostic accuracy study. Lancet Reg June 2025. DOI: 10.1016/j.lanepe.2025.101309Coldiron ME, et al. Single-dose oral ciprofloxacin prophylaxis as a response to a meningococcal meningitis epidemic in the African meningitis belt: A 3-arm, open-label, cluster-randomized trial. PloS Med 2018. DOI: 10.1371/journal.pmed.1002593Hasbun R, et al. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med 2001. DOI: 10.1056/NEJMoa010399Glimåker M. Lumbar puncture in adult bacterial meningitis: time to reconsider guidelines? BMJ 2013, DOI: 10.1136/bmj.f361

Send us a textHey my beautiful friends –This week's conversation was sparked by a funny little tech discovery and a box I mailed — both of which got me thinking about food in a new way. You know how people are always quick to tell you what not to eat? Well, this week we flip the script. I'm sharing thoughts from my own journey and a coach that made me laugh and think — and you'll hear why his words still stick with me to this day. We're keeping things simple, kind, and grounded in something real. I'm not handing out rules, I'm sharing a mindset and maybe even a little inspiration for your next grocery run or packed lunch. And as always, we'll close with a little heart lift — this one from Michael Pollan, who said, “Eat food. Not too much. Mostly plants.”Come hang out with me, and let's talk about what loves us back. References:1.    Zhang & Talalay, Frontiers in Nutrition, 20232.    Liu, Nutrients, 20233.    Viguiliouk et al., Obesity Reviews, 20234.    Jenkins et al., AJCN, 20245.    Estruch et al., The Lancet Diabetes & Endocrinology, 20236.    Guasch-Ferré et al., BMJ, 20237.    Yao et al., Nutrients, 20238.    Harvard Nurses' Health Study Update, 20239.    Anderson et al., AJCN, 202410.Simopoulos, Frontiers in Endocrinology, 202311.Ye et al., Nutrients, 202312.Sonnenburg et al., Cell Metabolism, 202413.Mozaffarian et al., AJCN, 202314.Mastrocola et al., Appetite, 202315.Pollan, M. (2009). In Defense of FoodLet's go, let's get it done. Get more information at: http://projectweightloss.org

Hello everyone! Thanks to Tom's holiday and Stuart's job we weren't able to record this week, so we've put out a classic paid episode to tide you over. We hope this goes some way to scratching your Studies Show itch.Most people think it's obvious that you should wear a helmet when cycling. It might save your life if you fall off and hit your head. Duh.But over the years, many contrarian arguments have pushed back against this seemingly-obvious point. What if people engage in “risk compensation”, where they cycle more dangerously because they know they're wearing a helmet? What about if encouraging helments puts people off cycling so they miss the health benefits?In this March 2024 episode of The Studies Show, Tom and Stuart try to work out who's right.Show notes* The original 1975 study on what's become known as the “Peltzman Effect”: risk compensation (in this case about car safety)* Potential evidence for risk compensation in AIDS* Claims of risk compensation relating to mask-wearing at the start of the COVID-19 pandemic* The eye-tracking study on helmet-wearing, which used the Balloon Analogue Risk-Taking lab task* n=27 study on helmets and cycling with one hand on the handlebar* Study on risk compensation with the following confusing structural equation model diagram:* Academic cycles around and records thousands of cars passing him while he's either wearing or not wearing a helmet* Forbes article about the statistical controversy over these data* Bizarre study on how motorists “dehumanize” cyclists* Could helmets make “rotational injuries” worse?* Cochrane review on cycle helmets and injuries from 1999* Ben Goldacre and David Spiegelhalter on cycle helmets - “uncertainty… is unlikely to be substantially reduced by further research”* Systematic review on helmet use and injuries from 2016* Review of meta-analyses from 2023* 2006 BMJ article finding “no clear evidence” that mandating cycle helmets reduces injuries* Negative correlation between cycle numbers and helmet usage, across different countriesCreditsThe Studies Show is produced by Julian Mayers at Yada Yada Productions. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.thestudiesshowpod.com/subscribe

Listener feedback on sports “disqualification,” big digoxin news, Brugada syndrome, another positive finerenone study, and unblinded transcatheter trials are discussed by John Mandrola, MD, in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback JACC EP Paper https://www.jacc.org/doi/10.1016/j.jacep.2025.03.013 II Digoxin News DIGIT HF Baseline Characteristics paper https://doi.org/10.1002/ejhf.3679 DIGIT HF Rationale paper https://pmc.ncbi.nlm.nih.gov/articles/PMC6607489/ Dig trial https://www.nejm.org/doi/full/10.1056/NEJM199702203360801 DECISION trial https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.3428 Ziff et al BMJ meta-analysis https://www.bmj.com/content/351/bmj.h4451 III Brugada Syndrome Gomes et al https://doi.org/10.1093/europace/euaf091 IV Another Finerenone Substudy Published FINEARTS-HF trial substudy, Bhatt, A et al https://doi.org/10.1016/j.cardfail.2025.05.006 FINEARTS HF Main paper https://www.nejm.org/doi/full/10.1056/NEJMoa2407107 TOPCAT https://www.nejm.org/doi/full/10.1056/NEJMoa1313731 TOPCAT regional variation Circ paper https://www.ahajournals.org/doi/10.1161/circulationaha.114.013255 V Another Opinion on Unblinded Transcatheter Intervention Trials Kaul https://eurointervention.pcronline.com/article/unblinded-trials-of-transcatheter-interventions-with-subjective-endpoints-what-are-the-implications You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

A Lancet study warns of consequences for HIV prevention if PEPFAR loses funding, potentially millions of new pediatric HIV cases and increased AIDS-related deaths. Medicare Part D is highlighted, with research linking subsidy loss to higher mortality rates. A report from BMJ notes a 3.1% decline in U.S. drug overdose deaths, signaling a possible peak in the fentanyl crisis.

You are capable of radical change. If you aren't convinced that you can create change in your life, take Aimee's story about how her hen became a rooster (seriously, just listen in and it'll make sense). Beyond that chicken talk, this episode is focused on our human potential for change and healing. We'll touch on neuroplasticity, epigenetics, and the motivational role of hope. We think you'll come away with a better understanding of how you're wired for change and can intentionally steer it towards greater wellbeing.  If you enjoyed this episode, please rate and review us wherever you listen to your favorite podcasts!  Sources and Notes: Joy Lab Program: Take the next leap in your wellbeing journey with step-by-step practices to help you build and maintain the elements of joy in your life. Emotional Inertia: Feeling Dull & Disconnected [Joy Lab ep. 207] Zhang, X., et al. (2023). Overview of Avian Sex Reversal. International journal of molecular sciences, 24(9), 8284. https://doi.org/10.3390/ijms24098284 Bian, Z., et al. (2024). Genetic predisposition, modifiable lifestyles, and their joint effects on human lifespan: evidence from multiple cohort studies. BMJ evidence-based medicine, 29(4), 255–263. https://doi.org/10.1136/bmjebm-2023-112583 Weger, U. W., & Loughnan, S. (2013). Mobilizing unused resources: using the placebo concept to enhance cognitive performance. Quarterly journal of experimental psychology (2006), 66(1), 23–28. https://doi.org/10.1080/17470218.2012.751117 Head to YouTube to see Haley's new spurs (16:28) Closing poem excerpt: Emily Dickinson, "Hope is the Thing With Feathers." Full transcript here. Please remember that this content is for informational and educational purposes only. It is not intended to provide medical advice and is not a replacement for advice and treatment from a medical professional. Please consult your doctor or other qualified health professional before beginning any diet change, supplement, or lifestyle program. Please see our terms for more information. If you or someone you know is struggling or in crisis, help is available. Call the NAMI HelpLine: 1-800-950-6264 available Monday through Friday, 10 a.m. – 10 p.m., ET. OR text "HelpLine" to 62640 or email NAMI at helpline@nami.org. Visit NAMI for more. You can also call or text SAMHSA at 988 or chat 988lifeline.org.