Podcasts about Warwick Medical School

In this episode, we talk to Dr Abi Eccles, Assistant Professor within Warwick Applied Health at Warwick Medical School. Title of paper: The GP's role in supporting women with anal incontinence after childbirth injuryAvailable at: https://doi.org/10.3399/BJGP.2023.0356Anal incontinence after childbirth injury has profound impacts on women's lives and many find they cannot access healthcare and support. GPs can play a crucial role, but we know that very few women speak to their GPs about their symptoms. In combining GPs' and women's views, we show how anal incontinence after childbirth injury is often missed in a primary care setting. Drawing on these findings, we highlight the key ways GPs can provide support for such womenClick here for the RCGP course on anal incontinence after childbirth.

In this episode of Causes or Cures, Dr. Eeks chats with researcher Omar Almahayni about his published systematic review on the physiological and psychological benefits of the Wim Hof Method for both healthy and non-healthy individuals. Wim Hof, known as "The Iceman," is a Dutch extreme athlete and motivational speaker famed for his extraordinary ability to endure extreme cold.During the podcast, Omar discusses his interest in Wim Hof, the components of the renowned Wim Hof Method, and theories on its potential health benefits. He explains his evaluation of the published studies on the method, the results, future research possibilities, and who might be interested in joining Wim Hof on one of his extreme excursions.Omar conducted his research at Warwick Medical School, University of Warwick, UK, and now works for a mental health biotechnology company based in Syria.You can contact Dr. Eeks at bloomingwellness.com.Follow Eeks on Instagram here.Or Facebook here.Or X.On Youtube.Or TikTok.SUBSCRIBE to her monthly newsletter here.Support the Show.

On 28 March it is the 60th anniversary of the discovery of Epstein-Barr virus, the most common viral infection in humans. The virus was first discovered in association with a rare type of cancer located in Africa, but is now understood to be implicated in 1% of cancers, as well as the autoimmune disease multiple sclerosis, among others. Ian Sample meets Lawrence Young, professor of molecular oncology at Warwick Medical School, to hear the story of this virus, and how understanding it might help us prevent and treat cancer and other illnesses.. Help support our independent journalism at theguardian.com/sciencepod

In this episode, Medical News Today investigates whether reversing prediabetes via lifestyle changes — such as diet and exercise — is possible. Joining the conversation with Dr. Hilary Guite and Global News editor Yasemin Nicola Sakay are Dr. Thomas Barber, associate clinical professor at Warwick Medical School and consultant endocrinologist at University Hospitals Coventry and Warwickshire, and Angela Chao, Managing Editor at Healthline Media, who shared her experiences about how she reversed her prediabetes diagnosis.

In this episode, my peer Samantha Ratner joins me to jointly interview two guests: Dr.Tamar Goldwaser and Dr.Felicity Boardman. In the first part of this episode, we give an overview of what prenatal testing is and how it works. We also highlight some of the experiences that Dr.Goldwaser, a medical geneticist and OB/GYN, has had with patients who seek or decline prenatal testing. In the second part we loop in Dr.Boardman, a professor in medicine ethics and society in Warwick Medical School, who explains expressivism and comments on the broader social meanings and messages of prenatal testing.

On the episode is Kelly Schmidtke.Dr. Kelly Schmidtke is a psychologist and a PhD in experimental psychology. She is currently an assistant professor at Warwick Medical School in England. She is the author of several book chapters and research papers. On decision making"Our brain doesn't make decisions, we make decisions, as people. And we have to own our decisions, not cast them off to our brain did all the hard work for us [...] You're the holistic thing."On population behaviour"My research drifts more towards population problems, how can we influence population behaviour to drift one direction we deem desirable and stop drifting the other direction we deem undesirable."On MINDSPACE"MINDSPACE is an acronym used to describe nine different ways you can nudge people: 1) Messenger, 2) Incentives, 3) Norms, 4) default, 5) salience, 6) priming, 7) Affects, 8) Commitments, 9) Ego these are nine different tools.On nudging"A nudge isn't an aspect of our choice environment that exists out there and influences us one way or another. I think a nudge has to be intentionally put there to drift your behaviour in one way or another" "Fun nudges: "small plates are often recommended to people who try to lose weight. These can work on two levels. 1) perception - visually triggering your mind, 2) practical - you can only get the amount of food (that can be) on the small plate unless you stand up again and refill the plate. This is an example of nudging as long as you're in control of the amount of food. Remember, nudges are supposed to be about your free choice." "My favourite example of a nudge is like Shore Drive, which is a road in Chicago that has BIG turns that people often miss if they don't pay attention. [...] When you drive, you use the lines as an indicator for how fast you drive, so what they did was shorten the lines, so people would think they drove faster when approaching a turn. Now perceptually, as you drive, it looks for you like you're driving faster, and you'd hit the brakes and drive the appropriate speed through the turn." 

In this week's episode anaesthetic resident Dr Tan shares her journey from studying medicine in the UK to moving over to the US and becoming a resident! Hear her story as she delves into sitting the USMLE, the barriers and obstacles she faced and the mindsets she employed to overcome and progress in her career. We discuss the difference in culture, training and supervision compared to the UK and the pros and cons for anyone wishing to make the leap. Tune in and see if the grass really is greener on the other side? Dr Tan graduated from Warwick Medical School in 2018, and worked as an FY1 in the NHS before moving to the US as an anaesthetic resident. Learn more about Dr Tan: LinkedIn: Dr Tan Learn more about Scrubbed In: YouTube: Scrubbed In with Amz & Abdul Twitter -@ScrubbedIn_ Instagram - @Scrubbedin_   Check out our latest platform Peerr Peerr socialises education by providing an interactive and collaborative way to learn and earn from your peers through custom-made quizzes.

Andrew Pierce talks to professor Lawrence Young, Virologist and Professor of Molecular Oncology at Warwick Medical School about why Boris Johnson's announcement to relax Covid restrictions might have come too soon, and to former Metropolitan Police Superintendent, Leroy Logan, about Cressida Dick's problem with public confidence in the police. Plus, tips on how to survive rising energy bills. See omnystudio.com/listener for privacy information.

Virologist at the Warwick Medical School at the University of Warwick, Professor Lawrence Young, says the new COVID-19 variant is "a bit of a worry because it's spreading really fast across Europe now". See omnystudio.com/listener for privacy information.

The emergence of a new coronavirus variant, Omicron, has put the world on high alert. It's been two years since the beginning of the pandemic, and just when there were signs of a return to some sort of normalcy, the new variant has caused concerns among health professionals. After scientists in South Africa announced its discovery, it wasn't long before the United States, the United Kingdom, European Union, and other countries began imposing travel restrictions. So, how is this variant different from Delta? Should the world be worried? Guests: Dr Mvuyisi Mzukwa Vice Chairperson of the South African Medical Association Oksana Pyzik UCL School of Pharmacy Senior Teaching Fellow Dr Lawrence Young Professor of Molecular Oncology at Warwick Medical School

Jim White, in for Andrew Pierce, talks to Dr. Lawrence Young, Virologist and Professor of Molecular Oncology at Warwick Medical School about the threat the new South African COVID variant poses to the world, and talks to Jenna Veerapen, Senior Therapist at the UK Addiction Treatment Group, about how the lack of face-to-face contact with healthcare workers in the last year has led to a shocking increase in deaths among alcoholics and drug addicts. Plus, how to check whether your cat is a psychopath. See omnystudio.com/listener for privacy information.

There's been a resurgence of COVID-19 cases in Germany and parts of Eastern Europe. The World Health Organization (WHO) has warned that the continent could be headed towards a deadly winter season. The COVID-19 has so far killed more than five million people the world over and as per the WHO, another 500,000 Europeans could lose their lives to the virus. With such high vaccination rates, why is then the situation still so critical in Europe? Guests: Dr Annelies Wilder-Smith Professor at the London School of Hygiene and Tropical Medicine Dr Bharat Pankhania Senior Clinical Lecturer at Exeter University Medical School Dr Lawrence Young Professor of Molecular Oncology at Warwick Medical School

Vegan and omnivorous diets promote equivalent muscle mass gain, study shows University of São Paulo (Brazil), May 19, 2021 Protein intake is more important than protein source if the goal is to gain muscle strength and mass. This is the key finding of a study that compared the effects of strength training in volunteers with a vegan or omnivorous diet, both with protein content considered adequate.  In the study, which was conducted by researchers at the University of São Paulo (USP) in Brazil, 38 healthy young adults, half of whom were vegans and half omnivores, were monitored for 12 weeks. In addition to performing exercises to increase muscle strength and mass, the volunteers followed either a mixed diet with both animal and plant protein, or an entirely plant-based diet, both with the recommended protein content (1.6 gram of protein per kilogram of body weight per day). At the end of three months, there was no difference between vegans and omnivores in terms of muscle strength and mass increase.  “Like any other protein in our organism, such as the proteins in our skin and hair cells, which die and are renewed, our muscles undergo synthesis and breakdown every day. Diet [protein intake] and exercise are the main protein balance regulators, favoring synthesis over breakdown,” said Hamilton Roschel, last author of the published study. Roschel is a University of São Paulo professor affiliated with both USP’s Sports and Physical Education School (EEEE) and Medical School (FM). He also heads the Applied Physiology and Nutrition Research Group jointly run by EEEE-USP and FM-USP. Protein sources are characterized primarily on the basis of essential amino acids, especially leukin, which plays a key role in anabolic stimulation of skeletal muscles. “Animal protein has more leukin than plant protein. Leukin is an essential amino acid in the anabolic stimulus signaling process. A plant-based diet is often thought to contain less leukin and hence trigger less anabolic stimulation, potentially affecting vegans’ capacity for muscle mass gain,” Roschel said. The study is published in Sports Medicine and resulted from the master’s research of Victoria Hevia-Larraín, with support from FAPESP.  The study innovated by including a clinical analysis of the effects of protein source quality on muscle adaptation in vegans as compared with omnivores, since most research on the topic to date has focused on the acute anabolic response of muscles to protein intake under laboratory conditions and not on muscle mass as such. “Our findings show that there is no impairment of muscle mass gain for young adult vegans if they ingest the right amount of protein. In fact, the outcome of both diets was the same in this respect,” Roschel said.  However, the researchers stress that, for the purposes of experimental control, protein intake was made the same in both diets by means of protein supplements. Omnivores and vegans were given milk serum protein isolate or soy protein respectively in accordance with individual dietary needs in order to attain the targeted protein intake.  “In clinical practice, we know foods of animal origin generally have a higher protein content,” Roschel said. “Meat, milk and eggs contain more protein per gram than rice and beans, for example. In a clinical application with plant-based foods as the sole protein source, vegans would need to ingest a large amount of food to obtain the same amount of protein. In some specific cases, this could be a major challenge.” The protein source (mixed or plant-based diet) made no difference, provided each subject received an adequate amount of protein. “This result corroborates other data in the literature showing that a vegan diet can absolutely be complete if it is properly planned and executed,” Roschel said. “Previous studies suggest it can even be healthier than an omnivorous diet. For this to be the case, however, it requires appropriate nutritional counseling and education regarding people’s choices in restricting their intake to plant-based sources.”  Another point noted by Roschel is that the subjects were healthy young adults, and the results might be different for older people or subjects with health problems. “Aging entails a phenomenon known as anabolic resistance, meaning a suboptimal anabolic response to the stimuli provided by diet and exercise compared with young people. Optimal response is possible in older people only if their protein intake is higher than that of the average healthy youngster. So we should be cautious about generalizing our findings for the entire population.”   Yoga and breathing exercises aid children with ADHD to focus Ural Federal University, May 17, 2021 Yoga and breathing exercises have a positive effect on children with attention deficit hyperactivity disorder (ADHD). After special classes, children improve their attention, decrease hyperactivity, they do not get tired longer, they can engage in complex activities longer. This is the conclusion reached by psychologists at Ural Federal University who studied the effect of exercise on functions associated with voluntary regulation and control in 16 children with ADHD aged six to seven years. The results of the study are published in the journal Biological Psychiatry. "For children with ADHD, as a rule, the part of the brain that is responsible for the regulation of brain activity - the reticular formation - is deficient," said Sergey Kiselev, head of the Laboratory of Brain and Neurocognitive Development at UrFU, head of the study. "This leads to the fact that they often experience states of inadequate hyperactivity, increased distraction and exhaustion, and their functions of regulation and control suffer a second time. We used a special breathing exercise based on the development of diaphragmatic rhythmic deep breathing - belly breathing. Such breathing helps to better supply the brain with oxygen and helps the reticular formation to better cope with its role. When the reticular formation receives enough oxygen, it begins to better regulate the child's state of activity". In addition to breathing exercises, psychologists used body-oriented techniques, in particular, exercises with polar states "tension-relaxation". The trainings took place three times a week for two to three months (depending on the program). "Exercise has an immediate effect that appears immediately, but there is also a delayed effect. We found that exercise has a positive effect on regulation and control functions in children with ADHD and one year after the end of the exercise. This happens because the child's correct breathing is automated, it becomes a kind of assistant that allows better supply of oxygen to the brain, which, in turn, has a beneficial effect on the behavior and psyche of a child with ADHD," says Sergey Kiselev. This technique was developed by the Russian neuropsychologist Anna Semenovich as part of a neuropsychological correction technique. UrFU psychologists tested how well this approach helps children with ADHD. But the study is pilot, says Kiselev. It showed that these exercises have a positive effect. However, more work needs to be done, involving more children with ADHD. This will also take into account factors such as gender, age, severity of the disease, concomitant problems in children (speech, regulatory, etc.).     Study findings suggest vitamin D deficiency may be associated with reduced arterial elasticity Guizhou Medical University (China), May 17, 2021   According to news reporting out of Guizhou, People’s Republic of China, research stated, “There is evidence that serum 25-hydroxyvitamin D [25-(OH) D] levels may be associated with cardiovascular disease and its risk factors. This study aimed to investigate the relationship between 25-(OH) D levels and blood pressure (BP), blood lipids, and arterial elasticity in middle-aged and elderly cadres in China.In this retrospective study, we included 401 civil servants and cadres aged >42 years who underwent medical examinations at Guiyang Municipal First People’s Hospital, China in 2018.” Our news journalists obtained a quote from the research from Guizhou Medical University, “The participants were assigned to deficiency ( 20 ng/mL), insufficiency (20-30 ng/mL), and sufficiency ( 30 ng/mL) groups according to 25-(OH) D levels in their blood. Demographics, brachial-ankle pulse wave velocity (baPWV), BP, ankle-brachial index (ABI), and blood lipids were compared among groups. The associations between 25-(OH) D and other parameters were evaluated using linear regression analysis.Median (range) 25-(OH) D levels in the deficiency (n = 162), insufficiency (n = 162), and sufficiency (n = 77) groups were 15.32 (2.93-19.88), 25.12 (20.07-29.91), and 33.91 (30.23-82.42) ng/mL, respectively. There were significant differences in systolic BP, pulse pressure, baPWV (left and right sides), ABI (left side), high-density lipoprotein-cholesterol, and triglycerides (TGs; all P< .05) among groups.” According to the news editors, the research concluded: “Multivariate linear regression revealed that TG, left baPWV, and right baPWV were significantly negatively correlated with 25-(OH) D levels (all P< .05).In this study, 25-(OH) D levels were found to be associated with TG, left baPWV, and right baPWV values. 25-(OH) D deficiency may be associated with reduced arterial elasticity.”     Icing muscle injuries may delay recovery Kobe University and Chiba Institute of Technology (Japan), May 19, 2021 A study using a mouse model of eccentric contraction (*1) has revealed that icing injured muscles delays muscle regeneration. The discovery was made by a research group including Associate Professor ARAKAWA Takamitsu and then PhD. Student KAWASHIMA Masato from Kobe University's Graduate School of Health Sciences, and Chiba Institute of Technology's Associate Professor KAWANISHI Noriaki et al. In addition, the researchers illuminated that this phenomenon may be related to pro-inflammatory macrophages' (*2, 3, 4) ability to infiltrate damaged cells. This research raises questions as to whether or not severe muscle injuries (such as torn muscles) should be iced. These research results were published online as one of the Journal of Applied Physiology's Articles in Press on March 25, 2021. Main points The research results revealed that applying an ice pack to a severe muscle injury resulting from eccentric contraction may prolong the time it takes to heal. The cause of this phenomenon is that icing delays the arrival of pro-inflammatory macrophages, which are responsible for the phagocytosis (*5), or removal, of damaged tissue. Furthermore, this makes difficult for the macrophages to sufficiently infiltrate the damaged muscle cells. Research Background Skeletal muscle injuries encompass a range of damage to muscles; from a microcellular level to a severe level. These injuries include not only those that happen during sports or schools' physical education lessons but also external injuries that occur as a result of accidents and disasters. 'RICE treatment' is a common approach for skeletal muscle injuries, regardless of the extent of the injury. This acronym stands for Rest, Ice, Compression and Elevation and is often used in physical education, sports and even medicine. Ice is commonly applied regardless of the type of muscle injury, yet little is known about the long-term effects of icing. Ice is used to suppress inflammation, however, inflammation in response to tissue injury is one of the body's healing mechanisms. This has come to be understood as a vital response for tissue regeneration. In other words, suppressing inflammation with ice may also inhibit the body's attempt to repair itself. Experiments investigating the effect of icing muscles after injury have produced conflicting results. Some have reported that it delays muscle regeneration while others have stated that it doesn't inhibit this process. However, none of the research up until now has investigated the effects of icing using an injury model that mimics common sports injuries caused by muscle contraction. Using a mouse model of eccentric contraction injury, the current research team decided to observe the effects of post-injury icing. In this mouse model, injuries were induced to resemble severe torn muscles. Research Methodology and Results Eccentric contraction was induced by electrically stimulating the leg muscles of the mice and then exerting a stronger force during this stimulation to make the leg muscles move in the opposite direction. After this, the muscles were harvested. Icing was performed by placing polyurethane bags of ice on top of the skin over three 30 minute sessions per day, with each session being 2 hours apart. This was continued until two days after the injury. The icing was based on the usual clinically recommended method. The researchers investigated the regenerated skeletal muscle two weeks after injury, comparing the icing group with the non-icing group. A significantly higher percentage of smaller regenerated muscle fibers were found in cross-sections from the icing group, with a greater number of medium to large fibers in the non-icing group (Figure 1). In other words, this revealed that skeletal muscle regeneration may be delayed as a result of icing. Next, the researchers periodically took samples of muscle from the icing and non-icing groups of animals in order to investigate what was happening in the regeneration process up until this point. In the regeneration process, inflammatory cells gather at the site of the injury, remove the debris from the damaged muscle and then begin to build new muscle. However, the results revealed that it is harder for inflammatory cells to enter the injured muscle cells if ice is applied (Figure 2). Macrophages are typical of the inflammatory cells that enter the injured muscle. These consist of pro-inflammatory macrophages, which phagocyte damaged tissue thus causing inflammation, and anti-inflammatory macrophages (*6), which suppress the inflammatory reaction and promote repair. It is thought that pro-inflammatory macrophages change their characteristics, becoming anti-inflammatory. The results of this research team's experiments showed that icing delays the arrival of pro-inflammatory macrophages at the site of the injury (Figure 3). These results indicate the possibility that macrophages are unable to sufficiently phagocyte the damaged muscle when ice is applied after severe muscle injuries caused by eccentric contraction, consequently delaying the formation of new muscle cells. Comment from Associate Professor Arakawa In sports, the mantra of immediately applying ice to an injury is commonplace, regardless of the injury's severity. However, the mechanism that we illuminated through this research suggests that not icing a severe muscle injury may lead to faster recovery. The idea of immediately cooling any type of injury is also entrenched in schools' physical education classes. I hope that in the future, the alternative option of speeding up recovery by not cooling severe muscle injuries will become known. However, even though icing may disrupt the recovery process for severe muscle injuries, there is no denying the possibility that there are degrees of mild muscle injuries that can be iced. The next issue is to work out where to draw the line. We are now in the middle of investigating what effect icing has on slight muscle injuries. Next, we will continue to investigate how icing should be carried out according to the extent of the muscle injury. We aim to contribute guidelines that will enable people in sports and clinical rehabilitation to make accurate judgements about whether or not to ice an injury.     Probiotics associated with fewer respiratory symptoms in overweight and older people Findings provide further evidence of relationship between the gut and lungs Imperial College London, May 14, 2021 Daily probiotic use was associated with fewer upper respiratory symptoms in overweight and older people, according to a study that suggests a potential role for probiotics in preventing respiratory infections. The study was selected for presentation at Digestive Disease Week® (DDW) 2021.  "This is not necessarily the most intuitive idea, that putting bacteria into your gut might reduce your risk of respiratory infection," said Benjamin Mullish, MD, a lead researcher on the study and clinical lecturer in the Division of Digestive Diseases, Imperial College London, England, "but it's further evidence that the gut microbiome has a complex relationship with our various organ systems. It doesn't just affect how our gut works or how our liver works, it affects aspects of how our whole body works." Researchers re-analyzed detailed daily diaries of 220 patients who participated in an earlier double-blind placebo-controlled study on probiotics and weight loss. Reviewing the entries for common symptoms of upper respiratory infection, including cough, sore throat and wheezing, researchers found that participants who took probiotics during the six-month study had a 27 percent lower overall incidence of upper respiratory tract symptoms compared to the placebo group. The effect was largest among participants who were aged 45 years or older, as well as those with obesity. People with obesity are at higher risk for respiratory infections. Previous research has shown that probiotics reduce upper respiratory infections in healthy adults and children, but little data exists on this vulnerable population of older, overweight and people with obesity. "These findings add to growing interest in the gut-lung axis -- how the gut and the lungs communicate with each other," Dr. Mullish said. "It's not just the gut sending out signals that affect how the lungs work. It works in both directions. It adds to the story that changes in the gut microbiome can affect large aspects of our health." The researchers did not measure immune response, only respiratory symptoms. Future randomized clinical trials could help identify the mechanisms related to the reduction in respiratory symptoms and explore the possible impact of probiotics on the immune system, Dr. Mullish said.     Fruit discovery could provide new treatments for obesity, type 2 diabetes and cardiovascular disease University of Warwick (UK), May 11, 2021    A combination of two compounds found in red grapes and oranges could be used to improve the health of people with diabetes, and reduce cases of obesity and heart disease. The find has been made by University of Warwick researchers who now hope that their discovery will be developed to provide a treatment for patients.   Professor Thornalley who led research said: "This is an incredibly exciting development and could have a massive impact on our ability to treat these diseases. As well as helping to treat diabetes and heart disease it could defuse the obesity time bomb."   The research 'Improved glycemic control and vascular function in overweight and obese subjects by glyoxalase 1 inducer formulation' has been published in the journal Diabetes, and received funding from the UK's innovation agency, Innovate UK. The project was a collaboration between the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW) NHS Trust.   A team led by Paul Thornalley, Professor in Systems Biology at Warwick Medical School, studied two compounds found in fruits but not usually found together. The compounds are trans-resveratrol (tRES) - found in red grapes, and hesperetin (HESP) - found in oranges. When given jointly at pharmaceutical doses the compounds acted in tandem to decrease blood glucose, improve the action of insulin and improve thehealth of arteries.   The compounds act by increasing a protein called glyoxalase 1 (Glo1) in the body which neutralises a damaging sugar-derived compound called methylglyoxal (MG). MG is a major contributor to the damaging effects of sugar. Increased MG accumulation with a high energy diet intake is a driver of insulin resistance leading to type 2 diabetes, and also damages blood vessels and impairs handling of cholesterol associated with increased risk of cardiovascular diseases. Blocking MG improved health in overweight and obese people and will likely help patients with diabetes and high risk of cardiovascular disease too. It has already been proven experimentally that blocking MG improves health impairment in obesity and type 1 and type 2 diabetes.   Although the same compounds are found naturally in some fruits, the amounts and type required for health improvement cannot be obtained from increased fruit consumption. The compounds that increase Glo1 and are called a 'Glo1 inducer'. Pharmaceutical doses for patients with obesity, diabetes and high risk of heart disease could be given to patients in capsule form.   Professor Thornalley increased Glo1 expression in cell culture. He then tested the formulation in a randomised, placebo-controlled crossover clinical trial. Thirty-two overweight and obese people within the 18-80 age range who had a BMI between 25-40 took part in the trial. They were given the supplement in capsule form once a day for eight weeks. They were asked to maintain their usual diet and their food intake was monitored via a dietary questionnaire and they were also asked not to alter their daily physical activity. Changes to their sugar levels were assessed by blood samples, artery health measured by artery wall flexibility and other assessments by analysis of blood markers.   The team found that the highly overweight subjects who had BMIs of over 27.5 with treatment displayed increased Glo1 activity, decreased glucose levels, improved working of insulin, improved artery function and decreased blood vessel inflammation. There was no effect of placebo.   Professor Thornalley said: "Obesity, type 2 diabetes and cardiovascular disease are at epidemic levels in Westernised countries. Glo1 deficiency has been identified as a driver of health problems in obesity, diabetes and cardiovascular disease."   "Diabetic kidney disease will be the initial target to prove effective treatment for which we are currently seeking commercial investors and partners. Our new pharmaceutical is safe and expected to be an effective add-on treatment taken with current therapy.   "The key steps to discovery were to focus on increasing Glo1 and then to combine tRES and HESP together in the formulation for effective treatment. "As exciting as our breakthrough is it is important to stress that physical activity, diet, other lifestyle factors and current treatments should be adhered to."   Professor Martin O Weickert, Consultant in Diabetes and Endocrinology at UHCW NHS Trust, and co-applicant for the grant, said: "We were really excited to participate in this study with Warwick Medical School, as taking part in world-leading research makes a real difference to our patients both now and in the future. "As well as the positive effects for the UHCW patients who took part in the trial, we hope this study will lead to new treatments to help patients with diabetes and cardiovascular diseases all over the world."   Prof. Thornalley and his team are now hoping manufacturers will want to explore the use of the compound as pharmaceutical products.       Vitamin D supplementation associated with less time spent in ICU among critically ill patients Lishui People’s Hospital (China), May 18, 2021 According to news originating from Lishui, People’s Republic of China, research stated, “Vitamin D deficiency is a common scenario in critically ill patients and has been proven to be associated with poor outcomes. However, the effect of vitamin D supplementation for critically ill patients remains controversial.” Our news correspondents obtained a quote from the research from Lishui People’s Hospital: “Thus, we conducted a meta-analysis to evaluate the effect of vitamin D supplementation among critically ill patients. Electronic databases PubMed, Embase, Scopus, and the Cochrane Library were searched for eligible randomized controlled trials between 2000 and January 2021. The primary outcome was overall mortality, and the secondary ones were the length of intensive care unit stay, the length of hospital stay, as well as the duration of mechanical ventilation. Subgroup analyses were performed to explore the treatment effect by type of admission, route of administration, dose of supplemented vitamin D, and the degree of vitamin D deficiency. A total of 14 studies involving 2,324 patients were finally included. No effect on overall mortality was found between vitamin D supplementation and control group [odds ratio (OR), 0.73; 95% CI, 0.52-1.03; I2 = 28%]. The vitamin D supplementation reduced the length of intensive care unit stay [mean difference (MD), -2.25; 95% CI, -4.07 to -0.44, I2 = 71%] and duration of mechanical ventilation (MD, -3.47; 95% CI, -6.37 to -0.57, I2 = 88%). In the subgroup analyses, the vitamin D supplementation for surgical patients (OR, 0.67; 95% CI, 0.47-0.94; I2 = 0%) or through parenteral way (OR, 0.42; 95% CI, 0.22-0.82, I2 = 0%) was associated with reduced mortality.” According to the news reporters, the research concluded: “In critically ill patients, the supplementation of vitamin D has no effect on overall mortality compared to placebo but may decrease the length of intensive care unit stay and mechanical ventilation. Further trials are necessary to confirm our findings.”

In this episode we speak to Dr Jo Parsons, Research Fellow at Warwick Medical School, University of Warwick. Paper: Which patients miss appointments with general practice and why? A systematic review https://doi.org/10.3399/BJGP.2020.1017 (https://doi.org/10.3399/BJGP.2020.1017) Missed GP appointments have considerable time and cost implications on healthcare services. This review reveals how many booked primary care appointments are missed, reasons given for this, and what characteristics are commonly associated with missed appointments. This has implications for general practices and clinicians aiming to reduce rates of missed appointments, and implementing strategies for this.

Professor Chris Imray is a consultant vascular, renal transplant and trauma surgery at the University Hospitals Coventry & Warwickshire NHS Trust in Coventry, UK. He is also an Honorary Professor at Warwick Medical School, Coventry and Exeter Universities and immediate Past President of the Vascular Society of Great Britain and Ireland. Professor Imray has combined his love of mountaineering with clinical vascular surgery - he is involved in a number of polar medicine societies and is a world expert on the management of frostbite and non-freezing cold injuries. He has conducted research into hypoxia and ischemia at altitude and has published extensively. His personal accomplishments include a wide range of expeditions across the globe, from the sea cliffs of the Outer Hebrides in Scotland to the volcanoes of Chile and, most notably, to the summit of Everest. Useful links: Selected papers about altitude / extreme medicine: Femoral stabs at 8400m with the lowest recorded ABGs: Grocott et al. Arterial blood gases and oxygen content in climbers on Mount Everest. N Engl J Med. 2009 Jan 8;360(2):140-9. Transcranial Doppler at 8000m, with novel insights: Wilson et al Cerebral artery dilatation maintains cerebral oxygenation at extreme altitude and in acute hypoxia--an ultrasound and MRI study. J Cereb Blood Flow Metab. 2011 Oct;31(10):2019-29. Novel insights from Everest (8000m) confirmed: Sagoo et al. The use of MR to investigate the potential mechanisms involved in the development of high altitude cerebral oedema. J Cereb Blood Flow Metab. 2016 Jan 8. pii Wilson et al.  The cerebral venous system and anatomical predisposition to high altitude headache. Annals of Neurology 2013 Wilson and Imray. The Cerebral Venous System and Hypoxia. J Appl Physiol. 2015 Aug 20:jap.00327.2015. The effect of altitude on the brain: Wilson et al.  The cerebral effects of ascent to high altitudes. Lancet Neurol. 2009 Feb;8(2):175-91. Women are at least as strong as men on hyper-endurance events: Hattersley et al.  A comparison of the metabolic effects of sustained strenuous activity in polar environments on men and women. Sci Rep. 2020 Aug 17;10(1):13912. Evidence-based guidelines on the management of frostbite: McIntosh et al. Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Frostbite: 2019 Update. Wilderness Environ Med. 2019 Jul 17. pii: S1080-6032(19)30097-3. Handford et al. Frostbite: a practical approach to hospital management. Extrem Physiol Med. 2014 Apr 22;3:7. Collaborative teamwork gives the best results: Fisher et al. Pedicled Abdominal Flaps for Enhanced Digital Salvage After Severe Frostbite Injury. Wilderness Environ Med. 2019 Mar;30(1):59-62. Other useful resources Information on the management of frostbite:  https://www.thebmc.co.uk/how-to-get-expert-frostbite-advice Oxford Handbook of Wilderness and Expedition Medicine: https://oxfordmedicine.com/view/10.1093/med/9780199688418.001.0001/med-9780199688418 Media appearances by Prof Imray: Radio: http://news.bbc.co.uk/today/hi/today/newsid_9722000/9722707.stm Television: BBC Panorama: Horizon Doctors in the death zone: http://www.bbc.co.uk/sn/tvradio/programmes/horizon/broadband/tx/everest/ Polar medicine / extreme environment and research organisations: https://worldextrememedicine.com/products/courses/polar-medicine/polar-medicine-norway/ https://www.rgs.org/in-the-field/advice-training/expedition-medicine-(1)/committee-members/ https://www.rgs.org/in-the-field/advice-training/resources-for-expeditions/global-polar-altitudemetabolic-research-registr/ https://bmrescouk.wordpress.com https://www.xtreme-everest.co.uk/Scientific-Strategy-Group The Vascular and Endovascular Research Network (VERN) COVER Study (COVID-19 Vascular sERvice Study): https://vascular-research.net/projects/cover-study-covid-19-vascular-service-study/ To learn more about The Rouleaux Club, visit http://rouleauxclub.com

A new study from the University of Warwick has concluded that lifestyle changes to manage weight loss are effective in reducing obesity regardless of age. Lead author Dr Thomas Barber of Warwick Medical School is with us to discuss.

A new study from the University of Warwick has concluded that lifestyle changes to manage weight loss are effective in reducing obesity regardless of age. Lead author Dr Thomas Barber of Warwick Medical School is with us to discuss.

If you enjoyed your time at business school, why not consider staying on after your MBA? Today we explore career opportunities in the higher education sector. We talk to Wendy Coy, Director of Operations, Innovation Group at the University of Warwick, about her post-MBA career in HE, the opportunities it provided for her to explore different roles and functions, and tips for applicants considering the sector.Link to statistics, MBAs and Higher Education About UsMany students come to an MBA from banking, consulting, or MNC backgrounds, but what about those that don't? The Modern MBA podcast with Marie Kirwan and Kristen Rossi shares the stories of those transitioning from or using their MBAs in unorthodox MBA sectors including the arts, healthcare, not-for-profit, academia, and more.Website: http://www.themodernmba.co.ukSubscribe: Apple Podcasts, Spotify, Google PodcastsFollow us on LinkedIn, Facebook, Instagram and TwitterPodcast Music Credit:Limit 70, courtesy of Kevin MacleodSupport the show

The Gary Null Show is here to inform you on the best news in health, healing, the environment.   Antioxidant-rich powders from blueberry, persimmon waste could be good for gut microbiota Polytechnic University of Valencia (Italy), July 24, 2020 Feeding the world's growing population in a sustainable way is no easy task. That's why scientists are exploring options for transforming fruit and vegetable byproducts -- such as peels or pulp discarded during processing -- into nutritious food ingredients and supplements. Now, researchers reporting in ACS' Journal of Agricultural and Food Chemistry have shown that blueberry and persimmon waste can be made into antioxidant-rich powders that might have beneficial effects on gut microbiota. In recent years, fruit and vegetable powders have become popular as a way to add beneficial compounds, such as polyphenols and carotenoids (two types of antioxidants), to the diet, either by consuming the powders directly or as an ingredient in food products. However, in many cases these healthful compounds are present at similar or even higher levels in byproducts compared to those in other parts of the fruit or vegetable. Noelia Betoret, María José Gosalbes and colleagues wanted to obtain powders from persimmon and blueberry wastes, and then study how digestion could affect the release of antioxidants and other bioactive compounds. They also wanted to determine the effects of the digested powders on gut bacterial growth. The researchers obtained powders from persimmon peels and flower parts, and from the solids left behind after making blueberry juice. The type of powder, drying method, fiber content and type of fiber determined the release of antioxidants during a simulated digestion. For example, freeze-drying preserved more anthocyanins, but these were more easily degraded during digestion than those in air-dried samples. Then, the team added the powders to a fecal slurry and conducted a mock colonic fermentation, sequencing the bacteria present before and after fermentation. Incubation with the fruit powders resulted in an increase in several types of beneficial bacteria, and some bacteria grew better with one powder compared to the other. These findings indicate that persimmon and blueberry waste powders could be included in food formulations to boost the content of carotenoids and anthocyanins, which could have a positive impact on human health, the researchers say.   Plant-based diets shown to lower blood pressure even with limited meat and dairy Consuming a plant-based diet can lower blood pressure even if small amounts of meat and dairy are consumed too, according to new research  University of Warwick (UK), July 27, 2020   Consuming a plant-based diet can lower blood pressure even if small amounts of meat and dairy are consumed too, according to new research from the University of Warwick. Published online by a team from Warwick Medical School in the Journal of Hypertension today (25 July), they argue that any effort to increase plant-based foods in your diet and limit animal products is likely to benefit your blood pressure and reduce your risk of heart attacks, strokes and cardiovascular disease. They conducted a systematic review of previous research from controlled clinical trials to compare seven plant-based diets, several of which included animal products in small amounts, to a standardised control diet and the impact that these had on individuals' blood pressure. Plant-based diets support high consumption of fruits, vegetables, whole grains, legumes, nuts and seeds, limiting the consumption of most or all animal products (mainly meat and diary). (See Notes to Editors for further details) High blood pressure is the leading risk factor globally for heart attacks, strokes and other cardiovascular diseases. A reduction in blood pressure has important health benefits both for individuals and for populations. Unhealthy diets are responsible for more deaths and disabilities globally than tobacco use, high alcohol intake, drug use and unsafe sex put together. An increased consumption of whole grains, vegetables, nuts and seeds, and fruit, as achieved in plant-based diets, could avert up to 1.7, 1.8, 2.5 and 4.9 million deaths globally respectively every year according to previous research. Vegetarian and vegan diets with complete absence of animal products are already known to lower blood pressure compared to omnivorous diets. Their feasibility and sustainability are, however, limited. Until now, it has not been known whether a complete absence of animal products is necessary in plant-based dietary patterns to achieve a significant beneficial effect on blood pressure. Lead author Joshua Gibbs, a student in the University of Warwick School of Life Sciences, said: "We reviewed 41 studies involving 8,416 participants, in which the effects of seven different plant-based diets (including DASH, Mediterranean, Vegetarian, Vegan, Nordic, high fibre and high fruit and vegetables) on blood pressure were studied in controlled clinical trials. A systematic review and meta-analysis of these studies showed that most of these diets lowered blood pressure. The DASH diet had the largest effect reducing blood pressure by 5.53/3.79 mmHg compared to a control diet, and by 8.74/6.05 mmHg when compared to a 'usual' diet. "A blood pressure reduction of the scale caused by a higher consumption of plant-based diets, even with limited animal products would result in a 14% reduction in strokes, a 9% reduction in heart attacks and a 7% reduction in overall mortality. "This is a significant finding as it highlights that complete eradication of animal products is not necessary to produce reductions and improvements in blood pressure. Essentially, any shift towards a plant-based diet is a good one." Senior author Professor Francesco Cappuccio of Warwick Medical School said: "The adoption of plant-based dietary patterns would also play a role in global food sustainability and security. They would contribute to a reduction in land use due to human activities, to global water conservation and to a significant reduction in global greenhouse gas emission. "The study shows the efficacy of a plant-based diet on blood pressure. However, the translation of this knowledge into real benefits to people, i.e. its effectiveness, depends on a variety of factors related to both individual choices and to governments' policy decisions. For example, for an individual, the ability to adopt a plant-based diet would be influenced by socio-economic factors (costs, availability, access), perceived benefits and difficulties, resistance to change, age, health status, low adherence due to palatability and acceptance. "To overcome these barriers, we ought to formulate strategies to influence beliefs about plant-based diets, plant food availability and costs, multisectoral actions to foster policy changes focusing on environmental sustainability of food production, science gathering and health consequences."   Health and happiness depend on each other Georgetown University, July 22, 2020   Good health and a happy outlook on life may seem like equally worthy yet independent goals. A growing body of research, however, bolsters the case that a happy outlook can have a very real impact on your physical well-being. New research published in the journal Psychological Science shows that both online and in-person psychological interventions -- tactics specifically designed to boost subjective well-being -- have positive effects on self-reported physical health. The online and in-person interventions were equally effective. "Though prior studies have shown that happier people tend to have better cardiovascular health and immune-system responses than their less happy counterparts," said Kostadin Kushlev, a professor in Georgetown University's Department of Psychology and one of the authors of the paper, "our research is one of the first randomized controlled trials to suggest that increasing the psychological well-being even of generally healthy adults can have benefits to their physical health." Intervention for Healthy Outcomes Over the course of six months, Kushlev and his colleagues at the University of Virginia and the University of British Columbia examined how improving the subjective well-being of people who were not hospitalized or otherwise undergoing medical treatment affected their physical health. A group of 155 adults between the ages of 25 and 75 were randomly assigned either to a wait-list control condition or a 12-week positive psychological intervention that addressed three different sources of happiness: the "Core Self," the "Experiential Self," and the "Social Self." The first 3 weeks of the program focused on the Core Self, helping individuals identify their personal values, strengths, and goals. The next 5 weeks focused on the Experiential Self, covering emotion regulation and mindfulness. This phase also gave participants tools to identify maladaptive patterns of thinking. The final 4 weeks of the program addressed the Social Self, teaching techniques to cultivate gratitude, foster positive social interactions, and engage more with their community. The program, called Enduring Happiness and Continued Self-Enhancement (ENHANCE), consisted of weekly modules either led by a trained clinician or completed individually using a customized online platform. None of the modules focused on promoting physical health or health behaviors, such as sleep, exercise, or diet. Each module featured an hour-long lesson with information and exercises; a weekly writing assignment, such as journaling; and an active behavioral component, such as guided meditation. "All of the activities were evidence-based tools to increase subjective well-being," Kushlev noted. When the program concluded, the participants were given individual evaluations and recommendations of which modules would be most effective at improving their happiness in the long term. Three months after the conclusion of the trial, researchers followed up with the participants to evaluate their well-being and health. A Happy Future Participants who received the intervention reported increasing levels of subjective well-being over the course of the 12-week program. They also reported fewer sick days than control participants throughout the program and 3 months after it ended. The online mode of administering the program was shown to be as effective as the in-person mode led by trained facilitators. "These results speak to the potential of such interventions to be scaled in ways that reach more people in environments such as college campuses to help increase happiness and promote better mental health among students," Kushlev said.   Rely on gut feeling? New research identifies how second brain in gut communicates Finders University (Australia), July 24, 2020   You're faced with a big decision so your second brain provides what's normally referred to as 'gut instinct', but how did this sensation reach you before it was too late? The Enteric Nervous System (ENS) is an extensive network of neurons and transmitters wrapped in and around the human gut with the prime function of managing digestion, but researchers at Flinders University are delving into the complexity of this brain like system to uncover it's secret capabilities.  In a new study published in the eNeuro journal, Professor Nick Spencer's laboratory has identified a particular type of neuron in the gut wall that communicates signals to other neurons outside the gut, near the spinal cord and up to the brain. "There is significant interest in how the gut communicates with the brain as a major unresolved issue because of growing evidence that many diseases may first start in the gut and then travel to the brain, an example of which is Parkinson's Disease," says Professor Spencer. "The new study has uncovered how viscerofugal neurons provide a pathway so our gut can "sense" what is going on inside the gut wall, then relay this sensory information more dynamically than was previously assumed to other organs, like the spinal cord and brain which influence our decisions, mood and general wellbeing." The results reveal why the ENS might play an increasingly important part on human health, and could shed light on potential new treatments for conditions like Parkinson's disease. This study represents a big step towards understanding ENS functions and the complexity of the gut and brain connection through the neurons that allow communication in the body.  Professor Spencer says there is increasing interest in understanding how the nervous system in the gut (ENS) communicates with the brain, to give us all those sensations we know of. "What is particularly exciting about the gut, is that it is unlike all other internal organs (e.g. heart, liver, bladder) because the gut has its own nervous system, which can function independently of the brain or spinal cord. Understanding how the gut communicates and controls other organs in the body can lead to important breakthroughs for disease treatment and this is an important step in the right direction."   The role of functional foods in treating chronic diseases Wuhan Sports University (China), July 24, 2020   In this study, researchers at Wuhan Sports University in China summarized several widely investigated bioactive components used as functional foods and their role in autophagy. Their review was published in the journal Food Science and Human Wellness. Functional foods, which could be either natural or processed foods that contain bioactive compounds, can provide health-promoting effects beyond basic nutrition. These foods also offer the benefit of preventing or treating chronic diseases. The bioactive components in functional foods often have pleiotropic effects, such as antioxidant, anti-inflammatory, hypolipidemic (cholesterol-lowering), blood sugar-regulating, cytoprotective and neuroprotective functions. Autophagy is a highly conserved cellular process used by the body to eliminate aberrant components in eukaryotic cells. It also plays an essential role in promoting health and preventing or treating several chronic diseases. When cells are in a stressful condition, autophagy accelerates the clearance of damaged or toxic cellular protein aggregates or dysfunctional cell organelles to maintain homeostasis. In this review, the researchers focused on several bioactive components of functional foods, such as resveratrol, epigallocatechin-3-gallate, curcumin and trehalose, and their regulatory functions in autophagy. They believe this review could serve as a reference or provide novel ideas for the development of functional foods capable of modulating autophagy for the treatment of chronic diseases.   Combination of vitamin E and Lactobacillius plantarum reverses mercuric chloride-induced neurotoxicity King Saud University, July 23, 2020   According to news originating from Riyadh, Saudi Arabia, by NewsRx editors, the research stated, “Mercury is the third most hazardous heavy metal and its toxicity causes a severe health risk through unfavorable detrimental pathological and biochemical effects. Mercury is widely found in many ecological and certain occupational settings.” Our news editors obtained a quote from the research from King Saud University: “The aim of this study is to elucidate the neuroprotective role of vitamin E (VE) and Lactobacillus plantarum (LTB) either alone or in combination against a toxic sublethal dose of Mercuric chloride (MC). First group served as a normal control group; rats from the second group were intoxicated with (5 mg/kg MC once daily); the third group was treated with VE; the fourth group was treated with LTB; and the fifth group was treated with VE and LTB. All treatments were given daily along with MC for fourteen days. The results of the current study confirmed that MC prompted an elevation in serum TNF-a, IL-6 and brain lipid peroxides, protein expression of mitogen-activated protein kinase (MAPK) and mRNA expression of Bax and caspase-3 level as well as DNA degradation. However, Brain-derived neurotrophic factor (BDNF) and cAMP response element-binding (CREB) protein expressions, GSH level and SOD activity were down-regulated. The intake of LTB and/or VE along with MC intoxication significantly mitigated the alteration in all the previous parameters. Moreover, histopathological analysis of brain sections confirmed that MC-induced brain injury and LTB or VE alone or together were capable of ameliorating brain artitechture.” According to the news editors, the research concluded: “The combination of LTB and VE was an effective therapy in the management of MC-induced neuroioxicity and this combination can be considered a useful therapeutic candidate against brain injury induced by MC. BDNF, MAPK and CREB protein expressions are implicated in MC -induced brain injury and its treatment.”     Plant-based diets high in carbs improve type 1 diabetes, according to new case studies Physicians Committee for Responsible Medicine, July 24, 2020   Plant-based diets rich in whole carbohydrates can improve insulin sensitivity and other health markers in individuals with type 1 diabetes, according to two case studies published by researchers from the Physicians Committee for Responsible Medicine in the Journal of Diabetes & Metabolism.  Both case studies followed individuals with type 1 diabetes who adopted plant-based diets rich in whole carbohydrates--including fruits, vegetables, whole grains, and legumes. The patients' health care teams tracked their blood sugar control, heart disease risk factors, and other health measurements before and after the diet change.  One case study followed a female patient who was diagnosed with type 1 diabetes in 2018. At the time, her A1c was 8.7%. She initially adopted a low-carbohydrate (less than 30 grams of carbohydrate per day), high-fat diet that was high in meat and dairy. Her blood sugar stabilized, but she required more insulin per gram of carbohydrate consumed. Her total cholesterol also increased from 175 to 221 mg/dL. In January 2019, she switched to a plant-based diet, eliminating dairy products, eggs, and meat. The patient was able to decrease her insulin dosage, maintain her A1c level at 5.4%, and drop her cholesterol level to 158 mg/dL. "This study challenges the misconception that carbs are the enemy when it comes to diabetes," says study author Hana Kahleova, MD, PhD, director of clinical research at the Physicians Committee. "The patient in this case study experienced the opposite: Adding more healthful carbohydrates to her diet stabilized her glycemic control, reduced her insulin needs, and boosted her overall health." The other individual--a 42-year-old man who had been diagnosed with type 1 diabetes at age 25--eliminated animal products from his diet and switched to a whole food, plant-based diet. He increased his consumption of carbohydrates from 150 grams to 400-450 grams per day. After adopting a carbohydrate-rich plant-based diet, he lost weight, required less insulin, and reduced his A1c--a measure of blood sugar levels over a 3-month period--from 6.2% to a range between 5.5-5.8%.  The authors note that a previous small study supported the case studies' results, finding that a high-carbohydrate, high-fiber diet improved glycemic control in 10 people with type 1 diabetes. As a next step, the authors suggest that randomized clinical trials are needed to verify the case studies' findings, assess their generalizability, and quantify the effectiveness of plant-based diets in the management of type 1 diabetes. Previous studies have found that low-fat, plant-based diets can be beneficial for those with type 2 diabetes. Research has also shown that those eating a plant-based diet have approximately half the risk of developing type 2 diabetes, compared with non-vegetarians. "Decades of research has proven that a plant-based diet can be beneficial for those with type 2 diabetes. Now, these groundbreaking case studies are offering hope that the same may be true for those with type 1 diabetes," adds Dr. Kahleova.         Raised iron levels linked to reduced life expectancy Imperial College London, July 24, 2020   Having too much iron in the body puts your long term health at risk but it could also take years off your life. These are the findings of a study using large scale genetic data to assess the impacts across a population of having naturally raised levels of iron, in terms of years of life expectancy. According to the researchers, the findings—which help to cut through the noise caused by confounding factors such as age, sex or diet—add to the increasingly complex picture of iron's role in our health and highlight the risks of having raised levels of iron. Dr. Dipender Gill, from Imperial's School of Public Health and who supervised the study, said: "We have known for a long time that having too much or too little iron in your system can have serious impacts on your health, and that effectively modifying iron levels can help many people with underlying conditions. Our findings build on previous work to clarify that picture further, showing that people who have genetic predisposition to slightly raised levels of iron in the body have reduced life expectancy on average. While we did not look directly at the impact of taking supplements, our results suggest that there is a need to better understand the health implications of people boosting their iron levels with supplements when they don't need to." Double-edged sword Iron is used by the body to make red blood cells, which carry oxygen. Most people without underlying health conditions should be able to get enough iron from their diet. But disrupting the balance can lead to a host of health implications: too little iron is associated with fatigue and impaired immune system, while too much can cause liver failure, and in high enough doses can even be fatal. A number of studies suggest small changes in iron levels can have protective and detrimental effects for different diseases, such as heart disease, stroke and infections. But the net effect of varying iron levels on life expectancy remains unclear. In the latest study, published this month in the journal Clinical Nutrition, Dr. Gill and Mr. Iyas Daghlas from Harvard Medical School used a statistical technique called Mendelian randomization to try to explore the effect of increasing levels of iron on health—using people's genetic variation as an indicator of their iron levels. The researchers trawled genetic data from almost 49,000 people to find genetic variants linked to iron levels. They focused on three points in the genome where a single "letter" difference in the DNA—called a single nucleotide polymorphism (SNP)—can slightly increase or reduce a person's iron level. When these same SNPs were then screened in a larger dataset combing lifespan data for more than one million people, they found that the genetic markers for higher iron levels on average associated with reduced life expectancy. The analysis revealed that for every one point of standard deviation increase in genetically predicted serum iron above baseline, people had an estimated 0.7 fewer years of lifespan. Furthermore, the findings were unlikely to be biased by lifestyle factors. A body of work The work builds on a number of previous studies by Dr. Gill, which have used genetic data to investigate the role of iron in hundreds of diseases. A 2017 study revealed the link between high iron levels and lower risk of heart disease. Further studies from 2019 showed naturally higher iron levels were associated with a lower risk of high cholesterol levels, reducing the risk of arteries becoming furred with a build-up of fatty substances, but also carried with it a higher risk of blood clots and skin infections. Taken together, the studies build a complex picture of iron status in health. The authors stress that the genetic markers themselves do not indicate reduced life expectancy or risk in the wider context, but are a tool to study how iron levels relate to health without the influence of a number of complex confounding factors such as diet, economic background, or smoking status. They add that the findings should not currently be applied clinically, at the individual level. Dr. Gill explained: "It's important to put these findings in context. Our analysis is indirect and uses genetic data as a proxy for raised iron levels. But the clinical implications warrant further investigation and could be important for long-term health at the population level." Mr Iyas Daghlas, from Harvard Medical School, said: "These findings should not yet be extrapolated to clinical practice, but they further support the idea that people without an iron deficiency are unlikely to benefit from supplementation, and that it may actually do them harm. We emphasize that these results should not be applied to patient populations with a compelling reason for iron supplementation, such as patients with symptomatic iron deficiency anemia, or in patients with heart failure."     Seven reasons to eat more watermelon Life Extension, July 22, 2020   There's a reason why summer is the season for watermelon. Not only does this favorite fruit reach its peak flavors during the warmer months, watermelon is also even more nutrient-rich this time of year. From being a great source of raw lycopene to its hydrating nature, here are seven reasons to eat more watermelon. Lycopene is the pigment that gives red and pink fruits, such as tomatoes, watermelons and pink grapefruit, their characteristic color. Lycopene has been linked to health benefits ranging from heart health to protection against sunburns and certain types of cancers. 1. Watermelon is a top source of lycopene. Tomatoes get the glory when it comes to lycopene, but watermelon actually has more ? about 40 percent more, on average. Our bodies also absorb lycopene from watermelon more easily. Unlike tomatoes, which need to be cooked in order to maximize lycopene absorption, we can effectively absorb and reap the benefits of lycopene from raw watermelon. 2. It's hydrating.No surprise here. (It is called watermelon, after all!) But you may find it interesting that watermelon is 92 percent water, so by enjoying it, you really are eating your way toward better hydration. 3. It may improve blood pressure; is a top source of citrulline, which can help to improve blood flow and blood pressure 4. Because it's so sweet, watermelon has a reputation for being high in sugar, but most fruits arenaturally high in sugar, but they're also rich in nutrients. However, compared to sweet potatoes, watermelon has only one-fourth of the carbs and only half the sugar. 5. All of the goodness of watermelon (lycopene, beta carotene, vitamin C, vitamin A, fiber and overall antioxidants) gets better with age. The redder the fruit's flesh, the higher the nutrient concentration. 6. Most of us eat the red flesh and leave the rinds, but the rinds are entirely edible (just remove the outer peel), and are as nutritious as the flesh itself. The rinds can be sliced and added to your favorite stir-fry recipe, juiced or pureed for chilled soups. 7. It can be prepared in countless creative ways.Simply slice it and eat it plain, or with a sprinkle of salt. Or go with the classic pairing of watermelon: fresh mint and feta (or goat cheese, for a lower-sodium option). Make watermelon salsa, using watermelon in place of some (or all) of the tomatoes in your favorite salsa recipe. Grill it. Juice it. Puree it, rind and all, for soups and mocktails. The options are endless! Molly Kimball, RD, CSSD, registered dietitian with Ochsner Health System, manages the nutrition department of Ochsner Fitness Center and is founder of the Ochsner Eat Fit nonprofit restaurant initiative.      

In this Podcast we talk to Charlotte Gath about public health and whether the Covid 19 epidemic has highlighted a deeper crisis in public health in the UK Public health is the science of protecting and improving the health of people and their communities. This work is achieved by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing and responding to infectious diseases. Overall, public health is concerned with protecting the health of entire populations. These populations can be as small as a local neighbourhood, or as big as an entire country or region of the world. Coronavirus is the biggest public health crisis in a generation, but it is also highlighting the crisis in our working culture, our social care system and the NHS. Charlotte Gath worked as a GP in Rugby for nearly ten years, as a tutor at Warwick Medical School and latterly as a Consultant in Public Health for Warwickshire County Council for four years. --- Send in a voice message: https://anchor.fm/globalnet21/message

There are a number of complications following infection with Covid-19 that doctors are continuing to find in hospitals. One of the most significant is an acute kidney injury or AKI which can come alongside the disease and NICE has just published rapid guidance to help healthcare staff on the Covid frontline who are not kidney specialists. Inside Health’s Erika Wright has been following staff at Southampton General Hospital during the coronavirus outbreak and meets Kirsty Armstrong, Clinical Lead for Renal Services, to discuss managing kidneys and Covid. Could injecting blood donated from a patient who has recovered from Covid 19 into someone who is ill help the recipient recover too? It’s a potentially viable treatment with a long history, known as convalescent plasma therapy, and trials of this technique against Covid are beginning around the world. We hear from Jeff Henderson, Professor of Medicine at Washington University in St Louis, on progress in the world’s largest trial of this passive immunisation against the virus in the US, and from James Gill, Honorary Clinical Lecturer at Warwick Medical School, who’s been following the latest game-changing refinement of this therapy. Just as the rest of us have been getting better at zoom meetings and remembering to unmute ourselves when we want to speak, so have GPs who are now getting rather good at having online consultations. Will this change the way we “go to the doctor” forever or is there sometimes no substitute for face to face contact? Dr Margaret McCartney gives a GP’s insights. As more people begin to wear face masks what kind of impact does it have on communication when a person’s mouth is covered up and it’s hard to tell whether someone is happy or cross? Claudia discusses this question with George Hu, a clinical psychologist in Shanghai where masks have now become ubiquitous, and Alexander Todorov, Professor of Psychology at Princeton University and author of the book “Face Value : The Irresistible Influence of First Impressions”. Are we more versatile in interpreting a masked person’s mood or intentions than we think? Producer: Adrian Washbourne

This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved. In this podcast, Chris Imray, describes the physiological changes within the brain when exposed to the hypoxic conditions of high altitude and how our understanding of this may change the management of patients. Presented by Joff Lacey with his guest Chris Imray, a Consultant Vascular Surgeon at University Hospitals Coventry and Warwickshire NHS Trust and a Professor at Warwick Medical School. Chris is a passionate climber and has long been involved in altitude research. He was the deputy climbing leader for the 2007 Xtreme Everest expedition and was part of the summit team. 

Every week we’re heading to Southampton General Hospital, where we’ve heard a lot about the doctors and nurses doing amazing work. But this week Erika Wright has been talking to Gemma Blanchett who does a job you might not even associate with the virus or with intensive care – and that’s physiotherapy. Gemma is a respiratory physiotherapist who has the joy of watching some recover with her extraordinary help. Recovery is going to be a long haul for some and can even take time for those who’ve had the virus with mild symptoms at home. So what do we know about how long a complete recovery takes? James Gill GP and Honorary Clinical Lecturer at Warwick Medical School discusses the latest insights. For people who have already found themselves worrying excessively about their health or who have an obsessive compulsive disorder related to hand washing, this is a particularly difficult time. With all of us now on the look-out for symptoms, Claudia Hammond speaks to Jo Daniels, a Senior Lecturer in Clinical Psychology at Bath University who specialises in health anxiety, and David Adam, author of the Man Who Couldn’t Stop – an intimate account of the power of obsessional thoughts. There’s been a lot of discussion about how to get accurate numbers for the people who have died from the virus outside hospital and one issue that’s been raised is whether doctors are wary of putting Covid-19 on a death certificate, when there’s been so little testing in the community. GP Margaret McCartney examines the current dilemmas. Amidst a host of trials to find effective treatments against Covid19, are there existing drugs which no one has thought of yet? We hear from Dr Lindsay Broadbent whose team at Queens University are testing more than a thousand drugs on human lung cells infected with Covid19 in the lab, to see what might work for both mild and more severe infection. Producer Adrian Washbourne

In this episode I address some of the more common viewer questions I've received recently about being a medical student at Warwick Medical School. We'll cover finances, a typical working week and what you might choose to do/not do before starting the course.

Video consultations are the new buzz in primary care and a mandated part of the new contract from April 2020.GPs and clinicians love evidence to justify the use of any service and in this post, I cover the evidence for video consultations in-depth with Prof Helen Atherton of the Academic unit of primary care at Warwick Medical School.

Alan is an Associate Professor and Director of Social Work in the Centre for Lifelong Learning. He has been at the University of Warwick for over 20 years. Alan spent 15 years within Warwick Medical School, where he was Senior Tutor for Year One students on the MB ChB programme and Module Lead for a number of modules on the medical degree. Alan's research tends to focus on men, masculinity and health. For example, his research has examined the on-going debates between neo-materialist and psychosocial explanations for current patterns of health from a masculine/gendered perspective. This research also sought to examine the intersections of social class and masculinity for understanding current patterns of working class male health and working class men's use of healthcare services.

This special four part series explores the fascinating story of Xtreme Everest – the ground-breaking, research programme that has pursued a novel approach to scientific exploration. Over the last decade, this innovative team has performed large scale studies at high altitude to mimic some of the effects of critical illness. The objective is for their findings to be brought “from the mountainside to the bedside” so that the care for our sickest patients may be improved. In this podcast, Chris Imray, describes the physiological changes within the brain when exposed to the hypoxic conditions of high altitude and how our understanding of this may change the management of patients. Presented by Joff Lacey with his guest Chris Imray, a Consultant Vascular Surgeon at University Hospitals Coventry and Warwickshire NHS Trust and a Professor at Warwick Medical School. Chris is a passionate climber and has long been involved in altitude research. He was the deputy climbing leader for the 2007 Xtreme Everest expedition and was part of the summit team. 

There is very little guidance on withdrawing or tapering opioids in chronic pain (not caused by cancer). People can fear pain, withdrawal symptoms, a lack of social and healthcare support, and they may also distrust non-opioid methods of pain management. This can mean that patients receive repeat opioid prescriptions for extended periods of time. In this podcast, Harbinder Sandhu, health psychologist in pain management at Warwick Medical School, Andrea Furlan, associate professor of medicine at University of Toronto, and Sam Eldabe, consultant in pain medicine at The James Cook University Hospital join us to set out the evidence on tapering opioids - and give practical advice on how to support patients. We're also joined by Colin, who was prescribed opioids for a decade, before he decided to reduce his usage. What you need to know: For people with chronic pain and who do not have cancer, the benefits of long term opioids are outweighed by the issues of tolerance, dependence, and the requirement for higher doses Tapering is the gradual reduction of opioids with the aim of limiting withdrawal symptoms; it may target complete discontinuation of the opioid, or on occasion a reduction of the dose It is not clear how best to support people to taper their opioids; whether it is best done by interdisciplinary pain management programmes, buprenorphine substitution, or behavioural interventions Read the full uncertainties paper: https://www.bmj.com/content/362/bmj.k2990

Does running damage your knees? And is cycling any better? Runner, cyclist, GP and Inside Health regular, Dr Margaret McCartney goes to the new Motion Analysis Lab at Glasgow's Jubilee Hospital and asks orthopaedic surgeon and competitive cyclist Jason Roberts about the latest evidence. Around 30,000 people a year suffer cardiac arrest - their heart suddenly stops pumping blood around their body - and fewer than one in ten survive. Paramedics and ambulance crews will give CPR and use a defibrillator to try to restart the heart, and for the past 50 plus years, most patients will be given a shot of adrenaline too. But a landmark new study funded by the government and run by Warwick Medical School reveals that giving adrenaline barely increases survival and almost doubles the risk of severe brain damage. Dr Margaret McCartney discusses likely changes to policy with Dr Mark Porter. It's said that eyes are the windows to the soul - and certainly looking into other peoples' is the key part of human interaction. But what if one of yours isn't real? Sixty thousand people in the UK have an artificial eye and Europe's largest maxillo-facial laboratory at Queen Victoria Hospital in East Grinstead offers a bespoke service where specialists make individual eyes from live sittings. Susan lost one eye as a child and she tells Mark that her latest prosthesis is her favourite. Why? Because it's almost half the weight of eyes she's had fitted before. Dr Emma Worrall, principal prosthetist, has invented a lighter sphere. In a lightbulb moment sitting in a café stirring a sugar cube into her coffee and watching it melt, Emma tells Mark that she realised she could build the plastic sphere around sugar, drill a tiny hole, then melt the sugar out of the middle! Twenty patients at the hospital are now benefiting from lighter eyes (which means less surgery). And there's another plus. The new eyes float in the swimming pool and the sea! Producer: Fiona Hill.

Damian Griffin is the Professor of Trauma and Orthopaedic Surgery at the University of Warwick. He trained in Cambridge, Oxford and the United States, and worked as a Consultant in Oxford before taking up the Foundation Chair in Warwick and helping to establish Warwick Medical School. Here’s a link to his personal website: http://www.hiparthroscopyclinic.co.uk/ He was the chief investigator for the FASHioN trial, a large, multicenter randomised controlled trial of treatments for people with FAI syndrome, comparing surgery with physiotherapy-led rehabilitation:www.nets.nihr.ac.uk/projects/hta/1310302. He has published a major paper in the field of hip pain in one of the top sports medicine journals – The Lancet. Published @TheLancet on June 2nd. http://ow.ly/4LhQ30kvJ1u BJSM fortunate to have chatted with @DamianGriffin courtesy of @footballmed. Podcast about it with the BJSM community in two weeks - 15th June (all 2018). Previous podcast with Damian Griffin: About the FAI syndrome: http://ow.ly/oo7530kvJB5. Two years ago. Griffin DR, Dickenson EJ, O'Donnell J, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med2016;50:1169-1176. http://bjsm.bmj.com/content/50/19/1169 You can follow Damian on Twitter @DamianGriffin and @WarwickOrtho or reach him on damian.griffin@warwick.ac.uk

Felicity Boardman discusses genetic screening for 'serious conditions'. But what, she asks, is a 'serious condition'? The answer to that question will vary, and might increase as genomic medicine expands. The answer, too, will have dramatic consequences for which people we will accept as future members of our society, and which we will not. As a medical ethicist, and an Assistant Professor at Warwick Medical School, Felicity believes that individuals and families living with inheritable and screened-for conditions should be key to answering the question. Producer: Peter Snowdon.

We have evidence on which to act, and inaction costs lives, argues Simon Capewell, Professor of Public Health and Policy, at the University of Liverpool. But Aileen Clarke, professor of public health and health services research at Warwick Medical School, says our understanding of the human behaviour that leads to unhealthy choices is still lacking Read the head to head http://www.bmj.com/content/360/bmj.k292

Mention arthritis and most people think of older people with osteoarthritic hips or knees. But children get arthritis too, although it's an inflammatory condition where the child's immune system attacks the lining of the joints causing pain, swelling and stiffness. But the joints aren't the only part of the body affected. Around one in six of the 12,000 children in the UK with juvenile idiopathic arthritis also develop worrying inflammation in their eyes, uveitis. This is a silent, symptomless condition which can result in significant visual impairment and even blindness. But a new drug treatment, tested in the UK, has proved to be so successful for this group of children that it has revolutionised treatment both in this country and around the world. The benefits were so large that the trial was stopped early and the new therapy adopted as frontline treatment. Dr Mark Porter visits the Bristol Eye Hospital and meets paediatric rheumatology consultant, Professor Athimalaipet Ramanan to find out more. Bigger babies can get stuck in the final stages of labour - a condition called shoulder dystocia. Most are delivered safely but there are both enormous risks to the baby through lack of oxygen and a traumatic experience for the mother. Professor of Obstetrics at Warwick Medical School, Siobhan Quenby, tells Mark that a nationwide trial of big baby births aims to find out whether delivering the child two weeks early, at 38 weeks, reduces shoulder dystocia and makes the birth safer for mother and child. A report by NHS England highlights cost savings of around £100,000 for GP practices that use telephone triage for patients. But the first independent evaluation of this system, where everyone speaks to a doctor on the phone before they get a face to face appointment suggests that policy makers should reconsider their unequivocal support. Inside Health contributor Dr Margaret McCartney, herself a GP, reviews the findings. Several thousand people a year, many of them children, are admitted to hospital every year with serious burns. One of the country's leading centres for burns victims is at the Queen Elizabeth Hospital in Birmingham. As well as serving 13 million people in the local area, the Healing Foundation UK Burns Research Centre treats injured service personnel, airlifted from conflict zones in Iraq and Afghanistan. Mark gets a tour of the unit from director Naiem Moieman and finds out about the newest research on burns treatment which uses some of the oldest remedies.

In this episode Dr Alastair Canaway (Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick) presents the findings of  study which aimed to develop an outcome measure suitable for use in economic evaluation that captures the benefits of end-of-life care to those close to the dying. Full paper from: http://journals.sagepub.com/doi/abs/10.1177/0269216316650616

Professor Damian Griffin talks about the Warwick Agreement, an international consensus on the management of femoroacetabular impingement syndrome. This podcast brings you right up to date on the most current thinking about hip impingement or FAI. 0.38 Aim of the consensus 1.36 Consensus methodology 2.26 What is FAI syndrome? Symptoms, clinical signs, and imaging findings. 3.40 How should FAI syndrome be diagnosed? 6.26 What is the appropriate treatment for FAI syndrome? 8.26 What is the prognosis of FAI syndrome? 10.23 How should someone with an asymptomatic hip, with cam or pincer morphology, be managed? 11.53 What research is now needed? 14.15 How is this new definition of FAI syndrome going to influence clinical care? @DamianGriffin #WarwickAgreement Damian Griffin is the Professor of Trauma and Orthopaedic Surgery at the University of Warwick. He trained in Cambridge, Oxford and the United States, and worked as a Consultant in Oxford before taking up the Foundation Chair in Warwick and helping to establish Warwick Medical School. Damian’s passion is the diagnosis and treatment of hip and groin pain in young adults. His clinical practice and research focus on joint-preserving surgery for early arthritis, hip arthroscopy, the management of femoroacetabular impingement and sport injuries of the hip. He runs the largest national referral service for young and active people with hip pain in the UK, based at the University Hospital of Coventry and Warwickshire NHS Trust, and for private patients and elite athletes in London and Coventry (www.hiparthroscopyclinic.co.uk). Damian leads a research team based at the University of Warwick, with a portfolio of hip research. In particular he is the chief investigator for the FASHioN trial, a large, multicenter randomised controlled trial of treatments for people with FAI syndrome, comparing surgery with physiotherapy-led rehabilitation:www.nets.nihr.ac.uk/projects/hta/1310302 You can follow Damian on Twitter @DamianGriffin and @WarwickOrtho or reach him on damian.griffin@warwick.ac.uk

Every three minutes somebody in the UK develops dementia, so when it's claimed that tailored computer brain training can reduce cases of dementia and cognitive decline by a third over a decade, people sit up and take notice. The research claiming the 33% reduction for the group of people whose "processing function" was targeted for brain training, hasn't yet been published - so isn't peer-reviewed - but the preliminary data by a US team was presented to the Alzheimer's Association International Conference in Toronto this week. Dr Doug Brown, Director of R&D at the UK's Alzheimer's Society speaks from the Canadian conference to Dr Mark Porter and says there's widespread excitement about the potential of brain training to protect against dementia. Dr Margaret McCartney urges caution, warning it's too early to make claims before the full data is available. James is a young man with a high pressure sales job, but every year in the summer months he is crippled by agonising headaches. He's one of the 100,000 people in the UK who suffers from cluster headaches, so called because they come in disabling bouts, lasting for 4-6 weeks at a time. Inside Health visits a new one-stop multidisciplinary rapid-access headache clinic at St Thomas's Hospital in London, where James is getting treatment. Dr Giorgio Lambru, who heads the new service, tells Mark why it's so vital that patients with cluster headaches have to be seen, diagnosed and treated quickly. Years after cardiac rehabilitation became a standard part of therapy for heart attacks, the same post-treatment care still isn't routinely available for people who've had cancer, despite decade-old guidance from NICE suggesting that it should be. The UK's first clinical trial to measure holistic cancer care is hoping to provide the evidence that will demonstrate the type of support and rehabilitation that really works. Professor of Nursing Annie Young from Warwick Medical School and University Hospitals Coventry and Warwickshire NHS Trust tells Mark that after treatment, patients can feel abandoned and vulnerable. #hellomynameis is a hugely successful social media campaign which highlights the importance of healthcare staff introducing themselves to patients. It was launched by Dr Kate Granger after her experience of being in hospital. Kate died at the weekend from cancer, aged just 34. Dr Margaret McCartney describes the enormous impact of Kate's campaign throughout the NHS.

Damian Griffin is the Professor of Trauma and Orthopaedic Surgery at the University of Warwick. He trained in Cambridge, Oxford and the United States, and worked as a Consultant in Oxford before taking up the Foundation Chair in Warwick and helping to establish Warwick Medical School. Damian’s passion is the diagnosis and treatment of hip and groin pain in young adults. His clinical practice and research are all around joint-preserving surgery for early arthritis, hip arthroscopy, the management of femoroacetabular impingement and sport injuries of the hip. He runs the largest national referral service for young and active people with hip pain in the UK, based at the University Hospital of Coventry and Warwickshire NHS Trust, and for private patients and elite athletes at the BMI Meriden Hospital. Damian leads a research team based at the University of Warwick, with a portfolio of hip research. In particular he is the chief investigator for the FASHioN trial, a large, multicenter randomised controlled trial of treatments for people with FAI syndrome, comparing surgery with physiotherapy-led rehabilitation: http://www.nets.nihr.ac.uk/projects/hta/1310302 You can follow him on Twitter @DamianGriffin and @warwickOrtho or reach him on damian.griffin@warwick.ac.uk, at www.hiparthroscopyclinic.co.uk or +44 1926 403529. BJSM is grateful for his contribution as a Senior Associate Editor. In this podcast, Damian speaks about Sports Hip 2016, a two day international conference held at St George’s park, the home of English football. The link to conference details: http://www2.warwick.ac.uk/fac/med/research/csri/orthopaedics/sportsurgery/hip/ Podcast timeline: 0.30 - St George’s Park and the England Football Association Perform Rehabilitation Centre 1.02 - Introduction to Sports Hip 2016: First time for a multidisciplinary meeting on sports hip injuries 1.58 - Instability of the hip 2.47 - Treatment of acute subluxation or dislocation, returning to 3.23 - Deep gluteal space, piriformis syndrome and sciatic nerve entrapment 4.54 - Cartilage repair 6.04 – Workshops in hip arthroscopy, hip replacement techniques suitable for athletes 6.00 - Workshop in hip arthroscopy 6.57 - New techniques in hip replacement suitable for young active people and athletes. 7.24 - World class rehabilitation after hip surgery 7.50 - Round table on challenges in managing elite athletes 8.15 - Femoroacetabular impingement (FAI) syndrome, and the movement towards reaching a consensus statement. 11.00 - Consensus meeting on FAI syndrome

• Evidence based dentistry in decision making • Actionable tips for your practice • Protocol specifics     For many years, dentist Dr. Liviu Steier has been successfully practicing a comprehensive and holistic dentistry with a specialty in implantology.   Furthermore, Dr. Liviu Steier is a specialist in prosthetics as well as a specialist in endodontics. Through his active professorships in Italy (Florence), England (Warwick) and the USA (Boston) he has a constant direct exchange with colleagues around the world.   ***   Dr. Steier received his Doctorate in medical dentistry from the University of Medicine and Pharmacy Faculty of Dentistry in Bucharest, Romania in 1982. He is a specialist in Prosthodontics and in Endodontics, has supervised several doctoral theses, and has lectured internationally. He has been Program Director and Co-director of over 200 CE programs around the world and has published extensively including referred chapters in textbooks. He is a Fellow of different international dental academies as well as having memberships in several societies. Currently, he is on the Faculty at Warwick Medical School and has been elected Visiting Professor to other European and US Dental Schools. He is Editor-in-Chief of REALITY ENDO and maintains private practices in Mayen, Germany and London, UK.       http://www.drsteier.de

Drug Mules - Laurie Taylor talks to Jennifer Fleetwood, Lecturer in Criminology at the University of Leicester, about her study of women in the international cocaine trade. Drawing on 'in depth' interviews with female traffickers imprisoned in Ecuador, she uncovered narratives which went beyond the stock dichotomy of helpless 'victims' versus confident 'agents'. Also, a 'dads only' parenting project. Alan Dolan, Associate Professor in the Warwick Medical School at the University of Warwick, considers how learning to be a good father can clash with ideals of masculinity as well as traditional notions of fathering. Producer: Jayne Egerton.