Clinical Update

Lord Heseltine tells the story of the birth of the European Space Agency. Why post-Apollo, when the US was spending £1.2 billion a year on space, the whole of Europe was spending just £200 million. Why the birth of ESA was driven by the self-interest of three major countries. Why the US general with a $29 billion budget for the Star Wars project wanted to invest in Heriot-Watt University in Edinburgh. Why, the idea that Britain could compete alone with the technologies that were accumulated and available to the American capitalist system was “simply laughable”. Why “being European is not selling out British interests”. And why Margaret Thatcher told him: “If you want to get on and put your budget into this, you can, but you're not getting any of mine." Join Alice and Lord Heseltine as they pick apart the negotiating contrivances and the wheeling and dealing to circumnavigate “turkeys not voting for Christmas” that ultimately put European space on the map.Contributors:Alice Bunn, President of UKspace Dr Alice Bunn OBE FIMechE FRAeS CEng | LinkedInUKspace: Overview | LinkedIn Lord Heseltine, Member of the House of LordsKey topics covered:Creation of the European Space Agency (ESA)US "Star Wars" program and brain drainGeopolitical case for European R&D collaborationImpact of Brexit on science and technology

GPs and other doctors are at risk of developing abnormal coping mechanisms including addiction, but can turn things around if they spot the signs and take action, according to GP Dr Michael Blackmore. As a recovering addict, he gives advice to patients and to other GPs about how admitting problems and seeking help and support are vital, and can enable doctors to reconnect with their practice as well as their personal life.Educational objectivesAfter listening to this podcast, GPs and other healthcare professionals should be better able to:Consider why doctors are particularly at risk of abnormal coping mechanismsSpot the signs of addiction including overprescription of medicationBe aware of sources of support for doctors affected by addictionUnderstand the role of self-referral to the GMCIdentify gaps in their knowledge of drug addiction Reflect on the potential for overcoming addiction and continuing to pursue a medical careerIf you are affected by issues discussed in this podcast, remember that support is available to all doctors through the Sick Doctors Trust, the British Doctors & Dentists Group and the Practitioner Health programme.You can access the website version of this podcast, along with key learning points, on MIMS Learning. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser and note-taking for appraisal.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.MIMS LearningRegister for a FREE accountWellbeing masterclassPodcast: Dr Farnaaz Sharief on finding balance in a pressured systemHarnessing conflict for growth: strategies for healthcare teams

Bloating is a common presentation in primary care and can be caused by a wide variety of conditions, including irritable bowel syndrome, food intolerances, and small intestinal bacterial overgrowth.[Main] Bloating is a key characteristic of irritable bowel syndrome (IBS), but can also be a sign of a food intolerance (such as lactose intolerance) and small intestinal bacterial overgrowth (SIBO). In this episode of the Clinical Update podcast, MIMS Learning editors Sangeeta and Rhiannon explore the potential causes of bloating and how they should be diagnosed and managed.They review both the NICE and the Rome IV criteria for diagnosing IBS, subtypes, and management options (such as the FODMAP diet), and look at red flag symptoms that require further assessment.  They also discuss the differences between functional gastrointestinal conditions and IBS.The bidirectional relationship between eating disorders and gastrointestinal conditions, and how bile acid malabsorption can masquerade as IBS-D, are also explored.Educational objectivesAfter listening to this episode, healthcare professionals should be more aware ofHow IBS is diagnosed and managedHow functional gastrointestinal disorders differ from IBSFood intolerances (including lactose intolerance) that are associated with bloatingThe bidirectional relationship between eating disorders and gastrointestinal conditionsYou can access the website version of this podcast, along with a list of key learning points, on MIMS Learning — and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.This episode was produced by Jude Owen.MIMS LearningRegister for a FREE accountBloatingConstipation: red flags and new dietary guidelinesDisorders of gut-brain interactionIrritable bowel syndrome: clinical reviewMIMS Learning Live SouthBook for free

Around a third of patients with dementia remain undiagnosed. Dr Alistair Robertson, a GP with an extended role in frailty, provides insights for GPs and other primary care professionals on how they can address  underdiagnosis and provide support for patients and their families. He covers signs and symptoms to look out for, assessments to conduct, the role of drug treatments, and the benefits of honest conversations with patients and families.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Consider the number of patients in their practice who may have undiagnosed dementiaReflect on differential diagnoses and how to take a good historyRecall key signs and symptoms to look out for and how these may differ in different types of dementiaUnderstand the role of cognitive assessment tools and how to use themReview current drug treatments and their effectivenessExplore how to address polypharmacyUnderstand the importance of early, honest conversations with patients and familiesYou can access the website version of this podcast, along with a list of key learning points and downloadable notes written by Dr Robertson, on MIMS Learning. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser and note-taking for appraisal.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.MIMS LearningRegister for a FREE accountRelated resources from MIMS Learning and MIMSPractical advice for GPs on dementia document created by Dr Alistair Robertson.Frailty: clinical reviewGuidance update: SIGN guidelines for support of people with dementia and their carersPolypharmacy in a patient with dementia: nursing home case studyAnticholinergic cognitive burden (ACB) scores for commonly used drugs

In this episode of the Clinical Update podcast, MIMS Learning deputy editor Rhiannon and medical editor Dawn provide a comprehensive update on prostate health. High-profile figures, such as Sir Chris Hoy, opening up about their own diagnoses have significantly increased public awareness of prostate cancer. In light of this, the editors discuss the rationale for targeted prostate cancer screening and patient counselling around prostate-specific antigen (PSA) tests. The conversation also highlights health inequalities in prostate cancer diagnosis, noting that Black men have double the risk of prostate cancer compared with other groups, and highlighting care for trans women, who may remain at risk of prostate cancer after gender-confirming surgery.Beyond malignancy, this episode covers the symptoms and management of benign prostatic hyperplasia (BPH) and chronic prostatitis in primary care.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Recall draft recommendations for targeted prostate cancer screening in high-risk groupsIdentify key risk factors for prostate cancer, including ethnicity and ageOutline factors that can raise or suppress PSA levelsUnderstand the diagnostic pathway and the role of digital rectal examinationRecognise symptoms and potential complications of BPH and prostatitisYou can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.This episode was produced by Jude Owen.MIMS LearningRegister for a FREE accountExpert perspective: prostate cancer diagnosisGuidance update: NICE guidelines on prostate cancerLatest updates in prostate cancer for primary careBenign prostatic hyperplasia: clinical reviewProstate Cancer UK

In this episode of the Clinical Update podcast, Dr Louise Warburton talks to Dawn Liz Powell about the effect that obesity can have on the musculoskeletal system. She explains that if adults carry excess weight for a long time, perhaps from young adulthood, this can put additional strain on weight-bearing joints and can lead to premature wear and tear — meaning that the joints may need to be repaired or replaced.Dr Warburton, who is a GP with an extended role in musculoskeletal conditions, also talks about the importance of physical activity during childhood for developing healthy bone mass, how to sensitively raise the issue of weight loss with a person with suspected obesity-related joint pain, and how to support people with joint pain to exercise safely. The need for strength training for people on weight loss medications is also discussed during this episode.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Discuss the effect of childhood obesity on spinal developmentSensitively raise the issue of weight loss with a person with suspected obesity-related joint painReflect on the effect of GLP-1 medications on the musculoskeletal systemReview the risks of toxicity reactions to pain medications in people living with obesitySupport people with joint pain to exercise safelyUnderstand the importance of strength training for people on weight loss medicationsYou can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.MIMS LearningRegister for a FREE accountBone pain - red flag symptomsObesity in adultsPodcast: musculoskeletal disordersMIMS Healthcare NetworkMIMS table on obesity treatmentsMIMS Learning Live South (12 June, London, UK)