Saving Lives In Slow Motion: Recent Episodes

Dr Ayan Panja

Dr Ayan Panja shares his expert generalist perspective on important themes around health & wellbeing, pondering what impacts our health journeys and attitudes.

A bite-sized, enriching and quietly mind-expanding podcast. Powerful storytelling with a professional but informal laid back tone.

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Yoga has been practised for thousands of years but as many people are cynical about trying it as there are huge fans of it.

In this episode I share my own experiences and the benefits yoga can confer to our health.

Links:

Barriers to yoga (Nepalese sudy): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8039334/

Yoga effects on brain health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971819/

The warrior positions: https://www.yogawitholivia.co.uk/blog/transitions1

Yoga and inflammation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842003/

Yogic breathing benefits: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336946/

Summary of benefits and starter guide:

https://www.womenshealthmag.com/uk/fitness/yoga/a706996/benefits-of-yoga/

Yoga courses and learning: https://ukyoga.co.uk/courses/

Sacropenia and how to prevent it: https://www.healthline.com/nutrition/sarcopenia

Dean Ornish and heart disease reversal: https://jamanetwork.com/journals/jama/fullarticle/188274


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Perfectionism has risen in the workplace in recent years. It can be a huge positive in terms of work standards but also predisposes people to stress, anxiety and burnout.

In this episode I look at ways to capitalise on its strengths and mitigate any negatives. Not sure if you are one? Take the quiz below.

Links:

Take the quiz - are you a perfectionist?: https://www.livewellwithsharonmartin.com/qsm_quiz/perfectionist-quiz/

Perfectionism in younger generations: https://www.bath.ac.uk/announcements/unreasonable-demands-lead-to-substantial-rise-in-perfectionism-among-young-people/

Downsides of perfectionism: https://www.bbc.com/future/article/20180219-toxic-perfectionism-is-on-the-rise

DSM-V - classification of perfectionism: https://www.sciencedirect.com/science/article/abs/pii/S0191886914001354

Mindfulness: https://www.mindful.org/meditation/mindfulness-getting-started/


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This is an argument that rages on in the world of nutrition and medicine. In this episode I look at what food is, what it does to us in terms of our health and the mechanisms behind it and give you my verdict on whether I consider it to be medicine or not.

Ultra processed foods - review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10899807/

Protein benefits: https://www.healthline.com/nutrition/10-reasons-to-eat-more-protein

Blue Zones diets: https://www.bbcgoodfood.com/howto/guide/what-is-the-blue-zones-diet

Herbs and spices with health benefits: https://www.healthline.com/nutrition/10-healthy-herbs-and-spices

Akkermansia mucinophilia in IBD: https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.1089600/full

T Reg cells - what are they?

:https://www.frontiersin.org/articles/10.3389/fnut.2022.878382/full

Apples and their in vitro benefits: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490512/

The all important Aryl hydrocarbon receptor (now a therapeutic target for big pharmaceutical companies): https://www.sciencedirect.com/science/article/pii/S221323172300023X

Short chain fatty acids and heart disease: https://pubmed.ncbi.nlm.nih.gov/24388214/#


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High blood pressure is the biggest modifiable risk factor for cardiovascular disease, which is still the leading cause of death worldwide.

It’s often called a silent killer because it has usually has no symptoms.

This episode give you the lowdown on high blood pressure (also known as essential hypertension).

Links:

WHO page: https://www.who.int/news-room/fact-sheets/detail/hypertension

NICE guideline for hypertension: https://www.england.nhs.uk/london/wp-content/uploads/sites/8/2019/11/NICE-NG136-Visual-Summary.pdf

A summary of high blood pressure: https://www.healthline.com/health/high-blood-pressure-hypertension

Vitamin D and blood pressure in African-Americans: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775458/

Salt and potassium: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7697211/

Low carb diets and blood pressure: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695889/

Potassium enriched salt and blood pressure: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10863666/

Salt substitutes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9532913/

Measuring blood pressure: https://www.youtube.com/watch?v=mfwBpBXUYHs

Why blood pressure matters: https://www.gov.uk/government/publications/health-matters-combating-high-blood-pressure/health-matters-combating-high-blood-pressure#

Resperate - the evidence is mixed, the effects small and it is not a substitute for any medication:

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/resperate/faq-20057998#

https://northyorkshireccg.nhs.uk/wp-content/uploads/2021/04/NYCCG-Resp-Devices-Hypertension_v1.0_01.07.2021.pdf


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Mind Body Medicine is fascinating but has been poorly understood over the years. I believe it is more important to try to understand better now more than ever as we are surrounded by medically unexplained symptoms and non-communicable symptoms and diseases.

In this episode I look at the origins and theories behind it as well as link to the evidence in the show notes.

Links:

The Holmes-Rahe Stress scale: https://www.mindtools.com/avn893g/the-holmes-and-rahe-stress-scale

The effectiveness of mind-body medicine (narrative): https://journals.lww.com/mjhs/fulltext/2023/11020/effectiveness_of_mind_body_medicine.2.aspx

Somatising: https://www.psychiatry.org/patients-families/somatic-symptom-disorder/what-is-somatic-symptom-disorder

Opinion piece - a new ear of mind body medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486127/#

Views on Dr Sarno’s work: https://www.vox.com/science-and-health/2017/10/2/16338094/dr-john-sarno-healing-back-pain

Mind Body Medicine in Crohn’s Disease: https://www.frontiersin.org/articles/10.3389/fnint.2022.960301/full

Mindfulness and meditation - effects on stress:

https://www.apa.org/topics/mindfulness/meditation

Repressed emotions and physical health: https://www.healthline.com/health/repressed-emotions

Heart rate variability and stress: https://www.webmd.com/heart/what-is-heart-rate-variability

Mechanisms on how writing can help: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957853/

Journaling and heart failure: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927423/

Psychoneuroimmunology during COVID-19: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075982/

THE HEALTH FIX: https://www.amazon.co.uk/Health-Fix-Dr-Ayan-Panja/dp/1914239326/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=


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This is a super hot topic in health care in some parts of the world at the moment. In this episode I look at how these drugs work and the pros and cons of taking them for weight loss purposes.

Obesity, in some instances, is in essence a form of ‘malnutrition’ because of the nature of food consumed and how rates have increased rapidly over the last 40 years.

Body Mass Index definition: https://www.bbc.co.uk/news/av/health-21264134

Heart disease risk reduced by weight loss jab: https://www.bbc.co.uk/news/articles/cd188m73vn1o

Ultra processed food and your brain:

https://www.bbc.co.uk/food/articles/junk_food_brain

Supersize Me: https://en.wikipedia.org/wiki/Super_Size_Me

Obesity health risks: https://www.healthline.com/health/obesity/how-obesity-affects-body

The genetics of obesity: https://www.nature.com/articles/s41576-021-00414-z

The story behind semaglutide: https://www.vox.com/22553793/gila-monster-lizard-venom-inspired-obesity-drug-semaglutide

Weight loss stats on semaglutide: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/

Semaglutide can stop working and even if it works it may need to be taken forever:

https://www.medicalnewstoday.com/articles/why-weight-loss-drugs-stop-working-how-to-break-past-ozempic-plateau#Hitting-a-weight-loss-plateau-after-a-year


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CGM has changed lives for the better people with Type 1 Diabetes but nowadays people without diabetes use it as a tool. In this episode I look at the pros and cons of CGM and how it can be used as a lens into our general health and how it is linked to our gut microbiome amongst many other systems.

Links:

CGM early days review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717493/

Prof Partha Kar: https://gettingitrightfirsttime.co.uk/girft-diabetes-lead-awarded-obe-in-new-year-honours/

Red meat and gut bacteria: https://www.nih.gov/news-events/nih-research-matters/gut-microbes-affect-harmful-compound-red-meat#

Akkermansia Muciniphilia: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8726741/

Gut bugs and metabolic disease: https://joe.bioscientifica.com/view/journals/joe/248/2/JOE-20-0473.xml#

Alcohol and blood glucose: https://blog.supersapiens.com/3-ways-alcohol-affects-your-glucose-levels/

Exercise and blood sugar: https://www.sugarfit.com/blog/workout-spikes-exercise-induced-gluconeogenesis/

Glucose spikes - the dangers?: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7530333/#:

The view of Harvard on CGM without diabetes:https://www.health.harvard.edu/blog/is-blood-sugar-monitoring-without-diabetes-worthwhile-202106112473

Walking after meals: https://www.healthline.com/nutrition/walking-after-eating

Advanced Glycation End Products (AGEs): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10401445/#

THE HEALTH FIX - the ultimate health manual tailored to you: https://www.amazon.co.uk/Health-Fix-Dr-Ayan-Panja/dp/1914239326/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=


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In this episode I look at smart phones. They have changed the way we live beyond imagination

but are they doing us any harm in terms of the way we think and behave?

Links:

Life before smartphones:

https://medium.com/be-unique/before-smartphones-were-a-thing-87208717b8d7

Teenage brain: https://www.healthychildren.org/English/ages-stages/teen/Pages/Whats-Going-On-in-the-Teenage-Brain.aspx

Teenagers and smart phones: https://www.scientificamerican.com/article/are-smartphones-really-destroying-the-lives-of-teenagers/

Alpha brain waves: https://www.healthline.com/health/alpha-brain-waves#bottom-line

Multitasking and switching focus: https://neuroscience.stanford.edu/news/why-multitasking-does-more-harm-good

Phones and attention: https://www.nature.com/articles/s41598-023-36256-4#

Alpha waves: https://www.healthline.com/health/alpha-brain-waves

Dopamine fasting: https://www.sciencefocus.com/science/dopamine-fasting-smartphone-addiction


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Addictions can ruin lives but why do they occur in the first place and what can we do to acknowledge them better?

In this episode Iook at why they can be so hard to conquer and touch on different aspects of addiction.

Links:

How the addicted brain works:

https://www.yalemedicine.org/news/how-an-addicted-brain-works

Sugar - why most of us could easily have a sweet tooth: https://theconversation.com/a-taste-for-sweet-an-anthropologist-explains-the-evolutionary-origins-of-why-youre-programmed-to-love-sugar-173197

Addiction and childhood: https://www.jkacap.org/journal/view.html?doi=10.5765/jkacap.2017.28.1.4#

Heroin detox in Thailand: https://www.bbc.co.uk/news/uk-england-berkshire-13674101

Dr Gabor Maté on trauma: https://www.theguardian.com/lifeandstyle/2023/apr/12/the-trauma-doctor-gabor-mate-on-happiness-hope-and-how-to-heal-our-deepest-wounds

Gambling addiction: https://www.nhs.uk/live-well/addiction-support/gambling-addiction/

A personal story: https://www.theguardian.com/commentisfree/2019/dec/30/studied-neuroscience-understand-addictions-not-cure


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Becoming a parent is a gift but it has its challenges. In this episode I look at some factors to be mindful of including the difference between the child and adult brain plus micro tips to help navigate your way through the maze of parenthood.

Links:

Parenting styles: https://www.parents.com/parenting/better-parenting/style/parenting-styles-explained/

Brain development in children: https://www.luriechildrens.org/en/blog/early-childhood-brain-development-and-health/

Parenting styles and psychological complaints: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873100/

Hoffman Process for understanding how early life connects to your adult behaviours: https://www.hoffmaninstitute.co.uk/about-the-process/

Unconditional love: https://www.psychologytoday.com/gb/blog/peaceful-parents-happy-kids/201504/how-give-unconditional-love-your-child-and-yourself?amp

Steve Biddulph’s advice: https://www.toorakcollege.vic.edu.au/blog/steve-biddulph-key-takeaways

The Health Fix: https://www.amazon.co.uk/Health-Fix-Dr-Ayan-Panja/dp/1914239326/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=


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Skin - it’s known as our largest ‘organ’ and most of us have had some kind of skin issue.

This is my 101. Enjoy!

Guttate psoriasis: https://www.healthline.com/health/psoriasis-guttate

Pitiryiasis rosea: https://www.aad.org/public/diseases/a-z/pityriasis-rosea-symptoms

Scarlet fever: https://www.medicalnewstoday.com/articles/176242

Slapped cheek syndrome: https://www.nhs.uk/conditions/slapped-cheek-syndrome/

Omega 3 and skin: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892455/

Probiotics and skin: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9386980/

Acne: https://www.webmd.com/skin-problems-and-treatments/acne/ss/slideshow-acne-dictionary

PCOS: https://www.healthline.com/health/polycystic-ovary-disease

Rosacea: https://www.rosacea.org/patients/all-about-rosacea

Non IgE cows milk protein allergy: https://www.allergyuk.org/about-allergy/allergy-in-childhood/cows-milk-allergy/

Dermatitis herpetiformis: https://www.coeliac.org.uk/information-and-support/coeliac-disease/dermatitis-herpetiformis/

Elimination diets: https://www.healthline.com/nutrition/elimination-diet

Atopy: https://www.healthline.com/health/atopy

Demodex: https://www.healthline.com/health/demodex-folliculorum

MI allergy: https://www.webmd.com/beauty/what-to-know-about-methylchloroisothiazolinone-allergies

Contact dermatitis: https://www.healthline.com/health/contact-dermatitis

Melanoma and ABCDE: https://www.melanomauk.org.uk/the-abcde-rule

Sunlight and cancer: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4571149/


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Health screening has exploded over the last 20 years. Is it a money making exercise or actually worth it? In this episode I look at the pros and cons and how you can decide what may be worth doing and the reason people decide they need it.

Links:

UK ethics of health screening: https://www.gov.uk/government/publications/uk-nsc-ethical-framework-for-screening/uk-nsc-ethical-framework-for-screening

Health Screening - a recent paper:

https://www.ncbi.nlm.nih.gov/books/NBK436014/

RCGP screening statement around extra work for NHS GPs from screening companies: https://www.rcgp.org.uk/representing-you/policy-areas/screening

Karen Brady’s story: https://www.theguardian.com/lifeandstyle/2006/apr/20/healthandwellbeing.health1

The pros and cons of PSA testing: https://prostatecanceruk.org/prostate-information-and-support/prostate-tests/psa-blood-test

Genomic (DNA) testing for propensity to disease (eg breast cancer): https://www.nhs.uk/conditions/genetic-and-genomic-testing/

MTHFR: https://www.medicalnewstoday.com/articles/326181

Our Future Health: https://ourfuturehealth.org.uk/

Bill Turnbull's prostate cancer story: https://www.bbc.co.uk/news/health-62755001

My book THE HEALTH FIX - paperback: https://www.amazon.co.uk/Health-Fix-Dr-Ayan-Panja/dp/1914239326/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=

"The only health manual you'll ever need..." Dr Rangan Chatterjee. "...lifechanging..." Dr Rupy Aujla


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There isn’t a week in practice when I don’t get asked about food intolerances and how to test for them. It’s a contentious topic that needs

some deconstructing.

In this episode I look at what is and isn't intolerance and how to proceed if you think you have a food intolerance.

Links:

Food intolerance vs allergy - official guidance: https://www.allergyuk.org/resources/food-intolerance/

IgG testing: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004213/

Elimination diets: https://www.healthline.com/nutrition/elimination-diet

SIBO and IBS: https://pubmed.ncbi.nlm.nih.gov/29761234/

Gluten sensitivity: https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/gluten-sensitivity/

Deeper dive on mucosal tolerance: https://courses.lumenlearning.com/wm-biology2/chapter/mucosal-surfaces-and-immune-tolerance/

Milk digestion over the years: https://pubmed.ncbi.nlm.nih.gov/35896667/

My book The Health Fix: https://www.amazon.co.uk/Health-Fix-Dr-Ayan-Panja/dp/1914239326/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=


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Lyme Disease rates have doubled in the last 30 years in the USA and rates are rising across the world in affected areas. In this episode I look at Lyme, other tick-borne illnesses and the mystery symptoms they can give rise to, as well as strategies to treat and prevent them.

Lyme disease factsheet:

https://www.ecdc.europa.eu/en/borreliosis/facts/factsheet

The Bullseye rash: https://www.cdc.gov/lyme/signs_symptoms/rashes.html

The life cycle of a spirochaete: https://www.nature.com/articles/nrmicro2714

B.Burgdorferi - the major cause of Lyme disease: https://www.ncbi.nlm.nih.gov/books/NBK532894/

B.mayonii - another strain causing Lyme disease: https://www.cdc.gov/lyme/mayonii/index.html

Dr Horowitz Lyme questionnaire: https://caudwelllyme.com/do-you-have-lyme-disease-the-horowitz-questionnaire

Differentiating arthritis from Lyme Diseases: https://www.webmd.com/rheumatoid-arthritis/ra-or-lyme

Dr Horowitz interview:

https://lymeconnection.org/support_and_resources/meet_the_lyme_disease_experts.html/title/dr-richard-horowitz-latest-treatments-in-lyme-disease


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Cholesterol has become an obsession for so many people over the last 50 years. In this episode I look at the story of cholesterol and why it is important and when to worry about it.

Links:

The history of cholesterol: https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-19/history-in-medicine-the-story-of-cholesterol-lipids-and-cardiology

Food and cholesterol: https://www.health.harvard.edu/heart-health/11-foods-that-lower-cholesterol

Monacolin K (in both red yeast rice and statins): https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/monacolins

Numbers need to treat (NNT):

https://www.cebm.ox.ac.uk/resources/ebm-tools/number-needed-to-treat-nnt

Diet and statins: https://www.theguardian.com/society/2016/aug/29/mediterranean-diet-better-than-statins-for-tackling-heart-disease-study

ApoB and Lp(a): https://www.pennmedicine.org/for-health-care-professionals/for-physicians/physician-education-and-resources/physician-interviews/2023/october/lipid-management-part-3-apo-b-and-lipoprotein-a

Homocysteine and heart disease: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-01977-8

Flawed study or is it because not all LDL is bad? https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/behind-the-headlines/cholesterol-and-statins

TG:HDL ratio (Triglycerides to HDL): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664115/#:~:text=3%20The%20ratio%20of%20triglycerides,lower%20than%20this%20value4.

NICE recommendation for statins:

https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2023/january/nice-recommends-statins-should-be-a-choice-for-more-people-to-prevent-heart-attacks-and-strokes


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TW: Sensitive topic: one in six people worldwide are now affected by infertility and rates have soared over the last 30 years.

In this episode I look at the reasons behind it and what we can do about it on an individual and societal level.

Childlessness: https://www.theguardian.com/lifeandstyle/2017/oct/02/the-desire-to-have-a-child-never-goes-away-how-the-involuntarily-childless-are-forming-a-new-movement

Rising infertility in men and women: https://www.scientificamerican.com/article/reproductive-problems-in-both-men-and-women-are-rising-at-an-alarming-rate/

1:6 with infertility: https://www.theguardian.com/world/2023/apr/03/one-in-six-people-worldwide-affected-by-infertility-who-reports

Birth rates in South Korea and reasons behind them: https://www.youtube.com/watch?v=tvpkEEmnZNU

Exercise and fertility: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10310950/

Female fertility and nutrition: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634384/

Sperm counts and time of day: https://pubmed.ncbi.nlm.nih.gov/32195611/

Semen and antioxidants: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5203687

Fertility support: https://www.nhs.uk/conditions/ivf/support/

Infertility counselling: https://www.bica.net/

Buy THE HEALTH FIX now: https://www.amazon.co.uk/dp/1914239326?ref_=cm_sw_r_cp_ud_dp_S32SMEDYMC4SBPSJ4CGV


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Minor illness seems trivial, but is it always simple to deal with and when do we need to think more carefully about what can seem like minor illness on the surface?

Lay referral: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1316199/pdf/brjgenprac004944500617.pdf

The debate about doctors and Physician Associates: https://www.bmj.com/content/383/bmj.p2449

Sore throat causes: https://twitter.com/DrSteveTaylor/status/1761753922920694133/photo/1

Rincke’s oedema: https://voicefoundation.org/health-science/voice-disorders/voice-disorders/reinkes-edema/

PEWS (scoring system for acute illness in children): http://generalpracticemedicine.org/PEWSSheetApril2017Final2.pdf

Recurrent UTI: https://www.mayoclinic.org/diseases-conditions/cystitis/expert-answers/bladder-infection/faq-20057833

The role of pharmacies: https://www.england.nhs.uk/primary-care/pharmacy/community-pharmacy-contractual-framework/referring-minor-illness-patients-to-a-community-pharmacist/

Managing uncertainty in medicine: https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.51925


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In this episode I look at ADHD which is increasing in prevalence due to increased diagnoses. There are many features to this condition which need unpacking. I look at the causes, what we can do to help manage ADHD and why it occurs in the first place.

The increase in diagnosis: https://www.ucl.ac.uk/news/2023/jul/significant-rise-adhd-diagnoses-uk

ADHD and dopamine - seeking rewards:

https://www.medicalnewstoday.com/articles/325499

Time blindness: https://add.org/adhd-time-blindness/

The risk and benefits of ADHD medication: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697582/

Risk factors for ADHD: https://www.healthline.com/health/adhd/causes

Time blindness: https://www.thecut.com/2020/04/coronavirus-self-isolation-time-blindness.html

Hyperfocus: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851038/

Rating scales for children: https://www.healthline.com/health/adhd/rating-scale#symptoms-checklist

For adults (website with advice and help): https://adhduk.co.uk/adult-adhd-screening-survey/

Once of many ADHD podcasts: https://podcasts.apple.com/gb/podcast/adhd-chatter/id1677158558


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It’s something that befalls most of us as we age, but what is it?

It is a marker of vulnerability as we age and in many ways a soft tool to

predict our risk of future illness and rate of decline.

In this episode I look at how it is assessed and what we can do to prevent it.

Links:

Rockwood score: https://www.england.nhs.uk/south/wp-content/uploads/sites/6/2022/02/rockwood-frailty-scale_.pdf

Standing desks: https://www.healthline.com/nutrition/7-benefits-of-a-standing-desk

Prognosis in frailty: https://www.bgs.org.uk/resources/end-of-life-care-in-frailty-identification-and-prognostication

Ageing well: https://www.hopkinsmedicine.org/health/wellness-and-prevention/stay-strong-four-ways-to-beat-the-frailty-risk

An AI device tech example:

https://www.miicare.co.uk/

Gait analysis: https://www.frontiersin.org/articles/10.3389/frobt.2021.749274/full

Creatine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996960/


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In this episode I look at what makes for good health in children.

It’s clearly multifactorial and the latest reports show that the health of children has declined in recent years in the UK. I look at why this may be the case and what the root causes might be.

Links:

Children ‘betrayed’ in UK: https://www.bbc.co.uk/news/health-68203749

WHO website on child health: https://www.who.int/health-topics/child-health#tab=tab_1

UNICEF: https://www.unicef.org/

UNICEF child satisfaction tables: https://www.weforum.org/agenda/2020/09/child-well-being-health-happiness-unicef-report/

Child development: https://medlineplus.gov/ency/article/002002.htm

Attachment theory: https://www.verywellmind.com/what-is-attachment-theory-2795337

What every child needs: https://www.childrenscolorado.org/conditions-and-advice/parenting/parenting-articles/what-children-need/


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In this episode I look at the history of sexual health, our attitudes towards it and how we things have changed over the last 100 years.

TW: use of sexual language and references to adult themes.

HPV: https://www.nhs.uk/conditions/human-papilloma-virus-hpv

Shame and STIs: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297218/

Philadelphia trailer: https://www.youtube.com/watch?v=CKDz2LVHz0Y

Venereal Disease bill 1916: https://pubmed.ncbi.nlm.nih.gov/11589807/

Dr Kellogg: https://www.history.com/news/dr-john-kellogg-cereal-wellness-wacky-sanitarium-treatments

Erectile dysfunction and heart disease: https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction/art-20045141

Pfizer propagated the term erectile dysfunction to replace ‘impotence’:

https://www.bloomberg.com/news/features/2017-12-11/the-little-blue-pill-an-oral-history-of-viagra?leadSource=uverify wall

LARCs and teenage pregnancy: https://www.england.nhs.uk/atlas_case_study/increasing-the-uptake-of-long-acting-reversible-contraception-larc-in-general-practice/

Young men, erectile issues and pornography: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8569536/


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This week is my 100th episode. I reflect on some of the topics I have covered over the last 20 months or so and beyond

the basics I talk about what I think is the most important aspect of our health in the modern world (and it's not food or relationships)!

Links below for a deeper dive... let's go.

School resources - how the NHS works: https://www.england.nhs.uk/publication/schools-resources-toolkit/#:~:text=This%20is%20a%20toolkit%20of,NHS%20Services%2C%20health%20and%20wellbeing.

My Symptom Web via NHS England: https://twitter.com/NHS/status/1167147825815314433

MTHFR gene mutation: https://www.healthline.com/health/mthfr-gene#symptoms

MTHFR - more info: https://www.medicalnewstoday.com/articles/318526

Free coaching framework: https://www.basic-coaching.com/

Mental health app Leafyard who I am proud to partner with: https://www.leafyard.com/healthfix

How food can regain nutrients: https://www.bbc.com/future/bespoke/follow-the-food/why-modern-food-lost-its-nutrients/

Journalling for beginners: https://www.bbc.co.uk/bitesize/articles/z3hshcw

Effect of trauma on the brain: https://www.urmc.rochester.edu/news/publications/neuroscience/researchers-reveal-how-trauma-changes-the-brain

Systems Medicine - Leroy Hood: https://laskerfoundation.org/leroy-hood-there-is-going-to-be-a-fantastic-revolution-in-medicine/

Earth’s environmental problems in 2024: https://earth.org/the-biggest-environmental-problems-of-our-lifetime/

My book THE HEALTH FIX - on offer now!: https://www.amazon.co.uk/Health-Fix-Dr-Ayan-Panja-ebook/dp/B0B2VTFFVS/ref=zg_bs_g_362843031_d_sccl_1/259-3769703-6680765?psc=1

New Book: Why can’t I see my GP?: https://www.amazon.co.uk/s?k=why+can%27t+i+see+my+gp&i=digital-text&crid=3EHTLXLDL76C7&sprefix=why+can%27t+i+see+my+gp%2Cdigital-text%2C71&ref=nb_sb_noss_1


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In this episode I look at the work of doctors being done by other professionals and try to balance the issues that surround it.

Links:

My rapid response from the BMJ in 2006: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325146/

Labels and role confusion: https://www.theguardian.com/society/2023/dec/13/public-confused-over-physician-associates-working-in-nhs-research-finds

Pay issues and regulation: https://www.dailymail.co.uk/health/article-12710201/Some-physician-associates-paid-90-000-year-twice-junior-doctors-salary-not-regulated.html

A sad case of a death: https://www.bbc.co.uk/news/uk-england-manchester-66211103

Endoscopy explained: https://www.nhs.uk/conditions/endoscopy


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Meditation and mindfulness are both useful interrelated tools to improve one’s mental health.

Meditation should ideally be a regular practice and in this episode I discuss some of the benefits as well as take you through a short guided mediation on self-compassion.

Links:

Mindfulness and CBT: https://www.nature.com/articles/s41598-022-24256-9

Mindfulness and changes in the brain - neuroplasticity: https://www.youtube.com/watch?v=7CBfCW67xT8

Meditation and mindfulness nuances: https://positivepsychology.com/differences-between-mindfulness-meditation/

Mindfulness and meditation during COVID-19: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287297/

Measurement of brain responses to meditation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8638869/


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In this episode I look at the concept of ‘ideas’ rather than resolutions that might shape your 2024 on an individual and societal level, including a couple of things I managed myself in 2023.

There are also some easy hacks to incorporate into your day which can work for everyone.

My IDEAL framework for behaviour change: https://shows.acast.com/savinglivesinslowmotion/episodes/behaviour-change-2-the-ideal-framework

Circular economy: https://unctad.org/topic/trade-and-environment/circular-economy

Ban on single use plastics: https://www.bbc.co.uk/news/business-66946643

AI and personalised medicine: https://www.theguardian.com/commentisfree/2023/jun/26/ai-personalise-medicine-patient-lab-health-diagnosis-cambridge

Leafyard - AI driven mental health app with 20% off here: https://www.leafyard.com/healthfix

My talk in London on Wednesday January 10th 2024: https://www.eventbrite.co.uk/e/dr-ayan-panja-the-health-fix-tickets-753931006937

Red January: https://join.redjanuary.com/

THE HEALTH FIX - all formats, paperback out NOW. Transform your health now: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296


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In this episode I look at the true essence of health.

We live a world that is increasingly confusing in terms of health messaging and priorities given the amount of inequality in the world.

I take a look at some basics of what is important to us in our lives which people may not consider important for health but not only nourish us as humans

but are important to both our short and long term health.

Links:

Self-esteem and the brain: https://www.ucl.ac.uk/news/2017/oct/self-esteem-mapped-human-brain

Hugs (they really are good for us): https://www.healthline.com/health/hugging-benefits

Quality of Life scoring: https://positivepsychology.com/quality-of-life-questionnaires-assessments

Weightless by Marconi Union (the most relaxing tune in the world?): https://www.google.com/search?client=safari&rls=en&q=weightless+by+marconi+union&ie=UTF-8&oe=UTF-8

Social connectedness (what we know): https://www.cdc.gov/emotional-wellbeing/social-connectedness/affect-health.htm

Eating together (like my taxi driver): https://blog.swedish.org/swedish-blog/7-benefits-of-eating-together-as-a-family

Salutogenesis: https://www.local.gov.uk/case-studies/salutogenesis-introduction

Come and say Hi to me in London: https://www.eventbrite.co.uk/e/dr-ayan-panja-the-health-fix-tickets-753931006937

Pre-order THE HEALTH FIX paperback version now (thank you for your support): https://www.amazon.co.uk/Health-Fix-Dr-Ayan-Panja/dp/1914239326/ref=monarch_sidesheet


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In this episode I look at the role of our genes in health and illness.

Patterns of inherited diseases: https://www.verywellhealth.com/how-genetic-disorders-are-inherited-2860737

Epigenetics explained: https://www.theguardian.com/science/occams-corner/2014/apr/25/epigenetics-beginners-guide-to-everything

Epigenetics and inheritance: https://learn.genetics.utah.edu/content/epigenetics/inheritance

Ethics of medical genetic testing: https://pubmed.ncbi.nlm.nih.gov/24300652/

CRISPR technology: https://frontlinegenomics.com/unlocking-the-future-where-is-gene-editing-going-next/


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TW: This episode mentions PTSD.

We all know what trauma means but how and why does it affect our physical health as well as our mental health?

In this episode I look at the reasons behind trauma being a trigger for illness and what we can do to prevent its effects over the years in terms of maintenance.

Links:

Trauma informed care: https://www.gov.uk/government/publications/working-definition-of-trauma-informed-practice/working-definition-of-trauma-informed-practice

Dr Gabor Maté: https://drgabormate.com/

“Negative thinking”: Gabor Maté’s thoughts on this: https://www.reflecttherapies.com/post/the-power-of-negative-thinking

Suppressed anger and illness: https://www.frontiersin.org/articles/10.3389/fpsyt.2021.637029/full

Empaths: If empathy is about stepping into someone’s shoes, compassion is instead “a feeling of concern for another person’s suffering which is accompanied by the motivation to help”: https://www.bbc.com/future/article/20200930-can-empathy-be-bad-for-you

Dr Nicole Le Pera: https://theholisticpsychologist.com/how-to-do-the-work/

The Hoffman Process: https://www.hoffmaninstitute.co.uk/about-the-process/

The seven A’s of healing: https://taliand.com/2012/05/04/the-seven-as-of-healing/

EMDR for PTSD: https://www.ptsduk.org/treatment-help/eye-movement-desensitisation-reprocessing-emdr/

For healthcare professionals: Gabor Maté live in London: https://www.tickettailor.com/events/practiceunbound/940200


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These are both words that are bandied around quite a lot in common parlance but what do they actually mean? And what is the difference between them?

In this episode I look at the similarities, differences and why they come about.

Links:

Trump - a textbook narcissist: https://www.uu.nl/en/node/541/donald-trump-textbook-narcissist

DSM-5 classification of Narcissistic Personality Disorder: https://emedicine.medscape.com/article/1519417-overview?form=fpf

Dr James Fallon: https://www.ted.com/talks/jim_fallon_exploring_the_mind_of_a_killer?language=en

Dr Supriya McKenna - expert support resources on living and dealing with narcissists: https://www.doctorsupriya.com/

The Bad Surgeon: https://www.rollingstone.com/tv-movies/tv-movie-reviews/bad-surgeon-netflix-paolo-macchiarini-true-crime-benita-alexander-nbc-news-1234904394/

The psychopath test: https://psychcentral.com/quizzes/psychopathy-quiz

My London talk in Soho: Wednesday January 10th: https://www.eventbrite.co.uk/e/dr-ayan-panja-the-health-fix-tickets-753931006937


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Medicalisation is the how human experience becomes something that needs medical attention.

There are pros and cons of this including the ‘need’ for medicine vs something that is being sold to us something that is unnecessary.

I look at some examples in this episode and why it is something that needs consideration.

Links:

Ivan Illich: https://www.theguardian.com/news/2002/dec/09/guardianobituaries.highereducation

Sadness vs depression?: https://www.sciencedirect.com/science/article/abs/pii/S0277953617302551#:~:text=Medicalization%20describes%20a%20process%20by,normal%20behavior%20into%20medical%20conditions.

A discussion on medicalisation: https://news.harvard.edu/gazette/story/2009/04/scholars-discuss-medicalization-of-formerly-normal-characteristics

The story behind PHQ-9 and assessing depression: https://www.medicalrepublic.com.au/strange-history-of-a-depression-screening-tool/86457

Lay referral: https://bjgp.org/content/49/445/617

THE HEALTH FIX (paperback version out Jan 24)!: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296


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Integrity - most of us know what it is and value it but does it always help us or can it hinder us? In this episode I look at why is it so important to so many people, what defines it and some extreme examples.

Links:

Generic examples of integrity: https://helpfulprofessor.com/integrity-examples/

The VW scandal: https://www.bbc.co.uk/news/business-34324772

Roddick vs Verdasco (tennis): https://www.youtube.com/watch?v=bma1NZuo_o4

Integrity in the workplace: https://www.betterup.com/blog/integrity-in-the-workplace


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In this episode I conduct a whistle-stop tour of musculoskeletal health and strategies to prevent joint, muscle and ligament problems and improve our ability to keep them healthy. Some of these conditions are genetic but many are not.

Links:

Biomechanics: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266544/

Exercise and osteoarthritis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165969/#:~:text=Muscle%20strengthening%20and%20programs%20that,activity%20(e.g.%2C%20walking).

Nightshades: https://www.arthritis.org/health-wellness/healthy-living/nutrition/anti-inflammatory/how-nightshades-affect-arthritis

Oxalates and pain: https://www.dailymail.co.uk/health/article-2174474/The-GP-gave-fruit-veg-cure-aches-pains.html

Connective tissue disorders (can be genetic): https://www.healthline.com/health/connective-tissue-disease#genetic-conditions

Gout and glycation: sugar is a big culprit for joint stiffness and uric acid deposition beyond seafood, red meat, spinach and tomatoes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2234537/#

Weights and resistance training to prevent muscle mass loss as we age:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849483/#

Turmeric and health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/

Turmeric and lead: https://stanmed.stanford.edu/turmeric-lead-risk-detect/

Fish oils and pain: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494084/

Pain and trauma: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578317/

THE HEALTH FIX: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296/ref=sr_1_1?crid=2RRCBAMHYXPWK&keywords=health+fix&qid=1699533165&s=books&sprefix=health+fix%2Cstripbooks%2C76&sr=1-1


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In this episode I look at the role of faith, prayer and mindset in health.

Links:

Medical study on whether prayer works: https://www.nytimes.com/2006/03/31/health/longawaited-medical-study-questions-the-power-of-prayer.html

Tanya Luhrmann’s work: https://press.princeton.edu/books/hardcover/9780691164465/how-god-becomes-real

Positive outlooks: https://psppjournals.org/index.php/jchp/article/view/212

Think yourself young?: https://www.bbc.com/future/article/20180410-how-your-mindset-determines-your-health

The story of Buddha: https://tricycle.org/magazine/who-was-the-buddha/


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Type 2 Diabetes has doubled in the last 15 years in the UK. It is associated with potentially serious complications from kidney failure to blindness but there is a process called insulin resistance that occurs prior to its onset.

In this episode I look at the development, prevention and management of this condition.

Diabetes stats for the UK: https://www.diabetes.org.uk/about_us/news/number-people-living-diabetes-uk-tops-5-million-first-time

Diabetes prevention strategies: https://evidence.nihr.ac.uk/alert/diabetes-prevention-programme-providers-need-more-consistency-flexibility-equality-of-access/

Group consultations for Type 2 Diabetes: https://www.knowdiabetes.org.uk/professional/group-consultations/

Medication for Type 2 Diabetes: https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/treating-your-diabetes/tablets-and-medication

Air pollution and Type 2 Diabetes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6931138/

Shift work and diabetes: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-16091-y

Dr David Unwin: https://amp.theguardian.com/society/2023/apr/09/british-doctor-pioneers-low-carb-diet-as-cure-for-obesity-and-type-2-diabetes

Low carb diets: https://www.diabetes.co.uk/diet/low-carb-diabetes-diet.html

Gut microbes and Type 2 Diabetes: https://www.sciencedirect.com/science/article/pii/S0955286318303073

Evidence for CGM (continuous glucose monitoring): https://www.ajmc.com/view/continuous-glucose-monitoring-overview-features-and-evidence (eg Dexcom/ Libre)

Zoe app: https://zoe.com/ (one example of an app which combines analysis of gut microbes and CGM)

GAD antibodies and Diabetes development: https://www.healthline.com/health/diabetes/gad-antibodies

THE HEALTH FIX: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296/ref=tmm_hrd_swatch_0?_encoding=UTF8&qid=1698178460&sr=1-1


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In this episode I look at travel related illness and some tropical diseases worth knowing about.

Traveller’s tummy: https://www.health.harvard.edu/blog/travel-tummy-troubles-heres-how-to-prevent-or-soothe-them-202208042796

Diarrhoeal illness: https://www.who.int/health-topics/diarrhoea#tab=tab_1

Oral rehydration therapy: https://www.unicef.org/supply/stories/oral-rehydration-salts-and-zinc-co-packaging-offers-simple-solution-save-children-diarrhoea

Probiotics for traveller’s diarrhoea: https://www.medicalnewstoday.com/articles/saccharomyces-boulardii-probiotic

Mosquito-borne illness: https://www.worldmosquitoprogram.org/en/learn/mosquito-borne-diseases

Dengue and severe Dengue: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue

Neglected tropical disaeases: https://www.who.int/health-topics/neglected-tropical-diseases#tab=tab_1

DVT: https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/

Sunburn and skin cancer: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/sun-uv-and-cancer/how-does-the-sun-and-uv-cause-cancer


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I don’t think there is anyone on the planet that hasn’t had a cough. It’s a biological reflex in basic

terms and as it seems to occupy up to 40% of presentations to a health care provider,

I thought it would be good to cover the why what and how of this ubiquitous symptom.

Links:

The mechanism of a cough: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502102/#

The anatomy of a cough: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415124/

Long term coughs: https://www.health.harvard.edu/staying-healthy/that-nagging-cough

Red flags for coughs: https://www.pulsetoday.co.uk/clinical-feature/clinical-areas/respiratory/red-flag-refreshers-cough/

A reminder about TB (tuberculosis): https://www.who.int/health-topics/tuberculosis

Honey for cough: https://ebm.bmj.com/content/26/2/57

A functional medicine case study: https://consultqd.clevelandclinic.org/patients-25-year-cough-relieved-by-diet-and-thermal-depuration/


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How we access medical information and where it comes from is all important. It has changed hugely in the last 50 years and in this episode I look at how and why that has happened and also the future.

Change in news sources: https://pressgazette.co.uk/media-audience-and-business-data/most-popular-news-sources-uk-tiktok-ofcom-news-consumption-survey/

Cochrane: https://www.cochrane.org/

Medline (electronic library): https://medlineplus.gov/

Dipex: https://dipexcharity.org/about-us/

Electronic records: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5171496/

Medical knowledge doubles every 73 days: https://www.nature.com/articles/s43856-021-00003-5

YouTube Health: https://health.youtube/

Prof Kausik Ray’s meta-analysis (a study of studies): https://bjcardio.co.uk/2012/03/aspirin-in-primary-prevention-new-meta-analysis/

Statins - one view: https://www.bmj.com/content/348/bmj.g3458/rr/761453

Reliable health info sources (in my opinion):

https://www.healthline.com/


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Lifestyle Medicine is now a well established discipline. I look at what it means today and how it has evolved over the years since its inception and how it is indispensable in this day and age.

Bromelain: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067380/#

James Rippe: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933565/

Behaviour change in lifestyle medicine: https://www.apa.org/topics/behavioral-health/healthy-lifestyle-changes

Soleus push ups: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9404652/#

Young people and cancer: https://news.cancerresearchuk.org/2023/01/24/early-onset-cancer-why-are-more-young-adults-being-diagnosed/

THE HEALTH FIX (understanding your own story and applying it to your health): https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296/ref=monarch_sidesheet

PRESCRIBING LIFESTYLE MEDICINE (certification course - open to medics and other healthcare practitioners): https://www.practiceunbound.org.uk/product/prescribinglifestylemedicine/enrol-plm


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It’s often known as the cornerstone of the NHS but general practice is under threat and in this episode I make the case for generalism.

The power of generalism: https://www.youtube.com/watch?v=ST6XEDcD_C4

Specialists and generalists: https://www.forbes.com/sites/forbeshumanresourcescouncil/2021/03/12/generalists-versus-specialists-the-winner-doesnt-take-it-all/

Additional roles in general practice:

Expanding our workforce

england.nhs.uk

Continuity of care: https://www.bmj.com/content/375/bmj.n2468

Johari’s window - you don’t know what you don’t know: https://www.communicationtheory.org/wp-content/uploads/2013/01/johari-model.jpg

General practice under threat: https://www.nuffieldtrust.org.uk/news-item/general-practice-on-the-brink-how-did-it-get-there

GP workload: https://www.rcgp.org.uk/news/fit-for-the-future-gp-pressures-report


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In this episode I look at the reason for health inequalities, the move towards health equity and what we can do to improve access to health for all.

Kings Fund health inequalities: https://www.kingsfund.org.uk/publications/what-are-health-inequalities

Self-reported illness: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122815/

The inverse care law paper by Tudor-Hart: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(71)92410-X/fulltext

End of life and palliative care inequality: https://www.who.int/news-room/fact-sheets/detail/palliative-care

Calcutta Rescue: https://calcuttarescuefund.org.uk/


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Polypharmacy is a situation where a person is on several medications. 

It is sometimes necessary but needs to be managed and monitored to avoid harm which can be anything from minor to major.

Links:

Polypharmacy in older adults: https://link.springer.com/article/10.1007/s41999-021-00479-3

Deprescribing: https://www.bgs.org.uk/AAAdesprescribing

Drug side effects: https://www.pharmacytimes.com/view/10-scariest-prescription-drug-side-effects

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Not being able to sleep well at night can be frustrating and drive people to distraction. In this episode I look at the causes and what we can do improve our sleep.

The work of Stephanie Romiszewski: https://www.sleepyheadclinic.co.uk/stephanie-romiszewski-sleep-expert/

The stages of sleep: https://www.sleepfoundation.org/stages-of-sleep

Supplements: https://www.healthline.com/nutrition/sleep-aids

Genes and sleep: https://www.nih.gov/news-events/nih-research-matters/gene-identified-people-who-need-little-sleep

Chronotypes: https://www.sleepfoundation.org/how-sleep-works/chronotypes

THE HEALTH FIX:

amazon.co.uk

Please VOTE for SAVING LIVES IN SLOW MOTION: https://www.britishpodcastawards.com/voting


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There are so many reasons for tiredness and fatigue. In this episode I try to explain the reasons behind the symptom and how to approach it.

Links:

For cases demonstrating the Health Loop to unpack symptoms here is a link to my book The Health Fix: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296/ref=sr_1_1?keywords=Dr+Ayan+Panja&qid=1692817923&s=audible&sr=1-1-catcorr

A mechanical reason for tiredness - sleep apnoea: https://www.nhs.uk/conditions/sleep-apnoea/

How mitochondria work: https://www.khanacademy.org/science/ap-biology/cell-structure-and-function/cell-structures-and-their-functions/v/mitochondria-video

Mitochondria and fibromyalgia: https://pubmed.ncbi.nlm.nih.gov/33142767/

Autoimmune conditions can present with tiredness or fatigue: https://www.healthline.com/health/autoimmune-disorders

Leafy greens and the liver: https://www.medicalnewstoday.com/articles/324041

Antioxidants: https://www.medicalnewstoday.com/articles/what-do-we-really-know-about-antioxidants

Please vote for me in The British Podcast Awards - just type in Saving Lives in Slow Motion :

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Do you get enough down time? Do you even have time for down time?!

In this episode I briefly look at what it is and why it is important. It’s a short episode but hope you enjoy the exercise in it

and the links in the show notes.

Links:

Why down time is important: https://www.scientificamerican.com/article/mental-downtime/

How to achieve ‘flow’: https://medium.com/swlh/the-brains-default-mode-what-is-it-and-why-meditation-is-the-antidote-d0408ab989d6

The default mode network of the brain:

https://neuroscientificallychallenged.com/posts/know-your-brain-default-mode-network

The science behind down time:

https://www.psychologytoday.com/intl/blog/play-your-way-sane/202201/the-scientific-case-downtime


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Blood tests and blood results dominate a GP’s day but why do we do them and what do they mean?

In this episode I rapidly cover the rationale behind some of the more common blood tests, what they mean and why we do them in the first place.

Links:

Further details on blood tests can be found here starting with the full blood count: https://labtestsonline.org.uk/tests/full-blood-count-fbc

Vitamin D deficiency: https://www.nice.org.uk/guidance/ph56

B12 deficiency: https://www.healthline.com/nutrition/vitamin-b12-deficiency-symptoms

Medics guide to abnormal liver function tests:: https://www.bsg.org.uk/wp-content/uploads/2019/12/Guidelines-on-the-management-of-abnormal-liver-blood-tests.pdf

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Bloating is a common symptom which most of us experience from time to time acutely, (for instance if we have a tummy bug or food poisoning), but in this episode I try to unpack the potential reasons behind why bloating can occur in the first place and how to approach it. This episode is a rapid 10-minute 101. Do check out the links in the show notes.

Links:

Digestion and enzymes: https://en.wikipedia.org/wiki/Digestive_enzyme#/media/File:Digestive_Enzymes.svg

IBS (made worse by stress): https://patient.info/digestive-health/irritable-bowel-syndrome-leaflet

SIBO: https://www.healthline.com/health/sibo

H pylori infection: https://gutscharity.org.uk/advice-and-information/conditions/helicobacter-pylori/

FODMAPs (can cause gas): https://www.healthline.com/nutrition/fodmaps-101

Testing gut bugs: https://gutscharity.org.uk/advice-and-information/health-and-lifestyle/testing/gut-microbiome-poo-testing/

Ovarian cancer awareness: https://targetovariancancer.org.uk/about-ovarian-cancer/symptoms

My book THE HEALTH FIX for case studies and tips: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296/ref=monarch_sidesheet

The importance of eating dietary fibre: https://www.nhs.uk/live-well/eat-well/digestive-health/how-to-get-more-fibre-into-your-diet/

Diverticulitis: https://www.healthline.com/health/diverticulitis

Coeliac Disease, can often start with mystery symptoms: https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/

Probiotics (can sometimes help replenish good gut bacteria after antibiotic use): https://my.clevelandclinic.org/health/articles/14598-probiotics


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The world seems to be full of ‘coaches’ but what is coaching and how can it help us?

I look at some examples in this episode and how it can help develop us by helping us create change to develop ourselves.

Links:

My GP trainer Ed Peile: https://warwick.ac.uk/fac/sci/med/staff/peile/

GROW model: https://www.performanceconsultants.com/grow-model

'SMART’ goals: https://coachfoundation.com/blog/smart-coaching-model

David Rock (ARIA model): https://davidrock.net/

The Coaching Habit: https://boxofcrayons.com/boc/the-coaching-habit-book/

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Medical imaging AI:

https://www.thelancet.com/journals/landig/article/PIIS2589-7500(20)30160-6/fulltext

Generative AI: https://generativeai.net/

AI driven CBT: Leafyard.com/healthfix

AI and skin cancer diagnosis: https://www.england.nhs.uk/long-read/artificial-intelligence-helping-to-speed-up-skin-cancer-diagnosis-in-leicester-leicestershire-and-rutland-integrated-care-system/

AI and symptom assessments by Ada: https://ada.com/

AI support for doctors: https://www.forbes.com/sites/katiejennings/2023/07/17/this-ai-chatbot-has-helped-doctors-treat-3-million-people/?sh=569b58aa4cea

Can AI be dishonest? https://www.instagram.com/p/CqjNUobpedJ/?hl=en-gb


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What is therapy and why do we need it, if at all?

In this episode I look at the common types of therapy as well as touch on some alternative types and how they work and what they hope to achieve. The key is that the therapy has to fit with the person.

The origins of therapy: https://www.talkspace.com/blog/psychotherapy-history-of-therapy/

Therapeutic relationships: https://www.family-institute.org/behavioral-health-resources/importance-relationship-therapist

CBT: https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/cognitive-behavioural-therapy-cbt/

Psychodynamic psychotherapy: https://www.psychologytoday.com/gb/therapy-types/psychodynamic-therapy

Play Therapy (Samatha Boyle) https://www.plays2talk.co.uk/what-is-play-therapy-1

Avatar therapy (Professor Julian Leff’s work): https://www.bbc.co.uk/news/health-22720248

Dungeons and Dragons (role play therapy): https://www.youtube.com/watch?v=EuDJ-x9HWyc

Reference to mental health in Cambodia (now much improved): https://www.voanews.com/a/cambodias-mental-health-services-critically-neglected/2775810.html

Leafyard - an online CBT based mental health app (partnership): Leafyard.com/healthfix


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The NHS is a jewel in the crown of British culture offering free healthcare for all at times of need. But it has come under stress in recent years. In this episode I take a look back at what the NHS has achieved and why it is so important.

The birth and history of the NHS: https://www.nuffieldtrust.org.uk/health-and-social-care-explained/the-history-of-the-nhs

Continuity of care: https://www.bmj.com/content/375/bmj.n2468#:~:text=A%20new%20research%20paper%20tells,a%20reduced%20risk%20of%20death.

The cost of hospital care (bills): https://www.buzzfeed.com/daniellaemanuel/expensive-medical-bills-america

NHS staff sickness: https://www.theguardian.com/society/2023/jun/29/nhs-staff-sickness-rate-england-record-high

NHS in charts and infograms: https://www.health.org.uk/news-and-comment/charts-and-infographics

Professor Stephen Hawking on the NHS:

https://www.facebook.com/RoyalSocietyofMedicine/videos/10154984279978693

New NHS roles in the community: https://www.england.nhs.uk/gp/expanding-our-workforce/

The future of the NHS?:

https://www.nhsconfed.org/publications/renewed-vision-nhs


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Midlife can be a hard time of life to navigate, but why is that the case?

When we are younger and trying to establish ourselves we look forward to midlife but when we get there it can feel uncomfortable.

I explore why this is the case and what we can do about it

Links:

The midlife crisis: https://www.forbes.com/health/mind/midlife-crisis/

Another take: https://www.telegraph.co.uk/news/2022/09/14/truth-midlife-crises-painful-many-confront/

The happiness curve and the midlife dip: https://www.inc.com/magazine/202303/ali-donaldson/need-some-help-heres-how-to-hire-a-remote-assistant.html

Change during midlife: https://hbr.org/2008/02/the-existential-necessity-of-midlife-change

Emotional healing: https://www.psychologytoday.com/gb/blog/rethinking-mental-health/201309/10-tips-emotional-healing

U3A: https://www.u3a.org.uk/


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Medical ethics is involved in every aspect of healthcare yet it is invisible.

In this episode I look at why it is important and some of the nuances that make it a hard topic to grapple with.

Links:

Ethical principles via the Clinical Ethics Network: http://www.ukcen.net/ethical_issues/ethical_frameworks/the_four_principles_of_biomedical_ethics

The story of baby Charlie Gard: https://www.bbc.co.uk/news/health-40554462

Ethical guidance for doctors: https://www.bmj.com/careers/article/ethical-guidance-for-doctors

Private medicine: https://indianexpress.com/article/lifestyle/health-specials/private-healthcare-must-fuse-ethics-with-efficiency-8052382/

Duty of candour: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/candour---openness-and-honesty-when-things-go-wrong/the-professional-duty-of-candour

Another recent example of medical ethics in the press: https://www.theguardian.com/world/2023/jun/12/woman-in-uk-jailed-for-28-months-over-taking-abortion-pills-after-legal-time-limit

Rationing in healthcare: https://www.nature.com/articles/s41581-021-00404-8


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In this episode I look at the concept of intelligence, what it means and whether it even matters on a practical level. What are the different types, how is it measured and are there ways that we improve our IQ?

IQ testing - a discussion: https://theconversation.com/the-iq-test-wars-why-screening-for-intelligence-is-still-so-controversial-81428

Howard Gardner’s work: https://pz.harvard.edu/resources/frames-of-mind-the-theory-of-multiple-intelligences

Virginia sterilisation act 1924 based on a flawed eugenics theory: http://www2.vcdh.virginia.edu/lewisandclark/students/projects/monacans/Contemporary_Monacans/racial.html

Jason Arday: https://www.theguardian.com/education/2023/feb/23/jason-arday-to-become-youngest-ever-black-professor-at-cambridge

Young chess grandmasters: https://khelnow.com/olympics/2023-02-top-five-youngest-grandmasters-in-chess-history#

Multitasking and it’s harms: https://www.lifespan.org/lifespan-living/multitasking-and-how-it-affects-your-brain-health

The cleverest man to have ever lived? William Sidis: https://interestingengineering.com/culture/william-james-sidis

Improving intelligence: https://blogs.scientificamerican.com/guest-blog/you-can-increase-your-intelligence-5-ways-to-maximize-your-cognitive-potential/

Mensa (high IQ society): https://mensa.org.uk/


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In this episode I look at the effects of the pandemic which still linger. How has it affected us and our health and outlook?

It’s been over 3 years since COVID-19 enveloped the planet and there have been myriad effects on people which have affected us in overt and subtle ways.

Big picture effects of the pandemic:

https://www.thebritishacademy.ac.uk/publications/covid-decade-understanding-the-long-term-societal-impacts-of-covid-19/

The COSMO study:

https://www.suttontrust.com/cosmo-the-covid-social-mobility-and-opportunities-study/

The effect of the pandemic on young people: https://www.kcl.ac.uk/an-isolated-generation-the-impact-of-covid-19-on-children-and-young-people

Global perspective from Chatham House: https://www.chathamhouse.org/2022/05/how-build-better-world-post-covid-19

Rebuilding relationships:

https://facultyadvancement.duke.edu/how-can-we-rebuild-relationships-after-covid

PTSD and COVID: https://www.ptsduk.org/the-link-between-covid-19-and-ptsd/


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Neurodiversity is becoming more of an important aspect of our lives as people are increasingly becoming more neurodivergent. In this episode I look at examples, the origins of the term neurodiversity and what it means for our lives now and moving forward. And I hope you like the quote at the very end of the show.

Judy Singer: https://www.forbes.com/sites/drnancydoyle/2022/08/26/hidden-figures-in-neurodiversity-judy-singer/?sh=4ab1f6765446

The spectrum and what it means: https://www.nm.org/healthbeat/healthy-tips/autism-awareness

Spiky profiles: https://stimpunks.org/glossary/spiky-profile/

Dr Asperger: https://www.bps.org.uk/psychologist/aftermath-hans-asperger-expose

Morrisby tests: https://www.morrisby.com/

Psychometric testing: https://www.prospects.ac.uk/careers-advice/interview-tips/psychometric-tests

One example of hiring initiatives in the work place: https://www.goldmansachs.com/careers/professionals/neurodiversity-hiring-initiative.html

The Gaps Diet: https://www.gapsdiet.com/

Scattered Minds: https://www.amazon.co.uk/Scattered-Minds-Origins-Attention-Disorder/dp/1785042211/ref=sr_1_1?crid=2AWYVNX2OO5IO&keywords=scattered+minds&qid=1685032359&s=books&sprefix=scattered+minds%2Cstripbooks%2C97&sr=1-1


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Pain affects almost all of us at some point. But some types of pain is experienced more severely than other types. In this episode I look at the factors which affect pain and our perception of it and what we can do handle it better.

Nociceptors: https://www.verywellhealth.com/what-are-nociceptors-2564616

The nail in the boot: https://www.painscience.com/biblio/source-of-boot-nail-guy-a-popular-medical-anecdote-about-pain-without-injury-nociception.html

COMT gene variation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151110/

Pain and attitudes in Chinese culture: https://journals.sagepub.com/doi/10.1177/1084822314547962

Chronic pain review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676152/

CBD oil and pain: https://www.healthline.com/health/cbd-oil-for-pain

Lifestyle based approach to chronic pain: https://www.amazon.co.uk/Pain-Free-Mindset-Control-Overcoming-Chronic/dp/1785043390/ref=sr_1_1?crid=1T1RG5XNM3Q6X&keywords=the+pain-free+mindset&qid=1685171099&sprefix=the+pain-free+mindset%2Caps%2C73&sr=8-1

Latest pain research in chronic pain by Prof Shirvalkar: https://www.ucsf.edu/news/2023/05/425386/has-science-cracked-code-chronic-pain

Fibromyalgia overview: https://www.ncbi.nlm.nih.gov/books/NBK540974/#:~:text=Fibromyalgia%20is%20a%20chronic%20pain,as%20emotional%20and%20physical%20trauma.

The Health Fix: https://www.amazon.co.uk/Health-Fix-Dr-Ayan-Panja-ebook/dp/B0B2VTFFVS/ref=sr_1_1?crid=11YZREGJ7IJRN&keywords=health+fix+kindle&qid=1684931474&s=books&sprefix=health+fix+kindle%2Cstripbooks%2C83&sr=1-1. (Kindle price 99p throughout June 2023)!


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Rejection is something that affects us all but how can we minimise its effects?

The effects can be minor or major and in this episode I look at strategies for recognising that it might be an issue, how we can learn from them and how we can better handle it so that it does not continue to affect our lives negatively.

Links:

Functional MRI of the brain and rejection and links to pain: https://www.science.org/content/article/rejection-pain-brain

Long term effects of bullying: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552909/

Protected characteristics: https://www.equalityhumanrights.com/en/equality-act/protected-characteristics

Feeling rejected? https://psychcentral.com/lib/good-news-if-you-often-feel-rejected

Rejection sensitivity: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424132/

100 rejections by Jia Jiang: https://www.youtube.com/watch?v=-vZXgApsPCQ


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Is listening an undervalued skill in today’s society?

It is an essential part of communication and can have a therapeutic effect.

Listening can be a gateway to empathy and compassion and I make the case that we should all do it better before it

becomes a lost art.

Active listening outperforms simple acknowledgement: https://www.tandfonline.com/doi/full/10.1080/10904018.2013.813234

Active listening:https://psychcentral.com/lib/become-a-better-listener-active-listening

Become a better listener: https://www.nytimes.com/guides/smarterliving/be-a-better-listener

Nushu: https://nushu.com/

AI listening: https://fortune.com/2022/09/08/ai-chatbots-empathy-manager-work-careers-tech-michelle-zhou/#

The Samaritans: https://www.samaritans.org


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It’s a word and characterisation we all know and use at times. Worried about your health? Perhaps too worried? What constitutes excessive worrying about one’s health?

This episode explores the reasons behind it and what can be done to help allay health or illness anxiety.

Links:

Three Men in a Boat: https://www.goodreads.com/book/show/4921.Three_Men_in_a_Boat

Redefining hypochondriasis: https://www.mayoclinic.org/medical-professionals/psychiatry-psychology/news/dsm-5-redefines-hypochondriasis/mac-20429763

Case study: https://www.psychologytoday.com/gb/blog/neuroprogress/202005/how-i-overcame-severe-hypochondria

CBT based approach: https://www.nytimes.com/2018/06/18/well/a-new-approach-to-treating-hypochondria.html


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It’s essential to leading a healthy life but is all movement the same? Are there any common themes? What is that makes some of us enjoy exercise and others dread it. In this episode I look at the types of exercise and how we do not all have to do the same thing.

Activation therapy: https://douglasheel.com

Soleus push ups and their benefits: https://stories.uh.edu/2022-soleus-pushup/index.html

NEAT: https://www.foodspring.co.uk/magazine/how-to-increase-neat

Endorphins and exercise - feeling high on exercise: https://edition.cnn.com/2016/01/13/health/endorphins-exercise-cause-happiness/index.html

Physical activity guidelines: https://www.nhs.uk/live-well/exercise/exercise-guidelines/physical-activity-guidelines-for-adults-aged-19-to-64/

Sarcopenia: https://www.healthline.com/nutrition/sarcopenia

Dr Mike Evans '23 and a half hours' (walking for health): https://www.youtube.com/watch?v=aUaInS6HIGo

THE HEALTH FIX: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296


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Some say it’s a modern illness but accounts go back hundreds of years.

It’s the ultimate invisible illness but is actually a reaction to a stressor.

How can we handle stress, what are the different types and are there any principles we can use to deal with our stress given how individual it is.

Links:

Insomnia and stress in the BMJ in 1894: https://www.bmj.com/rapid-response/2011/10/30/bmj-110-years-later

Stress and its effects on health: https://psychcentral.com/stress/long-term-effects-of-chronic-stress-on-body-and-mind#how-to-recover

Stress in students: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8062254/

Stress and heart disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6568256/

Osler’s day-tight compartments: https://spectrummagazine.org/article/2016/06/25/living-day-tight-compartments


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We all know that friendships can be complicated. In this episode I look at why they can be important to health, how they change over the years and the different types of friendship.

Links:

Childhood friendships and adult health: https://academic.oup.com/eurpub/article/22/3/378/507548

Meaningful interactions in younger people (conclusion is interesting): https://www.frontiersin.org/articles/10.3389/fpsyg.2021.617267/full

Friendship jealousy and social media:

https://www.emerald.com/insight/content/doi/10.1108/INTR-02-2020-0103/full/html. (Listen to my episode on jealousy too)

The nun study and Alzheimers: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2734290/

Reciprocity in friendship: https://psychcentral.com/lib/fairness-and-reciprocity-in-friendships#2


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In this episode I look at the science and psychology behind kindness.

Why is kindness important? Are there any downsides?

And is it good for both the giver and receiver?

Kindness and stress:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8848115/

The doctor as a drug:

https://www.psychologytoday.com/gb/blog/the-power-rest/201103/the-doctor-is-drug

Oxytocin increases with age:

https://www.frontiersin.org/articles/10.3389/fnbeh.2022.846234/full

Spreading kindness:

https://www.kent.ac.uk/staffwellbeing/documents/Covid-19%20Articles/The%20Power%20Of%20Random%20Acts%20Of%20Kindness.html

The anatomy of kindness (Radio 4) - interviews:

https://www.bbc.co.uk/programmes/m00154cp

Study kindness (postgraduate course):

https://study-online.sussex.ac.uk/news-and-events/what-is-the-psychology-of-kindness/

Action for Happiness:

https://actionforhappiness.org

Kindness in religions:

https://www.abc.net.au/everyday/five-religious-australians-reflect-on-kindness-and-faith/11852608


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Our body clock is something most of us have heard of but is more important than we might think, as it can literally make or break our health.

It can be easy to take for granted and in this episode I look at some of the science and tips to change ‘timings’ of activities in our lives to our advantage.

Links:

Satchin Panda TEDx talk: https://youtu.be/erBJuxVR7IE

Russell Foster’s work: https://www.ndcn.ox.ac.uk/team/russell-foster

Stephanie Romiszewski’s work: https://www.sleepyheadclinic.co.uk/stephanie-romiszewski-sleep-expert/

Nobel Prize on molecular mechanisms in circadian rhythm:

The Nobel Prize in Physiology or Medicine 2017

nobelprize.org

Responding to light: https://www.npr.org/sections/health-shots/2022/12/17/1139780998/light-brain-circadian-rhythms-blind

Shift work and the WHO: https://www.iarc.who.int/news-events/iarc-monographs-volume-124-night-shift-work/

Chronotypes: https://www.healthline.com/health/chronotype


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This is a great topic which feeds into all sort including self-care, information gathering, overdiagnosis and

the accuracy of resources online plus the dangers of counterfeit medication.

Here are some interesting links:

Doctor vs Internet: https://www.bbc.co.uk/programmes/p019px0x

The pros and cons of AI based diagnosis: https://www.statnews.com/2023/02/13/chatgpt-assisted-diagnosis/

The story of AccuRx, one of a few companies which offers triage for primary care: https://www.accurx.com/our-story

Ada Health, an example of an AI driven symptom analysis: https://ada.com

Counterfeit medicines: https://www.nhs.uk/nhs-services/prescriptions-and-pharmacies/pharmacies/dangers-of-buying-medicines-online/

Overdiagnosis (there is a separate podcast episode on this topic): https://www.ncbi.nlm.nih.gov/books/NBK430655/


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This is a phenomenon that occurs when someone stops trying to escape pain or bad situations.

It is linked to depression and there are certain risk factors for it.

In this episode I look at how it can just manifest and how to help yourself out of it.

Learned helplessness - Seligman et al: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4920136/

Link to depression and anxiety: https://pubmed.ncbi.nlm.nih.gov/1185158/

The ABCDE model: https://www.verywellmind.com/learned-optimism-4174101

Cognitive distortions: https://psychcentral.com/lib/cognitive-distortions-negative-thinking#list-and-examples

Attribution testing: https://testyourself.psychtests.com/bin/transfer


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I struggle with this myself and am grateful to one of my listeners suggesting it.

In this episode I look at the reasons why some people seem to do this with ease and others seem to find

it much harder and tools that can help us make it easier.

Links:

Delayed gratification - the benefits: https://jamesclear.com/delayed-gratification

Self-awareness: https://www.betterup.com/blog/what-is-self-awareness

Self regulation theory: http://changingminds.org/explanations/theories/self_regulation.htm

ADHD and impulse control: https://www.additudemag.com/adhd-impulse-control-social-spending/

Niksen: https://www.theguardian.com/lifeandstyle/shortcuts/2019/jul/22/people-just-do-nothing-is-the-dutch-concept-of-niksen-the-best-way-to-relax


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Ever wonder what in our environment might affect our health? Often these things are ‘invisible’ or we are not consciously aware of them, but they can have a continued and profound effect on our health.

In this episode I look at some everyday environmental hazards and what we can do minimise their effects on us.

Links:

Air pollution: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044178/

Paper on micro plastics and health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068600/

Diet and air pollution: https://pubmed.ncbi.nlm.nih.gov/35179602/

Background to MI allergy: https://www.occderm.asn.au/health-professionals/epidemic-of-allergy-to-preservative-methylisothiazolinone-mi/

MI allergy and the effect of reducing it’s prevalence: https://onlinelibrary.wiley.com/doi/10.1111/jdv.15875

Social media and mental health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7785056/

Carbon monoxide poisoning: https://www.nhs.uk/conditions/carbon-monoxide-poisoning/

Sick building syndrome and mould: https://academic.oup.com/mmy/article/47/Supplement_1/S217/1073035

Minimising air pollution in a city: https://www.bbc.co.uk/news/av/health-35885569

Mercury in large fish: https://www.bbc.co.uk/news/av/health-35884051

Prescribing Lifestyle Medicine: https://www.practiceunbound.org.uk/product/prescribinglifestylemedicine/home

The Health Fix (contains my health loop): https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296/ref=nodl_?dplnkId=1ba53367-030f-4f3f-ad09-4a1fc81eadf5


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Longevity seems to be in fashion at the moment. Almost everyone wants long and healthy lives but how can we achieve that? How long is too long?

In this episode I look at commonalities between the populations on earth that live the longest ‘best’ lives.

Links:

Blue Zones - Dan Buettner’s work with National Geographic:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125071/

Smoking bans and how they change community behaviours:

https://pubmed.ncbi.nlm.nih.gov/33928714/

'Community Cure': https://www.newlocal.org.uk/articles/the-community-cure/

How disease increases with age: https://blogs.bmj.com/bmj/2018/02/01/richard-smith-doctors-and-patients-heading-in-opposite-directions/

The power of community in health: https://www.youtube.com/watch?v=8dYTa6xhHlM

The Health Fix: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296/ref=nodl_?dplnkId=1ba53367-030f-4f3f-ad09-4a1fc81eadf5


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Most people have heard of the placebo effect but is it real and why does it occur?

In this episode I look at how placebos may exert their effects and some examples of where they have worked.

Is the placebo something that can be used to our advantage? And why do some people experience a nocebo?

Links:

Ted Kaptchuk and his work on placebo:

https://www.harvardmagazine.com/2013/01/the-placebo-phenomenon

Mechanisms of the placebo effect: https://www.ncbi.nlm.nih.gov/books/NBK513296/

Knee surgery (placebo as good as surgery): https://www.nejm.org/doi/full/10.1056/NEJMoa013259

Placebo and treatment resistant depression: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784479

Nocebo: https://www.ox.ac.uk/news/science-blog/harmful-placebos

Balint and the doctor as a drug: https://www.psychologytoday.com/intl/blog/the-power-rest/201103/the-doctor-is-drug?amp


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One of the hardest things people often find is to get going with things. How do you motivate yourself and how do you keep momentum going?

I have struggled with procrastination myself in the past.

In this episode I look at ways to make motivating yourself easier, the different drivers involved and what makes us tick when it comes to turning contemplation into action.

The science motivation: https://www.apa.org/science/about/psa/2018/06/motivation

Daniel Pink on motivation: https://www.ted.com/talks/dan_pink_the_puzzle_of_motivation?language=en

How to motivate others with MI: https://motivationalinterviewing.org/understanding-motivational-interviewing

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Our monkey brain is the part of our brain that is impulsive and powerful, hijacking us when we are tired or stressed.

Ever regretted shouting at someone? Ever gorged yourself on food and then regretted it?

In this episode I explore why this happens, the links to our past experiences and our neuroanatomy.

Links:

Anatomy of the brain: https://www.hopkinsmedicine.org/health/conditions-and-diseases/anatomy-of-the-brain

Dopamine and impulsivity: https://www.jneurosci.org/content/30/26/8888

Schizophrenia and the amygdala: https://www.nature.com/articles/s41598-020-74771-w

Calming the monkey mind: https://www.psychologytoday.com/gb/blog/the-empowerment-diary/201709/calming-the-monkey-mind

Prof Steve Peters work on this subject of the chimp or monkey brain: https://chimpmanagement.com/books-by-professor-steve-peters/the-chimp-paradox/

THE HEALTH FIX: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296


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TW: (this episode mentions death)

Leadership takes many guises. Some people are born leaders and other have to learn it. What makes a good leader?

No business or organisation could survive without it and we know how bad leadership can damage organisations.

In this episode I look at types of leadership, the qualities of a good leader, what to do about toxic leaders and what sets a leader apart from other roles.

Links:

Understanding leadership: https://hbr.org/2004/01/understanding-leadership

12 types of leadership: https://www.usa.edu/blog/leadership-models/

Bad leadership: https://www.forbes.com/sites/mikemyatt/2012/10/18/15-ways-to-identify-bad-leaders/?sh=7f03512115da

Good leadership: https://www.ccl.org/articles/leading-effectively-articles/characteristics-good-leader/

Traits of successful leaders: https://www.forbes.com/sites/deeppatel/2017/03/22/11-powerful-traits-of-successful-leaders/?sh=5a85589e469f

The future of leadership: https://quantic.edu/blog/2022/08/05/the-future-of-leadership-in-2030-6-new-disruptive-trends/


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Change can be fun or stressful depending on what it is.

Until I did my GP training 20 years ago I didn’t realise that change needs to be managed. Change often happens ‘to’ us but we need to be mindful of how to manage it and particularly if we want to make changes for ourselves.

Links:

Bridges Transition model: https://wmbridges.com/about/what-is-transition/

Kotter’s Framework for change: https://www.kotterinc.com/methodology/8-steps/

The PDSA cycle: https://www.england.nhs.uk/wp-content/uploads/2022/01/qsir-pdsa-cycles-model-for-improvement.pdf

My IDEAL framework (at 29 minutes): https://www.youtube.com/watch?v=jhN12lmePQE

Order THE HEALTH FIX: https://rb.gy/uhvnxl


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Thank you for your support with the release of THE HEALTH FIX which has become an instant bestseller on Amazon.

In this episode I dive into the method of the book by going over my own health story which was the catalyst for me writing it. I then look at The Health Loop which turns 'what' into ‘why’.

I hope it makes sense and remember to cross refer to previous episodes.

Links:

Re-activation of viruses in long COVID: https://www.news-medical.net/news/20221116/SARS-CoV-2-infection-triggers-reactivation-of-latent-viruses-in-people-with-chronic-fatigue-syndrome.aspx

The effects of sleep deprivation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449130/

The ‘when’ of eating: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520689/

Stress and its effect on body function: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579396/

NICE guidance on Vitamin D supplementation: https://www.nice.org.uk/guidance/ph56

Buy THE HEALTH FIX now (UK): https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296


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Happy New Year!

In this episode I look at the different ways people approach a 'new year' and discuss the principles I use myself to get through what is undoubtedly a tough time in history.

A lot has happened over the past 2 years and we need a way of coming out of that.

What are your plans for 2023? I’d love to hear from you on my socials.

Links:

Have people changed since COVID? https://www.theguardian.com/world/2022/sep/28/covid-might-have-changed-peoples-personalities-study-suggests

Sleep: https://www.sleepfoundation.org/sleep-hygiene/why-do-i-wake-up-at-the-same-time-every-night

Generalism and why I think it is crucial to society: https://www.youtube.com/watch?v=ST6XEDcD_C4

My book THE HEALTH FIX: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296/ref=cm_cr_arp_d_product_top?ie=UTF8


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Today’s episode is on antibiotics. The balance between increasing resistance and lack of effectiveness and saving lives is increasingly difficult to navigate.

Antibiotic resistance: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance

Longer term effects of antibiotics: https://pubmed.ncbi.nlm.nih.gov/32319703/

Vitamin D and sepsis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377223/

Sepsis information: https://www.sepsis.org/sepsis-basics/what-is-sepsis/

Invasive group A strep info iGAS - a particular type of group A strep: https://www.england.nhs.uk/publication/group-a-strep/

Health Freaks trailer 2013: https://www.youtube.com/watch?v=hEGH4hfxMfU

Turmeric and infection: https://www.medicalnewstoday.com/articles/326809

THE HEALTH FIX: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296


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TW: Today’s episode is on cancer which will affect one in two people.

I look at the different types, the variables that cause it, whether there are ways of preventing cancer and also why some cancers are common and others not.

Links:

How cancer starts: https://www.nature.com/scitable/topicpage/cell-division-and-cancer-14046590/

Way are cancers on the rise?: https://news.harvard.edu/gazette/story/2022/09/researchers-report-dramatic-rise-in-early-onset-cancers/

The commonest cancers: https://www.healthline.com/health/most-common-cancers

Viruses and cancer: https://www.cancer.org/healthy/cancer-causes/infectious-agents/infections-that-can-lead-to-cancer/viruses.html

David Servan-Schreiber, the author of anti-cancer (survived over 20 years after being given 3 months to live): https://www.youtube.com/watch?v=0VNjuBgHIAw

RAS genes and signalling: https://www.frontiersin.org/articles/10.3389/fonc.2019.00965/full

Dr Carl June and CAR T cell therapy: https://www.pennmedicine.org/news/news-releases/2022/november/car-t-cell-therapy-reaches-beyond-cancer

Macmillan Cancer Support: https://www.macmillan.org.uk/


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This episode is about prevention. What do we mean by it and how can we make prevention accessible?

There is prevention on a public health level but also we take precautions as individuals.

I look at examples of both and try to separate out the different types plus a living example of prevention at work (Dr David Unwin).

Links:

Global patterns of disease: https://ourworldindata.org/burden-of-disease

Non-communicable disease: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases

Leading causes of global mortality: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

The DASH diet: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456

Turmeric and Alzheimer’s Disease: https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-018-0577-2

Press ups and heart disease: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2724778

Dr David Unwin and his work on diabetes: https://www.youtube.com/watch?v=OlKDM3SDHPA


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Personalised medicine is the future. We live in a world of AI and machine learning and the expectation of medicine is to be more precise. Can we get half way there ourselves by thinking about things a certain way? How do we get to the root cause?

Leroy Hood: https://isbscience.org/bio/leroy-hood/

P4 medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204402/

The counterpoint to P4 medicine: https://academic.oup.com/jalm/article/4/1/108/5603054

David Unwin’s work on type 2 diabetes: https://collegeofmedicine.org.uk/our-beyond-pills-campaign-dr-david-unwin-on-beating-diabetes-with-diet-and-how-his-own-merseyside-practice-has-saved-68000-a-year-on-drugs/

Group consultations:

https://www.england.nhs.uk/gp/case-studies/group-consultations-together-patients-are-stronger/

Leafyard: AI driven mental health app (COI: I am in a partnership with Leafyard): https://www.leafyard.com/healthfix


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Why is teamwork important? Are teams all they’re cracked up to be? What makes a good team? Is it personalities, culture or beyond?

In the episode I look at what makes teams work and what factors to consider when creating an effective team.

Do listen right to the end until I get to the bit where you I leave you with some thoughts as I'd love to hear your analysis

Links:

Hackman’s five factor model: http://www.free-management-ebooks.com/faqld/development-03.htm

Why teams don’t work: https://hbr.org/2009/05/why-teams-dont-work

Belbin - Dr Meredith Belbin’s tool used commonly to work out what your role in a team might be: https://www.belbin.com

A story of teams trying something different: https://willitmaketheboatgofaster.com/about/

"Forming, norming, storming and performing": https://www.mindtools.com/pages/article/newLDR_86.htm


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TW: I talk about manipulation and harm in relationships.

Toxic people drain us. Is it 'them' or their behaviours? 

Many people develop these toxic behaviours because of their early life. In this episode I discuss the features to look out for and what we can do about them. 

Toxic traits: https://www.betterup.com/blog/toxic-traits

Toxic people - another view: https://www.purewow.com/wellness/traits-of-toxic-people

Everyday narcissism: https://www.psychologytoday.com/gb/blog/the-author-speaks/201708/everyday-narcissism

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Allergies are on the rise and can range from mild to life threatening.

In this episode I look at how they originate, why they are increasing in prevalence and what we can do about it.

The show notes and links below contain texting methods and some of the many themes covered in this episode.

(TW: I talk about a case of life threatening anaphylaxis).

Links:

The allergic cascade: https://www.medicinenet.com/allergic_cascade/article.htm

Cows Milk Allergy - IgE and non-IgE: https://www.allergyuk.org/about-allergy/allergy-in-childhood/cows-milk-allergy/

Peanut allergy - the LEAP study: https://www.leapstudy.co.uk

Anaphylaxis: https://www.nhs.uk/conditions/anaphylaxis/

The Hygiene Hypothesis - outdated?: https://www.pnas.org/doi/10.1073/pnas.1700688114

Rook and the Old Friends Hypothesis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868387/

Gut flora and allergies: https://www.scientificamerican.com/article/gut-microbes-may-be-key-to-solving-food-allergies/

Intolerances: https://www.allergyuk.org/about-allergy/allergy-vs-intolerance/

Vitamin D and allergy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369152/

Immunotherapy: https://www.anaphylaxis.org.uk/fact-sheet/allergen-immunotherapy/

MI allergy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4689087/

Testing methods for allergies: https://www.medicalnewstoday.com/articles/allergy-testing


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Both of these potentially debilitating conditions are often experienced together and affect up to 1 in 4 people at any time.

In this episode I look at the underlying reasons, what we can do about them and how to approach depression and anxiety practically.

Links:

NHS waiting list: https://www.independent.co.uk/news/health/nhs-mental-health-waiting-list-b2145432.html

Definitions and statistics: https://www.mind.org.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental-health/how-common-are-mental-health-problems/

The genetic basis of depression: https://journals.lww.com/hrpjournal/fulltext/2015/01000/genetic_determinants_of_depression__recent.1.aspx

DNA methylation and depression: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6362194/

NICE guidance and treatment of depression: https://www.nice.org.uk/guidance/ng222

CBT (cognitive behavioural therapy): https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/

Adolescent depression: https://www.hindawi.com/journals/drt/2020/5951792/

Cultural influences on mental health: https://pha.berkeley.edu/2017/04/16/cultural-influences-on-mental-health/

Box breathing: https://www.healthline.com/health/box-breathing

Mindfulness (being in the moment): https://www.mind.org.uk/information-support/drugs-and-treatments/mindfulness/about-mindfulness/

The Power of Now: https://www.amazon.co.uk/Power-Now-Guide-Spiritual-Enlightenment/dp/0340733500

Pre-order my book now: THE HEALTH FIX > https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296

Leafyard (CBT based app): Leayard.com/actnow


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Jealousy is something most of us have experienced from both sides.

In this episode I look at the different types of jealousy, the reasons behind it, and discuss whether it can be ‘normal’ or not.

The evolutionary psychology of jealousy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609545/

Jealousy in the first year of life: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5302134/

Othello syndrome: https://www.medicinenet.com/othello_syndrome/definition.htm

Famous examples of jealousy from books and films: https://blog.ted.com/9-memorable-manic-moments-of-jealousy-in-literature/

Keeping up with the Joneses: https://pubmed.ncbi.nlm.nih.gov/26190653/

Managing jealousy and abusive behaviours: https://respectphoneline.org.uk/resources/resources-for-perpetrators/factsheets-hp/managing-jealousy/


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Self-care sounds pretty obvious but is it? There are so many definitions of self-care and here I make the argument that it is actually totally individual.

We know the public health messaging around the basics such as alcohol, smoking, diet, exercise and sleep, but self-care goes way beyond these.

What do you think of as self-care? We explore more in this episode.

Links:

The Health Fix (pre-order): https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296

The self-care continuum: https://www.selfcareforum.org/about-us/what-do-we-mean-by-self-care-and-why-is-good-for-people/

The benefits of exercise: https://inews.co.uk/inews-lifestyle/exercise-benefits-weekend-two-days-1874641

Garlic ; )

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7570905/

Extra Virgin Olive Oil: https://pubmed.ncbi.nlm.nih.gov/30487558/

Maslow’s hierarchy: https://www.masterclass.com/articles/a-guide-to-the-5-levels-of-maslows-hierarchy-of-needs


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TW: Today’s episode covers death.

What is a good death and is it important?

In my work I see examples of good and bad deaths depending on how it is perceived by those who bear witness to it and those left behind.

I discuss whether death planning is something we should talk about more as a society as death is an inevitable part of life.

Links:

BMJ article - A good death: https://www.bmj.com/content/320/7228/129

Elisabeth Kubler-Ross: https://www.ekrfoundation.org/elisabeth-kubler-ross/quotes/

Euthanasia: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8857436/

Merope Mills article:

https://www.theguardian.com/lifeandstyle/2022/sep/03/13-year-old-daughter-dead-in-five-weeks-hospital-mistakes

Marie Curie (end of life care charity): https://www.mariecurie.org.uk/blog/we-cant-prevent-death/153956

Death planning: https://www.mariecurie.org.uk/talkabout/articles/get-your-planning-checklist/260241

Why smell is so evocative: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3782615/

Puja flowers (my favourite smell): https://www.thedailystar.net/lifestyle/spotlight/flowers-my-goddess-159139


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Feedback is a part of everyday life. 

It is used in most industries as a learning tool but is it help or hindrance? 

Here I look at types of feedback and how we can give and receive it better.

Links:

Building a feedback culture: https://hbr.org/2013/12/building-a-feedback-rich-culture

Pendleton feedback rules: https://www.thecoach.zone/a-method-of-delivering-a-great-feedback-session-pendletons-rules/

Giving feedback effectively: https://online.hbs.edu/blog/post/how-to-give-feedback-effectively

Types of feedback: https://www.betterup.com/blog/types-of-feedback

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Failure and feelings of failure are common. Where do they come form? Why do some people feel like failures when others don’t?

I explore this and ways to combat feelings of failure in our lives.

Schema: https://www.youtube.com/watch?v=F624Baz-Vzk

Human failure and its types: https://www.hse.gov.uk/humanfactors/topics/types.pdf

Failure is essential for success: https://www.scientificamerican.com/article/failure-found-to-be-an-essential-prerequisite-for-success/

My musings on failure - BMJ 2003: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC261763/

Leafyard app - one of many CBT based apps which can help with false beliefs: https://www.leafyard.com/actnow


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TW:

This is a topic close to my heart having had colleagues and friends succumb to it. In the UK it has never been a harder time to be a doctor, but it’s not about us - burnout can affect anyone.

I hope you find the episode and these links useful.

Burnout - a paper by Prof Maslach: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911781/

Burnout and the brain: https://www.psychologicalscience.org/observer/burnout-and-the-brain

Burnout recovery tips: https://www.healthline.com/health/mental-health/burnout-recovery#assessment

Dr Claire Ashley, burnout survivor and coach: https://www.drclaireashley.com

Dr Kim Hires, TikTok burnout coach: https://www.tiktok.com/@drkimhires?is_copy_url=1&is_from_webapp=v1

For anyone working in the NHS who feels they need help for burnout: https://www.practitionerhealth.nhs.uk

Micro breaks: https://www.medicalnewstoday.com/articles/10-minute-micro-breaks-may-help-prevent-worker-burnout-study-finds


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This episode is about mentoring which I think is much needed in the world today. Many of us will have had incredible mentors who selflessly give up their time and knowledge in order to help others.

I feel it is a way of paying it forward and that both mentors and mentees to help each other grow and learn.

Beyond Ed Peile who I mention in the episode I would like to acknowledge and thank Jon Fowler, Mark Allen, Julian Godlee and my late father for their inimitable ability to mentor, inspire and transform others.

Links:

The power of mentorship: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8406889/

Mentorship behaviours: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8406889/

Mentoring for UK doctors: https://www.bma.org.uk/advice-and-support/career-progression/mentoring/mentoring-for-doctors

The 5 stages of mentoring: https://www.nihr.ac.uk/documents/phases-of-the-mentoring-relationship/27693

Ed Peile: https://warwick.ac.uk/fac/sci/med/staff/peile/


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Singing is something close to my heart and I feel it does not get enough attention for it’s

multiple health benefits.

It is accessible to so many and is an easy thing to take up and enjoy.

In this episode I explore the benefits to almost every body system which singing can confer.

Links:

Social prescribing: https://www.telegraph.co.uk/news/2017/12/26/nhs-should-prescribe-tango-dancing-book-clubs-not-pill-every/

The vagus nerve: https://www.medicalnewstoday.com/articles/318128

Alexander technique: https://alexandertechnique.com/

Breathing and singing: https://www.backstage.com/magazine/article/common-misconceptions-breath-support-singing-1872/

Singing and COPD: https://www.bbc.co.uk/news/av/health-25237125

Singing and cortisol: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854222/

Immunity and singing (in a choir): https://pubmed.ncbi.nlm.nih.gov/15669447/

The effect of singing on pain: https://journals.sagepub.com/doi/10.1177/147470491201000403

Effect on memory and cognition: https://www.sciencedaily.com/releases/2021/02/210210133432.htm

Bereavement and singing: https://spcare.bmj.com/content/early/2019/06/26/bmjspcare-2018-001642


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Triage is increasingly being used in healthcare outside the emergency setting to help filter urgent from non-urgent.

With the growing use of artificial intelligence, triage algorithms are becoming more reliable. I look at the pros and cons of triage from the view point of both patient and practitioner.

Links:

Triage and it’s background: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5649292/

Continuity of care: https://www.bmj.com/content/375/bmj.n2468

And article on the ethics of triage:

https://www.vox.com/platform/amp/coronavirus-covid19/2020/3/31/21199721/coronavirus-covid-19-hospitals-triage-rationing-italy-new-york

Sample triage protocol: https://www.medicalprotection.org/ireland/practice-matters/may-2014/example-triage-protocol-for-non-clinical-staff


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In this episode I look at symptoms affecting the gut. They are one of the most common presentations in

general practice.

Most of us experience some kind of gastrointestinal symptom at some point in our lives. I delve into my understanding on how the gut works and how and why things can go wrong and what we can do to help ourselves.

Links:

Mintel gastrointestinal problems data: https://www.mintel.com/press-centre/beauty-and-personal-care/86-of-brits-have-suffered-from-a-gastrointestinal-problem-in-the-past-year/amp

Mintel article on gut health determinants: https://www.mintel.com/blog/food-market-news/gut-health-goes-beyond-digestion/amp

Ultra-processed foods: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399967/

Aryl-hydrocarbon receptor: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5777317/

Short chain fatty acids: https://www.frontiersin.org/articles/10.3389/fendo.2020.00025/full

Diet and reflux disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702398/

H. pylori infection and reflux disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502218/

Low FODMAP diets: https://pubmed.ncbi.nlm.nih.gov/33585949/

Probiotics and their potential role in reflux disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019778/

SIBO and IBS - is there a link?: https://pubmed.ncbi.nlm.nih.gov/29761234/

Gallstones and SIBO:

https://pubmed.ncbi.nlm.nih.gov/29392773/

A review of inflammatory bowel disease (Crohns and Ulcerative colitis): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6685307/

‘Red flag’ gut symptoms needing medical assessment: https://bowelinterestgroup.co.uk/resources/red-flag-symptoms-in-gi-conditions/

Diverticulitis: Diverticulitis: Symptoms, Causes, Diagnosis, Treatment, Surgery (healthline.com)

The popular ‘4 R’s of gut health’: https://thenutritionalinstitute.com/resources/blog/292-the-4-r-s-of-gut-health


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TW Today’s episode is on a topic which affects us all.

Prejudice, bias and inclusion are all ongoing hot topics which can affect our wellbeing, how we feel about ourselves and our experience of the world.

Here I look at the reasons why it is such a complex area to navigate and not as simple as it should be.

There are some anecdotes on this episode that might be difficult to listen to.

Links:

Protected characteristics: https://www.equalityhumanrights.com/en/equality-act/protected-characteristics

A paper on similarities and differences in people and their perceptions: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00849/full

Health inequalities and gender: https://eurohealthnet.eu/publication/gender-health-and-inequalities-before-and-after-the-pandemic-where-we-go-from-here/

Microsoft video training on bias and inclusion: https://www.microsoft.com/en-us/inclusion-journey/learn

Medical regulators and racism: https://blogs.bmj.com/bmj/2021/06/29/racism-and-the-general-medical-council/

The 2004 film Crash that cleverly gets under the belly of prejudice and bias: https://youtu.be/DEJH0hEoHc4


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This framework that I have created helps turn what is in your mind into action.

IDEAL:

Identify, Define, Engage, Activate and Look Back

One of the hardest things can be to turn intentions into reality. This simple framework along with the work of known behavioural theory experts can help implement your behaviour change intentions.

Links:

BJ Fogg behaviour model: https://behaviormodel.org/

Susan Michie and COM-B: https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-6-42

Pre-order your copy of The Health Fix now: https://www.amazon.co.uk/Health-Fix-Ayan-Panja-ebook/dp/B0B2VTFFVS/ref=mp_s_a_1_1?qid=1655897648&refinements=p_27%3AAyan+Panja&s=books&sr=1-1


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This is such a trenchant topic and I wanted to cover it for so many reasons.

Most of us get some kind of brain symptom at times but it is short lived, but that is not the case for many people. Alzheimer’s Disease is the commonest form of dementia affecting over 60% of all dementia sufferers worldwide.

This episode looks at the determinants of brain health and the aetiology of Alzheimer’s Disease.

Links:

Facts, figures and information on dementia: https://www.who.int/news-room/fact-sheets/detail/dementia

Food and brain health: https://www.healthline.com/nutrition/11-brain-foods (did not focus on this in the episode but in case you want to know more).

Brain health and food chat with @Doctors_Kitchen: https://www.listennotes.com/podcasts/the-doctors/8-eat-to-boost-your-brain-W4eh8cIyNHf/

The hippocampus and memory: https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.12009

Association between diabetes and Alzheimer's Disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265876/

The ApoE gene: https://www.frontiersin.org/articles/10.3389/fnins.2021.630502/full

Cognitive stimulation therapy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639131/

Alzheimer’s support: https://www.alzheimers.org.uk/

101 on Alzheimer’s Disease - what it is and it’s pathology: https://www.nia.nih.gov/health/what-happens-brain-alzheimers-disease

Treatment of Alzheimer’s Disease: https://www.alzheimersresearchuk.org/dementia-information/types-of-dementia/alzheimers-disease/treatments/


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Sometimes in order to get to the underlying reason behind symptoms that may arise from your lifestyle and environment.

It is a way of dissecting an area that may need more focus, for instance: diet, environment, movement, sunlight exposure, sleep, historic infections and your family history.

They are good tools to use if you are not making huge progress with conventional habit changes.

Links:

Some benefits of a health diary: https://blog.vantagefit.io/health-diary/

Caffeine overload? https://www.healthline.com/nutrition/caffeine-side-effects

Fish in your diet - risks and benefits: https://www.bbc.co.uk/news/av/health-35884051

Methylisothiazolinone and skin: https://mi-free.com/

Back pain and posture: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828513/

Foot shapes: https://www.healthline.com/health/types-of-feet#pronation-and-supination


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Self talk is something we all do. It’s how communicate with ourselves and it can have a significant

impact on our health.

In this episode I give examples of cognitive distortions which can lead to poor self esteem, false beliefs and negative thinking.

Links:

Cognitive distortions and CBT: https://positivepsychology.com/cognitive-distortions/

Monkey brain: https://www.forbes.com/sites/alicegwalton/2017/02/28/8-science-based-tricks-for-quieting-the-monkey-mind/?sh=699868ec1af6

Self help therapies and mental health apps: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/self-help-therapies/

There are many mental health apps which may be of benefit and there is also scope for doing CBT online. Disclosure: I am medical adviser to a web-based app called Leafyard which is AI driven and based on CBT: Leafyard.com/actnow


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This week I cover the topic of overwhelm, suggested by a listener.

It’s a feeling we all know and dislike. I try to get under its belly and look at the causes behind it as well

as solutions to minimise the chance of it arising.

Links:

Overhelm and burnout: https://careerpivot.com/2020/overwhelm-and-burnout-whats-the-difference-guest-post/

Saying no: https://tinybuddha.com/blog/stop-saying-yes-want-say-no/

Perfectionism and its pitfalls: https://www.bbc.com/future/article/20180219-toxic-perfectionism-is-on-the-rise

Anxiety and overwhelm: https://www.calmclinic.com/anxiety/symptoms/feeling-overwhelmed

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This week I discuss supplements. It’s a veritable minefield.

How do you know the quality of what you are taking?

Are there some supplements that are essential and others that should be avoided?

I give you my take on all this and more in this episode.

Links:

Vitamin D NICE guidance: https://www.guidelines.co.uk/nutrition/nice-vitamin-d-guideline/252552.article

Types of vitamin D: https://www.healthline.com/nutrition/vitamin-d2-vs-d3

B12 deficiency symptoms: https://www.healthline.com/nutrition/vitamin-b12-deficiency-symptoms

Do probiotics work? https://www.scientificamerican.com/article/do-probiotics-really-work/

Digestive enzymes: https://www.hopkinsmedicine.org/health/wellness-and-prevention/digestive-enzymes-and-digestive-enzyme-supplements

Antioxidants: https://www.frontiersin.org/articles/10.3389/fphys.2020.00694/full

A great go to resource for truly independent analyses and views on supplementation: https://examine.com/supplements/

Signs of nutrient deficiency: https://www.rush.edu/news/6-signs-nutrient-deficiency


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The How, What and When of our habits can have significant effects on our health.

Here are some papers on related topics. The abstracts make interesting reading.

Time restricted eating - changing when you eat: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262456/

Sleep - the how and when: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3174832/

Morning exercise: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492403/

Weblink for exercise: https://www.healthline.com/health/fitness-exercise/best-time-to-workout#The-Case-for-Sweating-in-the-Afternoon,-or-Night

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In this episode I cover the concept of adding in and removing. It seems devilishly simple but can have profound effects on health.

This is one of many concepts I cover in my book which is out in January 2023.

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My book The Health Fix launches next January in 2023 and I submitted my draft last month. I wanted to let listeners know about what inspired the book and how it might be of help.

It is a toolkit for self care like no other (in my opinion)! I will be sharing some vignettes from it over the next few weeks which I hope you enjoy.

Links:

Pre-order The Health Fix: https://www.amazon.co.uk/Health-Fix-Ayan-Panja-ebook/dp/B0B2VTFFVS/ref=mp_s_a_1_1_nodl?qid=1655897648&refinements=p_27%3AAyan+Panja&s=books&sr=1-1

Monkey brain: https://www.stress.org/please-meet-your-monkey-mind


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Relationships (good ones) are essential to our lives. What do they go wrong and what factors are at play?

How do we sustain them and what are the basic underlying pillars that make or break them?

They need work and attention and there are many ways of looking at them.

Links:

Psychotherapist Esther Perel: https://www.estherperel.com/

Transactional analysis and the work of Eric Berne: https://ericberne.com/

Dysfunctional relationships: https://www.psychologytoday.com/gb/blog/rediscovering-love/201401/is-your-relationship-dysfunctional

How to improve relationships: https://www.psychologytoday.com/gb/blog/mate-relate-and-communicate/201412/10-ways-improve-any-relationship


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This episode is about loneliness. Why is loneliness an issue? What are the different types of loneliness and how do we define them?

I look at this huge issue which is a global issue that can be deceptively hard to identify.

Loneliness by country: https://www.statista.com/statistics/1222815/loneliness-among-adults-by-country/

Social isolation and health: https://www.cdc.gov/aging/publications/features/lonely-older-adults.html

Loneliness can be as bad as smoking 15 cigarettes a day: https://www.inc.com/amy-morin/americas-loneliness-epidemic-is-more-lethal-than-smoking-heres-what-you-can-do-to-combat-isolation.html

Intergenerational connection: https://www.theguardian.com/society/2018/nov/12/children-care-homes-residents-feel-more-human

Seal (Killer - live in Paris): https://www.youtube.com/watch?v=V5xAyX_U2GM


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Today’s episode is all about empathy.

Is it valued in today’s society? Is it important to us as human beings and what does it mean to you?

Health care and the role of empathy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151200/

Physician empathy and patient satisfaction: https://www.prnewswire.com/news-releases/physician-empathy-a-key-driver-of-patient-satisfaction-300228070.html

The three types of empathy: https://www.inc.com/justin-bariso/there-are-actually-3-types-of-empathy-heres-how-they-differ-and-how-you-can-develop-them-all.html

Some evidence that social media may actually marginally improve empathy (no causality): https://www.researchgate.net/publication/336326078_Social_Media_Use_and_Empathy_A_Mini_Meta-Analysis

An expert view on empathy and reasons for it decreasing: https://genius.com/Dr-sara-h-konrath-why-is-empathy-decreasing-annotated


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This week’s episode is all about time. The pandemic, people’s loss and the state of the world right now has brought time into sharp focus. Is it really the only thing that matters? I talk about ways that I have managed to see time in a different way and share some perspectives on how we might look at it and mould it to suit our own lives.

Links:

Myths about time management: https://www.forbes.com/sites/forbescoachescouncil/2018/11/05/11-time-management-myths-that-are-hurting-your-productivity/?sh=2fbb64254f80

Time management grid (leaving everything to the last minute makes it become urgent and important):

https://weekplan.net/academy/weekly-planning/4-quadrants-of-time-management

Time perspectives: https://psychcentral.com/lib/whats-your-time-perspective#1

Volunteering: https://worksmart.org.uk/news/any-volunteers-how-giving-your-free-time-good-your-career

Ferris Bueller: https://www.youtube.com/watch?v=vsYBtfQ3QDo

ABC method and time management grid: https://s3.wp.wsu.edu/uploads/sites/471/2019/08/Prioritization-Methods.pdf

A great conversation between Sadiq Khan and Alistair Campbell: https://www.youtube.com/watch?v=qeA-7oS1Lhk


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Language is important in all walks of life and has changed hugely over the years because

of how humans communicate.

In this episode I look at its importance and its role in health and medicine, nuances in language and how we can try to work out what someone means from what they say.

You can cross reference to my episode on Consultations which overlaps with this nicely and covers the way in which we communicate.

Links:

Rita Charon's work on narrative medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949238/

John Launer’s 7 C’s: https://www.gp-training.net/communication-skills/communication-skills-theory/narrative-based-medicine/

Interesting paper on language, culture and medicine: https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1060&context=fmch_articles

Pragmatics in language: https://all-about-linguistics.group.shef.ac.uk/branches-of-linguistics/pragmatics/what-is-pragmatics/


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This episode is all about perspective.

How can we improve our ability to look at other’s points of view and

why is it so important?

Can we avoid conflict by being mindful about language and behaviours?

Protected characteristics: https://www.equalityhumanrights.com/en/equality-act/protected-characteristics

Taking perspective:https://www.psychologytoday.com/gb/blog/the-power-personal-narrative/201906/the-power-perspective-taking

Perceptual positions: https://www.brilliantminds.co.uk/video-perceptual-positions/

The age of the individual?: https://www.theguardian.com/books/2020/jan/16/the-age-of-the-individual-must-end-tom-oliver-the-self-delusion


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We know what wellbeing means - or do we?

What does it really mean and how do we acknowledge and make it a priority at work and in our

lives?

One of my friends triggered this episode having been unsure how to acknowledge and accommodate wellbeing at work.

In this episode we look at the determinants of wellbeing and how to take practical steps to improve yours.

Links:

World Health Organisation: https://www.who.int/about/governance/constitution

Various wellbeing wheels: rb.gy/pxbmfq

What Works Wellbeing: https://whatworkswellbeing.org/resources/wellbeing-evidence-at-the-heart-of-policy/

Educating Ruby by Claxton and Lucas: https://www.amazon.co.uk/Educating-Ruby-Children-Really-Learn/dp/1845909542

Wellbeing stories (for children): https://www.wellbeingstories.com/

AI driven mental health app for which I am medical adviser: https://www.leafyard.com/actnow


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Today I’ll be looking at medical myths. It’s a fascinating area which most of us will be able to relate to.

How many times have you found yourself saying we only use 10% of our brains

or that you should feed a cold and starve a fever?

I’d love to hear your experiences of this via Insta, Twitter, LinkedIn or FB.

Here are some links based on the show for more info:

Do we only use 10% of our brains? https://www.bbc.com/future/article/20121112-do-we-only-use-10-of-our-brains

Is crossing your legs bad for you? https://www.bbc.com/future/article/20151013-is-crossing-your-legs-bad-for-you

Greying hair: https://www.sciencedaily.com/releases/2021/06/210622154339.htm

Feed a cold, starve a fever? https://www.healthline.com/health/feed-a-cold-starve-a-fever

Health Freaks 2013: https://www.youtube.com/watch?v=hEGH4hfxMfU

Garlic and libido (a study): https://pubmed.ncbi.nlm.nih.gov/24844765/

An apple a day keeps the doctor away: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2210883


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Today’s episode is about medical diagnosis. It’s a tricky business and

as patients we want to make sure the diagnosis is as accurate as possible without

something being missed or the opposite - the risk of overtreatment.

I look at the role of screening and talk through some of the challenges we face as both patients and

clinicians.

Links:

Improving diagnosis: https://www.improvediagnosis.org/stories/ (USA based)

Screening and ethics which govern it in the NHS: https://www.gov.uk/government/publications/uk-nsc-ethical-framework-for-screening/uk-nsc-ethical-framework-for-screening

“Too much medicine”: https://www.bmj.com/too-much-medicine

Overdiagnosis: https://www.bmj.com/content/362/bmj.k2820

Ivan Illich and his Medical Nemesis: https://www.rcpe.ac.uk/sites/default/files/jrcpe_46_2_omahony_0.pdf

Achenbach syndrome (just FYI): https://casereports.bmj.com/content/13/9/e238156

Medically unexplained symptoms: https://bjgp.org/content/67/656/106

Bill Turnbull documentary: https://www.channel4.com/programmes/bill-turnbull-staying-alive


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Impostor syndrome affects up to 70% of people and I see it so often that I wanted to look at what it is, where it came from and what we can do about it.

It’s a fascinating phenomenon which once uncovered can lead to self-exploration and changing our thoughts.

Links:

The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy: Theory, Research & Practice, 15(3), 241–247:

https://psycnet.apa.org/record/1979-26502-001

Latest large scale review study on Impostor syndrome: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174434/

Dr Valerie Young: https://impostorsyndrome.com/

An article I wrote many years ago:

"Failures can be the pillars of success”:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC261763/

CBT techniques which may help: https://www.healthline.com/health/cognitive-restructuring


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Medical errors are common and need to be minimised. They are the 3rd commonest cause of death in the USA.

In this episode I look at why these errors happen and what we can do to prevent them.

Links:

Patient safety (WHO): https://www.who.int/news-room/fact-sheets/detail/patient-safety

Surgical safety checklist (WHO): https://www.who.int/teams/integrated-health-services/patient-safety/research/safe-surgery/tool-and-resources

Martin Bromiley’s charity looking at human factors: https://chfg.org/chfg-history/

PIP implant update: https://www.bbc.co.uk/news/health-57179180

Consent: https://www.nhs.uk/conditions/consent-to-treatment/

PALS (NHS): https://www.nhs.uk/nhs-services/hospitals/what-is-pals-patient-advice-and-liaison-service/

HealthWatch: https://www.healthwatch.co.uk/what-we-do


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This episode is about grief and bereavement.

It is different for everyone but I share my own experience of it here.

Links:

The Kubler-Ross stages of grief: https://www.healthline.com/health/stages-of-grief

Transgenerational grief: https://www.griefrecoverymethod.com/blog/2018/01/transgenerational-grief

Theories on grief: https://griefjourney.co.uk/startjourney/for-professionals-and-caregivers/articles-for-professionals-and-caregivers/theories-of-grief/

General bereavement support: cruse.org.uk

Support for grieving children: https://www.winstonswish.org/

Support for grieving parents: https://www.careforthefamily.org.uk/family-life/bereavement-support/bereaved-parent-support


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What exactly is resilience?

Is it more than being able to recover from adversity or stresses?

It’s a term that has annoyed me in the past so I wanted to get under it’s belly and explore where it came from beyond flexibility and adaptability in thinking or

handling stressful situations.

The work of Emmy Werner fascinates me and I try to draw out her key findings.

Summary article by Dr Werner: https://www.sciencedirect.com/science/article/abs/pii/1054139X92901577

Dr Werner’s longitudinal study: https://psycnet.apa.org/doiLanding?doi=10.1111%2Fj.1939-0025.1989.tb01636.x

Resilience in healthcare: https://bmjopen.bmj.com/content/10/1/e031765

Mayo Clinic tips on resilence: https://www.mayoclinic.org/tests-procedures/resilience-training/in-depth/resilience/art-20046311


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Today I’ll be talking about Lifestyle Prescriptions, covering what they are and how you can make a start on generating them for yourself starting with The Symptom Web® - a really simple concept which I devised and continue to teach on Prescribing Lifestyle Medicine

Prescribing Lifestyle Medicine: https://www.practiceunbound.org.uk/product/prescribinglifestylemedicine/home

Gut flora and antibiotics: https://atlasbiomed.com/blog/probiotics-after-antibiotics/

Caffeine and migraines: https://www.healthline.com/health/migraine/caffeine-migraine


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This episode is all about consultations, their history, evolution and how to get the most out of them with your health care practitioners.

Dr Michael Balint: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1464079/

Dr Milton Erickson: https://www.erickson-foundation.org/

Continuity of care: https://bmjopen.bmj.com/content/8/6/e021161

The Patient Revolution: https://www.amazon.co.uk/dp/B07Q8YTYTG/ref=dp-kindle-redirect?_encoding=UTF8&btkr=1

Consulting models for GPs: https://www.gponline.com/consultation-models-practice/article/988629

Person centred care and social prescribing: https://www.rcgp.org.uk/clinical-and-research/our-programmes/about-person-centred-care.aspx


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Today we're talking all about invisible illnesses, in particular long covid and the explosion in the need for mental health support.

Here are some links that might be of interest:

Mental health information: mind.org.uk

ZOE: https://covid.joinzoe.com/

Long Covid: https://www.nice.org.uk/guidance/ng188

A ‘pacing’ resource: https://www.torbayandsouthdevon.nhs.uk/uploads/24053.pdf

High blood pressure: https://www.healthline.com/health/high-blood-pressure-hypertension#overview

Rolling with resistance - https://sbirt.publichealthcloud.com/resources/images/MI%20Strategy%20-%20Roll%20with%20Resistance%20-%20Updated.pdf


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Welcome to episode one of Saving Lives In Slow Motion.

Today I'll be talking about behaviour change, whether it's giving up smoking, exercising more or just spending less time on your phone - making a change can be difficult.

I share the real reasons people change their behaviours and how you can too.

Show notes:

Here are some links that might be on interest.

BJ Fogg’s simple but effective method on behaviour change: https://tinyhabits.com/start-tiny/

Experts, including myself, talking about behaviour change during the pandemic: https://www.bbc.co.uk/sounds/play/m000mzm7

Neuroplasticity - how the brain changes as your behaviours change: https://www.verywellmind.com/what-is-brain-plasticity-2794886

For more from me click here


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Dr Ayan Panja shares his perspective on the most important themes which impact our health & wellbeing and ponders on what we can do to improve our own health journeys. Bite-sized enriching episodes with an informal laid back tone which to make you sit back, think and create change.