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Surgeon's anger at Hammersmith Bridge closure after patient died while he was stuck in traffic - MyLondon
For Martin Hayward, a cardiothoracic surgeon living in Barnes, it has drastically increased his journey times when he is called to perform life-saving surgery.

“Cardiothoracic surgeons are a specialist service. We're only in 28 hospitals across the whole country and there’s not many of us in London. So we’re on-call all the time,” said Mr Hayward.

Many of the call-outs are to the National Heart Hospital in Westmoreland Street, central London. But occasionally he’ll need to drive to Barnet Hospital, or The Whittington Hospital in Highgate, journeys which he now says are a “nightmare”.

“I have to go in once a fortnight, either for a stabbing or a cardiac arrest. Those journeys are now genuinely a nightmare thanks to having to fight through all the traffic.”
cycling  driving  medicine  London 
6 weeks ago by juliusbeezer
What Will You Say to Your Grandchildren? - EcoWatch
"likelihood" and "inevitability" stand a long way from each other. As Rebecca Solnit points out in Hope in the Dark, hope is not a prognostication. Taking either an optimistic or pessimistic stance on the future can justify a cop-out. An optimist says, "It will turn out fine so I don't need to do anything." A pessimist retorts, "Nothing I do will make a difference so let me not waste my time." Hope, by contrast, is not a matter of estimating the odds. Hope is an active state of mind, a recognition that change is nonlinear, unpredictable, and arises from intentional engagement.

Bendell responds to this version of hope with a comparison to a terminal cancer patient. It would be cruel, he suggests, to tell them to keep hoping, pushing them to "spend their last days in struggle and denial, rather than discovering what might matter after acceptance." This is a false equivalency. A terminal cancer condition has a statistical history, derived from the outcomes of many thousands of similar occurrences. Our current situation is unique. There is no history available of thousands of global civilizations bringing their planetary ecosystems to breaking point. This is the only one we know of, and it would be negligent to give up on it based on a set of projections. If a doctor told your mother, "This cancer is unique and we have no experience of its prognosis. There are things we can try but they might not work," would you advise her to give up and prepare for death? I'm not giving up on Mother Earth that easily.
climatechange  politics  psychology  medicine 
may 2019 by juliusbeezer
Clinical Orthopaedics and Related Research, The Bone & Joint... : JBJS
Preprint servers may be perceived by some (and used by less scrupulous investigators) as evidence even though the studies have not gone through peer review; the public may not be able to discern an unreviewed preprint from a seminal article in a leading journal. We are concerned that publishing in a preprint server may be a self-serving move by individuals with secondary-gain incentives and by those whose work is unlikely to withstand serious scrutiny by peer-reviewed journals.
scholarly  sciencepublishing  archiving  preprint  medicine  peerreview 
march 2019 by juliusbeezer
How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure | British Journal of Sports Medicine
Results We included a total of 391 RCTs, 197 of which evaluated exercise interventions (10 461 participants) and 194 evaluated antihypertensive medications (29 281 participants). No RCTs compared directly exercise against medications. While all medication trials included hypertensive populations, only 56 exercise trials included hypertensive participants (≥140 mmHg), corresponding to 3508 individuals. In a 10% random sample, risk of bias was higher in exercise RCTs, primarily due to lack of blinding and incomplete outcome data. In analyses that combined all populations, antihypertensive medications achieved higher reductions in baseline SBP compared with exercise interventions (mean difference −3.96 mmHg, 95% CrI −5.02 to −2.91). Compared with control, all types of exercise (including combination of endurance and resistance) and all classes of antihypertensive medications were effective in lowering baseline SBP. Among hypertensive populations, there were no detectable differences in the SBP-lowering effects of ACE-I, ARB, β-blocker and diuretic medications when compared with endurance or dynamic resistance exercise. There was no detectable inconsistency between direct and indirect comparisons. Although there was evidence of small-study effects, this affected both medication and exercise trials.

Conclusions The effect of exercise interventions on SBP remains under-studied, especially among hypertensive populations. Our findings confirm modest but consistent reductions in SBP in many studied exercise interventions across all populations but individuals receiving medications generally achieved greater reductions than those following structured exercise regimens. Assuming equally reliable estimates, the SBP-lowering effect of exercise among hypertensive populations appears similar to that of commonly used antihypertensive medications. Generalisability of these findings to real-world clinical settings should be further evaluated.
medicine  exercise  health  drugs 
january 2019 by juliusbeezer
There is no version of Brexit which will benefit the NHS—only varying degrees of harm - The BMJ
It is likely that there will be provision for doctors and nurses coming to the UK after Brexit, albeit at extra cost and bureaucracy, if the government—as it has indicated—follows the guidance of the Migration Advisory Committee. But the effect on the social care workforce and those who rely on them for care will be particularly significant because of the salary threshold of £30,000.

Just over 5% of the regulated nursing profession, 16% of dentists, 5% of allied health professionals, and around 9% of doctors are from elsewhere within the EEA. We cannot afford to lose or further demoralise those who have given so much to our health service. That so many colleagues now feel unwelcome, as a result of the divisive and xenophobic rhetoric of the last campaign, shames us all.
Brexit  uk  medicine  politics 
november 2018 by juliusbeezer
The forensic pathologist who got PTSD: ‘Cutting up 23,000 dead bodies is not normal’ | Science | The Guardian
Shepherd’s career as one of the UK’s most distinguished forensic pathologists saw him involved in disasters from the Hungerford shootings to the Bali bombings, and in high-profile cases from Harold Shipman to Stephen Lawrence...
it wasn’t a particular incident that left him immobilised by dread, struggling with sleep and plagued by panic attacks. Instead, it was the gradual accumulation of stress from 30 years confronting violence and the grave, the steady buildup of emotional damage from putting 23,000 dead bodies under the knife...
Shepherd’s mother succumbed to the heart condition that had dogged her for years in 1962, when he was only nine. As well as doing all the shopping and cooking, Shepherd says his father unlocked stores of kindness and affection that were often untapped in men of his generation. But when a friend brought a copy of Simpson’s Forensic Medicine into school, Shepherd found himself fascinated by the gallery of stranglings, knifings, shootings and electrocutions the textbook contained. Between those tatty red covers, the worst that could happen – the terrible thing that had, in fact, already happened – was laid out, anatomised and dissected...


While he prided himself on his ability to switch between mortuary and home, from objective investigator to loving husband and father, his marriage was beginning to show signs of strain, eventually collapsing in 2007. Although his wife would ask him to “show some emotion”, he says, “I hadn’t realised that it was so tightly screwed down. I was blocking the emotion that was bad, but I was also blocking the emotion that was good.”
medicine  health  psychology  spectacle  education 
september 2018 by juliusbeezer
ACS Advocates a Consensus Strategy to Prevent Injury, Disability, and Death from Firearms
The ACS COT’s Consensus Strategy views firearm injury and mortality in the larger context of violence toward oneself or others, which is a major cause of unnecessary injury and death in the United States, claiming on average 175 American lives every single day.*

“To reduce death and disability associated with firearm injuries, we have to think about the strategies that cover the entire spectrum of violence-related events: how firearms are stored in the home, recognition that people who are at risk of self-harm or domestic violence should not have access to weapons, and addressing the causes of interpersonal violence. These strategies don’t get a lot of attention. These are not controversial ideas. All are achievable and could make a huge impact in terms of reducing injury, disability, and death,” said Eileen M. Bulger, MD, FACS, Seattle, Wash., current ACS COT Chair.
Violent Intentional Injuries and Deaths Are a Neglected Public Health Crisis

In 2016, the most recent year for which data are available, a firearm was involved in 51 percent (22,938) of suicides and 75 percent (14,415) of homicides. Since 1999 there has been a 17 percent increase in firearm-related intentional injury death rates; over the same time period, there was a 22 percent decrease in traffic-related deaths.*

Since 2014, the ACS COT has been engaged in a firearm-injury prevention consensus-building project that involved surveys of its members and the ACS Board of Regents and Board of Governors, town hall meetings, and outreach to a broad group of stakeholder organizations.
us  politics  deaths  guncontrol  medicine  healthcare  health 
september 2018 by juliusbeezer
Hunt and May apologise for Gosport hospital deaths | Society | The Guardian
An independent inquiry, published on Wednesday, found that 456 patients died and possibly 200 more had their lives shortened because of the routine practice at Gosport War Memorial hospital.The inquiry, led by the former bishop of Liverpool James Jones, concluded that Dr Jane Barton, the GP who ran wards at Gosport War Memorial hospital, routinely overprescribed drugs for her patients in the 1990s. Consultants were aware of her actions but did not intervene.
Gosport hospital: more than 450 patients died due to opioid drugs policy
Read more

The panel said concerns were raised as early as 1988, and three years later when a staff meeting was held supposedly for nurses to address the issue it “had the effect of silencing the nurses’ concerns”.
medicine  drugs  deaths 
june 2018 by juliusbeezer
Illness and Attitude – Richard Holton's 3rd Uehiro Lecture | Practical Ethics
Although there is little empirical research directly on this question, Holton draws on research on self-efficacy to support his initial hypothesis that the conception of a disorder one has may play a role in the course that it takes. Self-efficacy refers to the concept that an individual’s beliefs about their ability to succeed in a particular task can significantly influence how they approach that task. Crucially in the current context, if I don’t believe that I will be able to succeed in task X, I will be less able to adopt coping behaviours, and to sustain effort in the face of obstacles to achieving X. To extend this to addiction, it seems plausible to suppose that if I believe that I cannot overcome an addictive craving, my low self-efficacy judgement will mean that I will be less likely to exert the sort of effort that might in fact lead me to succeed in resisting the craving.

Rather than focus primarily on addiction though, Holton’s main focus in this lecture is on psycho-somatic illness. These illnesses might plausibly be understood as extreme cases of something like the phenomenon Holton is interested in, namely, attitudes mediating illness in some sense.
medicine  psychology  drugs  healthcare  philosophy 
june 2018 by juliusbeezer
Relaxe pour l’automobiliste qui avait mortellement percuté un cycliste - La Voix du Nord
Une lumière aveuglante qui l’éblouissait malgré son pare-soleil. Les gendarmes ont d’ailleurs fait état de cette même gêne à laquelle ils ont dû faire face en arrivant sur les lieux du drame ce matin-là...
Aucune faute de conduite n’avait été relevée par l’enquête et tous les tests toxicologiques d’usage en matière d’accident routier étaient revenus négatifs. C’est logiquement que l’affaire avait été classée sans suite...
Les parties civiles s’appuient sur la maladie de Parkinson dont le prévenu est atteint depuis 2009 et qui a la particularité d’être dégénérative. Prendre le volant constituerait selon eux une imprudence. Mais le prévenu suivait son traitement lui permettant d’atténuer les tremblements. Le tribunal a considéré qu’il n’y avait pas de faute de conduite pouvant lui être imputée, prononçant une relaxe.
driving  france  medicine  crash_report  drugs  deaths  disease 
march 2018 by juliusbeezer
The case for consistent use of medical eponyms by eliminating possessive forms
Unfortunately, despite criticisms, the possessive forms of medical eponyms remain in common use (e.g., Down’s syndrome rather than Down syndrome). Inconsistency in the use of eponyms in medical literature poses a problem not only to scholarly writing, but also to medical education [2]. Whereas the possessive form was applied nearly universally to medical literature from 1960s until the early 1970s [3], arguments both for and against the use of possessive medical eponyms emerged in the mid-1970s. Since then, however, there has been a slow move away from the use of possessive medical eponyms. “Stigler’s law of eponymy” from 1980 stated that no scientific discovery should be named after its original discoverer [3]. In addition, the World Health Organization in 2004 and the American Medical Association in 2007 advocated for eliminating the possessive form [4, 5].
editing  medicine 
march 2018 by juliusbeezer
Schmidt sting pain index - Wikipedia
The Schmidt sting pain index arose from the pursuit of a larger hypothesis: that the evolution of sociality in Hymenoptera was dependent on the evolution of venom that was both painful and toxic.[16] Pain is an advertisement of damage in the body, but molecules that produce pain and those that are toxic, and actively cause damage, are not the same. Although the painful signal acts as a deterrent, intelligent predators will learn the dishonesty of this signal with repeated exposure – that there is no real damage being done.[17] For the early Hymenoptera that were primarily solitary, the pain alone would allow them the chance to escape. Furthermore, solitary insects do not provide a high energy reward for predators, and therefore predators do not expend significant effort to hunt them. However, with the evolution of sociality where many Hymenoptera cluster together in colonies, nests become a nutritionally rich and therefore worthwhile target.[18] If there were no defenses, predators would devour the defenseless society, leaving few surviving individuals and eliminating social reproduction.[17] Sociality would therefore not be beneficial. In order for sociality to evolve, Hymenoptera needed a defense beyond a painful sting to protect their whole colony. Their sting was an advertisement of damage, and toxicity evolved as its truth.
evoscidebate  insects  medicine  psychology 
january 2018 by juliusbeezer
Whose interests are the GMC really trying to serve in the Bawa-Garba case?
When I look at some of the arguments advanced in the Crown Court by both the defence and prosecution I cannot quite believe such arguments were part of criminal proceedings. A significant amount of them were technical points relating to the clinical assessment of shock. How has a junior doctor found themselves in the dock in criminal proceedings arguing that they were “correct to be cautious about introducing too much fluid into the [patient] because of his heart condition”? Together with the prosecution, in order to gain a conviction making points about capillary refill and high levels of lactate in the blood. It was also decided to to use Dr Bawa-Garba’s educational ePortfolio reflections against her, this will have a catastrophic effect on a future doctor’s ability to reflect openly and honestly about serious incidents and mistakes.
medicine  law  uk  healthcare 
january 2018 by juliusbeezer
Down and Almost Out in Scotland: George Orwell, 1948, and Nineteen Eighty-Four | Absolutely Maybe
Random allocation of patients to receive some of the limited supply of streptomycin was an equitable way of distributing the drug. It was also the way to find out more about the magnitude of streptomycin’s beneficial effects in a form of TB from which many people recover spontaneously, and about the drug’s unwanted effects, including the development of drug-resistant forms of TB. The first patients entered the trial in 1947.

Orwell’s hospital was not one of the hospitals in the trial: in fact, no Scottish hospital was included (MRC 1948b). That didn’t make any difference for Orwell – he wouldn’t have been eligible to participate in the study for several reasons, including his age (he was too old).

However, even with narrow entry criteria, the trial did help many people. Instead of languishing for months on a waiting list, being chosen for the trial meant that people were admitted to hospital within a week, even if they weren’t going to end up in the group of patients randomized to receive the drug.
orwell  medicine  healthcare  science 
january 2018 by juliusbeezer
Why I Don’t Have a Sobriety Date | The Fix
It's not a magical fix for addiction. There is no magical fix for addiction. By the time I decided I wasn't going to track my sobriety date anymore, I was already involved in outpatient recovery. I had professional support, peer support, and medication-assisted treatment to help me along. But I realized that by fixating on my sober time, I was setting myself up for devastation if a relapse happened. I decided to shift my focus from the length of my sobriety to the quality of my recovery, and it worked...
Recovery is about much more than sobriety. I don't know my exact sobriety date, but I do know that I've been in recovery about four years, which is considerably longer than the time it's been since I last used. That's because my recovery is not only defined by abstinence from addictive substances...
When people celebrate their sobriety birthdays, it's supposed to be a celebration of their accomplishments. I think a more palatable way to celebrate recovery is to consider every day that I'm working toward a better future a success. Instead of one birthday, I celebrate myself every day, the same way I destroyed myself every day during my active addiction.
drugs  psychology  medicine 
november 2017 by juliusbeezer
How did the BMA get bicycle helmets so wrong? | At War With The Motorist
Which is why British doctors should be embarrassed that the British Medical Association currently lobbies for helmets to be compulsory when riding a bicycle. Imagine if a pharmaceutical company developed a drug which, if administered before receiving a specific kind of traumatic injury, makes that injury easier to treat. Imagine doctors and medical scientists lobbying for it to be compulsory for everybody to take this drug daily, without anybody ever having checked for side-effects.

How has this situation arisen? The policy decision has largely been made on the insistence of A&E consultants and trauma surgeons. Consider the anonymous quotations that are scattered through the BMA’s cycling pages:
helmetwars  medicine  cycling 
november 2017 by juliusbeezer
Santiago Ramon y Cajal: "The Father of Neuroscience" - Brain Connection
Cajal added several levels of preparation and made other refinements as the debate over the true structure of the central nervous system was intensifying. While no one had yet seen an entire nerve cell, or could tell whether it was independent or just part of a larger structure, some scientists already questioned the old “single network” theory. Fridtjof Nansen, better known today for his Arctic explorations, had joined several others in theorizing that nerve cells were independent, basic structures. Still, almost everyone else, including Golgi and Cajal, believed in the network structure.

cajaldrawIn 1887, Cajal became chair of Normal and Pathological Histology at the university in Barcelona. His most consuming work, however, was slicing, soaking, staining and affixing to glass slides, slivers of the cerebellum of the embryo of a small bird. Then he carefully drew what he saw under the microscope. He became an ardent convert to the independent-cell camp.
history  medicine  science  philosophy 
october 2017 by juliusbeezer
Learn more about OpenTrials
Open Knowledge is developing Open Trials, an open, online database of information about the world’s clinical research trials. We are funded by The Laura and John Arnold Foundation through the Center for Open Science. The project, which is designed to increase transparency and improve access to research, will be directed by Dr. Ben Goldacre, an internationally known leader on clinical transparency.

OpenTrials is building a collaborative and open linked database for all available structured data and documents on all clinical trials, threaded together by individual trial. With a versatile and expandable data schema, it is initially designed to host and match the following documents and data for each trial:

Registry entries
Links, abstracts, or texts of academic journal papers
Portions of regulatory documents describing individual trials
Structured data on methods and results extracted by systematic reviewers or other
Researchers
Clinical Study Reports
Additional documents such as blank consent forms, blank case report forms, and protocols

The intention is to create an open, freely re-usable index of all such information, to increase discoverability, facilitate research, identify inconsistent data, enable audits on the availability and completeness of this information, support advocacy for better data and drive standards around open data in evidence-based medicine.
science  medicine  sciencepublishing  openmedicine  openscience  research  search 
october 2017 by juliusbeezer
Analyzing the side effects of common drugs; questioning conventional pregnancy wisdom - The Washington Post
The Web site eHealthMe.com aims to help people connect the dots between the drugs they take and how they feel. The site, which is free, merges social media and medical data to help people get to the root of their problems.

Users can find studies, anonymously ask a question or peruse queries posed by others. The site provides an extensive database of the possible side effects of 45,000 drugs, vitamins and supplements; it also connects users with other people who suffer from similar problems.

Questions are not answered by medical professionals. Instead, when someone posts a question, the site invites other eHealthMe users of the same gender and similar age who have taken the same medications to answer the question. As the site warns, this does not replace the advice of a doctor, but knowing, for example, that you’re not the only one who has experienced sudden hearing loss when using eye drops is comforting. It may also help users ask better informed questions when they do seek medical help.
socialmedia  socialnetworking  internet  medicine 
september 2017 by juliusbeezer
GPs in England 'unconfident' discussing physical activity with patients – report | Society | The Guardian
Set out in July 2011 by the Chief Medical Office, national guidelines recommend that adults aged between 19 and 64 undertake 75 minutes of intense activity or 150 minutes of moderate physical activity a week.

But in 2015-16 more than a quarter of adults in England were deemed “inactive”, undertaking physical activity for less than half an hour a week.

Now a nationwide study [published in BrJGP] has revealed that 80% of GPs in England say they are unfamiliar with the national guidelines, and more than one in seven doctors say they are not confident raising the issue of physical activity with their patients.

“Many people have described [physical activity] as the most cost-effective drug we have, yet we are not implementing it properly,” said Justin Varney, co-author of the research from Public Health England (PHE). “This is as appropriate as having a conversation about smoking,” he added.
medicine  uk  exercise 
september 2017 by juliusbeezer
Margaret McCartney: Why GPs are always running late | The BMJ
As a colleague puts it, general practice is based on a lie—a lie that we can do this safely and well in 10 minutes. I reckon that acceptably safe practice would take double that, and excellent practice would need more again to ensure that everything’s in place for proper, shared decision making.
medicine  uk  attention 
september 2017 by juliusbeezer
Letting neural networks be weird • A neural network invents diseases you don’t want...
Strecting Dissection of the Breath
Bacterial Fradular Syndrome
Milk Tomosis
Lemopherapathy
Osteomaroxism
Lower Veminary Hypertension Deficiency
Palencervictivitis
Asthodepic Fever
Hurtical Electrochondropathy
Loss Of Consufficiency
Parpoxitis
corpus  learning  medicine  funny 
august 2017 by juliusbeezer
Can we trust research in science and medicine? | Practical Ethics
Readers of the Practical Ethics Blog might be interested in this series of short videos in which I discuss some of the major ongoing problems with research ethics and publication integrity in science and medicine. How much of the published literature is trustworthy? Why is peer review such a poor quality control mechanism? How can we judge whether someone is really an expert in a scientific area? What happens when empirical research gets polarized? Most of these are short – just a few minutes. Links below:
medicine  ethics  video 
august 2017 by juliusbeezer
There’s plague in Arizona. Authorities warn of fleas that can infect people and pets. - The Washington Post
@optometrist: I am right and the comment is not uncharitable. We're living in a time where people mouth off on subjects they have NO knowledge about and make comments that are wholly unfounded in fact and learning. I have no problem in telling them they're wrong about microbes in the hopes that they'll cease and desist. It is misinformation and outright lies that have lead to a record number of children not being vaccinated for measles, mumps, rubella, diphtheria, pertussis and tetanus AND subsequent outbreaks in measles and pertussis in California. The arrogance of ignorant people knows no bounds and I have no problem refuting the crapola they spout online.
commenting  medicine 
august 2017 by juliusbeezer
One man's mathematical formula for happiness | The Independent
one man says he has come up with a mathematical solution. Mo Gawdat was miserable for several years in his twenties and thirties despite his high-flying job, income and happy family unit. Determined to turn this around Gawdat, an engineer by trade who is now an executive at Google, formulated an equation for happiness.

A couple of years later, he put this to the test when his 21-year-old son Ali died unexpectedly in what should have been a routine operation.

He has now shared the secrets to his formula for being happy – no matter what life throws at you – in his new book Solve For Happy...

Due to the circumstances of Ali’s death, senior officials in Dubai that Gawdat knew asked if he would mind them requesting an autopsy...

“Nibet said in her own very wise way, as always, ‘Will it bring Ali back?’’ This question came four hours later [after Ali’s death] and we were completely anchored in reality.

(via siobhan on fb, dccomment:

"The speaker is Mo Gawdat. Hmm. He's right in a way of course, though it is a potentially conservative (with a small 'c') philosophy. Should we be happy with the world as it is? According to the Independent his "21-year-old son Ali died unexpectedly in what should have been a routine operation"; should his son's surgeon share this philosophy?")

Gawdat's book reportèdly promotes "intelligent design" over naturalism. Hmm.
google  psychology  medicine  ethics  philosophy 
august 2017 by juliusbeezer
Le pneumologue Michel Aubier fait appel de sa condamnation pour faux témoignage
la présidente de la 31e chambre, Evelyne Sire-Marin avait estimé que les peines étaient « motivées par la particulière gravité de ce faux témoignage de M.Aubier, fait en toute conscience devant la représentation nationale, alors que, comme l’a souligné à l’audience le sénateur Husson, les commissions d’enquêtes parlementaires travaillent pour éclairer le législateur dans l’intérêt général, en s’appuyant sur les auditions publiques de personnalités expertes, qu’elles choisissent en toute confiance ».
conflict_of_interest  france  politics  medicine 
july 2017 by juliusbeezer
How Rich Would Bill Gates Be Without His Copyright On Windows? | HuffPost
And, there is a huge amount of money at stake here. The fortunes going to Bill Gates and other beneficiaries of intellectual property protection come out of the pockets of the rest of us. The clearest case is prescription drugs where we will spend over $440 billion this year for drugs that would likely sell for less than $80 billion in a free market.

The difference of $360 billion a year is a bit less than 2.0 percent of GDP. If we carry this out over the course of a decade we’re likely talking about more than $4 trillion. By comparison, the battle on repealing Obamacare largely boils down to a fight over $600 billion in tax cuts for the rich, an amount that is less than one-sixth this size.
software  economics  copyright  medicine 
july 2017 by juliusbeezer
Procès : « Si Total a choisi d’employer Michel Aubier, c’est parce qu’il s’intéressait à la pollution » - La Croix
Me François Lafforgue, l’avocat de deux associations écologistes, fait valoir que c’est pour son statut de leader d’opinion que Total rémunérait ce médecin de renom. Un « bon client pour les médias », affirme l’avocat, en relevant que le professeur était très souvent interviewé sur la pollution.

Une nouvelle fois, le médecin répond qu’il a publié de nombreux articles sur les dangers de la pollution. Mais il peine à expliquer pourquoi il n’a jamais déclaré à l’AP-HP son cumul d’activités chez Total. Certes, en 1997, il a demandé l’autorisation à la directrice de son hôpital. Mais ensuite, plus un mot à sa hiérarchie.

Petits secrets d’un médecin dont il apparaît aussi qu’il ne déclarait aux instances réglementaires chargées d’examiner d’éventuels conflits d’intérêts qu’une partie de ses multiples collaborations avec l’industrie pharmaceutique.
medicine  france  conflict_of_interest 
june 2017 by juliusbeezer
A portrait of poly psychopharmacology – Everything Matters: Beyond Meds
God knows what all these drugs have done to me.

In order roughly by class (class is a bit subject to interpretation as so much of this stuff is used off label, especially when it was given to me):
drugs  medicine  psychology 
february 2017 by juliusbeezer
A brief medical history of farting - The Verge
The other study worth noting found that beans' bad reputation may be undeserved: fewer than half of people noticed an increase in flatulence from eating pinto or baked beans; only 19 percent had more gas with black-eyed peas. Amusingly, people on control diets also reported a 3 percent to 11 percent increase in farting. "People's concerns about excessive flatulence from eating beans may be exaggerated," the authors write helpfully. "It is important to recognize there is individual variation in response to different bean types."
food  medicine  science 
february 2017 by juliusbeezer
Does ELF Have a Role in EAP Writing? – ELT Research Bites
Tribble sees EAPWI based on genre analysis situated within a expert/apprentice dichotomy in which native language plays absolutely no role. Tribble claims that native academic English does not really exist. Rather, what does exist is a set of conventions developed by experts and writers with expertise within a particular discipline regardless of first language.

Study

To demonstrate this, Tribble built a corpus of research articles from international journals. This was chosen, as the writers and editorial board would likely be those whose mother tongues were not all English. He then focused on a single journal from the corpus (a biology journal called Acta Tropica). Through random sampling of 10 articles, he investigated errors (or what he called “non-canonocial” uses, or deviations from “textbook norms”) in order to determine whether these authors were forced to conform to native speaker norms of language usage. He found that errors were common, about once every 60 words. He found these errors at the clause level but noted that all of the writings stayed consistent at the stage and moves level. ...ELFA really has no role in academic writing, as academic writing has nothing to do with conformity to nativeness but rather “expertise that is required for acceptance by specific discourse communities”
editing  english  medicine  sciencepublishing  language 
december 2016 by juliusbeezer
No one should be diagnosed at a distance – even Donald Trump | Hannah Jane Parkinson | Opinion | The Guardian
Today, that article might have been “10 reasons why Barry Goldwater is too crazy for the Oval Office”. Then it was “The unconscious of a conservative: a special issue on the mind of Barry Goldwater”. The case led to the establishment of a 1973 edict (Section 7.3) that psychiatrists should not diagnose individuals they have not personally treated. The American Psychiatric Association (APA) sets out the Goldwater rule thus: “On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorisation for such a statement.”
psychology  journalism  medicine  privacy  ethics 
december 2016 by juliusbeezer
Joseph Asbury Bell and the birth of randomized trials. - The James Lind Library The James Lind Library
Nowhere in the memorial issue of the journal, however, is there any discussion of Bell’s exemplary reports of randomized trials of pertussis (whooping cough) vaccines in the 1940s, the decade during which randomized trials can be said to have been born. This is particularly surprising given that Bell’s reports of his randomized trials were not published in obscure places, but in mainstream journals. Yet, as far as I am aware, none of the many people who have written about the history of randomized trials have referred to the remarkable report that Bell published in 1941, seven years earlier than the now iconic report of the randomized trial of streptomycin in pulmonary tuberculosis conducted under the aegis of the Medical Research Council (MRC 1948).
medicine  science  history 
november 2016 by juliusbeezer
Official Google Blog: A remedy for your health-related questions: health info in the Knowledge Graph
when my infant son Veer fell off a bed in a hotel in rural Vermont, and I was concerned that he might have a concussion. I wasn’t able to search and quickly find the information I urgently needed (and I work at Google!). Thankfully my son was OK, but the point is this stuff really matters: one in 20 Google searches are for health-related information. And you should find the health information you need more quickly and easily...
We worked with a team of medical doctors (led by our own Dr. Kapil Parakh, M.D., MPH, Ph.D.) to carefully compile, curate, and review this information. All of the gathered facts represent real-life clinical knowledge from these doctors and high-quality medical sources across the web, and the information has been checked by medical doctors at Google and the Mayo Clinic for accuracy.
search  google  health  healthcare  medicine 
november 2016 by juliusbeezer
Stop the EMA Backsliding on Open Clinical Data [Updated] - Open Enterprise
the drug companies really don't want their dirty washing for all to see, and they have been lobbying extremely hard to water down the provisions. And in fact, it seems they have succeeded, as the All Trials Web site explains:

The good proposals in the European Medicines Agency’s (EMA) draft policy on sharing clinical trial data could be at risk.

The EMA has produced a further draft of the policy which would introduce barriers to access to clinical trial data that would make the job of researchers who want to scrutinise it almost impossible.

The policy introduces terms of use which say that researchers can access the data on screen only with printing, sharing or saving of the data forbidden.

It allows the company who supplied the data to the EMA to decide which information to redact so researchers may never know what information is being kept hidden.
drugs  research  medicine  openness  eu 
october 2016 by juliusbeezer
How Drug Companies Keep Medicine Out of Reach - The Atlantic
"So there is the idea that there are gaps in research," Love told me in February, "and the second idea is that linking the cost of R&D to the price of the drug through the grant of a monopoly is inherently problematic, and the problems are diverse." The existing system relies on the promise of drug sales under patent to incentivize innovation -- an effective monopoly on production, typically lasting more than a decade. That system leads drug makers to set prices at whatever level they think the market can bear, regardless of the cost of manufacture or even the cost of development. The point was driven home last year, when Memorial Sloan-Kettering Cancer Center, in New York, refused a new colorectal cancer drug priced at over $130,000 per year. The drug maker, Sanofi, promptly cut the price in half...
[dccomment, disqus: A martian writes:
"The discomfort of M. Gates' conflicted position is very interesting. Presumably much of his 'wealth' is still 'invested' in companies that rely on 'intellectual property' to make 'money.' Yet clearly, the experts who advise him how to spend it, are clear that for things that actually matter for humanity—curing tropical diseases, rather than selling dodgy software upgrades—this model is of proven ineffectiveness. However, should he concede the point, the resulting cultural matter-antimatter explosion could leave him standing alone in a desert, spectacles fogged by dust, and wearing only a pair of frazzled underpants."]
drugs  medicine  research  dccomment  funny 
october 2016 by juliusbeezer
About
OpenTrials is building a collaborative and open linked database for all available structured data and documents on all clinical trials, threaded together by individual trial. With a versatile and expandable data schema, it is initially designed to host and match the following documents and data for each trial:

Registry entries
Links, abstracts, or texts of academic journal papers
Portions of regulatory documents describing individual trials
Structured data on methods and results extracted by systematic reviewers or other
Researchers
Clinical Study Reports
Additional documents such as blank consent forms, blank case report forms, and protocols

The intention is to create an open, freely re-usable index of all such information, to increase discoverability, facilitate research, identify inconsistent data, enable audits on the availability and completeness of this information, support advocacy for better data and drive standards around open data in evidence-based medicine.
openaccess  openmedicine  medicine  sciencepublishing  indexing  database 
october 2016 by juliusbeezer
Open Source Malaria’s First Paper | Intermolecular
Open Source Malaria (OSM) publishes its first paper today. The project was a real thrill, because of the contributors. I’d like to thank them.

Skepticism about open source research is often based on assumptions: that people will be too busy or insufficiently motivated to participate, or that there will be a cacophony of garbage contributions if a project is open to anyone. I’m not sure where such assumptions come from – perhaps people look first for ways that things might fail. We can draw upon many experiences of the open source software movement that would suggest such assumptions are poor. We can draw on successful examples of open collaboration in other areas of science, such as the Human Genome Project and the projects it has spawned, as well as examples in mathematics and astrophysics. This OSM paper addresses open source as applied to drug discovery, i.e. experimental, wet lab science in an area where we normally expect to need secrecy, for patents. It is based on the experience of 4-5 years of work and describes the first series examined by OSM. The paper argues strongly against these assumptions, since:

Many people contributed enthusiastically
The contributions came from a wide range of institutions, from Pharma through to Universities, from undergrads through to professors.
Those contributions, many of which were unsolicited, were of a high quality.
openscience  opensource  opennotebook  open  medicine 
october 2016 by juliusbeezer
Exclusive: World’s first baby born with new “3 parent” technique | New Scientist
Zhang has been working on a way to avoid mitochondrial disease using a so-called “three-parent” technique. In theory, there are a few ways of doing this. The method approved in the UK is called pronuclear transfer and involves fertilising both the mother’s egg and a donor egg with the father’s sperm. Before the fertilised eggs start dividing into early-stage embryos, each nucleus is removed. The nucleus from the donor’s fertilised egg is discarded and replaced by that from the mother’s fertilised egg.

But this technique wasn’t appropriate for the couple – as Muslims, they were opposed to the destruction of two embryos. So Zhang took a different approach, called spindle nuclear transfer. He removed the nucleus from one of the mother’s eggs and inserted it into a donor egg that had had its own nucleus removed. The resulting egg – with nuclear DNA from the mother and mitochondrial DNA from a donor – was then fertilised with the father’s sperm...

Neither method has been approved in the US, so Zhang went to Mexico instead, where he says “there are no rules”. He is adamant that he made the right choice.
genetics  medicine  ethics  mexico  us  uk 
september 2016 by juliusbeezer
The Tale of the Ethical Neonatologist – And Why There Shouldn’t Be a Legal Right of Conscientious Objection | Practical Ethics
If, and only if, the patient is not affected by conscientious objection in that institution: if they can see a doctor in a timely fashion and without humiliation, delay, or misinformation, who will give them their legal treatment, which they competently believe is in their best interests, then it would be reasonable for an institution to allow its medical workforce to choose which treatments they offer. However, if, as is all too often the case, conscientious objection in practice leads to patients being denied such treatments, refused them, or struggling to understand whether or not they are ultimately allowed such a treatment, the patient should be prioritized. For example, in Italy, 70-80% gynaecologists – the only health professionals authorized to perform abortions – are conscientious objectors.
medicine  ethics 
september 2016 by juliusbeezer
The Mass Production of Redundant, Misleading, and Conflicted Systematic Reviews and Meta-analyses. - PubMed - NCBI
There are many important issues raised in this paper on which I strongly agree with John Ioannidis. There is a lot of research waste in meta-analyses and systematic reviews, and a flood of very low quality, and he points out the contributing factors clearly. However, there are some issues to be aware of in considering the analyses in this paper on the growth of these papers, and their growth in comparison with randomized and other clinical trials.

Although the author refers to PubMed's "tag" for systematic reviews, there is no tagging process for systematic reviews, as there is for meta-analyses and trials. Although "systematic review" is available as a choice under "article types", that option is a filtered search using Clinical Queries (PubMed Help), not a tagging of publication type. Comparing filtered results to tagged results is not comparing like with like in 2 critical ways.
medicine  research  editing  reviews  commenting 
september 2016 by juliusbeezer
Why Medical Schools Should Embrace Wikipedia: Final-Year Me... : Academic Medicine
Between November 2013 and November 2015, the authors offered fourth-year medical students a credit-bearing course to edit Wikipedia. The course was designed, delivered, and evaluated by faculty, medical librarians, and personnel from WikiProject Medicine, Wikipedia Education Foundation, and Translators Without Borders. The authors assessed the effect of the students' edits on Wikipedia's content, the effect of the course on student participants, and readership of students' chosen articles.

Outcomes: Forty-three enrolled students made 1,528 edits (average 36/student), contributing 493,994 content bytes (average 11,488/student). They added higher-quality and removed lower-quality sources for a net addition of 274 references (average 6/student). As of July 2016, none of the contributions of the first 28 students (2013, 2014) have been reversed or vandalized. Students discovered a tension between comprehensiveness and readability/translatability, yet readability of most articles increased. Students felt they improved their articles, enjoyed giving back "specifically to Wikipedia," and broadened their sense of physician responsibilities in the socially networked information era.
wikipedia  medicine  education 
september 2016 by juliusbeezer
Who Will Heal the Doctors? - Los Angeles Review of Books
Recently, however, doctors have turned their diagnostic skills on themselves. Several of these narratives were discussed in Meghan O’Rourke’s 2014 Atlantic essay “Doctors Tell All — And It’s Bad,” which draws on Sandeep Jauhar’s account of his participation in questionable practices for profit (Doctored: The Disillusionment of an American Physician [2014]), Terrence Holt’s exposé of how overwork can lead young doctors to disrespect and even mistreat patients (Internal Medicine: A Doctor’s Stories [2014]), and Atul Gawande’s insider view of expensive and often futile end-of-life care (Being Mortal: Medicine and What Matters in the End [2014]).
medicine  work 
september 2016 by juliusbeezer
Theresa May’s hidden British value -- monolingualism
David Jones, a GP, has argued that translation services are a good use of money. Writing back in 2007 in the British Medical Journal he argued:

In my practice in Tottenham, a deprived inner-city area of London with a diverse population of new migrants to the UK, like all GPs, I often care for three generations. It seems completely unrealistic to expect, for example, a 76-year-old Somali woman, often with no previous formal education, to attend English classes and acquire English. Such patients, who may expect to live for 20 years, will always need an interpreter. Her daughter struggles a bit, and we often use an interpreter, usually via the telephone. Her granddaughter, aged 10, is of course effortlessly bilingual. We need to take a long view sometimes.
language  medicine  interpreting 
july 2016 by juliusbeezer
Why getting medical information from Wikipedia isn't always a bad idea
The Wikiversity Journal of Medicine, which was launched in 2014, is hosted directly by the Wikimedia Foundation, the same organisation that hosts Wikipedia. It uses the same software, MediaWiki, which makes editing and processing very easy.

The whole service is free to authors and readers; as with Wikipedia our operating costs are covered by donations from around the world. The Wikiversity Journal of Medicine follows standard international best-practice guidelines for medical journals, drawing from such reputable bodies as the International Committee of Medical Journal Editors.
wikipedia  peerreview  medicine 
june 2016 by juliusbeezer
BMJ Blogs: The BMJ » Blog Archive » Jeffrey Aronson: When I use a word . . . Naming biologics—principles and practice
Last week I discussed how drugs get their International Nonproprietary Names (INNs). The World Health Organization’s expert panel that assigns INNs has nine principles to guide its decisions, two primary and seven secondary. Here they are in abbreviated form:

1. The names should be distinctive in sound and spelling. They should not be inconveniently long and should not be liable to confusion with names in common use.
language  medicine  drugs  science 
march 2016 by juliusbeezer
Trip Rapid Review System – Rapid-Reviews.info
The system is designed to replicate the results of a systematic review but using a number of shortcuts. It doesn’t rely on a full search, it doesn’t critically appraise the articles. But, that aside, if you’re interested in the bottom line result of whether an intervention has some ‘worth’ it gives surprisingly good results.

The principle stems from sentiment analysis, a technique that “…aims to determine the attitude of a speaker or a writer with respect to some topic or the overall contextual polarity of a document.” In short, it says whether a section of text is saying positive or negative things. So, from an abstract we can say if the article is saying positive or negative things about the intervention (currently, the system only works on placebo-controlled trials).
reviews  sciencepublishing  tools  attention  medicine 
march 2016 by juliusbeezer
BMJ Blogs: The BMJ » Blog Archive » Jon Brassey: The rise of rapid reviews
The reality is that systematic reviews are costly interventions that typically take over a year to produce and which are, frankly, boring.

Rapid reviews fill an evolutionary gap long vacated by traditional systematic reviews—meeting the dual requirements of speed and low cost. If a review is needed in a month and on a modest budget, a systematic review isn’t worth considering. The scenario of the need for a rapid and low cost evidence synthesis is hardly atypical and it’s a result of this that rapid reviews are on the rise.

However, rapid reviews are an ungainly collection of different techniques, ranging from Trip’s five minute system to those taking six months or longer. There is no coherent language to describe them, leaving users to ask for “rapid reviews” with little appreciation of the diverse methods that are available.
ebm  medicine  publishing  attention 
march 2016 by juliusbeezer
Aubier, le médecin qui minimise la toxicité du diesel, carbure pour Total - Le Point
Michel Aubier, chef du service de pneumologie-allergologie de l'hôpital Bichat, également médecin-conseil du groupe pétrolier Total, est au coeur d'une polémique mercredi en raison notamment de propos tenus dans plusieurs médias, minimisant la toxicité du diesel sur la santé. "Dans l'émission Allô Docteur du 1er mars (sur France 5), le Pr Michel Aubier, pneumologue à l'AP/HP (Assistance publique/hôpitaux de Paris), a affirmé que la pollution atmosphérique n'était pas cancérigène sauf à de très forts taux d'exposition et essentiellement chez les fumeurs", déplore le collectif "Strasbourg respire". "Un rectificatif nous semble indispensable pour corriger certains propos d'un médecin universitaire qui vont à l'encontre des principales études médicales, et notamment des études de l'OMS qui a classé le diesel cancérigène en 2012 et la pollution atmosphérique cancérigène en 2013", ajoute ce collectif dans un communiqué.
conflict_of_interest  medicine  france  environment  driving 
march 2016 by juliusbeezer
Institute for the Study of the Neurologically Typical: The Diagnostic and Statistical Manual of 'Normal' Disorders
DSN-IV (The Diagnostic and Statistical Manual of 'Normal' Disorders)
Disorders Usually First Evident in Infancy, Childhood, or Adolescence
666.00 Neurotypic Disorder

The essential features constitute a severe form of Invasive Developmental Disorder, with onset in infancy or childhood.
funny  satire  medicine  psychology 
march 2016 by juliusbeezer
Should there be greater use of preprint servers for publishing reports of biomedical science? - F1000Research
We know remarkably little, formally, about why researchers do and don’t do the things that they do and don’t do. Some efforts to secure research funding to investigate why researchers don’t publish reports of their research have not been successful (Professor Mary Dixon-Woods, personal communication). If the attractive vision of a more efficient publishing model for the life sciences is to be promoted effectively, research is needed to find answers to the questions raised by Tracz and Lawrence themselves: why are researchers reluctant to post preprints, and will sufficient other researchers post useful and critical comments on them to make the effort worthwhile?
sciencepublishing  medicine  preprint  archiving  scholarly  research 
march 2016 by juliusbeezer
Large 'jump in deaths' expert warns - BBC News
Prof Harrison's own analysis backs up figures in the Health Service Journal which suggest there have been 5.6% more deaths in England and Wales in 2015 than in the previous year - the biggest increase in the national death rate since the 1960s.

Though the final figures - which take changes in population size into account - will not be released by the Office for National Statistics until the summer, experts say more needs to be done to understand the reasons behind the spike and urge public health experts to focus on wider factors, not just influenza.
medicine  health  healthcare  disease  uk 
february 2016 by juliusbeezer
Nantes. Torturé chez lui : le crime a bien failli rester impuni | Presse Océan
L’enquête sur la mort Nantais de 44 ans torturé avait d’abord été classée sans suite. Lors du premier examen de corps, sur les lieux du crime, le médecin-légiste n’avait « rien relevé de suspect ».


"Dans cette affaire, on est vraiment passé à deux doigts d’un déni de justice incroyable ».
C’est un proche du dossier qui le dit. Cette affaire, c’est le meurtre de Stéphane Frémont...
La procédure a pourtant bien failli être classée sans suite. Aucun obstacle médico-légal n’ayant été délivré, l’enquête allait s’arrêter là. Aucune autopsie n’allait être pratiquée. Ni aucune suite donnée.
nantes  medicine  law  journalism 
january 2016 by juliusbeezer
Recovering From Lateral Epicondylitis, A.K.A. Tennis Elbow - PowerPlay
It’s not traumatic, and it’s not glamorous, but lateral epicondylitis, a.k.a. tennis elbow, will keep you off your bike just as effectively as any other sports injury that I’ve endured.

So now you’re asking, how does a cyclist get tennis elbow, right? Easy…hold your handlebars at a wonky angle and then ride your road or mountain bike every single day for a month without recovery. Sounds fun, right?
cycling  health  medicine 
december 2015 by juliusbeezer
The mysterious aging of astronauts | Daniel Lemire's blog
So it looks like despite short stays, and very attentive medical care, astronauts age at a drastically accelerated pace… not just in one or two ways but across a broad spectrum of symptoms.

I looked as hard as I could and I could not find any trace of medical scientists worrying about such a phenomenon a priori.

What is going on? Why does life in space accelerate aging so much?
science  medicine  dccomment 
december 2015 by juliusbeezer
Free Open Access Medical education (FOAM) for the emergency physician - Nickson - 2014 - Emergency Medicine Australasia - Wiley Online Library
FOAM is ‘free open-access med(ical ed)ucation’.[2, 3] As such, FOAM is a dynamic collection of resources and tools for lifelong learning in medicine, as well as a community and an ethos. FOAM is continually evolving and growing rapidly, and from anarchic beginnings is increasingly attracting interest from practicing clinicians, trainees, educators, researchers and publishers alike. This article defines FOAM, details its development and considers its role, particularly in relationship to scientific journals, textbooks and medical education as a whole...
FOAM is sometimes portrayed as being at loggerheads with ‘the establishment’, including traditional medical journals. We think this is overstated, and both social media and FOAM have a growing role in the post-publication analysis of scientific research and in bridging the gap between research and practice.

There has been a push from some quarters to make FOAM more ‘journal like’, and a common criticism of FOAM is that it is not peer reviewed in the traditional sense.[8] However, FOAM is not scientific research. Instead, FOAM is a useful way of disseminating, discussing, dissecting and deliberating over the products of that research...
Twitter® has been central to the development of the FOAM community.[7]
openmedicine  socialmedia  medicine  twitter  hippocrates 
november 2015 by juliusbeezer
Open Access, and why it matters to medical students. |
Students access research literature across both pre-clinical and clinical phases. In both instances, students are encouraged to consult a variety of sources, ranging from traditional textbooks to more current journal articles, with the aim of forming a solid and current knowledge base. Additionally, medical school curricula feature assignments where students are required to gain skills in searching and evaluating research literature. Since medical students encounter research output in a variety of ways, any methods which facilitate these process are encouraged.

OA allows medical students to draw on a wider array of research output than would otherwise be possible. Increasing journal numbers mean that university libraries are unable to afford subscriptions to quality indexed journals. Frequently a “perfect” article is found, only to soon realise it’s behind a paywall with no library journal subscription. The option of paying $US30-40 for access to single paper is rarely palatable for a student budget. For the same reason that OA is said to bring knowledge to developing nations, local medical students can have access to a wider array of research to incorporate into their knowledge base.
medicine  education  openaccess  openmedicine  openness 
november 2015 by juliusbeezer
The Statistical Alchemy of Meta-Analyses | Alert & Oriented
the founding father of clinical epidemiology brilliantly identifies the wishful thinking underlying meta-analysis and exposes its methodological fallacies.

Feinstein begins by reminding the reader of the four necessary requirements for acceptable scientific evidence. Translated to clinical research, these become 1) that the population under investigation be identified reliably (“in a reproducible manner”); 2) that the relevant characteristics be homogeneous; 3) that comparisons performed between subgroups of the population be unbiased (internal validity); 4) that the evidence obtained be extrapolated to a broader population (external validity).

Because meta-analyses necessarily fail on one or more of these requirements, the wished-for results can never produce better information than the trials upon which they are constructed—hence the analogy with alchemy.

With clear prose and dry humor, Feinstein proceeds to systematically uncover flaw after flaw in the meta-analytic approach.
ebm  medicine  healthcare 
november 2015 by juliusbeezer
John Maddox Prize: Scientist who once claimed Prince Charles tried to silence him wins for 'standing up for science' | Science | News | The Independent
Sir Colin Blakemore, an Oxford neuroscientist and judge, said: “Edzard Ernst, rightly known as the ‘scourge of complementary medicine’, has doggedly pursued the argument that there is only one kind of medicine – medicine that works.”
medicine  philosophy  chinois 
november 2015 by juliusbeezer
Safety case - Wikipedia, the free encyclopedia
A Safety Case is a structured argument, supported by evidence, intended to justify that a system is acceptably safe for a specific application in a specific operating environment.[1] Safety cases are often required as part of a regulatory process, a certificate of safety being granted only when the regulator is satisfied by the argument presented in a safety case. Industries regulated in this way include transportation (such as aviation, the automotive industry and railways) and medical devices.
safety  nukes  medicine  law 
october 2015 by juliusbeezer
Medical Translation Gone Wrong: 4 Devastating Examples - K International
Mainly interpretation problems, but one serious error in documentation for an orthopedic prosthesis
translation  interpreting  error  medicine 
october 2015 by juliusbeezer
Etude des leucémies de l’enfant à proximité des routes à fort trafic | carfree.fr
l’équipe de recherche a pris en compte la totalité des 2760 cas de leucémie diagnostiqués chez des enfants de moins de 15 ans en France métropolitaine sur la période 2002-2007. Les résultats montrent que la fréquence de nouveaux cas de leucémie de type myéloblastique (418 cas sur les 2760 cas de leucémie) serait plus élevée de 30% chez les enfants dont la résidence se situe à moins de 150m des routes à grande circulation et qui ont une longueur cumulée dans ce rayon dépassant 260m.
medicine  health  driving  pollution  france 
october 2015 by juliusbeezer
On evidence tools for public health policy | SKAPE
A range of techniques and methods exist to assemble and present research findings in a way that will be ‘useful’ to policymakers. In public health, three of the most popular are Health Impact Assessments, systematic reviews, and economic decision-making tools (including cost-benefit analysis and scenario modelling). Despite the broadly shared goals, these methodologies have developed distinct, and often parallel, ‘epistemic cultures’ (Knorr-Cetina), through mailing lists, training courses, journals and conferences devoted to each one. In a recent article we conceptualised all three as examples of ‘evidence tools’, arguing that despite their differences they all assemble, assess and present evidence in an effort to influence decision-making processes. Paradoxically, we found that despite this explicit aim, very little attention had been paid to how policymakers experienced these tools. Based on Katherine’s interviews with public health policymakers, in policy practice, evidence tools are perceived as useful when they:-

save time, especially where the work has been carried out by others
can be adapted to different contexts
convey credibility to external audiences
offer clear, quantified answers and/or predictions of likely policy outcomes

Scenario modelling, which is widely perceived to have been a critical factor in the introduction of minimum unit pricing for alcohol in Scotland, was described as particularly appealing because it predicted a very specific, quantified benefit (for example, potential saved lives). This was described as gold dust in the political process. However most research users were frank in admitting that they had little understanding of how modelling produced this figure. Far from being a drawback, we argue (in contrast to researchers who have found that policymakers value transparency in their evidence tools) that in public health policy, at least in this particular example, the black magic of modelling actually appeared to enhance its appeal.
ebm  attention  medicine 
october 2015 by juliusbeezer
"Les médecins sont désormais plus nombreux dans les déserts médicaux" ? | France info
L'Ain, l'Eure, la Mayenne, la Haute-Loire ou encore l'Indre sont souvent cités comme des "déserts médicaux", c'est-à-dire des départements dont la couverture médicale est plus faible que dans les autres territoires (le ministère retient deux critères de classement : une densité 30% inférieure à la moyenne et une activité par médecin 30% supérieure à la moyenne).

Or, les effectifs de médecins généralistes libéraux et mixtes, principaux concernés par les mesures gouvernementales, n'ont pas "considérablement augmenté" dans ces territoires. Au contraire, leur nombre est stable, voire en légère baisse dans les départements concernés. L'Eure en a par exemple perdu une dizaine entre 2012 et le début de cette année.
france  medicine  politics 
september 2015 by juliusbeezer
No correction, no retraction, no apology, no comment: paroxetine trial reanalysis raises questions about institutional responsibility | The BMJ
Few studies have sustained as much criticism as Study 329, a placebo controlled, randomized trial of paroxetine and imipramine carried out by SmithKline Beecham (which became GlaxoSmithKline (GSK) in 2000). In 2002, a US Food and Drug Administration officer who formally reviewed the trial reported that “on balance, this trial should be considered as a failed trial, in that neither active treatment group showed superiority over placebo by a statistically significant margin.”4 Yet this same year, according to the New York State Attorney General’s office, which sued GSK, over two million prescriptions were written for children and adolescents in the United States, all off-label, after a marketing campaign that characterized Study 329 as demonstrating “REMARKABLE Efficacy and Safety.”

The disparity between what the manufacturer and study authors claim the trial found and what other parties say the data show was an important element in the US Department of Justice’s criminal charges against GSK. In 2012, GSK was fined a record $3bn (£2bn; €2.7bn), in part for fraudulently promoting paroxetine.

Then there are the matters of “editorial assistance” and undisclosed financial conflicts of interests of one of the paper’s authors.
medicine  psychology  science  sciencepublishing  editing  misconduct 
september 2015 by juliusbeezer
Registered clinical trials make positive findings vanish : Nature News & Comment
by having to state their methods and measurements before starting their trial, researchers cannot then cherry-pick data to find an effect once the study is over. “It’s more difficult for investigators to selectively report some outcomes and exclude others,” she says.
sciencepublishing  science  medicine 
august 2015 by juliusbeezer
How Research into the Reasons Doctors Get Sued Explains Why People Believe in Quacks | Big Think
Levinson compared doctors that had been previously sued and doctors who had never been sued. She found that doctors that were sued didn't differ in the content of what they said, but in the way that they communicated. Doctors who were sued not only spent less time with their patients, but also interacted with them completely differently. They used less humour and laughed less, indicating less warmth and friendliness; they provided fewer orientation statements, such as: "First I'll examine you and then we will talk the problem over." They also used fewer facilitation statements, such as: "Go on, tell me about that," and, "What do you think caused that to happen?" which indicate interest in the patients' opinion.
medicine  law  communication 
august 2015 by juliusbeezer
Doping in Football: Fifty Years of Evidence | Four Dimensional Football
footballers who want to use performance enhancing drugs face relatively low risks, compared to cyclists. Footballers and clubs have more money available, making doping a cheap investment. And whereas cyclists have to deal with far more, far better tests (which they have no problem circumventing), footballers are rarely tested. And when they are, usually all they have to do is give a urine sample – through which a variety of advanced doping techniques cannot be detected.
sport  football  drugs  medicine 
august 2015 by juliusbeezer
One in 3 trainee GP posts are empty, amid warnings of crisis shortage - Telegraph
New figures from the UK’s medical deaneries show that 30 per cent of the vacancies for trainee GPs which will open this summer have not been filled. In all, more than 1,000 GP training posts are vacant.
Shortages are most severe across the East Midlands, with 64 per cent of positions vacant and the North East of England, with 63 per cent vacancy rates.
In West Midlands the figure is 47 per cent, and along the south coast it is 41 per cent, the statistics, disclosed by Pulse magazine, show.
medicine  uk  general_practice 
june 2015 by juliusbeezer
'It's problematic': inventor of US lethal injection reveals death penalty doubts | World news | The Guardian
Dr Jay Chapman, the pathologist who invented the lethal injection that has been the dominant execution protocol in the US for 40 years, says he has growing doubts about the death penalty in the wake of mounting evidence of wrongful convictions...

Chapman, 75, said that he had revised his view of capital punishment despite having been the architect of the lethal injection in 1977.

Chapman’s own association with America’s modern way of executions came about almost by chance – as he is keen to emphasise, never having wanted to be labelled as the “father of the lethal injection”. It was 1977, and Gary Gilmore had just volunteered to be the first person to be executed in America after a lengthy moratorium imposed by the US supreme court.

Gilmore’s execution sparked a debate that fanned out to other states including Oklahoma where Chapman was asked by a legislator to come up with a more humane method than either the firing squad – which Gilmore had opted for – or the electric chair used previously in Oklahoma.
death_penalty  medicine  ethics 
may 2015 by juliusbeezer
IATEFL2015 | Sheila Thorn: Practical advice on creating authentic Medical English listening materials | Talk summary | ELT stories
Abstract. It is almost impossible to get permission to record medical interactions between patients and doctors. However, it is relatively easy to record interviews with ordinary people from all walks of life talking about their current or previous health conditions. I shall demonstrate how these authentic recordings can be used to create highly-motivating Medical English teaching and listening practice materials.
teaching  english  medicine 
april 2015 by juliusbeezer
Philosophy, et cetera: Questioning Moral Equality
Suppose Gandhi and Hitler are both dying in agony before you, and you have but a single dose of pain-relief you can administer. Is it really plausible that you should flip a coin to decide who to help? Surely the fact that Gandhi was (let's suppose for sake of argument!) an all-things-considered good guy, whereas Hitler was a vicious monster, gives us reason to prefer to help the former.
philosophy  ethics  medicine  dccomment 
april 2015 by juliusbeezer
ICMJE | Recommendations | Purpose of the Recommendations
ICMJE developed these recommendations to review best practice and ethical standards in the conduct and reporting of research and other material published in medical journals, and to help authors, editors, and others involved in peer review and biomedical publishing create and distribute accurate, clear, reproducible, unbiased medical journal articles. The recommendations may also provide useful insights into the medical editing and publishing process for the media, patients and their families, and general readers.
editing  medicine 
april 2015 by juliusbeezer
BioMed Central | Why has BioMed Central chosen to partner with Edanz? Why has BioMed Central chosen to partner with Edanz?
BioMed Central has chosen Edanz because of their excellent track record, proven high quality, their capacity to handle high volumes of submissions, their locations and their author workshops. Authors expect BioMed Central to recommend a company which consistently provides high quality services.
editing  medicine  openaccess 
april 2015 by juliusbeezer
Physician guidelines for Googling patients need revisions -- ScienceDaily
in what circumstances is it appropriate for a doctor to research a patient using online search engines?

"Googling a patient can undermine the trust between a patient and his or her provider, but in some cases it might be ethically justified," Baker says. "Healthcare providers need guidance on when they should do it and how they should deal with what they learn."

With regard to future guidelines, Baker and her co-authors suggest 10 situations that may justify patient-targeted Googling:
medicine  ethics  search  google  confidentiality 
march 2015 by juliusbeezer
JAMA Network | JAMA | Ethical Implications of Patients and Families Secretly Recording Conversations With Physicians
With recent advances in technology, smartphones can become recording devices with the touch of a button. This technological capability gives patients and their families the ability to easily and surreptitiously record conversations with physicians. The frequency of such recordings or whether they even occur is unknown. The ubiquity of smartphones, however, suggests the potential for secret recordings to occur. As of January 2014, 58% of Americans owned a smartphone, including 83% of young adults.1 Although recording conversations with physicians may provide some benefit for patients and their families, secret recordings can undermine patient-physician relationships and ultimately affect the provision of health care.
medicine  ethics  privacy  confidentiality  gronkulation  technology  internet 
march 2015 by juliusbeezer
Freeing the Data: For Clinicians | Free the Data
The Sharing Clinical Reports Project (SCRP) is a volunteer, grass-roots effort to encourage open sharing of genetic variant information. SCRP specifically aims to collect information on BRCA1 and 2 variants and make this information publicly available in the NCBI ClinVar database. SCRP is a component of the International Collaboration for Clinical Genomics (ICCG), a group of laboratories, physicians, genetic counselors, researchers, and others dedicated to raising the standard of patient care by improving the quality of genomic testing.

Free the Data aims to revolutionize how vital information is shared and accessed, in order to further translational research and advance clinical care towards lower costs, higher quality, and more efficient treatments. In addition to the educational materials that you give your patients who are about to have a BRCA1/2 genetic test performed (or have already had one), you can give them this one-pager, asking them to share their data. Alternatively, you can share the data for them.
opendata  medicine  genetics  crowdscience  crowdsourcing 
march 2015 by juliusbeezer
The fate of manuscripts rejected by a general medical journal - The American Journal of Medicine
Using a retrospective cohort study design, we examined 350 manuscripts rejected by the Annals of Internal Medicine, a general medical journal, during 1993 and 1994. We assessed the number of manuscripts that were published after initial rejection, time to eventual publication, journal type (general versus specialty), and journal impact factor (higher scores indicated greater impact) and immediacy index.

RESULTS: Of 350 rejected manuscripts, 240 (69%, 95% confidence interval [CI]: 64% to 73%) were eventually published after a mean of 552 days (95% CI: 479 to 544 days, range 121 to 1,792 days).
sciencepublishing  rejecta  medicine 
march 2015 by juliusbeezer
Measles: Shaming Anti-Vaccine Parents Isn't the Answer - Bloomberg Business
If vaxxers can’t force people to get their shots, they can try shaming them into it. But vilification, however satisfying, doesn’t do much good. People who are told that their dearly held beliefs are stupid and selfish tend to withdraw from the conversation while continuing to do whatever they did before...
Physicians can increase compliance by making clear that full and prompt vaccination is an expectation...
ditching an uncompliant family is a mistake. “You’re decreasing the possibility of changing their mind and pushing it toward zero,”
insurance billing code for vaccine counseling, which would give doctors a financial incentive to bring around a resistant family...
As those Twitter tweets show, it’s not just the anti-vaxxers who come from a place of fear and anger. It’s the vaxxers, too. A democratic society must search for common ground. Let’s make this a time for healing. And not just from measles...
vaccines  culture  psychology  medicine  healthcare 
february 2015 by juliusbeezer
I Asked My Mom Why She Didn’t Vaccinate Me
made me wonder whether vilifying anti-vaccine parents — as the press has done repeatedly this week — is a good strategy for increasing vaccine coverage. When parents make medical choices, good or bad, it’s for one simple reason: They’re trying to do the right thing for their kid. Refusing vaccination is not a political statement.
vaccines  medicine  healthcare  health  agnotology  politics  journalism 
february 2015 by juliusbeezer
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