Not Saussure

April 27, 2007

More IT fun from HMG — too much of a good thing

Filed under: Medicine, nemesis, Politics, UK — notsaussure @ 12:29 am

Hard upon yesterday’s revelation that junior doctors’ personal details were publicly available on the ill-fated MTAS website, we get this:

A controversial job application website for junior doctors has been suspended, amid fresh concerns of security lapses.The Department of Health said it was investigating claims that doctors were able to read each other’s messages.

The new concerns come a day after revelations that applicants’ personal information could be freely accessed.

The MTAS website has been the subject of protests from junior doctors. The Conservatives say the system is in “complete crisis”.

Channel 4 News reported that applicants had been able to see each other’s files by changing two digits in the personalised web address given to each individual.

Channel 4 report, including video, here.

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March 18, 2007

Skunk and schizophrenia

Filed under: Medicine, Mental Health, Stats — notsaussure @ 8:23 pm

Among the Sindy’s reasons for no longer wanting cannabis legalised (though they’re still in favour of decriminalisation):

25,000 schizophrenics could have avoided the illness if they had not used cannabis

Anyone got any ideas about how that figure’s arrived at? How can they say with any certainty that it’s nearer 25,000 rather than nearer 12,500 or 50,000?

I’m sure there is a good reason for using that figure, but any calculation, I’d have thought, must involve an awful lot of rather speculative assumptions about schizophrenia, what causes it and what triggers its onset.

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Sally Clark and the eminent professors

Filed under: Law, Medicine — notsaussure @ 2:34 pm

Via Devil’s Kitchen, I see this, from the blog of Terry Hamblin, [update:  Prof Hamblin has removed the post from his blog, so I’ve had to take a copy from the Google archive] Professor of Immunohaematology at the University of Southampton, on the subject of Sally Clark’s death:

So far response in the correspondence columns of the major newspapers has been that the ordeal of unjust imprisonment had driven her to it.I wonder. Perhaps she was possessed by guilt that she really had killed her kids and remorse that she had brought down two eminent professors of paediatrics in getting the decision reversed.

I have not followed the case closely

One can understand Professor Hamblin’s prudence in waiting until Mrs Clark was safely dead until rehearsing his suspicions. After all, she was apparently able, initially from a prison cell, to press-gang the Court of Appeal, the Royal Statistical Society and the General Medical Council into bringing down two eminent professors of paediatrics. Heaven only knows what she might have done to an eminent Professor of Immunohaematology while alive and at liberty.

Not having followed cases closely hasn’t, of course, in the past prevented eminent professors sticking their oar in; besides Sir Roy Meadow, the other eminent professor ‘brought down’ by the late Mrs Clark was

Professor David Southall, a leading expert in child protection, [who] intervened in the case of Sally Clark, the solicitor jailed for life for killing her two sons, in a “dogmatic and high-handed manner”, despite having no professional involvement in the case, the GMC heard.The consultant paediatrician had not seen any medical records or postmortem results relating to the death of Mrs Clark’s two babies. But after watching her husband Stephen talking about his wife’s murder conviction on a documentary, he telephoned police to state that the father rather than the mother had deliberately suffocated the babies.

As a result of this intervention, he was found guilty of professional misconduct by the GMC. Can’t imagine why.

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January 7, 2007

Is this man in the pay of BUPA?

Filed under: Medicine — notsaussure @ 3:32 am

You live and learn. I never thought anyone would be able to turn me against the NHS, but Dr Tim Crayford, president of the Association of Director of Public Health, might just manage it:

“When the NHS is not spending money on really important public health measures but spending it on what people want, then this is a debate we should have.”

Dr Crayford also

questioned why a hysterectomy costing £2,800 is sometimes carried out to prevent heavy menstrual bleeding when a coil costing £100 can do the same thing without surgery.

I think I can assist him there; it’s probably because they suffer, as did my late wife before she had an hysterectomy (paid for by her private health insurance) , from severe endometriosis. Her gynecologist didn’t suggest it until they’d tried all other treatments, including a laparotomy, but the pre-cancerous growths it was causing eventually persuaded them that there was no alternative. Even then they were were dubious about performing it on a woman in her late 30s but the fact that previous surgery had left her with little chance of ever conceiving, let alone bearing a child to term, plus the fact that on one occasion ‘heavy menstual bleeding’, as Dr Crayford puts it, meant collapsing in the middle of Knightsbridge and being taken to hospital by paramedics who thought she must be miscarrying, pursuaded the doctors that there was little alternative.

The idea that when it’s so severe that radical surgery is contemplated the symptoms be perhaps be controlled by fitting a coil is about as sensible as suggesting Lemsip as a suitable treatment for pneumonia.


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November 14, 2006

Drugs in Prison

Filed under: Law, Medicine, UK — notsaussure @ 8:01 pm

Great annoyance in the press about the out-of-court settlement worth about £3,750 each for the six prisoners and former prisoners who sued the Prison Service for trespass and criminal negligence for denying them methadone while they were in prison. The Telegraph’s editorial is typical:

Those naïve enough to think that a prison sentence should entail an element of punishment, even perhaps a smidgen of hardship, must think again.

Six drug-addicted prisoners who were deprived of their narcotics are — outrageously — being paid compensation after arguing that being subjected to the “cold turkey” of drug withdrawal breached their human rights.

Poor things. Has New Labour’s infatuation with human rights legislation ever produced a more spirit-lowering outcome?

This misses the point. It was a medical negligence case; the prisoners were receiving methadone as a heroin substitute under prescription from their GPs. This was withdrawn when they went into prison, not because their medical needs changed in any way but because the Prison Service doesn’t like dispensing methadone since it’s got a black market value in prison — a problem that could easily be solved, it seems to me, by dispensing it in liquid form and watching the prisoners while they drink it.

These chaps needed medical treatment and didn’t receive it. That shouldn’t have happened. Simple as that.

The inmates seem to have suffered more than ‘a smidgen of hardship’; the same issue of the Telegraph quotes one of them, Mark Philips, who

said he was given nothing for his drug addiction for three months after which he collapsed at Elmley Prison on the Isle of Sheppey. Only then was he given sleeping tablets and for 10 days, a drug called subutex.

“Those of us who have done this lawsuit are not money-grasping,” Mr Phillips, 38, told the Sun. “We are deserving cases. I have received a letter saying I should get my money in 28 days. When I was sent to prison I was on a methadone prescription. Once inside I was given nothing at all.

“I went through two or three months of hell. I could not sleep and I was given no anti-depressants. I collapsed in front of prison officers, but no one seemed to care.”

If anyone’s naïve in this it’s the Telegraph, or so it seems to me since, as anyone who knows about prisons and the criminal justice system will confirm, people aren’t generally deprived of narcotics while they’re in prison; if you’re inside and you want some heroin, it’s all too easy to buy some, as the results for mandatory drugs testing — released earlier this month — will confirm. If Mr Philips had merely wanted to relieve his withdrawal symptoms rather than — as he clearly did — to get off drugs, he’d have had very little difficulty laying his hands on black market heroin while he was inside.

The idea that all these drugs could be smuggled into prison only by visitors, or that, once the drugs are in the prison, the prison staff couldn’t locate them is absurd. The situation presumably exists, as The Magistrate’s Blog suggested a couple of months ago, because

Quite apart from the chance of a profit, many officers see drugs as a way of keeping inmates in a compliant drug-soaked haze.


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November 9, 2006

Latin is a dead language, because of lead

Filed under: environment, Medicine — notsaussure @ 7:15 pm

As dead as dead can be.

First it killed the Romans,

And now it’s killing me!

As we used to sing at school. Now we know better; the culprit was apparently plumbum, or lead in the vulgar tongue.

Somewhat confusing, not to say confused, article in the Guardian today by Sarah Boseley about study in The Lancet by Dr Philippe Grandjean, from the University of Southern Denmark, and Philip Landrigan, from the Mount Sinai School of Medicine in New York which warn of the potential dangers posed by environmental pollution. The study’s subscription only, so I’ll have to rely on the Guardian’s summary: (more…)

November 6, 2006

Evidence-based epidemiology

Filed under: Medicine — notsaussure @ 6:59 pm

The BBC:

Lung cancer could be virtually wiped out in Scotland as a result of the smoking ban in public places, according to the chief medical officer.

Dr Harry Burns said lung cancer rates would be reduced to just a few hundred cases a year in the future.

That’s encouraging news.  How do we know this happy result is to take place?

Dr Burns said: “Imagining Scotland with no lung cancer is not trivial speculation.

“In the 1960s, one in 100 men died of lung cancer.

“Today, rates are falling all the time and thanks to the smoking ban, I expect the reduction in deaths to accelerate until dying from the disease becomes a rare occurrence.

“Anecdotal evidence shows that since the smoking ban, there has been a surge in the numbers of smokers seeking help to give up.”

Can’t argue with hard science like that.


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October 25, 2006

The Army and doping tests

Filed under: Food, Medicine, UK — notsaussure @ 8:18 pm

All very serious, and I know I shouldn’t chuckle, but I rather liked this report from the BBC:

A controversial drug which can keep people awake for days has been tested by the UK military, MPs have been told.
Modafinil pills – known on the drugs scene as "zombies" – are used to treat the rare sleeping disorder narcolepsy.
The Ministry of Defence has previously denied testing the drug on troops although it reportedly bought thousands of pills ahead of the Iraq war.
Defence contractor Qinetiq told the commons’ science committee the drug had recently been tested for military use.
Qinetiq scientist Dr Anna Casey told the Science and Technology Committee the MoD funded research into stimulant and performance-enhancing drugs and dietary supplements.
"One is always looking for something that would give military personnel an extra edge," she told the committee which is investigating the use of such drugs in sport.

She said the military was not under the same constraints as the International Olympic Committee, which had banned Modafinil and another stimulant, Ephedrine, which she said had also been tested by the MoD.

Well, errm, quite.  The report continues,

Ephedrine, which is similar in effect to amphetamine or "speed", had so far been ruled out for use by British combat personnel due to its side effects, which included anxiety.

But caffeine was "something we may well end up using in the future," she added.

Hang on a minute,  I thought the Army already did;  according to Wikipedia,

Tea is another common source of caffeine. Tea usually contains about half as much caffeine per serving as coffee, depending on the strength of the brew.


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October 12, 2006

Deaths in Iraq and a feeble lie from the PM’s Office

Filed under: Iraq, Medicine — notsaussure @ 5:34 pm

The Lancet (free registration required) has reported that, in the words of the Telegraph,

 

About 650,000 more Iraqis have lost their lives since the start of the war than would have died if the occupation had not occurred, research shows. American and Iraqi epidemiologists, whose research was published online yesterday by the medical journal The Lancet, said that a more than doubling of the mortality rate between the periods before and after the March 2003 invasion constituted a “humanitarian emergency”. The estimate, far higher than the figures produced by other bodies, including the Iraqi government, was calculated by randomly sampling homes containing 12,800 individuals across Iraq and checking death certificates.

Not surprisingly, these figures have been questioned because they are so much higher than those collected by other means. The Lancet study addresses this point, however: (more…)

October 6, 2006

Vaccine ‘encourages under-age sex’???

Filed under: Education, Medicine, UK — notsaussure @ 2:31 pm

I don’t have children, so maybe I’m not the best person to comment, but why on earth is this contentious:

Girls as young as 11 should receive compulsory vaccinations against a sexually transmitted virus that causes cervical cancer, according to an influential medical journal.

The Lancet published an editorial calling for compulsory jabs for 11- and 12-year-olds despite fears that they could encourage under-age sex.

The Sunday Telegraph revealed last month that ministers have commissioned secret research into parental attitudes towards a concerted vaccination programme in primary schools.

What on earth is wrong with just explaining to the child — if you don’t want to go into details of sexually transmitted diseases — that the vaccination’s to protect her against a nasty disease that little girls can’t catch but which she might catch when she’s a grown up if she doesn’t have the jab? If she wants to know whether Mummy’s had the jab and, if not, why hasn’t she caught the disease, then the truthful answer is that not that many people catch it anyway, but this makes it even less likely you’ll get it.

As I say, I don’t have children, but I’d have thought that if a parent seriously believes that the only thing preventing his daughter from having under-age sex is the fear of catching something nasty, then something’s gone badly wrong somewhere.

My late wife, who was sometimes called upon to dispense advice to female teenage relatives in her role as somewhat glamorous and louche auntie, used to have far more convincing arguments than that for waiting until you were a bit older; frequently that was what the girls wanted to hear, anyway — they just wanted reassurance that all their friends weren’t actually all at it like knives and that, if their boyfriend was threatening to dump them if they wouldn’t give him sex, he was ipso facto a blackmailing loser who didn’t deserve to get any and would, in any case, almost certainly be useless in bed anyway.


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