Pharmacy medication use reviews: http://burningourmoney.blogspot.com/2009/11/earning-your-pharmacist-honest-crust.html. I don’t find them useful. Several of my patients found themselves half way through them before they realised it was not just some strange delay in collecting their medicines. This is not a good use of NHS money.
Medicines use reviews poorly conceived
January 28th, 2010Sexual health is mostly looked after by GPs
January 23rd, 2010As with most common problems, most of the work is done by GPs, and their staff, in General Practices. It is done cheaply, conveniently, quickly, and well. Sometimes people are referred onward.
So why does the NHS’ misleadingly named “Choices” website rank general practices last, mis-describe them “local doctor” and point people with very ordinary common problems toward newer, more expensive, less convenient other locations for service?
Perhaps because the advice panel is chosen to not include a GP.
If I was looking for a cause for irritation, I’d complain that my taxes were being used to direct me toward someone’s empire that would cost me more to provide than wahat is already to hand.
http://talk.nhs.uk/blogs/sexualhealth/archive/2010/01/22/i-frequently-get-a-white-vaginal-discharge-increased-need-to-go-to-the-toilet-and-also-a-burning-sensation-after-sex-what-could-it-be.aspx#comments
The advice sucks, also, and it isn’t a blog despite being labelled as such in its URL.
US supremes on patents
January 20th, 2010Heavy, but potentially interesting.
http://www.supremecourtus.gov/oral_arguments/argument_transcripts/08-964.pdf
Judgement is awaited in June.
From http://www.theregister.co.uk/2009/11/11/patent_arguments_at_us_supreme_court/
neologism definition: methadrone
January 5th, 2010Methadrone: a doctor employed by the drug addiction service to prescribe according to guidelines.
New World Encyclopaedia, and other filtration of the wonders
January 5th, 2010If you look for things using Google you will sometimes see this reference come up. It is quite obviously lifted from the Wikipedia Project (WP), and properly acknowledges that and links back to article history, but is written explicitly with a Reunification Church (“Moonie”) point of view.
WP espouses – and sometimes fights about – a neutral POV – (NPOV).
Looking at the WP articles I’m particularly aware of, there is some subtle distortion having passed through the approved Moonie (would “Moonist” be more polite, I’m not trying to be rude about them particularly) authors’ hands.
I assume as a default that any religious preface or shell to writing or other media will be pushing an agendum by distortion. The Moonies are actually slightly more explicit and clear about what they are doing than some Xian sects flogging DVDs with a whiff of irreducible complexity and the argument that only immaterial superbeings of immense powers but with no telephone number can arise out of nothing with no antecedent reality, and must do so in order to produce a less complex universe which is too complicated to have simply arisen.
Possibly I’ve missed a subtlety, and possibly I simply don’t have the right phone directory.
Kings fires Albany
January 5th, 2010From the Kings press release. (I’m behaving like Press)
http://www.kch.nhs.uk/news/archive/2009/albany-midwifery-practice/
Albany Midwifery Practice
King’s College Hospital puts patient safety before all other considerations. For this reason we have terminated our contract with the Albany Midwives practice.
We have become concerned about the safety record of the practice in comparison with the Trust’s overall maternity safety record. Our records show that whilst Albany delivered babies for 4% of all King’s births, those births accounted for 42% of our full term babies born with Hypoxic Ischaemic Encephalopathy, a condition whereby brain damage may be caused by a lack of oxygen to the brain, at or around the time of delivery. The Trust formed the view based on this evidence that babies delivered by an Albany midwife were at higher risk of contracting serious Hypoxic Ischaemic Encephalopathy (HIE). Albany are responsible for some 200 births out of an annual total of around 5,700 babies born at King’s.
Because of our concerns, we also asked The Centre for Maternal and Child Enquiries (CMACE) to carry out an independent investigation. The review was not a statistical analysis – it set out to ascertain the underlying causes of the poor outcomes associated with the Albany practice.
Albany are working with us to ensure that women booked with them are being looked after. We also hope that individual Albany midwives will join the Trust as employees. The Trust runs nine other midwife-led community practices, who offer choice to the women of SE London. At 9%, King’s has one of the best records of home births in the county.
We have shared a copy of the CMACE report with the Albany practice. We have also briefed and sent a copy of the report to the Royal College of Midwives, The Nursing and Midwifery Council, Monitor, the Care Quality Commission and the Department of Health, as well as other local and national stakeholders.
”
Odd description of 9% as being best, given the rest of the content. Absolute numbers and risks are better than relative ones, but that does not look like something that was working well.
Trilobites’ eyes
December 30th, 2009Trilobites made their eye lenses out of calcite, an interesting mineral. (Not all Trilobites had eyes, some lived where it was dark, and there were a lot of species).
Only one[2] extant species uses that arrangement, or any other mineral as a lens
Eyes of various sorts exist and have existed. The eye of the Nautilus, a sea-going cephalopod with its shell on the outside unlike all other surviving cephalopods are pinholes.
The octopus has an eye very similar to the backboned animals, but better in one way if considered as a design[1] than ours, with the wiring behind the sensor rather than in front and in the way.
The Nautilus then has perhaps 10% of an eye, if we were to consider the octopus as having 100% and us as perhaps 95%
And that 10% of an eye is superbly effective and useful for them, although ours and our 8-limbed distant cousins’ are even more superb and even more effective.
The amount of data required to specify a human is very large. Arthur C Clarke discusses it in the last of the Space Odyssey novels.
That required to specify a Trilobite is rather less.
I propose a (large) unit of data, the Trilobyte, that amount of data sufficient to specify a Trilobite. It would be 8 Trilobits if we stick with the 8 bit byte..
[1] which would be a silly way to actually consider the eye, or any other of our evolved structures
[2] http://news.nationalgeographic.com/news/2001/08/0822_starfisheyes.html a 2001 report in National Geographic of the use of Calcite over photoreceptors on the arms of the brittle star “Ophiocoma wendtii is the first of its kind observed in nature”. Thanks to Iain Varley
[3] now with a marginal addendum in the passage from Fortey 2000 published in The Oxford Book of Modern Science Writing.
My cat jumping at laser pointer dot
December 30th, 2009This took a bit of setting up, but then for reasons which escape me rose very high in the Google image search.
The shadow is a little like a cave painting.
Epiphenomena of the act of travelling.
December 29th, 2009Pictures: The act of travel: Flickr set
Practice boundaries
December 18th, 2009The debate reported in Parliament touches some useful points.Debate: Hansard However, the reason we have practice boundaries is that since 1948 the Department of Health (with or without Social Security) and the Executive Ctees and various health authority names – now PCTs – have always declined to relax the rule they insist on that anyone within our Practice boujndary may register and seek our services, and crucially that anyone outside we accept we must agree to visit when needed at that address.
Removing that would be a very easy way to eliminate at a stroke and in a quiet and gradual way the problem the government discern with registration.