Category Archives: medical

amusements, history, links, medical, science

Links What You May Have Missed

A pretty mixed bag of the curious and interesting which you may have missed in this instalment. Let’s start with the historical …

Archaeologists reckon they’ve located the exact site, and part of the structure of, the Curtain theatre in London’s Shoreditch area, which was used by Shakespeare prior to The Globe.

Meanwhile on the south coast some other archaeologists have discovered wall paintings of a dozen or so medieval ships in a Winchelsea cellar. That has to be worth a visit!

Elsewhere historians are puzzling over the possibility that the ancients were also visited by UFOs and flying saucers.

From ancient history to natural history … You always wanted to know about turtle sex, didn’t you? Well here’s a disquisition on the terrifying sex organs of male turtles. We’re promised girlie turtle anatomy to follow.

While on the subject of sex (well you just knew there’d be more, didn’t you!) back in 2006 an American Roman Catholic nun and theologian wrote a sensible book about sex and relationships. But now the Vatican has decided it doesn’t like the content and has banned it. What price Galileo?

Now, what will the medics come up with next? Oh, I know, fungi. After investigating the bacteria and viruses which reside in our guts they’ve now started to investigate similarly located fungi.

Scientists have also been investigating whether whether human farts are germ-laden, or merely malodorous. Turns out they are germ-laden, but only if you’re naked.

So now for something a little more appealing. Emily is getting married. (Well people will do it, y’know!) But what’s this? The latest wedding accessory appears to be … a birdcage! Her only question is “why?“!!

And finally while on the subject of nubiles, didn’t you always want to know what was inside Kylie’s knickers? Well now you can thanks to a surprisingly interesting collection of X-ray images of of everyday objects as art.

Toodle pip!

medical, science

Plastic Animals

Yesterday we took a trip to London’s Natural History Museum. I’ve not been inside the NHM for maybe 50 years although I go past fairly frequently. I left feeling strangely disappointed.

We went mainly to the the latest Gunther von Hagens exhibition, Animals Inside Out, which is a display of his plastination, anatomical and display skills. It is the animal equivalent of the blockbuster Bodyworlds, which I’ve still not managed to see.

Von Hagens’s skills are incredible. And the displays were interesting, revealing and illuminating. They varied from the tiny brain of a hare to a complete giraffe; from a scallop to a shark. The blockbuster pieces had to be the giraffe, an elephant and an entire bull. Oh and this camel which is outside the (paid) exhibition in the impressive Central Hall of NHM underneath the dinosaur’s tail!

Plastinated Camel Plastinated Camel

The actual display pieces were amazing. But having said that I was disappointed. We spent about 45 minutes in the exhibition. I would have liked to spend longer there, and would have done had there been any more to see. The expense of putting on an exhibition like this is immense; GOK how much it costs and how much time it takes to plastinate an ostrich, let alone a bull or a giraffe! But even so I felt the exhibition was a bit thin, both in the number and variety of exhibits and the information provided. I would have liked many more examples.

Especially I would have liked a lot more explanation of what I was looking at. My anatomy is pretty damn good for a non-medic/zoologist/vet. I know where a fish’s gill plates are but does Joey Schoolboy? But I don’t know the detail of how a sheep’s guts are arranged. And I wanted to be told, if only with some labelled diagrams. I felt the explanatory texts were much too terse. OK many people don’t want, and can’t take in, huge amounts of detail. So put that detail in separate panels which they can choose not to read.

Oh, you mean the detail is all in the book of the exhibition? But why do I have to buy the book? OK so it’s only £12.99, but I neither want nor need the book. I wanted to be told what I was looking at! But then the exhibition is only £9 (full price) which I thought very reasonably priced — I’d expected it to be more like £15 or even £20. So I suppose I shouldn’t complain.

After the exhibition we went to the main restaurant for coffee and cake (the NHM has something like four food outlets and as many shops!). This was another depressing experience. The restaurant system is so arcane (and unwelcoming) they have to employ someone full time to explain it to people. The décor was fairly dire. The only saving grace was that the chocolate fudge cake was fairly good.

Then after that I wanted to look at the fishes. What fishes?! The fish displays seem to consist of four wall displays tucked in a blind corridor at the back of nowhere. And totally uninteresting. This was old style museum display at its worst: a selection of almost random exhibits stuck in a case with nothing to make it at all interesting, no obvious variety of different biotypes (marine vs freshwater; tropical vs temperate). The marine invertebrate displays next door were exactly the same: a huge room with very boring displays in wall cases and nothing else.

After that, and looking at the plastinated camel and (over-hyped) dinosaur in the Central Hall my back was complaining so we didn’t investigate further. Maybe we should have done and maybe some of the other displays would have been better, but it didn’t look enticing. So we gave in and came home.

OK so what’s the bottom line?

If you’re interested in the broad ideas of how animals work then do go and see Animals Inside Out. It is worth the admission charge; just don’t expect too much. If you go expecting anatomical detail and explanation, as I did, you’ll be disappointed. And judging by our experience if you go on a mid-week early afternoon during school term the exhibition will be quiet.

As for the rest, frankly I won’t be going back in a hurry.

Sorry guys, but I much expect better of major world museum in this day and age.

medical, quotes, science, thoughts

Gardening the Mind

I came across the following quote from Jill Bolte Taylor’s Stroke of Insight on the interwebs the other day. It seems a good take on personal development and personal responsibility.

I view the garden in my mind as a sacred patch of cosmic real estate that the universe has entrusted me to tend over the years of my lifetime. As an independent agent, I and I alone, in conjunction with the molecular genius of my DNA and the environmental factors I am exposed to, will decorate this space within my cranium. In the early years, I may have minimal input into what circuits grow inside my brain because I am the product of the dirt and seeds I have inherited. But to our good fortune, the genius of our DNA is not a dictator, and thanks to our neurons’ plasticity, the power of thought, and the wonders of modern medicine, very few outcomes are absolute.

Regardless of the garden I have inherited, once I consciously take over the responsibility of tending my mind, I choose to nurture those circuits that I want to grow, and consciously prune back those circuits I prefer to live without.

Although it is easier for me to nip a weed when it is just a sprouting bud, with determination and perseverance even the gnarliest of vines, when deprived of fuel, will eventually lose its strength and fall to the side.

amusements, arts, links, medical, science

In Case You Missed …

The usual links to things which have amused me and which you may have missed …

First of all … politics. Never short of an Idiot, and interesting cynical take on James Murdoch vs David Cameron.

And secondly … politics. The politicians are about to remove some of the interest in our lives by having “a bonfire of dead wood statutes” and abolishing some 800 outdated and obsolete laws. Have they really nothing better to do? Oh, sorry, it’s their job to make our lives boring.

So to alleviate that boredom here are a few seriously amazing items …

How long would it take to travel to the moon at the speed of whale? One Minute Physics has the answer.

[Not safe for the faint-hearted!] Turning to biology, entomologists have recently found and described an enormous Warrior Wasp, aka. Waspzilla. Talk about awesome! Yes, I really would love to meet one.

Still on the biological, I discovered The Tiny Aviary, the website of illustrator Diana Sudyka. Gorgeous drawings like the one above.

And finally more stunning art, this time from Dalton Ghetti who carves sculptures in pencil lead. How you even start doing that makes my head hurt!

Enjoy!

current affairs, environment, medical, science

Fukushima Reprise

4 Comments

There’s so much going on at the moment that I should be writing about that I’m having a hard time keeping up! Anyway here’s the next piece.

There was an interesting, and I suggest important, “Opinion” article in last week’s New Scientist (dated 17 March 2012). In it Don Higson, a fellow of the Australasian Radiation Protection Society, argues for the total revision scale on which nuclear accidents are measured and points up the lack of true comparison between Fukushima and Chernobyl. Along the way he highlights the major differences between the two in health effects, adding some further important perspective on the situation.

The article itself is behind a paywall, so I hope I’ll be forgiven for reproducing some factual highlights here.

Everybody who gets cancer in Japan over the next 40 years will no doubt blame their misfortune on radiation from Fukushima Daiichi […] This would be entirely understandable but will have no basis in science […]

[T]here is no possibility that the physical health consequences of Fukushima Daiichi will be anywhere near as bad as those of Chernobyl.

As far as anyone knows, no member of the public received a significant dose of radiation attributable to the Fukushima Daiichi reactor emergency […]

Chernobyl was the worst that could happen. Safety and protection systems failed and there was a full core meltdown in a reactor that had no containment […]

237 Chernobyl workers were taken to hospital with suspected acute radiation sickness; 134 of these cases were confirmed; 28 were fatal; about 20 other workers have since died from illnesses considered to have been caused or aggravated by radiation exposure […]

On top of that, it has been estimated that about 4000 people will die […] from radiation-induced cancer […]

At Fukushima Daiichi, the reactors shut down safely when struck by the magnitude-9 Tohoku earthquake […] problems arose after they were inundated by a much larger tsunami than had been anticipated when the nuclear plant was designed […] The reactor containments were partially effective […]

There were no deaths attributable to radiation. Two workers received burns from beta radiation. They were discharged from hospital after two days. Two workers incurred high internal radiation exposure from inhaling iodine-131, which gives them a significant risk of developing thyroid cancer.

Doses incurred by about 100 other workers have been high enough to cause a small risk of developing cancer after 20 or more years […] About 25 per cent of the population dies from cancer whether accidentally exposed to radiation or not. This rate might be increased by an additional one or two per cent among the exposed workers […]

[T]here have been no radiation injuries to children or to other members of the public […]

[T]he amount of iodine-131 escaping from all the reactors at Fukushima Daiichi was less than 10 per cent of the amount released at Chernobyl, and the release of caesium-137, the next most important fission product, was less than 15 per cent of the Chernobyl total […]

As I’ve said before, we need to keep this in perspective.

While there are clearly many, many lessons to be learnt Fukushima should be looked on as a success story in terms of reactor design. Yes there were shortcomings in the design of the resilience, the fall-back ability, the processes and the communications. And there have been massive knock-on effects on the population and the environment — and indeed it has been argued the worst of the health effects will be the devastating mental stresses on the Japanese people (see, inter alia, this Guardian report).

But given that those reactors are 40-ish years old, and that even before March 2011 we knew a lot better how to design safe and secure reactors, this should be viewed as a (limited) success story.

current affairs, medical, ramblings, science

Curing the NHS

Recently I’ve been looking at the NHS as an outsider and a user. This has led me to think about the organisation, it’s shortcomings and whether anything really can be done to improve it.

The Health Service is something that we all want, and for which we all pay taxes. So we expect that when we need it not only will it be there, free at the point of use, but we will get the best possible treatment, speedily, in a good environment, from professional people and a professional organisation.

Sadly one or more of those elements are nearly always lacking, often conspiring to make patient care less than optimal.

Don’t get me wrong. Many parts of the health service are excellent. And in an emergency they generally work brilliantly, at least in the short-term.

Recently Noreen and I attended a Patient Participation Group which our GP practice has started. Everyone there was self-selected and had volunteered; they were not “yes men” hand-picked by the practice. And everyone there had nothing but praise for our excellent GPs, nurses and admin/reception staff — indeed we found it quite difficult to come up with anything major we thought they needed to improve. The only significant thing we homed in on for improvement was some of communicating with the body of patients as a whole. But our doctors are lucky; they have excellent staff throughout the practice and new-ish purpose-built accommodation. Nevertheless they are now short of space to do all the things they want to do.

Many parts of the Health Service are not so lucky. Visit the average NHS hospital and you’ll find a run-down building containing a large number of staff many of whom (especially at the lower levels) appear poorly paid, poorly trained, poorly managed and demotivated, giving off an air of being oppressed and disinterested. One suspects there may also be bullying by both management and unions. They seem ground down and struggling to do a good job against a background of inefficiency, waste and the awfulness of the people (mostly patients!) they have to deal with.

And that’s a two way thing. Staff (and an organisation) that don’t care about patients encourage patients to not care about how they treat the staff.

This has to lead to an attitude of unprofessionalism. As an example I am continually horrified by the awfulness of the communications I receive from all parts of the NHS. They are written in poor English (GOK what their Gujarati translations are like!); poorly typed; poorly designed; poorly printed. One recent letter I received was offset such that the right hand edge of the text was missing, it was faintly printed, poorly worded and covered in printed-on splodges of toner. It looked slapdash and unprofessional; the work of a not very careful 10-year-old. Frankly I would have been ashamed to even put it in my rubbish bin, let alone send it to anyone. And yet this was an important communication.

Go to a private hospital and you generally find exactly the opposite of all this: personable, helpful, interested, caring and motivated staff at all levels and good communication.

Why does the NHS have to be this way?

The simple answer is that it doesn’t.

Whilst bringing the whole of the NHS up to the standards of the best private hospitals may be neither achievable nor affordable, it should be possible to achieve a 500% improvement. (And this doesn’t mean US-style healthcare where one has to pay for everything or go without.) It won’t be easy; but if there’s a will I believe it could be done. In broad terms this is how I see it being done …

  • The NHS always maintains it is short of money. It isn’t; it has shedloads of money to do everything it should (and we want it to) sensibly do. But …
  • It also has too many meaningless, politically imposed, targets.
  • In consequence there are also far too many managers.
  • It probably also has too many (non-productive) admin staff. There always seem to be lots of people walking about carry pieces of paper but apparently doing little else. I’m not saying they are all unnecessary, but does anyone really know?
  • On top of this there appears to be an especially corrosive and pervasive culture; a culture of mistrust and of doing the minimum necessary; a culture which generates unprofessionalism and a couldn’t-care-less attitude.

So what can/should we do about it?

  • Well first of all there has to be a real will to do something and act sensibly, not just out of short-term political expediency or protecting one’s backside.
  • Then the budget has to be maintained at least at current levels, in real terms.

  • In doing that there has to be a vast improvement in cost control (yes, drug spend does need to be monitored, but hopefully not rationed), which means good stock control and the reduction of waste.
  • Scrap all but the most essential of targets and have what targets there are set by the clinicians for it is they who really understand what the patient needs. One target which must remain is to ensure the service is the same across the whole country; there must be no postcode lottery.
  • That should mean a reduction in the number of managers required, which will free large sums of otherwise non-productive money for patient care.
  • Then we need to look very critically at the number of non-clinical, non-managerial staff required. Reductions, where sensible, should be achievable by streamlining much of the (still largely paper-based) admin. That doesn’t mean an all-singing-all-dancing ginormous IT system; it means a large dose of analysing what really happens, what needs to happen and lots of common sense.
  • Much of all of this can be achieved by empowering all NHS staff to make the right decisions for the patients (both individually and collectively), empowering the staff to help improve their environment (why shouldn’t they repaint a wall or fix a door handle? — they’d do it at home!) and take pride in what they do.
  • All of this will only happen with a major change in culture to one which cherishes and values both the employees and the patients; a culture in which the staff treat the patients (and each other) as they would wish to be treated themselves. That has to start at the top: the top of each hospital/practice and the top of the NHS, ie. with the politicians and Civil Servants. Lip service won’t do; management have to demonstrate that they mean what they say. It also needs the staff — and the unions — to engage with, and believe in, the process and have an element of trust in it.

None of this will be easy. I’ve worked in an organisation where it has been done. It is difficult, painful and takes time. It needs a determination from everyone to make it work. Heads will have to be banged together. It almost certainly means shedding staff: if nothing else the non-believers have to be encouraged to change or move elsewhere — for their good and that of the organisation. It needs good, no-nonsense, management at the top; management with a long-term vision, a determination to make the right things happen and the charisma/skills to be able to fully engage with their staff at all levels. It also needs the unions to be willing to embrace the change (or be sidelined).

What is not needed is what we currently have: short-termism, poor management, bullying and continual change driven b
y political expediency.

Someone has to get a grip. Sadly I don’t see who that someone is.

amusements, medical, ramblings, science

Did You Know ….

There is a brothel in Prague where the “services” are free, but live video streams of the “activity” in the brothel are shown on their website (for a fee).
[Wikipedia]

Male chimps, bears, dogs — indeed almost all mammals except humans — have a bone in their penis, called the baculum (photo is a raccoon baculum). No-one knows why it was evolved out of humans.

In the US, of those men who take paternity tests some 30% find out they are not the father of the child concerned – although of course these are cases where there is doubt to start with.
[Sheril Kirshenbaum, The Science of Kissing]

amusements, medical, science

You've Got What?!?!?!

One of my less endearing qualities is a lay-scientist’s interest in emerging infectious diseases (of plants and animals). And as such I follow ProMED which disseminates reports of these things from around the world to the scientific community.

And are there some strange and amusingly named diseases out there. So I was amused, but not surprised, this morning to see a report of Wobbly Possum Disease in New Zealand. If you wrote it in a novel, or indeed a comedy script, no-one would believe it! But what would you call a disease which makes possums, well, wobbly?

Others that always amuse me for their names are Astrakhan Spotted Fever (which affects humans), Flaccid Trunk Disease (of elephants), Lime Witches’ Broom Phytoplasma (affecting citrus trees) and O’nyong-nyong Fever (also affecting humans).

Yes, it’s a strange world we live in!

links, medical, photography, science

In Case You Missed It …

Links to a selection of the curious and interesting items you may have missed in the last week or so.

Do You Have Free Will? How can we know?

Heroes of the Hot Zone: pen portraits of some of the guys who are trying to clean up Fukushima.

Waterstones ditches apostrophe. English must be under threat when a bookshop ignores good grammar and makes it’s possessive Waterstones’s which is worse!

OK, here’s one for the mathematicians out there: 153 and narcissistic numbers. I want to know how they’ve proved what the biggest such number is.

Here are some seriously stunning 100 year old colour photographs of Russia (see right).

Difficult to work out here who is the madder: Amish men jailed over reflective triangle dispute.

Cats occasionally like all sorts of unsuitable things. Apparently some even like mushrooms.

And finally, just to prove it is worth goig to the gym … Scientists name rare horse fly after Beyonce “in honour of its impressive golden behind”.

medical

On the Sociobollocks of Wellbeing

OMG here comes another “deep thought” posting! GOK what they’re putting in my tea this year?!

David Colquhoun at DC’s Improbable Science has a reputation, along with Ben Goldacre, of exploding the myths of bad and pseudo science. In a post yesterday he’s got his knife into “Wellbeing“, that subject so beloved of the much reviled HR departments.

Sure we all like wellbeing. Who wouldn’t. But can we sensibly measure it? Can big (or small) organisations do anything meaningful to change it? I suggest the answers are no and no. It is a wimpy way for terminally ineffective and unnecessary droids to appear to do something useful. In fact I maintain it is divisive and destructive.

Divisive in that it ultimately sets one group of people at odds with another; eg. those who want extra time off for parents against those who have to pick up the extra work; us against HR. Destructive because it wastes time and money which could be better used.

Throughout my working life I have taken part in countless wellbeing type surveys: my former employer conducted just such a survey of employees every couple of years. There was a standard core of questions, and a set which varied according to mood of the year. It was supposedly used to measure employee morale and tell senior management what we thought of company policy, management, etc.

I must have completed well over a dozen, maybe as many as 20, such surveys in the course of my employ. Although optional I always took part on the basis that that however ineffective I thought they were, if you didn’t express an opinion then certainly nothing would change.

And that is exactly what happened: nothing changed. Not once in almost 35 years did I see any action result from survey feedback. Senior management were allegedly incented on increasing morale etc. (as measured by the survey). But this was never more than lip-service. Over the years morale steadily fell as HR policies became less sympathetic to the employee (pay freeze, less empowerment, emasculated pension schemes, downsizing, etc.). But neither senior management nor HR people ever suffered. Unlike the rest of us they always went on to bigger, better and more lucrative jobs.

Should this surprise us? Well no, not really. Because apart from a few headline figures (like the morale index, based on some fixed core questions) all the opinions expressed were aggregated and thus watered down into useless generalisations by the time they reached senior management. So the high-ups could then say things like “But that doesn’t tell us anything”, “That’s meaningless” or “They [employees] don’t understand”. And thus our views were universally ignored, despite platitudes to the contrary.

Result: a huge waste of time and money which could be better spent moving the business forward. At best all it did was to act as a brake on some of the more oppressive ideas which might have come out of the profit-hungry upper echelons. At worst it wasted 2-3 hours per employee. In a company of 250,000+ employees worldwide that’s an extra 400-500 people to develop the business.

Should it have been this way? Of course it shouldn’t. But such, I fear, is the way of the organisation — large or small. It is all too easy to cover a multitude of sins in smooth management platitudes; even I can do it!

But, you say, wellbeing is important. Yes, of course it is, at a personal level. It is at the peak of Maslow’s Hierarchy of Needs and is surely the hallmark of a civilised society. And morale should certainly be important to any organisation.

But I would maintain that wellbeing and morale are best changed at a personal level. They’re my responsibility. We don’t need a “wellbeing industry” composed, as it so often is, of quackery and get-rich-quick scams. Wouldn’t it be better to empower (and teach) people to look after themselves? Empowerment is, after all, one of the quickest ways to improve perceived wellbeing and morale at all levels.

I can’t do justice to Colquhoun’s latest article; it just contains the exposure of too much corporate HR hokum and sociobollocks. You need to go read it for yourselves. It’s too good to miss!