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Health Care

The gall is strong with this one

Iagree with Will Hutton that the essence of socialism is fellowship, and it’s easy to show what that can mean in practice (“Socialism isn’t a dirty word. It’s simply about wanting to make a fairer society”). The NHS is essentially a system of mutual medical aid with state funding, paid for by income tax – the more you earn, the more you contribute – which means it is firmly rooted in the socialist principle “from each according to his ability, to each according to his needs”. It has been the most popular institution in the country for almost 80 years. People may complain about its performance (largely caused by Tory attempts to dismantle it), but how many of them criticise it for being socialist?

I’d like Labour politicians to pledge to apply the principles of the NHS to other state bodies. And if the Tories and the rightwing press scream that this is socialism, Labour should ask people how bad the socialism of the NHS has been for them.
Charles Osborne
Prague, Czech Republic

Prague, eh?

The Czech Republic has a universal health care system, based on a compulsory insurance model, with fee-for-service care funded by mandatory employment-related insurance plans since 1992.[1] According to the 2018 Euro health consumer index, a comparison of healthcare in Europe, the Czech healthcare is ranked 14th, just behind Portugal and two positions ahead of the United Kingdom.

Ah.

I stand to be corrected

Actually, I ask so as to be corrected:

The world’s first personalised mRNA cancer vaccine for melanoma halves the risk of patients dying or the disease returning, according to trial results that doctors described as “extremely impressive”.

Melanoma affects more than 150,000 people a year globally, according to 2020 figures from World Cancer Research Fund International.

Patients who received the vaccine after having a stage 3 or 4 melanoma removed had a 49% lower risk of dying or the disease recurring after three years, data presented at the world’s largest cancer conference showed. The NHS in the UK is among the organisations testing the jab.

I’ve a very vague idea running around my head. Rough mind – a rough idea not a rough mind, we all already know that.

So, it’s long been an idea that it would be really great if we could “vaccinate” the immune system to go eat cancers. This would require a cheap – in fact by the standards of the industry, very, very, cheap – method of producing vaccines. There are so many cancers, the “vaccine” would need to be personalised for each patient. We’d like to get that “vaccine” production price – not per shot, but per personalisation – down into the $100s or perhaps $1,000s per treatment.

Hmm, OK. Now, I’ve got this vaguery that that’s what mRNA was all about. Covid was a sidestep, it just happened to arrive as the tech was maturing. But the aim was always cancers.

So, am I right on this? Or is this something I’ve made up after the fact?

BlokeinGermanywhoisnowinmycountry?

Erm

The official inquiry by Sir Brian Langstaff concluded the pharmaceutical industry’s contaminated product manufactured by subsidiaries of Bayer, Baxter and other drug groups to treat haemophilia did not contain adequate warnings and should never have been licensed.

Diana Johnson, the Labour MP and the chair of all-party parliamentary group on haemophilia and contaminated blood, said: “The pharmaceutical companies need to apologise and there needs to be a claim against them for some of this money.”

If it was the licence that was the problem then it should be those who granted the licence, no?

It’s also worth making another point or two. Hep C, for example, we didn’t even know it existed in the 70s, didn’t have a test until into the 80s. At some point of ignorance the outcome, however appalling and shitty, becomes just one of those things. It’s also true that even if we accept that then there’s still that further point. The scandal here isn’t that shit happens, it’s that shit having happened the establishment blew smoke and backfilled for decades.

Finally, there are those who insist that it was all about neoliberalism and capitalism and using paid donors in the US and all that. And here’s the problem. There’s not one place, not a single country nor health system, that collects enough plasma or blood products without the use of paid donors. Whole blood, yes, but not blood products. Again, jus’ one of those things. Factor VIII means paid donors. As the UK – or the NHS – goes into complete conniption fits whenever money is mentioned this does mean buying from the US. Sorry, but it does.

This sounds like a very high rate

Results Individuals who underwent gender-affirming surgery had a 12.12-fold higher suicide attempt risk than those who did not (3.47% vs. 0.29%, RR 95% CI 9.20-15.96, p < 0.0001).

I’m not competent to deconstruct a medical paper in the same way that I sometimes to often can an economic one. Anyone with that sort of training (BiG? Grikath?) like to walk us through this?

My immediate response is that it’s not looking at those who think they are trans and don’t have surgery with those who think they are and do. But as above, what do I know?

A plan that could actually work – better bras

Women are driving record worklessness because of ill health, analysis has found, as a growing number drop out of the jobs market because of neck and back pain.

More than 1.5m women have dropped out of the workforce because of long-term sickness, according to analysis by the Trades Union Congress (TUC), which blamed rising NHS waiting lists for the crisis.

The figure marks a 48pc increase compared with five years ago, equivalent to 503,000 women.

This means that women account 59pc of the rise in economic inactivity due to long-term sickness over the past five years, compared with 37pc for men.

Musculoskeletal issues, such as back and neck pain, were the biggest driver of women leaving the workforce due to ill health, with the number of women economically inactive as a result rising by 126,000.

So, we know frpm other sources that Britons are becoming ever fatter. Some of that weight gain will be, in women, in bigger tits. Big tits is a well known – possible, obvs – caise of back and neck pain. Something that can be alleviated by wearing a properly fitted and sized bra.

So, the Worstall solution is the British Bra Service. Checking that the laydeez are indeed properly fitted. It’ll have to be a proper hands on job of course. Willing to help out on that side directly – see the sacrifice I’m willing to make for the public good? – but very selectively of course.

The weird thing here is that actually checkling bra fittings would in fact help this specific problem. Not that we want the British state – or Worstall – to be doing any of it but it would still help.

Bandwaggoning a bit, innit?

And when grief is compounded by an injustice — an outside factor, a chain of decisions that were morally unlawful — it can become unbearable. I often have to bury the issue of my mum’s contamination with hepatitis C because it hurts too much.

Well, OK.

I feel both guilty and conflicted for not standing up for my mum more vocally, especially since she championed so many vulnerable people. I am part of a congregation of heartbroken families who have been subjected to a form of institutional manslaughter or murder. I use the term “murder” because the negligence has continued to knowingly cause harm.

Wellll

The Body Shop founder contracted fatal hepatitis C from a transfusion after giving birth in 1971.

Ah. 1971. Hmm:

In the mid-1970s, Harvey J. Alter, Chief of the Infectious Disease Section in the Department of Transfusion Medicine at the National Institutes of Health, and his research team demonstrated how most post-transfusion hepatitis cases were not due to hepatitis A or B viruses. Despite this discovery, international research efforts to identify the virus, initially called non-A, non-B hepatitis (NANBH), failed for the next decade. In 1987, Michael Houghton, Qui-Lim Choo, and George Kuo at Chiron Corporation, collaborating with Daniel W. Bradley at the Centers for Disease Control and Prevention, used a novel molecular cloning approach to identify the unknown organism and develop a diagnostic test.[128] In 1988, Alter confirmed the virus by verifying its presence in a panel of NANBH specimens, and Chiron announced its discovery at a Washington, DC Press conference in May 1988.

In 1971 we – as a species – didn;t even know of the existence o9f hepatis C. Let alone have a test or anything.

It’s really a bit over the top – de trop even – to be calling this institutional murder you know….

Fascinating

Nearly half of all cancer cases are linked to obesity, new research has found.

The study of more than four million adults, who were tracked for decades, found excess weight could be fuelling more than 30 types of the disease.

Experts said the findings, which will be presented at the European Congress on Obesity in Venice, were “groundbreaking”, showing a timebomb ahead.

Health charities urged ministers to act on the “wake-up call,” with obesity already estimated to cost the country almost £100 billion a year, including £19 billion in NHS costs.

Could even be true. But we do still need to shoot the first person who claims that us all being thing will save the NHS money.

As explained so often, we all die, we all gain terminal care, the NHS is a lifetime health care organisation. The determinant of the lifetime cost is not, therefore, what we die of nor that terminal care – it’s how may years we’re cared for. Well, within certain bourndaries that is.

Obesity, tabs and booze all save the NHS money, not cost it.

The Telegraph and numbers

Really not sure about this at all:

How risky was the AstraZeneca vaccine?
Compared to other scenarios

Death from giving birth

1 in 12,500

That looks about right. Maybe? But it’s the number for those who give birth. Maternal mortality is 6 per 100k or something I think?

Death from receiving

general anaesthetic

1 in 100,000

Can believe that, not that I know anything about it.

Chance of being hit in your

home by a crashing aeroplane

1 in 250,000

Umm, no?

The other numbers are for people who do something. That one’s for the entire population. We do not have 268 people a year who die from a plane landing on them.

No, it’s possible that they’ve taken death as being already certain, so Bayesian and all that. Which would – given 500k deaths a year – mean 2 people a year die from planes hitting houses. About right. But then that’s not the risk of dying from – that the risk of the cause of your death being.

Well, sorta

Teenage cancer patients will die because of trial age limits which prevent them from testing new drugs, a charity has warned.

A new report published by the Teenage Cancer Trust has found that young people aged 13–24 are missing out on the chance to take part in clinical trials, leaving them unable to get innovative new treatments that could increase their chances of survival.

The report found that young people often find themselves too old to take part in pediatric trials and too young for adult trials.

They also don’t risk being killed by the treatments that don’t work. Bit of a swings and roundabouts thing.

The assumption being made is that these experimental treatments do, on average, work, which is why those not in the trials are missing out. Which is a fairly brave – in that ministerial sense – assumption, no?

Yes, yes, I know that absolutely everything about this is wrong

But a way for me to think about this:

The vaccine is an individualised neoantigen therapy. It is designed to trigger the immune system so it can fight back against a patient’s specific type of cancer and tumour.

Known as mRNA-4157 (V940), the vaccine targets tumour neoantigens, which are expressed by tumours in a particular patient. These are markers on the tumour that can potentially be recognised by the immune system.

The jab carries coding for up to 34 neoantigens and activates an anti-tumour immune response based on the unique mutations in a patient’s cancer.

To personalise it, a sample of tumour is removed during the patient’s surgery, followed by DNA sequencing and the use of artificial intelligence. The result is a custom-built anti-cancer jab that is specific to the patient’s tumour.

There’s a story doing the rounds about what happened to a covid patient. Flus and the like can kill through a “cytokine storm”. When the immune system goes absolutely wild trying to kill off whatever and it kills the whole body.

However, occasionally – occasionally! – such a storm doesn;t kill the patient. And this happened to that one covid patient – his terminal cancer got killed off by the storm and he didn’t. The storm was, that is, just enough to kill everything that wasn’t exactly him but not enough to kill him.

So, me being me, I’ve been just assuming that a decent treatment for all sorts of things would be an induced cytokine storm (not that I actually know what one is in any detail) that did that 99% but not the last 1%.

And it’s possible to think of this new vaccine – possible, obviously, because that’s the way I am thinking of it, rightly or wrongly – as being a smaller version of just that. Get the immune system to go wild on the cancer. Sorta, go Israeli on Gaza rather than go British on Dresden as in the true storm.

It’s not right but suits me as a mental model.

The problem with such not right metnal models is that this then leads one on to further speculation. What about inducing more vicious but not fatally vicious such storms? How far could you take this over-excite the immune system?

Confounding factors

The death rate for female patients was 8.15 per cent when treated by female physicians compared to 8.38 per cent when the physician was male.

It means that in every 1,000 patients treated, an extra two would be expected to survive if they were treated by a woman.

While the difference for male patients was smaller, female physicians still had the edge with a 10.15 per cent mortality rate compared with male doctors’ 10.23 per cent, a difference of around one death in a thousand.

There will be some – even many – and the researches validity will depend upon whether they deal with them properly or not.

A study in February found there is still “considerable gender inequality” in surgical fields in England and Wales and that “surgery is still a specialty that struggles to recruit women”.

Quite so, there are distinct gender inequalities across fields of medicine. Maybe the birds are more likely to be treating the easier stuff?

Well, no, not as far as I know

In the late 18th century, as recounted in Gary Taubes’s book Rethinking Diabetes: What Science Reveals About Diet, Insulin and Successful Treatments, a Scottish doctor by the name of John Rollo helped two patients with diabetes (a rarer condition those days) return to health by restricting their carbohydrate intake.

I have a feeling that “rarer in those days” was because those who did have diabetes were dead. So the incidence of the disease was the same, but the ongoing populsation of those with was lower. Combine that with hte number already dead from lurgy, plague or teeth and we’ve a pretty comprehensive explanation.

As I’m not an expert in health I’d not insist upon that explanation – but I’d want to see that refuted before I believed other explanations. Espeically since people are using the grifter Taube as their source here.

Fuck off, Matey

So I’ll try here to follow Michael Foot’s advice. Let’s acknowledge and confront the strongest argument against assisted dying. As (objectors say) the practice spreads, social and cultural pressure will grow on the terminally ill to hasten their own deaths so as “not to be a burden” on others or themselves.
I believe this will indeed come to pass. And I would welcome it.

Come on Granny, top yersel’, we want the money.”

Fuck off.

Trade offs, all is trade offs

A contraceptive injection has been linked to brain tumours in women, a BMJ study has found.

Researchers found those who had used the contraceptive injection were 5.6 times more likely to develop a brain tumour. The study was the first to assess the risk of treatments using the hormone progesterone in relation to brain tumours.

Doesn’t ring right really

Calmette and Guérin could have never imagined that their research would inspire scientists investigating an entirely different kind of disease more than a century later. Yet that is exactly what is happening, with a string of intriguing studies suggesting that BCG can protect people from developing Alzheimer’s disease.

If this is true then those who have had the BCG should be protected against Alz. Yet all those in the care homes are of an age where they would have had the BCG in childhood…..

What’s the bit I’m missing here? Attenuation (right word?) of the effect over time?

Umm

Prosecutors in Canada have upgraded murder charges against the man who allegedly mailed “suicide kits” and is allegedly linked to more than 100 deaths in several countries.

Kenneth Law, who is due to appear in court on Thursday, now faces 14 counts in Ontario of first-degree murder and 14 counts of counselling and aiding suicide in the province. Canada’s criminal code punishes anyone who “counsels or abets” a person to die by suicide with a sentence of up to 14 years in prison. The victims range in age from 16 to 36.

Fair number of doctors are going to get caught by that, aren’t they?

Oooops, sorry, of course it’s legal for the State to do what people can’t.

Two things here

A former Champneys spa doctor has been struck off after he had a nine-year affair with a patient.

GP Simon Berrisford, 57, began seeing the woman after meeting her during a consultation.

The woman, named only as Patient A, was also given prescription drugs from Mr Berrisford until the couple split up in 2018.

Yes, shagging the patients is a bad idea.

But there’s an obvious thought. The complaint came 9 years later – after the split up. Which leads one to possibly suspect that it wasn’t the how they met but how they left which led to the complaint. Almost as if there was this technical matter which could be weaponised over the leaving, not the meeting.

But this:

‘‘The Tribunal acknowledges Dr Berrisford’s ongoing right to deny the allegation but found that his characterisation of the GMC’s proceedings as ‘persecutory nonsense’ exemplifies his hostile attitude towards his regulator.’’

How very dare you not take the posturings of bureaucrats seriously? A most serious crime that is.