invisible disability.

28 Sep

Originally posted on at least i have a brain:

I was a long time diagnosed with, and talking about my Chiari malformation.
It’s one of those lifelong conditions..
the invisible chronic pains…
the one that you spend about 10 years proving you have…
and then you read the support literature which talks about “spoons”.
i said nothing for a while …before i ventured to ask…”what are the spoons about?” – round here in northern ireland  “you’re a right spoon!” is NOT a compliment.

So have discovered the Spoon analogy but still refuse to use it… BUT i understand the concept of chronic pain…everyday pain…deciding whether you have the energy to get off the bed…recovery days.

THIS IS a GOOD DIAGRAM representing invisible conditions.

I don’t have any listed but it covers connective tissue disorders, neurological conditions, brain malformations…even depression.

The easiest answer on the ODD day that you are OUT and met in town , to the question “How…

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Are lawyers and pharmacists addicts to tranquilizers ?

13 Sep

Two studies, whose material encompassed the Independent workers health plan data base, analyze the consumption of tranquilizers among various categories of professionals. Lawyers ranked high and pharmacists too.

Lawyers are confronted to conflictual situations by the nature of their work itself and pharmacists are tempted, being surrounded by the product itself; these are the two explanations that I could find for these intriguing results.

Here below are the links to the two studies (I contributed to the second paper).

1-Oxford JournalsMedicine & Health Occupational Medicine Volume 64, Issue 3Pp. 166-171.
Mental health and substance use among self-employed lawyers and pharmacists
S. Leignel1,2,3, J.-P. Schuster1,2,3, N. Hoertel1,2,3, X. Poulain1,2,3 and F. Limosin1,2,3

http://occmed.oxfordjournals.org/content/early/2014/02/09/occmed.kqt173.short

2-Presse Med. 2011 Apr;40(4 Pt 1):e173-80. doi: 10.1016/j.lpm.2010.10.026. Epub 2011 Jan 11.
[Psychotropic medication use by French active self-employed workers].
[Article in French]
Ha-Vinh P1, Régnard P, Sauze L.

http://www.ncbi.nlm.nih.gov/pubmed/21227628

We need to talk about titles

19 Aug

Originally posted on The Research Whisperer:

Jonathan LaskovskyJonathan Laskovsky is the Senior Coordinator, Research Partnerships in the College of Design and Social Context at RMIT University. He is primarily responsible for managing research partnerships support and administration within the College.

Alongside this role, Jonathan has research interests in modern and postmodern literature with a particular focus on fictional space and critical theory.

He tweets infrequently as @JLaskovsky and can be found on Linkedin.


A colon

The dreaded colon

We need to talk about titles. We’ve been neglecting them and it’s starting to show.

Neglect signifies that we once cared for titles but, for some reason, the care has ceased or become sporadic at best (insert your favourite garden-tending metaphor here).

This neglect might partly be explained by the ever-increasing pressure on academic life: large teaching loads, increasing demands for research output, conferences, meetings and other administrative distractions, as well as our paltry attempts to maintain some kind of work-life balance…

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Mediator

29 Jul

The French regulator ANSM is sued by a patient for not having withdrawn the Mediator from the market in the same timeline as the other developed countries.
Nevertheless the administrative court states that given that the French regulator ANSM speaks in the name of the French State the responsibility of the State is involved in this case should the causality between the product and the disease be shown.

The judgement of the administrative court (in French):

http://www.pearltrees.com/s/file/view/89794209/mediator.pdf

Propensity scores

25 Jul

Propensity score gives the probability of a subject in a population to belong to a group of interest such as a treatment group.
Then comparing subjects with the same propensity scores across treatment and no-treatment groups enables the researcher to infer on the effect of the treatment regarding a given outcome even if he works on merely observational data.
But the researcher must beware of the unobserved differences between the group of interest and the comparison group created using the propensity score.
As always the relevance of the model depends on the nature of the covariates entered in it.

Garrido, M. M., Kelley, A. S., Paris, J., Roza, K., Meier, D. E., Morrison, R. S. and Aldridge, M. D. (2014), Methods for Constructing and Assessing Propensity Scores. Health Services Research. doi: 10.1111/1475-6773.12182

http://onlinelibrary.wiley.com/doi/10.1111/1475-6773.12182/abstract

http://theincidentaleconomist.com/wordpress/methods-propensity-scores/

Case base study vs case control study

25 Jul

Unlike the case control studies the case base studies are well suited to the cross sectional extractions from the reimbursement data bases that we usually do.
The case base studies use the whole population of the database as a control group , including the subjects who are affected by the disease (ie the cases).
Thus, making no difference whether the subjects have the disease or not , the control group is far more easy to constitute.

Citation: Chui TT-T, Lee W-C (2013) A Regression-Based Method for Estimating Risks and Relative Risks in Case-Base Studies. PLoS ONE 8(12): e83275. doi:10.1371/journal.pone.0083275

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0083275#pone-0083275-g001

New blood thinners: the French studies in real life.

14 Jul

One more time CNAMTS boys have crunched the numbers from the reimbursement data bases.
They previously had done this exercise in real life for the mediator and they had found cardiac side effects. This time they investigated a new category of blood thinner the NACOs (Nouveaux Anti Coagulants). Unlike the mediator they have concluded that in the short term (3 months) no evidence of any adverse side effects such as bleeding or thrombosis could be found.

The mediator study:

http://www.ncbi.nlm.nih.gov/pubmed/20945504#

The NACOS study of the risk associated with the initiation of treatment with the new blood thinner in anticoagulant treatment naive patients (3 months of follow up):

http://ansm.sante.fr/var/ansm_site/storage/original/application/6372793e0dfaf927308665a647ed0444.pdf

The NACOS study of the risk associated with the change in treatment consisting in replacing Warfarin by the new blood thinner in anticoagulant treatment experienced patients (4 months of follow up):

http://ansm.sante.fr/var/ansm_site/storage/original/application/5504a80da7d6ec6eab26798eebf64fb3.pdf

Massaging Medicaid

3 Jun

A week-and-a-half ago, the D.C. Circuit upheld the criminal conviction of the owner of a clinic that bilked Medicaid out of millions of dollars: Wheeler owned

via Massaging Medicaid.

France has the best health care system in the world

30 May

It’s not me it’s Aaron Carroll from healthcare Triage who says that:

 

 

 

 

listening

30 May

Originally posted on earthskybelly:

 

let me catch my breath, she says

I can’t breathe

her brow is folded into deep furrows

like ancient river beds curved over time

 revealing the frustration with an old body

once so familiar and resilient

that now simply fails to take care of the basics

like breathing

and balance…knowing where the earth lies

underfoot

I also see the fear

as her hands reach up to her head

grasping for comfort or fending off the overwhelming onslaught

of questions and concerns and suggestions and pleas for her to just try

just try to accept this wearing down of time

as if I can know how she really feels

or what it’s like to become acquainted with so few remaining months, weeks, maybe days

I can only offer my presence and attention

not to say, oh I know…because I don’t

but to simply be there, listening

letting her say all…

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