A short video on urticaria and the biology of the mast cells

 

[This is about a drug to lower cholesterol in those who don’t tolerate statins]

“Still, evolocumab is likely to be controversial for some time, primarily because of its cost: $14,000 a year in the US. Last year, the National Institute for Health and Care Excellence in Britain recommended that doctors should not use Repatha, but the NHS says it is likely to revise its recommendation this year. Without Nice support, the NHS will not provide the drug”. FT

So, treat 4 people and you have spent a similar about to a junior medic, nurse or therapist?

This is referring to Harry Frankfurt’s excellent monograph on bullshit.

Frankfurt concluded that the difference between the liar and the bullshitter was that the liar cared about the truth — cared so much that he wanted to obscure it — while the bullshitter did not. The bullshitter, said Frankfurt, was indifferent to whether the statements he uttered were true or not. “He just picks them out, or makes them up, to suit his purpose.”  Statistical bullshit is a special case of bullshit in general, and it appears to be on the rise.

And there is plenty to go around — even in medicine.

[or as one FT commentator christened it:“taurine waste”  a euphemistic reformulation of “bullshit”]

This article from a young medic is ‘as it is’. I seem to remember the House line: ‘I didn’t  come here to treat patients, but to treat disease!’ Easy to fault, but devotion to the craft and the ability to practice that craft is a central part of gaining technical competence. Practising scales is not the same as giving a concert, but the latter is impossible without the former.

“In an attempt to clean up, Novartis has appointed a chief ethics officer and is in the process of tightening its rules on relations with doctors”. FT

Martin Wolf awhile back in the FT drew attention to the danger of pharma being viewed in the same light as many of us view Banks. Ethics committees don’t work. It is in  the corridors outside the committee rooms that people act natural. The problem is both with an organisation, and with what organisations are.

“In sum, plaintiffs were deceived into spending tens of thousands on tuition alone for a program that functionally required them to teach themselves the material,” the complaint reads.”

I came to this story via Stephen Downes. The story is about an online degree that was more expensive than the residential degree, and where ‘online learning’ consisted of badly scanned pdfs and Powerpoint text. Ahem. Stephen Downes’ summary phrase: cash grab

Roger Schank has a new web site (not before time), so I have been rereading some of his stuff. Wonderful: (he of: ‘There are only two things wrong with the education system (i) what we teach and (ii) how we teach it’. Below are some of his choice phrases, but it really is worth a visit. I think he gets most things right. (FWIW, I have said on more than one occasion, that if universities were serious about learning, they would ban Powerpoint text slides).

On school

“So, my advice. Know what matters to you. Learn that. Temporarily memorize nonsense if you want to graduate but have a proper perspective on it. Nothing you learn in high school will matter in your future life……That having been said, in honor of the coming school year, I have decided to give students some ammunition. Here are most of the subjects you take in high school, listed one by one, with an explanation about why there is no point in taking them.”

On corporate training

“In 1989, I witnessed corporate training for the first time. We had just started the Institute for The Learning Sciences, which was sponsored by Andersen Consulting (now Accenture). I visited their campus in St. Charles, Illinois, and saw many classrooms full of people who were mostly half asleep or in a daze from being talked at about corporate culture, and Andersen’s core values, and client needs, and so on……So, now I want to say something easy to understand about corporate training: STOP IT”

“Content cannot be delivered. If it could, you could hire FedEx to do it.”

“But we keep talking at people. If your training includes talking, then it isn’t working. If it includes Power Point it isn’t working.” 

“There are always assessment questions. Why? Because the training department wants to know if the students have “learned the material.” What the training department should really want to know is what the student can do that they couldn’t do before the training.”

elearning

What I said was: “e-learning is the same garbage just in a new medium.”

From Rolling Stone

One rarely discussed feature of the “student loan industrial complex” is the $200 billion market for student loan asset-backed securities (SLABS). This is a circular business, involving lenders like Sallie Mae and big banks like Wells Fargo and Bank of America. Like mortgages, student loans get pooled and repackaged into new financial products (securities). The lenders then sell the securities to investors. Investors receive the reward of monthly loan payments, plus interest. They can hold the securities themselves, trade them or bet on them. In turn, lenders receive quick cash, including fees and commissions, and push the risk of the underlying loans onto investors. This shift allows lenders to make more, and larger, loans…….They often have a stake in borrowers defaulting rather than paying smaller amounts over a longer period of time….It’s perverse policy — bankers are pampered because student debtors are hounded and pounded. 

Here is number 3. My favourite bit of skin biology.

Here is video number 2 in the ‘clinical’ skin biology series.