Lancet 2012 on multimorbidity http:/http://www.thelancet.com/cms/attachment/2009245825/2032056163/gr1.jpg Guidelines and multi morbidity = BMJ Guidelines and drug interactions  Burdens of treatment  the work done by patients when doctors stick to guidelines Polypharmacy aids  for deprescribing Drug Drug interactions 

GP Forward view. Many of the points are not evidence based – esp access, e.g. text message consultations – we may end up doing more with little benefit to patients and actually creating more work for ourselves. The ForwardView recommends touch typing and speed reading to release time to care – move upstream – needs […]

Come to Edinburgh! Not something a Glaswegian says very often, but…. My next (and last book about health) will be out around October: The State of Medicine – keeping the promise of the NHS. I’ve been doing a lot of reading, writing and thinking about why the NHS is in such a mess: how we […]

paper in the BMJ, co-authored by members of the RCGP overdiagnosis group free link 

HEALTH CHECKS the NHS Health Check programme is being implemented in the absence of direct randomised controlled trial evidence to guide it – Public Health England BJGP editorial http://bjgp.org/content/64/627/493 BMJ OPEN January 16 http://bmjopen.bmj.com/content/6/1/e008840.full BMJ review of public health policy http://www.bmj.com/content/343/bmj.d7310 Inter99 – A community based, individually tailored intervention programme with screening for risk of ischaemic […]

    Mexico 1 year later http://www.bmj.com/content/352/bmj.h6704 2013 meta analysis http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-1072 20% tax modelling in UK http://www.bmj.com/content/347/bmj.f6189 the role of ‘signalling’ http://www.bmj.com/content/352/bmj.h6904 Mexico changes products http://www.euromonitor.com/soft-drinks-in-mexico/report head to head in BMJ including re Denmark http://www.bmj.com/content/351/bmj.h4047 background Click to access HoC-Health-follow-up-info-Feb-2015-financial-final.pdf St Helena Click to access Budget-Speech-2014-15-21-March-2014.pdf https://sthelenaonline.org/2014/03/28/st-helena-shows-uk-the-way-with-fizzy-drinks-tax/

ASTHMA Dutch study in question http://bjgp.org/content/66/644/e152 SIGN guidelines on asthma Click to access pat141_CHILDREN.pdf In children with mild, intermittent wheeze and other respiratory symptoms which occur only with viral upper respiratory infections (colds), it is often reasonable to give no specific treatment and to plan a review of the child after an interval agreed with […]

Vaginal seeding BMJ article http://www.bmj.com/content/352/bmj.i227 suggestion that babies born as result of CS don’t have the same microbe make up http://www.cell.com/trends/molecular-medicine/abstract/S1471-4914(14)00216-0?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1471491414002160%3Fshowall%3Dtrue and hygeine hypothesis http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110651/ http://www.ncbi.nlm.nih.gov/pubmed/?term=20566857 Other studies have linked different microbes to increased risks of some disorders (increased risk not diagnosis) http://www.jacionline.org/article/S0091-6749(14)01650-9/abstract Nature study http://www.readcube.com/articles/10.1038%2Fnm.4039   HEALTH CHECKS/ ONE YOU http://www.nhs.uk/Conditions/nhs-health-check/Pages/NHS-Health-Check.aspx

http://www.ncbi.nlm.nih.gov/pubmed/26689397 “Multiple studies of ovarian cancer and genital talc use have led only to consensus about possible carcinogenicity. Seeking greater clarity, we examined this association in 2041 cases with epithelial ovarian cancer and 2100 age-and-residence-matched controls. METHODS: We defined genital talc use as regular application to the genital/rectal area directly, on sanitary napkins, tampons, or […]

Junior doctors review of morale: I suggested that the RCGP creates its own review of the evidence on moral and fatigue in junior doctors in particular and uses this as an independent reference and review when the AoMRC undertakes its’ review spoke to issue about post graduate learning and sponsorship of modules – these should […]