Early Risers.

[Tony_S]

57 minutes ago, polybear said:

 

Thanks - Bear has the tin (one of today's Bin Dive finds - a Tefal jobbie that's like new) but was wondering how much cake mix is needed to fill it.

I think we may be the wrong way round here. Recipes usually specify something like “use an 8inch tin”. Aditi said she does have a book that tells you how to change quantities if you don’t have a particular tin. I expect a commercial cake mix packet will specify the tin size. Sadly we are avoiding cakes now, and in my case probably for ever except of course for a tiny slice for celebrations. 

[Darlington_Shed]

1 hour ago, polybear said:

wondering how much cake mix is needed to fill it

 

The lovely Nigella has a great many cake recipes online. This one uses a 20x8 tin:

https://www.nigella.com/recipes/dark-and-sumptuous-chocolate-cake

 

I'd say you could skip the rose petals but they're unlikely to make much difference to the weight.

[PhilJ W]

Goodnight all.

[skipepsi]

7 hours ago, New Haven Neil said:

So an early start was wasted by....oh never mind, not important.

 

However, my car has been serviced (nowt wrong, thankfully) and we had a ride out on the bikes to see a chap that has been making a buckle-less leather belt for her indoors, who was actually outdoors, but never mind that.  Nice job, she's very pleased with it.  The old guy doing it used to fix the sort of planes Dave H used to fly, Fan-toms or something, maybe his rivets helped Dave defend the realm, who knows.  Nice old boy.

 

So car is collected, in the Manx way the garage chappie has not yet bothered with the bill, I'll pop in next week to settle up with him.  This relaxed attitude is one of the things that makes life here so pleasant - and people's basic honesty of course.

 

Better get on with making dinner I suppose, and worry about cholesterol, mine is always a bit high.  GP wants to try statins but a friend was crippled by them - I have doubts about how they are presented as a cure-all.  Jury currently out on that one.

My GP said you have a 35% chance of a heart attack unless you take statins smug mug me a 65% chance of not having a heart attack, statins are awful things. The 31st of July 2018 was nearly the last day of my life. The only problem I have with statins is swallowing them the pills are huge.

[skipepsi]

6 hours ago, Coombe Barton said:

... After a (strong) suggestion from my son that I have been a grumpy old fart all my life I have again changed my LinkedIn Status ...

https://johncolby.wordpress.com/2024/09/18/postcards-from-home-2024-21/

Out of the mouths of children...

[jjb1970]

I remember media articles a few years ago advocating that everyone should be on statins as they were the miracle cure-all of the age.

[Ozexpatriate]

19 hours ago, pH said:

We have an Elgin Street close to us, pronounced “Eljin”.

Guess how Elgin, Illinois is pronounced.

[Ozexpatriate]

18 hours ago, Barry O said:

But they aren't fully fledged.. they are still learning by experience..

Yes, they are "practicing" medicine. Like lawyers "practice" law.

 

The length of time until they get it right is indeterminate.

[Ozexpatriate]

18 hours ago, jjb1970 said:

I really don't see why the term junior is demeaning. 

Nevertheless people interpret it that way.

17 hours ago, monkeysarefun said:

An Intern would be thought of as a "junior Doctor", once they've levelled up they all all "residents". 

Flavio's ( @iL Dottore's ) observation is a good one. The med. student - intern - resident - attending physician is helpful for patients who are likely to be anxious - and not want to be observed by a "junior" but happy to be observed by a "resident".

 

And it is the norm in the US and Australia. It's descriptive without implying inferior status. 

 

Status designators are a UK hangover of a society ruled by aristocrats. Get rid of 'em!

 

(I didn't specify whether I meant the status designators or the aristocrats.) 😉

 

[Ozexpatriate]

12 hours ago, Hroth said:

Daring to speak of things that run on parallel strips of steel, I see that Rapido are doing "Ivor the Engine".

 

With or without sound.

 

And the sound version sounds are sourced from the original films.

 

Rule 1, here I come....

 

Will there be an optionally fitted calliope from Morgan the roundabout?

 

That would be fun with sound.

 

(Though I'm guessing the three pipes, rather than the single whistle, were from Morgan's calliope, so that's covered - based on the pictures.)

 

Edited 19 hours ago by Ozexpatriate

[BR60103]

One of our newspaper columnists made fun of Nova Scotia's naming practices by calling his town Upper Lower Musquodoboit Bridge.  I just checked a map and also found Mus. Harbour.

 

I think I mentioned our neighbour is having her driveway redone. It's now stone or concrete blocks. Today they did the blocks and it involved an awful lot of power sawing.  This produced clouds of grey dust blowing into the street. My wife reported that they cleaned this up with a leaf-blower. I had to wipe down the bird feeder when I brought it in.  I pity the fellow across the street who had his car in the driveway all day -- he's even more decrepit than I am. I see that the back patio has not yet been done. 😒

 

Tomorrow we plan to go to the Friends of the Library book sale. First day has a $10 admission fee; I'll consider that a donation. 

[TheQ]

4 hours ago, skipepsi said:

My GP said you have a 35% chance of a heart attack unless you take statins smug mug me a 65% chance of not having a heart attack, statins are awful things. The 31st of July 2018 was nearly the last day of my life. The only problem I have with statins is swallowing them the pills are huge.

Don't know what they are, both swmbo's atorvasatin and mine simvastatin are smaller than our other pills. Neither of us have a problem with them.

[polybear]

6 hours ago, Tony_S said:

I think we may be the wrong way round here. Recipes usually specify something like “use an 8inch tin”. Aditi said she does have a book that tells you how to change quantities if you don’t have a particular tin. I expect a commercial cake mix packet will specify the tin size. Sadly we are avoiding cakes now, and in my case probably for ever except of course for a tiny slice for celebrations. 

 

VSBT's on the lack of cake....😢

As for using a "Commercial Cake Mix Packet" - I suspect I'd incur serious grief** from a certain iD if I went down that route....

 

**Oh, hang on....I get that anyway.....

 

3 hours ago, Ozexpatriate said:

Nevertheless people interpret it that way.

Flavio's ( @iL Dottore's ) observation is a good one. The med. student - intern - resident - attending physician is helpful for patients who are likely to be anxious - and not want to be observed by a "junior" but happy to be observed by a "resident".

 

 

Let's see now.....

 

Doctor:  "I'm a med. student"

Patient:  "P1ss Off - I want a REAL Doctor, one who's qualified....."

or......

Doctor:  "I'm a Resident Doctor"

Patient:  "So you actually live in the Hospital then?"

or.....

Doctor:  "I'm an attending Physician"

Patient:  "What does that mean?"

Doc:  "It means I'm a Doctor, and I'm here....."

Patient:  "Well you wouldn't be much bluddy good if you weren't here, now would you?"

or.....

Doctor:  "I'm an Internal Doctor"

Patient:  "An Intern? What does that mean?"

Doc:  "Oh Buggerrit, it means I'm a Junior Doctor.....

Edited 16 hours ago by polybear

[Barry O]

Ey up!

 

Plan for the day.. visit the Tanfield Railway then off back to the North West Leeds Highlands.

 

Had some great weather and nice days out this week. I feel re-energised...

 

I know most GPs want you to take stations..  consultants in other areas don't.. and I quickly realised that the cardio consultants are not keen on using networking either.. justvtry getting the GPs to walk away from using that. I question why the real reasons for the use of some drugs are. Similarly they use a calculation sheet to see if you could have a heart attack or stroke.. marked out of 9 score 1 if you are over 65, 1 for if you have high blood pressure, 1 if  you are type 2 diabetic.. outcomes.. take blood thinners.. but these can affect how you live your life...great but far too simplistic approach I fear.

 

Time to get ready for my migatea then breakfast then... off to enjoy the day.

 

Stay safe!

 

Baz

 

 

 

[Barry O]

Oops, I see drugs companies do pay GPs and others to make use of their products..quel surprise..

 

Baz

[New Haven Neil]

Morning, from a rock experiencing a nice sunrise.

 

Jury's out on statin - one of the two Q mentioned are the cause of my pals issues.  I know I am at some risk (T2DB, over 65, hypertension (controlled) etc) but am still wary.  Only way is to try I suppose.

 

ION off the the Manx Museum after brekky to scan the microfiches, hopefully anyway!

 

Then, er, housework I suppose. Pah.

[iL Dottore]

14 hours ago, PupCam said:

I’m fairly certain Triglycerides are not a new toy.   A very good friend has been having his tested/checked for the last 30 years. 

I guess most ER’s have been neglecting their biochemistry studies as of late….

12 hours ago, New Haven Neil said:

worry about cholesterol, mine is always a bit high.  GP wants to try statins but a friend was crippled by them - I have doubts about how they are presented as a cure-all.  Jury currently out on that one.

Statins, and similar drugs, are by no means a cure all. But they have certainly have had a major (and positive) impact on the way GPs can manage their patients.

 

Yes, there IS anecdotal evidence that some people do do badly on statins (not to mention other drugs - like aspirin or ibuprofen), but that’s all they are: anecdotal and of limited scientific utility. What were the comorbidities of that individual? (anyone on statins is going to have comorbidities), what other drugs was the individual taking at the same time? (Not all GPs are assiduous in checking for drug-drug interactions with a new prescription), what other things (lifestyle choices like alcohol or tobacco use) were also present? These are the things that we need to know in order to properly assess what’s been going on.

 

As I explained in an earlier post about CoVID vaccine adverse events, when you have a large enough patient population getting therapeutic doses of a drug (any drug) then you will see rare and potentially very serious, if not fatal, adverse events. That’s why proper pharmacovigillance monitoring is so critical, as it allows us to see if anything flagged as of concern represents an anomaly, an outlier or a trend.

 

5 hours ago, skipepsi said:

My GP said you have a 35% chance of a heart attack unless you take statins smug mug me a 65% chance of not having a heart attack, statins are awful things. The 31st of July 2018 was nearly the last day of my life. The only problem I have with statins is swallowing them the pills are huge.

Many GPs definitely need to up their communication skills. Undoubtedly the GP meant the probability of having a MI or other cardiac event. Such an increase in risk over baseline (i.e. what is normal for people of a certain age/gender) doesn’t mean you will have the event, but it does mean you have an increased probability of having such an event.

 

To put it into context, a 35% chance of winning the Euromillions jackpot would be considered as very good odds indeed!

4 hours ago, jjb1970 said:

I remember media articles a few years ago advocating that everyone should be on statins as they were the miracle cure-all of the age.

That sort of reporting (invariably from the tabloid press) really makes me see red. The number of times I have seen tabloid headlines along the lines of “New Drug Kills Cancer Cells Stone Dead” only to find that when you read between the lines they are referring to either pre-clinical or Phase 1 work, in limited numbers of animals or patients with loads of caveats, is beyond counting.

[iL Dottore]

1 hour ago, polybear said:

 

VSBT's on the lack of cake....😢

As for using a "Commercial Cake Mix Packet" - I suspect I'd incur serious grief** from a certain iD if I went down that route....

 

**Oh, hang on....I get that anyway.....

 

 

Let's see now.....

 

Doctor:  "I'm a med. student"

Patient:  "P1ss Off - I want a REAL Doctor, one who's qualified....."

or......

Doctor:  "I'm a Resident Doctor"

Patient:  "So you actually live in the Hospital then?"

or.....

Doctor:  "I'm an attending Physician"

Patient:  "What does that mean?"

Doc:  "It means I'm a Doctor, and I'm here....."

Patient:  "Well you wouldn't be much bluddy good if you weren't here, now would you?"

or.....

Doctor:  "I'm an Internal Doctor"

Patient:  "An Intern? What does that mean?"

Doc:  "Oh Buggerrit, it means I'm a Junior Doctor.....

Are you saying that you, and/or the Great British Public, are too thick to be able to understand the differences between a medical student, an intern, a resident or an attending (consultant)?

 

Australians manage it, Americans manage it and the British aren’t able to?

 

Hardly a ringing endorsement of your (and the Great British Public’s) education and educational achievements..

[iL Dottore]

40 minutes ago, Barry O said:

Oops, I see drugs companies do pay GPs and others to make use of their products..quel surprise..

 

Baz

True, in the 1980s. No longer.

 

Those without a visceral hatred of “Big Pharma” will have long realised that the regulatory environment (from drug trials to approval of new drugs to the promotion of drugs) have changed radically since the 1960s, 1970s and 1980s. Freebies are ‘VERBOTEN”  (even buying a GP a cup of coffee at a conference can land you, your company and the GP in very hot water indeed). Promotional materials are very tightly regulated and if any monies are paid to physicians, it’s to reimburse them for work done (such as taking part in a post approval safety monitoring study) and even then it’s for expenses occurred (such as cost of lab work).

 

”Big Pharma” is not without its faults (especially American companies), but they have certainly transformed over the last 40 years, for the better, patient treatment and patient outcomes (including survival) in countless diseases. 

 

Or perhaps you would prefer a nationalised pharma industry? Something along the lines of the nationalised steel or car industries (and we know what happened with them)

[monkeysarefun]

2 hours ago, polybear said:

 

VSBT's on the lack of cake....😢

 

 

Let's see now.....

 

Doctor:  "I'm a med. student"

Patient:  "P1ss Off - I want a REAL Doctor, one who's qualified....."

or......

Doctor:  "I'm a Resident Doctor"

Patient:  "So you actually live in the Hospital then?"

or.....

Doctor:  "I'm an attending Physician"

Patient:  "What does that mean?"

Doc:  "It means I'm a Doctor, and I'm here....."

Patient:  "Well you wouldn't be much bluddy good if you weren't here, now would you?"

or.....

Doctor:  "I'm an Internal Doctor"

Patient:  "An Intern? What does that mean?"

Doc:  "Oh Buggerrit, it means I'm a Junior Doctor.....

You lot invented the language, you only have yourselves to blame if it confuses you...

Edited 14 hours ago by monkeysarefun

[jjb1970]

Whenever I have been in hospital the Consultants were 'Mr' (I presume female colleagues are Ms/Mrs?) with all others being 'Doctor'. So Mr Smith will be doing his rounds soon, or the Doctor will be here soon etc. I had no idea where they were in the pecking order other than as in most organization's I figured that the ones doing all the running around at all hours and all the bread and butter work on the ward are probably bottom of the pile.

Edited 14 hours ago by jjb1970

[BSW01]

Good morning everyone 

 

Another bright and sunny start to the day here in England’s northwest corner. Sheila is busy getting herself ready for her Zumba class, something she hasn’t done for 4 weeks, due to her not wanting to leave me alone since my recent operation. She’s quite happy to do so now, so I’m currently sat at the dining room table, keeping out of the way until my chauffeuring services are required. Once I’ve dropped her off at the church hall, I’m going to call at the butchers. I normally do this on a Friday, but Ava I coming round to spend the day with us tomorrow instead of Saturday, as she’s doing something with her boyfriend on Saturday. 
 

This afternoon Charlie is coming round, so an afternoon in the workshop is on the cards too, so it’s looking like it’s going to be a good day. 
 

Back later. 
 

Brian

[jamie92208]

10 hours ago, polybear said:

 

Thanks - Bear has the tin (one of today's Bin Dive finds - a Tefal jobbie that's like new) but was wondering how much cake mix is needed to fill it.

I would say that thst is a 2ib tin. 

 

Good moaning from a sunny Charente.  Back after a shortened break in Switzerland, where my pal Andy and I had a good personally and bespoke guided tour of parts of the tram and train network in Basel. I'D and Captain Cynivpcal were in attendance.  A good time was had.  Monday was meant to be a day touring the country but Andy had some health problems and we had to abort at Zurich then head home a day early.  He seems to ve OK now.  

 

Our visitor is still with us and goes back to the UK tomorrow.  Beth and she seem to have had a good time though the gin stocks have gone down. 

 

Sunny here today so some grass cutting is in prospect. 

 

Jamie

[Tony_S]

34 minutes ago, jjb1970 said:

Consultants were 'Mr

Mine seem to be “Professor”.

[iL Dottore]

40 minutes ago, jjb1970 said:

Whenever I have been in hospital the Consultants were 'Mr' (I presume female colleagues are Ms/Mrs?) with all others being 'Doctor'. So Mr Smith will be doing his rounds soon, or the Doctor will be here soon etc. I had no idea where they were in the pecking order other than as in most organization's I figured that the ones doing all the running around at all hours and all the bread and butter work on the ward are probably bottom of the pile.

It derives from the medieval difference between physicians (educated at university) and barber-surgeons (basically tradesmen who learned on the job).

 

So, at least in the UK, surgeons were always "Mister" and physicians "Doctor" and I have heard of many surgeons (who since at least late Victorian times get the same medical education as physicians) who get very put out when you address them as "Doctor" as opposed to "Mister" - but this nomenclature is slowly dying out.

 

Equally interesting, and again a relic of the past, in the UK you could become a physician without actually being a doctor. University medical education in England culminated with the Bachelor of Medicine qualification (B.Med, MB) and in Scotland the Doctor of Medicine. (the US went with the Scottish nomenclature).

 

So, theoretically, the physician who is treating you would have been trained but only have a B.Med degree, but in practice most nowadays (in the UK) go on to get an MD (Medicinae Doctor - Doctor of Medicine) and often - especially if they are research oriented - a PhD in a relevant discipline as well.

 

p.s. ALL physicians and surgeons start their career by running around at the beck and call of the nursing staff and senior medics, as well pulling all-nighters, sewing up drunks, being bled and vomited upon and living on donuts and coffee. One of the criticisms of my senior medical colleagues of the youngsters starting out today, is that the various working directives have diluted down a lot of the above activities, which my colleagues think Is Not A Good Thing, because such long hours and intense, stressful work Provides Experience And Builds Character.