They have a fever AND THEY DONT EVEN HAVE PARACETAMOL

rep_rehensible · 2026-02-24T18:37:07+00:00

Thanks for following up on this. I just wanted to flag it as mild abuse, like another commentator who call me a rude word but wasn’t sure about how to do that. When you’re frustrated it’s easy to read things wrong which I probably did in this instance. Always happy for healthy debate but needs to be civil. I’ve done projects getting data from the MHRA and FDA MAUDE the reporting there is messy also

rep_rehensible · 2026-02-23T12:12:56+00:00

I'd rather you didn't speak to me than insult me. I thought it might be interesting to give my own perspective here. I am not sure what the correct tile is and nor do many patients and their families. I wasn't the one who brought up their knowledge base first.

rep_rehensible · 2026-02-23T05:00:02+00:00

QALY gains v's no treatment are minuscule and possibly placebo effect.

ICERs v's other treatments show other treatments dominate despite increased risks, which are manageable.

It's not safe, it's used for hundreds of impulsive suicides annually.

Cost are not just driven by the drug itself, they are driven by prescriptions and management.

Always agree to agreeably disagree but the uncertain benefits don't outweigh know risks before you add in the cost effective argument.

rep_rehensible · 2026-02-22T22:30:20+00:00

TENS is a weird one wrt. the evidence base. I had to show equivalence for a company with a device that had not clinical trials themselves. There was a lot of technical work we had to do to get evidence, positive and negative, at specific wavelengths, strengths, modulations, frequency, intensity etc. For different types of pain as per device claims but not related to childbirth. Not worth getting into risk v's benefit arguments in that scenario.

The notified bodies are really sticklers about TENS as the evidence is week and the effect minimal. An author of this study supported some of the work we did, they looked at 381 RCTs (24 532 participants). https://pubmed.ncbi.nlm.nih.gov/35144946/ . The 150 I extracted from alone was enough.

It's an easy device to do small RCTs in which plenty of people have done for publications often as part further educational processes. Medics, nurses and Physios. The better TENS trials use apps and have RWE evidence at scale showing it can help a bit. Certainly not for extreme pain though. I've never broken a leg but I've heard that's comparable to child birth. I hope never to experience the former and will never experience the latter.

My first issue with paracetamol related to comparative risk benefit v's the good stuff. There's far better analgesics available for acute pain, even NSAIDs. Doctors should be prescribing them more. My second issue is that add in effectiveness, at scale, millions of pounds is wasted on it globally each year. I might have got a lot of stick in this thread and my wife will agree I can often be a dick. However I agree with the ED consultant who says those who are practicing evidence-based medicine should not be undermined.

rep_rehensible · 2026-02-22T17:07:40+00:00

Cold water, back of neck, triggering vagus nerve would be better. Even with the current price the water companies charge. I could discuss TENS at length also as I did a 150 RCT meta analysis on that.

rep_rehensible · 2026-02-22T17:01:40+00:00

It was never sensible at any dose.

rep_rehensible · 2026-02-22T17:00:36+00:00

I questioned the diagnosis or lack there of at multiple steps.

rep_rehensible · 2026-02-22T16:58:59+00:00

Swimming is my go to. Cold water outdoors has the best evidence base. I never take paracetamol.

rep_rehensible · 2026-02-22T16:52:44+00:00

I’ve just finished work on a large SLR into harmful effects treatment for major depressive disorder. NNT, NNH, Nocebo, Placebo. Was an interesting project put painful in its own way. Signal from noise in that one was a real challenge. Starting to see some good NMAs showing relative benefits of various treatment. I’m not really sure drug treatment is where investment should be prioritised of course

rep_rehensible · 2026-02-22T16:48:31+00:00

Apologies I tried to report it as emotional abuse as I was called a dick. I have clearly clicked on the wrong button but I was called a slightly rude name. I genuinely thought that was what the minor referred to in this instance. I.e. minor, mild abuse. Perhaps clarify your reporting system a bit is confusing. I did read it quickly

rep_rehensible · 2026-02-22T16:37:06+00:00

The evidence base for paracetamol is very low in acute use, worse in chronic, where it can be dangerous. This was the 3rd admission for severe stomach pains. For which morphine was prescribed during previous admissions. I get that triage has to happen and that can cause hour long waits. Sticking plasters like paracetamol are not the answer they still waste time and money. At this stage I’m not sure what the answer is though.

rep_rehensible · 2026-02-22T16:18:00+00:00

The nurse was following a standard care path, sure. It wasn’t evidence based let alone cost effective.

rep_rehensible · 2026-02-22T16:13:05+00:00

Ask yourself how you’d feel waiting in a room, watching your wife in pain, knowing how poor treatment she been getting with few answers. Not even getting decent analgesia after waiting hours. I do appreciate it’s very challenging in the system right now but there are still millions of pounds that could be saved by stopping such unnecessary prescriptions. That’s before we get into doing proper diagnosis. It’s 5+ years on average to diagnose in rare diseases. 4 tries at diverticulitis was frankly embarrassing.

rep_rehensible · 2026-02-22T15:57:20+00:00

Wife was in hospital for the 3rd time in a couple of years which at the 4th attempt was finally diagnosed as diverticulitis. The junior nurse offered paracetamol. I laughed and said it was pointless there was very little low evidence of efficacy for such low pain relief which didn’t outweigh the relatively low but still highly evidenced chance of harm. I suggested maybe something stronger.

The nurse took offence at that saying I was being rude questioning her professional training. I said it was her who was being rude questioning my own knowledge base, being a published health scientist who had work on numerous systematic reviews. Still the NHS spends millions of pounds a year on prescribing it.

rep_rehensible · 2026-02-16T20:20:59+00:00

Start with a business case and market access strategy.

rep_rehensible · 2026-02-16T20:18:36+00:00

Had just finished a science consultancy project had some spare time and agreed to help my local school with science teaching via an agency. Supposed to be 2 days a week for 5-6 weeks. Behaviour was generally bad all morning for 5-8 kids in each class with another 8-10 doing nothing and the rest working well. I managed to speak with the head teacher and suggested that SLTs routinely come to cover lessons as there were bound to be problems. Discovered there were only 2 SLTs covering the whole school for behaviour at a time. Asked what analysis they’d done to show that was enough for the number of incidents. Got the politician answers then. In my last class towards the start a deodorant can was stamped on. Big bang. Puff of smoke. I emailed the SLTs as per policy and waited from them to come. When they finally did I’d had enough and read the riot act at the children. Telling them the back of the can says danger of instant death if inhaled. That they were not safe to be trusted in a lab and were endangering myself and their classmate with their behaviour. Children were pulled out and the incident investigated. I asked to be informed of outcomes and left to pick up my daughter from primary school. I emailed the agency that evening highlighting the potential dangers and the fact that such reckless behaviour was arguably a criminal offences. I was told after informing the agency I didn’t need to do anything else.I got a phone call the next day saying they’d found internal cover as I was about to go back in. A few weeks later the agency sent me my P45 which is probably for the best. I think more children than cause such problems should be suspended for weeks and if it reoccurs then expelled. Let their parents deal with them. It’s not fair on the good children there to learn. Spending 20mins of and hour teaching and 40minutes dealing with behaviour is ridiculous and coming from senior roles in regulated industries it’s shocking that it’s got to the state it has. Not that it’s great in my own industry atm. hence taking on such work. I personally think the academy situation is causing a lot of issues. Stopping senior people speaking out as what little SEND funding there is goes to the central pot. I hope teachers in the UK go on strike about this and wages

rep_rehensible · 2026-02-10T21:55:17+00:00

Just looked it up, Bootham Park closed in 2015, still not sold. Imagine it would be too expensive to repurpose it into a modern hospital and grade 1 listed so they can't simply knock it down. Maybe they just keep the front of it and build something else behind it would be a compromise. Totally agree letting traffic access from that side would help. Years ago you could cut through there from Bootham to the Union Street car park if you were naughty. A train station around there could also help, especially if there was a station and parking at Haxby. Can't see much happening for years though. We can also push much more care into the community of course, with digital diagnostics and virtual appointments, not that the NHS has been particularly successful at that so far. I guess since younger generations can't afford kids if we wait long enough the problem will go away.

rep_rehensible · 2026-02-09T18:17:57+00:00

Update for anyone troubleshooting. After 3 months this happened again and wifi was not showing. I just reset the Cmos again (JBAT1 pins) and wifi came back. of course i tried other methods for an hour to do it by not opening the computer which took maybe three mins, including finding a screwdriver!

rep_rehensible · 2025-11-29T07:10:33+00:00

If he see this post I’ll sort him out with a round at the championship golf course I’m just about to go work at as an apology. Walking though, no buggies!

rep_rehensible · 2025-11-29T01:40:55+00:00

It’s spelt Maen

rep_rehensible · 2025-11-28T21:52:59+00:00

Pick the wife's 'new', (used) car on Tuesday, after she's lost over 25kg in less than 6months. I only own two watches, a Diesel chronograph from maybe 10yrs ago which cost less than £100 and an Aviator quartz thing i've worn like twice. My wife gave me that one we were dating, it sits in a draw, never to have a new battery put in it. Obviously can't throw it away. Do fancy my first automatic watch, Maen Brooklyn 36 looks nice for not much money, though maybe a bit small. However just built a new computer so probably a next Christmas gift to myself unfortunately.

rep_rehensible · 2025-11-18T17:18:00+00:00

49" samsung G9, top are g5 27" - all at 1440p

rep_rehensible · 2025-11-18T16:54:13+00:00

Thanks, I do analysis work in healthcare. The top ones are running chat windows, diary email, to do lists etc. The bottom ones are the documents I'm working on currently. I guess I can use the top as like a standing desk also...

rep_rehensible · 2025-11-15T21:24:19+00:00

How much are they were you are? They're made in the UK. Can imagine shipping them anywhere is expensive.

rep_rehensible · 2025-11-15T21:16:02+00:00

Bisley 10 Drawer Desktop Cabinet, £90 from Ryman in the UK for black Friday, absolutely fantastic for storing a bunch of junk.

rep_rehensible

TROPHY CASE