NHS Dentists – Bart writes

You want to play don’t you? Bart generator


The Monday Morning #639

“Hope is not optimism, which expects things to turn out well, but something rooted in the conviction that there is good worth working for.”

Seamus Heaney  (via Mike Hogan)

This portion of a portrait of Heaney was painted in 1974 by the artist Edward McGuire and is in the Ulster Museum.

Who I read – John Naughton

Probably the best daily blogger of the several I read. Here’s the profile of a true polymath, an excellent writer and sharer of knowledge. I often do not understand fully the subjects he covers but I always come away feeling grateful for his insights. 

Yesterday’s blogpost featured a long discussion on Brexit, which he was against, with the title, “On Brexit, grief and moving on”, I am quoting his conclusion.

I can see where he’s coming from. During the Referendum campaign two things puzzled me. One was the feebleness of the Remain campaign — it was as if nobody was interested in making a passionate argument for continuing to participate in the greatest geopolitical experiment in European history. As a result, the Remain campaign was essentially negative — as the Europhobes dismissively labelled it — ‘Project Fear’.

The other puzzle was the failure to make a reasonable case against the European experiment. The truth about the EU is that it has always been an elitist, technocratic experiment. It would never have happened as a democratic project — it had to be driven by political elites from the moment the European Coal and Steel Community was established in the early 1950s as a (laudable) attempt to ensure that the nations of Europe could never go to war against one another again. But as it developed into the EEC — and, later, the EU — the project always had a yawning democratic deficit (as Jurgen Habermas lamented in his book The Lure of Technocracy) — a deficit that was only partially filled by the creation of the European Parliament.

In that sense, there never was much in the way of democratic legitimacy for the EU project. And in a number of crises, notably the 2008 banking catastrophe, that lack of legitimacy was painfully obvious. Similarly the creation of the Eurozone was an elite project — it had to be — because its internal contradictions would never have withstood proper democratic scrutiny. (Indeed, one of the really good things Gordon Brown did was to keep the UK out of the Euro, despite Tony Blair’s anxiety to join it.) And then there was the crazily-accelerated post-1989 drive to incorporate the Eastern European states liberated by the implosion of the Soviet empire. And, finally, there’s the fact that all these initiatives and policies were driven or inspired by a Commission staffed by a technocratic elite that had been drinking the neoliberal Kool Aid from the time they’d been in kindergarten.

So in 2016 there were plenty of reasons to debate the wisdom of continuing to belong to such a flawed institution. But mostly those arguments were never made — or if they were they were drowned out by the crude xenophobia of the two Leave campaigns. Worse still, the corollary was never explored — the idea that a Britain governed by a radically reformist regime could forge an interesting future for itself outside of the EU.

But we are where we are: out. So it makes sense to think about the future as one that could have real possibilities for radical improvement — if Britain had a radical reforming government that was competent. It doesn’t have that at the moment, so the question is: where could such an administration come from?

The Johnson administration is incapable — for social, ideological and capacity reasons — of measuring up to the task. All that vapouring about “levelling up” is just sloganeering. They don’t have a clue about even where to start. (Dominic Cummings’s fantasies about the revolutionary possibilities of a British DARPA were the ravings of an elitist technocrat on steroids.) There’s no strategy, or indeed no real understanding of what would need to be done to transform a ‘liberated’ UK into a progressive, successful, fairer, more dynamic society.

So the odds are that the slogans will fizzle out and the decay set out by ‘Project Fear’ will come to pass. The United Kingdom will fracture, with Scotland eventually going its own way; Ireland slowly re-uniting, de facto if not de jure; and a Westminster parliament with just one pocket borough left — England. Or, as Philip Stephens put it in the FT the other day, “Forget the guff about embarking on a new Elizabethan age. ‘Global Britain’ is at present heading towards the rocks of constitutional break-up.”

So what could be done to move on creatively from Brexit? The only answer I can see is a radically revitalised Labour Party that comes to power four years from now. The question then becomes: could Keir Starmer build such a party? And where would its ideas come from?

More posts here.

The Dental Marketing Secrets Podcast

I was delighted to be a guest of Mark Thackeray from Salt Lake City on his Dental Marketing Secrets Podcast in December.  He was great host, made me very welcome and I commend the Podcast to you.

Here’s a link to the back catalogue of more than 40 Podcasts with some useful and interesting guests.

Here’s the one we did together.

You can find out more about Mark and his work at Practice Rocket

Happy New Year

“I hope that in this year to come, you make mistakes.
Because if you are making mistakes, then you are  
making new things, trying new things, learning, living,
pushing yourself, changing yourself, changing your world.”

Neil Gaiman

Where it began…

The first time that many became aware of something going on in Wuhan. It was published on February 7th a day when I was teasing my wife about her birthday that day and we were looking forward to our holiday in La Gomera in a fortnight. We managed to take the holiday but the world felt as if it has been wobbling on its axis ever since.

Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China


Importance  In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.

Objective  To describe the epidemiological and clinical characteristics of NCIP.

Design, Setting, and Participants  Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020.

Full article from JAMA here. 

The Monday Morning Quote #638

“When the winds of change blow, some people build walls and others build windmills.”

“When the winds of change rage, some build shelters while others build windmills.

Chinese Proverb

Dental research and experiences pay dividends.

Amongst the things that came to my notice this week.

  1. Via the FT “How to spend it” magazine came “BONDIC”, which is apparently developed using concepts from Dentistry. It comes in an applicator with a built-in UV beam. Apply, shine the light and off you go.  www.notaglue.com






2. From Nature 2004 (via reestheskin) the story of a breakthrough in cataract surgery. How a jolt and a bolt in a dentist’s chair revolutionized cataract surgery” tells the story of Charles Kelman and his pioneering technique of “small incision phacoemulsification” which allowed rapid, painless restoration of vision. His epiphanous moment is described….LINK

The idea for phacoemulsification came to Kelman in 1964 while sitting in his dentist’s chair and having his teeth cleaned. A sudden jolt from the dental drill produced an epiphanous bolt from the blue. As Kelman writes in his memoir, “I sat in his chair, as he reached over, took a long silver instrument out of its cradle and turned it on. A fine mist came off the tip but the tip didn’t seem to be moving. He applied the tip to my teeth, and I felt an exquisite vibration and heard a high-pitched sound.” Kelman asked, “What is that thing?” The dentist replied, “An ultrasonic probe.” “I knew this was the moment,” Kelman wrote.

Before the era of Charles Kelman, the surgical removal of cataracts was a major ordeal, requiring a hospital stay of 10 days (if no complications occurred) and a convales- cence of several months2. Typically, the patient underwent general anesthesia, after which a large, semicircular (180°) incision was made in the cornea to allow the entire lens to be grasped with a forceps and pulled from the eye in one piece. Eight or more sutures closed the incision, and the patient was kept on absolute bed rest for 3–5 days with both eyes occluded with patches. To restrict movement of the head, sandbags were placed along both sides of the head, and both wrists were bound with restraints to the bed. This enforced immobilization often led to mental disorientation, prostatic obstruc- tion, bedsores and pulmonary embolism. As many as 20% of patients developed vitreous hemorrhage, macular edema, eye infections and retinal detachment. After discharge from the hospital, the eyes and lids remained red, swollen and irritated for as long as 6 weeks. The surgically treated eye had to be patched for several months, and the aphakic patient had to wait for as long as 6 months to be fit-ted with thick spectacle glasses.


The Monday Morning Quote #637

“Political promises are like biscuits, once they are broken, they can’t be repaired.”

Roy Lilley


Safety of lateral flow tests questioned.

From British Medical Journal

The lateral flow devices used in the community testing pilot in Liverpool only picked up half the covid-19 cases detected by polymerase chain reaction (PCR) tests and missed three out of 10 cases with higher viral loads, according to the government’s own policy paper.1

Jon Deeks, professor of biostatistics at the University of Birmingham and leader of the Cochrane Collaboration’s covid-19 test evaluation activities, told The BMJ, “The results are hidden as a single sentence in the annex of a document. This is not the way important scientific findings should be made public, particularly when the test is going to be used off label with hundreds of thousands of people.”……..“These results are devastating—they are missing a third of those with high viral loads. How can these tests be used for safe entry into care homes, for healthcare workers to safely return to work, or for the safe return of students? They are not fit for purpose.”

Allyson Pollock, director of the Newcastle University Centre for Excellence in Regulatory Science and a member of Independent SAGE, said, “This is scandalous. Where are the data underpinning the statement in the document? Mass testing should be paused until we see the evidence and Liverpool evaluation.”…“The Liverpool public who went for testing seem to have been grossly deceived and misinformed about the usefulness of the test and purpose of testing. They were not told that one of the purposes was research on the lateral flow test in healthy people.”

So I was curious…..

Where and what did the new Cabinet study?

The subject mix is firmly in favour of the humanities (57%) and social sciences (30%), with seemingly only one minister having studied a STEM subject, Alok Sharma, International Development Secretary, who studied Applied Physics.

Source HEPI (July 2019)

All italics and emphases are mine.

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