Paracetamol and pregnancy: what’s the fuss?

A great message about the reporting of research in the media. Beware the unwary and salute the responsible science journalist.

drjustincoleman

1. pregnancy Could paracetamol be linked to ADHD? Photo by tipstimes.com

Yesterday’s study linking paracetamol use during pregnancy with behavioural problems in childhood has hit news headlines around the world, and this morning ranked first among Australian health news stories, according to Google trends.

[Clarification: paracetamol brands include Panadol and Tylenol. In the US, the chemical name for the drug is acetaminophen.]

What is the fuss about?

A study published yesterday in JAMA Paediatrics analysed data from 7796 mothers from Bristol, England, who were part of a prospective birth cohort study in 1991-2. The self-recorded data included maternal use of paracetamol during pregnancy (at 18 and 32 weeks) and five years later, and the presence of behavioural issues when the child was seven years old.

The study found an association between antenatal paracetamol use at 32 weeks gestation and behavioural problems for the 7-year-old children, as measured by a high scores on a conduct…

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My first blog – look out world!

DrAliceClark

Will you sit idly by and let this world go to the dogs?  Well I won’t.  I know we are all on information overload, with thousands of issues, causes and opinions competing for attention, shocking images flashed before our eyes before we can look away and paid advertisements, it can be difficult to know where you stand on important issues.

Information is not knowledge.  I’ve started this blog so that I can independently share my personal views and partake in social and political commentary on what is happening in Australia and the world.  I hope my blog may tease out some of the underlying tensions around what we hear and see and be useful in my quest for a better world, a more humane and caring society and social policies that work on the ground.  Feel free to join me.

Those of you who know me, will understand why I am a big fan of social media.  For…

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Warning: Dear patients, you’ve been targeted!

Primary care works.

Doctor's bag

You've been targeted

The co-payment is coming back. Australians will have to pay more for a visit to the GP or specialist. The freeze on your Medicare rebate means you will get less back from Medicare. It is expected that many practices will stop bulk billing. Join the ‘You’ve been targeted’ campaign and let your local member know that you oppose the freeze on your Medicare rebates.

The Federal Government is reducing its investment in your healthcare by freezing your Medicare rebates. This means your Medicare rebates will remain the same until 1 July 2020, despite the cost of delivering healthcare services increasing (see graph below).

The freeze is a co-payment by stealth and the Government has implemented this measure to reduce the amount it spends on all Medicare subsidised services, including general practice services.

Your health is important. Please do not let the freeze on your Medicare rebates stop you from seeking the healthcare…

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Our Health Funding – being gamed or are they just incompetent?

Great blog from Thinus Van Rensburg.
The circus of stupid in health care funding.

Dr Thinus' musings

Health funding in an acute care setting, especially in a Primary Care setting is always an challenging situation. Bringing small business owners, entrepreneurs, corporates and non-medical stakeholders interests together and then expecting Public Servants to make sense out of all the issues was, is, and always will be, a dog’s breakfast.

General Practice has always been an easy target for the Bureaucrats when they needed a scapegoat. The Public perception of rich greedy doctors is an easy myth to perpetuate despite Medicare’s own statistics showing that Total Professional Attendances had increased by a mere 6% over the last calendar year.

The focus in the media has also been on bulk billing rates and no amount of factual information seems to shift the public perception. The belief that a Standard Medicare rebate for a GP with ten years of formal training should be less than $ 40 is ingrained and seemingly…

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THE FARAWAY TREE

yestolifeblog

“I don’t believe in things like that – fairies or brownies or magic or anything. It’s old-fashioned.’

‘Well, we must be jolly old-fashioned then,’ said Bessie. ‘Because we not only believe in the Faraway Tree and love our friends there, but we go to see them too – and we visit the lands at the top of the Tree as well!”  – Enid Blyton, The Folk of the Faraway Tree 

 

The Faraway Tree is a story or series of stories by Enid Blyton. The first of the stories was written in 1939. The story is that in an enchanted wood, there is a giant tree  – a tree that is a portal to magical worlds. Its branches reach high into the sky, so much so that its top most branches are immersed in the clouds. Three children discover the Faraway Tree and journey up into its realms. Each time they discover a new…

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Zero Tolerance for Zero Tolerance

Nice thoughts on bullying, angry staff and patients and reflective practice by nursing educator Paul McNamara. How Zero tolerance doesnt work so well as inviting dialogue. Not shouting in order to get the message across. Nice one Paul.

meta4RN

photoA while ago I wrote about my most frightening workplace experience in a post called “Emotional Aftershocks“, which included a section titled “Zero Tolerance is Unrealistic and Unfair”.

Today, via a Tweet by Nicky Lambert I am reminded of how ridiculous the “Zero Tolerance” approach in hospitals is and (more importantly) have been introduced to an evidence-based alternative strategy that has recently been launched in the UK. To cut-out the middle-man and go straight to source of this pretty-cool strategy, click on the link: www.abetteraande.com

To subject yourself to my ideas and waffle, please read on…

What’s Wrong with Zero Tolerance?

A dumb, shouty poster. A dumb, shouty poster.

It is inevitable that health services, hospitals especially, will have a large percentage of patients who have cognitive and perceptual deficits due to the very medical condition that has them bought them to the health facility in the first place. About 9% of the over-65s…

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Leadership. What is it?

 

Virchow

First of all the issue is what do we mean by Leadership?

This blog is in response to comments made on the medical forum GPs Down Under.

In  references in my article AFP Article here

I Referenced a UK Document  about a National Leadership Competency Framework for Doctors.   NHS Leadership Academy  page 9. has the five core domains of leadership.  Its a big document but page 9 is good.

Leadership was defined as a set of competencies    From the above document:  “The Medical Leadership Competency Framework (MLCF) is built on the concept of shared leadership where leadership is not restricted to people who hold designated leadership roles, and where there is a shared sense of responsibility for the success of the organisation and its services.”

We often do see leadership as a role and this may not be what is always required or desired.  So the comment from my colleague on GPDU is entirely appropriate and that is that “not everyone wants to or aspires to or can- participate in Leadership Roles. “ Very true.

The challenge in the discussion is what about those who do wish to have a voice in their profession, but who face individual, workplace or cultural barriers?  Whilst the desire to participate in leadership or not may not necessarily be a gendered issue- the barriers to express that desire may well be.

Way back in 2004 Dame Carol Black commented here about

The dangers of a feminised profession

Her comments were not unlike the recent O and G debate- stirred up controversy of course but were not anti-feminist.

Iona Heath Professor of GP ( and such an eloquent speaker) wrote  a response to Dame Carol Blacks comments.

Essentially the point of both women is that

“Continuing unequal status of women may reduce the influence of the profession”

Heath I. Women in medicine. BMJ Editorial. 2004;329(7463):412-3.

In other words:

Who argues policy and procedures for Medicine?  Will it only be from the point of view of a traditionally male stereotyped bloke who has the archetypal “wife” supporting his role and after hours political activism.    The issue is that part time medical practice is seen as a norm for “women” and not so much for men although this is changing.  Without representations form the diverse membership (and I hesitate to say female gender is part of diversity when it is 50% of the population) then diverse opinions and needs are lost. Carers are seen as “slackers” for not being full time in the work force.

It is every couples choice how they might manage this but a “choice” is a loosely used word and a National Child Care policy is long overdue in Australia.

Re thinking how we go about providing support for both men and women who are caring for others and bringing the domestic life into the work life and not the other way around would be a start.  The Domestic Life and its multitude of needs are absent and invisible in the workplace. Yet they save the country a fortune in voluntary labour and GDP.   Any gender can be unfairly  discriminated against as an individual family if domestic work creeps into the workspace too often.

So there are policy and procedures that this Country needs to have not just for the Medical Community but for all working families. Have a look at equity within the workplace as per Norway and other countries who are doing this much better than Australia.  Legislation changes discrimination.  With a national child care policy for example, we wouldn’t blame individuals and the choice would truly be one of choice and not of necessity reinforced by traditional gender roles.

I havent got time to clarify issues of

  • part time medical practice and its necessity for burnout prevention.

See here : 1.     Stevenson AD, Phillips CB, Anderson KJ. Resilience among doctors who work in challenging areas: a qualitative study. The British journal of general practice : the journal of the Royal College of General Practitioners. 2011;61(588):e404.

  • Nor about developing confidence for those (often women) who need practice and assistance in developing a voice.
  • Nor did I get time to say that technology can’t help women/carers attend after hours meetings if their time at home is not protected.
  • Nor did I get to discuss the role of women in politics and why that might not be a desired outcome by some supported by privilege -hence the rather aggressive at times push back against ‘feminism’.

Another blog for another day.

My point is we are all leaders and it’s important not to be silent or absent even if you don’t have a leadership role. At some time in your medical life or at home- life will ask of you to advocate.  Your privilege as an educated man or woman is to speak up on behalf of those who cannot.