> and the guys watching him were very lackadaisical about it.
Anyone who knows anything at all about suicide prevention is unsurprised by this. We know that observation does not work because staff cannot maintain it. This is true whether it's 15 minute obs, 5 minute obs, permanent line of sight obs, arms length obs, two to one arms length obs: they do not work.
There are countless examples of staff in hospital, on duty, doing obs, knowing their patient is at increased risk of suicide, falling asleep.
> Depression and sucidides in first world countries, the ones that tick all the intial boxes, are a highs not experienced since WWII. [1] is just from a quick googling and US-only. You won't have trouble finding much more evidence to support this though, for many other 1st world countries.
It's difficult to compare suicide statistics over time, especially over decades, because definitions change. (For one example, in England a coroner used to need to be able to prove beyond all reasonable doubt that a person had died by suicide, and that changed to balance of probabilities in 2018).
It's also important not to use sources like media outlets for suicide statistics, because they often don't understand what's being counted or how it's being counted. Statistics are tricky, and media often get them wrong.
You say that it's easy to show that suicides are at an all time high in many first world countries, but that's not correct. In many countries rates peaked in about 2008 - 2010 because of world wide financial crash, and have been declining since then. We might see another peak because of the financial (and other) distress caused by pandemic, but so far we're not seeing a big increase.
> maybe it’s just me, but most of the new drugs seem to come from USA.
It's just you.
What we see from the US is re-patenting. Citalopram gets a minor change and becomes escitalopram, it gets a new patent and some bullshit sales pitch to make doctors switch from a cheap generic to a more expensive branded med. Or ketamine infusion becomes eskatamine nasal spray - moved from a generic and tricky to administer med to a branded and easy to administer med (and, it turns out, much less effective).
The other thing the US does is "Me too" drugs - someone develops an SSRI and the US is then able to spin up 8 different versions of SSRIs that are different enough to get their own names and patents.
Most of the funding in the US doesn't come from big pharmaceutical companies, but is government funding.
For the new meds that are developed in the US the funding normally comes from Government (NIHR) funding, and not direct from pharmaceutical companies.
It's also difficult to work out what to measure: do we look at GERD (gross expenditure on research and development) or do we look at GDP too? DO we look at the quantity of new meds, or the impact on quality of life or years of life lost to disability? Do we focus on meds aimed at diseases that affect wealthy countries (diabetes, breast cancer, etc) or on disease that mostly affects poorer countries? Because three meds that have moderate impact for a small population are "less" than one med that has a good strong impact on a large population.
The Cass Review has also said that children should have easier access to cross sex hormones - they're considering removing the requirement for children to have spent time on puberty blockers before moving onto CSH.
The alternative explanation is that it was almost impossible for trans children to access healthcare in the UK and the only people making their way through the pipeline of GP to GIC to hormone centre were those who were undeniably trans.
Double check those bone density results, because new research shows they're present before treatment with puberty blockers starts. Some theories are that some children have reduced access to sporting activity.
Puberty blockers have a long use in children. Unlike a lot of paediatric medications puberty blockers are licensed for use in children, and are used for their licensed use (blocking puberty), albeit for a different population (gender incongruent children with strong trans indicators, instead of children with precocious puberty).
This - being licensed in children, and being used mostly in line with the license - is better than many paediatric meds.
We have a lot of research about use in precocious puberty - they meds are mostly harmless. We don't have a huge amount of research in trans children, but that's for exactly the same reason we don't have research in a bunch of different meds for children.
> they wheel you into the procedure room, and then you pass out.
This is the bit that a lot of people have a problem with, and there's usually some choices in the amount and type of sedation you get.
In the US they use much heavier sedation than other countries - use of propofol is not uncommon in the US - and it's one of the things that makes colonoscopy more risky than it needs to be.
> One thing is clear: Screening works. If you’re of the appropriate age, please get screened. If your tubes are acting funny, please get screened without delay.
Screening is for people without symptoms.
If you have symptoms it's not screening, it's diagnostic testing. Diagnosis is important - if you bleed from anywhere you need it to be explained - but there are big differences in how you look at a test that's done for screening vs diagnosis.
Shaun Lintern is an experienced health system journalist. This piece, written by him and Danny Fortson, is a comprehensive take down of Babylon.
Lots of people had serious concerns about Babylon Health - mostly around obviously false claims of accuracy - for years, and it was baffling to see them keep getting money.
And the real story is pretty grim - copious amounts of corruption and deception, and a system not holding them to account.
It's notable that a key feature of their model - quick access GP appointments to push patients to private secondary care (where the people providing the GP appointments and the people providing the hospital care are in the same company) did not work, and could not work because the finances didn't make any sense even with the corruption and deception.
There are often discussions around NHS models of care, and people will suggest moving to a mix of public and private, or private but non profit insurance models. The simple fact is the model doesn't matter: healthcare doesn't work unless you fund it.
We do have the money to fund the NHS. Successive Conservative governments have made the choice to defund the NHS, along with public health, and social care. And they did all of this on top of Brexit.