Refeeding syndrome and dementia training

Not in the same person ... but in the same lunchtime meeting.

Good overview of refeeding syndrome presented at the departmental meeting in Truro. It was based on a recent review in the BMJ (1) but presented with a bit of a memorised case from the wards and a lot of slides. Could have done with less time on phosphates, a few more pictures, some historical perspective and some more time on those clinical circumstances where it can be easily missed - high-dependency unit patients, post-op patients, eating disorders etc.

Whilst in the meeting managed to search BMJ Case Reports for 'refeeding syndrome' and found several cases. Would be good for future meetings to perhaps highlight such a wealth of cases and the associated media that would come with them.

Then had a whistle-stop tour of dementia which apparently counted, in part, for 'dementia training' for all the staff. Marvellous.

1. Mehanna HM, Moledina J, Travis J. Refeeding syndrome: what it is, and how to prevent and treat it. BMJ. 2008;336(7659):1495 -1498

BMJ on iPad - tool, toy or trinket?

The BMJ is the first general medical journal to launch on Apple's iPad tablet computer.

http://resources.bmj.com/bmj/about-bmj/bmj-on-the-ipad

I hear that because of a lack of iPads (see below) the BMJ editor's children and the children of other senior management have fully tested the new journal experience and approve.

In the early days of developing websites programmers had the dilemma of making their content visible on any screen size or being more visual and making it fit the at-the-time-luxurious 800 x 600 pixel screen. They still have that dilemma and the enlightened ones choose the 'any screen' option and some choose the 'best viewed in a something x something screen size'.

The iPad is just a screen. That's its main function - being a screen. It is a certain size since Apple feel that this is the best designed size which it probably is. After all, they know what they are doing. It is exactly 1024 x 768 pixels which is quite generous really.

When you develop an App you don't have to worry about the borders of a browser since you have full control over all the pixels. This is the main function of an App. It delivers the content to you perfectly designed for the screen size that you are viewing.

Add that perfect viewing experience to mobile access and 'key content' from the current issue of the BMJ and you have a tool. At £9.99 for 4 weeks it gives you a rational reason to buy an iPad for yourself and not one of the kids.

I think the business philosophy is great. Get people to buy a highly desirable gadget that kids and other commuters will drool over that costs a lot of money and so makes them look sophisticated and important. Then get them to pay more money to give them a grown-up reason for having it. This not a trinket or toy - oh no - it is an important tool for work.

Here is the formula:

iPad toy + BMJ subscription = happy (smug) doctor

In response to any criticism you just say "I'm reading the BMJ thank you very much".

Apparently a 'sit-in' is planned at BMA House by employees not as a sympathy vote for students but as a protest against the lack of iPads at Head Office. If you have an unwanted iPad toy then please consider those hard-working publishing types who rely on such essential pieces of equipment.

Neurosurgery case

Just blogged on a very public neurosurgery case in the BMJ Case Reports Blog which gives an account of the shooting of congresswoman Gabrielle Giffords.