Ian Smith

Frailty. NHS. Violinist. Gardener. Tennis. Love, life, laughter.

[Ian Smith @IjsSmith]

Wisdom from a 95 year this weekend;

"Let me tell you this, it is those things in life that bring you great joy and happiness that really are worth dying for."

A poignant message loaded with all I'd hope to hear from a person confronted with ill health at this auspicious time.

[DaVinci @BiancoDavinci]

Let's increase tree cover in our cities.

[Matthew Marsden @matthewdmarsden]

I grew up in the Uk.

Almost every Friday or Saturday night there was a fighting a pub. I have seen loads of them.

Not once did I see a knife pulled. In fact, you were considered a coward if you ever did.

This is an imported culture, and it has been allowed to fester like a cancer.

And like cancer, it will continue to grow until it kills its host, unless it is destroyed.

[William Yarwood @yarwoodwilliam]

The BMA’s “pay restoration” campaign is built on one giant sleight of hand.

They deliberately start their analysis in 2008 because it ignores the huge above-inflation pay rises doctors received before then. In reality, resident doctors’ pay was already around 35% higher in real terms than in 1990. They have also been widely criticised for using a discredited measure of inflation (RPI) to calculate pay erosion, despite it being dropped as a national statistic more than a decade ago.

And despite all the rhetoric about “underpaid doctors”, resident doctors have already received multiple inflation-busting pay rises, the NHS is receiving record taxpayer funding, and they enjoy employer pension contributions worth 23.7%, which is nearly double what it is in Australia and around six times the private sector average.

At some point, politicians need to stop treating the BMA’s figures as neutral facts and deal with them for what they are - union militancy dressed up as economic analysis.

[Giuseppe Bellelli @GiusepeBellelli]

Growing evidence that cognitive decline should be fully considered as an outcome measure before surgery in older adults

[Norman Brennan @NormanBrennan]

Folks Millions of people today saw Britains CJS at its worst; it’s a CJS that I was once part of & proud to serve But I’m ashamed to state that it’s completely lost its way & I’ve lost my Faith in it; I also know that I’m far from being alone in feeling this way! UK CJS >RIP🤦‍♂️😞

[Dr Steve Taylor @DrSteveTaylor]

Not the NHS Again!

As @wesstreeting resigns, his claim of success sticks in the craw:
‘The results are in & I am pleased to report that I have delivered against the ambitious targets you set for me when I became SoS’
(full podcast next Friday)

@keepnhspublic @MrMarkEThomas

[Dr Huw @DrHuw]

Ladies & gents, the new NHS Health Secretary

[htw @heniek_htw]

Chronic stress dysrupts HPA axis → changes in speech: ↓ fluency, fragmentation, more “I/me/my” (~30-50%↑ in some studies), ↑ negative words. Linguistic patterns as stress biomarkers. But safe communication (therapy, expressive writing) may regulate stress.

[Tony Breu @tony_breu]

14/14 - Conclusions

ᯓ➤ Hemostasis and most thrombotic conditions begin with the extrinsic pathway and involve the endothelium
ᯓ➤ Thrombosis in the setting of mechanical valves begins with the intrinsic pathway and is independent of the endothelium
ᯓ➤ The result: (1) lots of thrombin; (2) loss of the usual checks on thrombosis; (3) failure of direct oral anticoagulants

[Tony Breu @tony_breu]

12/
In addition to generating massive amounts of thrombin, the foreign surface of a mechanical valve means it does not induce the same endogenous anticoagulant mechanisms.

Many of these require an endothelial surface.

❌TFPI
❌Endothelial antithrombotic surface
⬇︎Antithrombin
⬇︎Protein C/S

[The BMJ @bmj_latest]

A 2025 report suggests that around 30% of people who died in the UK in 2023 had unmet palliative care need.

Services need to be integrated within community care, argues this Editorial
https://t.co/GQCYFUQMe6

[Melike Dönertaş @melikedonertas]

Check out our new review on evolutionary genetics of ageing 🔥 https://t.co/FCecUm4OBM @NatureRevGenet @LeibnizFLI @IHAatUCL

[Nature Reviews Drug Discovery @NatRevDrugDisc]

Blood–brain barrier (BBB) dysfunction is a hallmark of many diseases of the brain, such as Alzheimer disease. This Review in the May issue covers strategies for BBB repair and protection in various diseases and during normal ageing
https://t.co/VELd6jgaSe
https://t.co/1w69Xpn5I3

[David Sinclair @davidasinclair]

ED drugs like Cialis & Viagra, when taken as a low dose daily, can help maintain vascular function in brain and muscle, and are a promising, though still debated, approach for preventing & treating dementias. The human data for Cialis (tadalafil) is stronger …🧵

[NHS England Workforce, Training and Education @NHSE_WTE]

Today is #InternationalNursesDay!

We would like to celebrate and thank all of the wonderful nurses that make up #OurNHSPeople.

Are you interested in a career in nursing? Find out more here https://t.co/Xc0OOfsoWh

#IND2026

[NHS England Workforce, Training and Education @NHSE_WTE]

Are you an NHS colleague with a particular interest in health and wellbeing and supporting #OurNHSPeople? Then becoming a Wellbeing Champion might be for you! Find out more here https://t.co/UstsLzHp7a #MHAW

[Leo @SpartanPsyche]

Your brain is worse at remembering future promises than it feels. “I’ll send it Friday” sounds solid when you say it, but future memory is fragile under load. Stress, noise, and new problems bury the cue. Put the follow-up in a calendar before the conversation ends. Do not trust a tired brain to remind itself.

[Dalton (Analyze & Optimize) @Outdoctrination]

Magnesium + potassium combination lowered cortisol by ~45% and completely eliminated severe insomnia in a recent clinical trial.

(🧵1/7)

[Satchin Panda @SatchinPanda]

Emerging research links vascular dysfunction to cognitive decline in aging & dementia.
Reduced blood flow and blood-brain barrier breakdown may play a key role—and could even be causally connected. Understanding this opens the door to new, much-needed therapies. #Neuroscience #Aging #Dementia
https://t.co/vcaZ7JMK3a

[Eric Topol @EricTopol]

Why is there such obsession with extending lifespan when the bigger issue is that average healthspan is 65 years and there are no data (except in super-centenarians) that longer lifespan = longer healthspan (known as compression of morbidity)?