Tom Yates

@DiabetesTimes @LDC_tweets @UHD_NHS @DiabetesUK @DiabetesUKProf Not me. Suspect you meant to tag Prof Tom Yates from @uniofleicester

@DrToddLee Amoebic dysentery

4 infectious mimics of non-responsive ulcerative colitis to consider (amongst others!) Strongyloides Cmv colitis Listeria Histoplasmosis Here someone reports 2 in the same patient! academic.oup.com/ecco-jcc/artic…

@DrToddLee @MichaelGIsonMD @DrJeanneM @NEJM We need to slaughter infected flocks/herds, compensate farmers, and put an end to it

@MichaelGIsonMD @DrJeanneM @NEJM We need an international pragmatic randomized controlled trial platform to rapidly test interventions in these cases rather than relying on expert opinion and practicing voodoo like plasma exchange.

It was an honor to write this contextualizing editorial with @DrJeanneM for the @NEJM about 2 important reports of recent human cases of influenza A(H5N1). nejm.org/doi/full/10.10… nejm.org/doi/full/10.10… nejm.org/doi/full/10.10…

NEW PAPER! Work led by @gushamilton and @gpollara finds reduced IL-6 signalling may REDUCE risk of TB disease Challenges idea that IL-6 plays essential role in immunity to Mtb, and suggests IL-6 drives immunopathology Great use of data from ITHGC thelancet.com/journals/lanmi…

@toast36742904 @BMA_James_Steen x.com/tomayates/stat…

@tomayates @BMA_James_Steen I always thought time in post meant actual time you do the job. If it's purely an age and life things that seems massively unfair and also raises questions about should older people just be paid more ? If not why not. It's the same premise

I'm preparing a fellowship application Need to cost consultant salary for when I CCT I work 80% LTFT and have taken research blocks, which didn't count towards training Think I should start few points up consultant payscale Is there a policy I can reference? @BMA_James_Steen

@toast36742904 @BMA_James_Steen 'A better childcare system' would also cost money and that money would go, perhaps 'unfairly' in your view, to those of us raising children I guess the fundamental difference here is whether you take a narrow or a bigger picture view of fairness?

@toast36742904 @BMA_James_Steen As I said, it is pretty standard to get increments for time in post, distinct from increments for additional ability/responsibility I think such increments are there to reflect fact that most of us accumulate financial responsibility over time (children, aging parents, etc)?

@toast36742904 @BMA_James_Steen Which comes back to what you think the purpose of annual increments is I think they are there to reflect the fact that, whilst you are at the same grade/level, people tend to get burdened with financial responsibilities over time

@tomayates @BMA_James_Steen But LTFT haven't served any more time, have no more experience or greater level of training than someone doing full time.

@toast36742904 @BMA_James_Steen Standard, in contracts, for both level of training/responsibilty and time served to factor into pay, the latter presumably to reflect fact that we tend to accumulate financial responsibility And til childcare sorted, measures like this essential to retain parents in workforce

@tomayates @BMA_James_Steen Yeah. Difference in opinions. In my mind fairness is finding a better childcare system. Since that is the issue. There seems to be no thought given to someone doing same job for less pay. Normally this individual gets the sympathy and union fighting for them

@toast36742904 @BMA_James_Steen I suspect we have different views on 'fairness' A doctor who can train full time will CCT earlier and with a whole load more money in their pocket than someone who trains LTFT whilst forking out for the flexible childcare needed to allow them to continue to work acute rotas

@tomayates @BMA_James_Steen Accepting that by doing this in effect you're valuing other consultants as lesser ? You seem to dodge the matter that what do you say to the person who is doing the same job at the same level getting paid less. How is actual discrimination fairer than perceived

@toast36742904 @BMA_James_Steen I think it is fair and legitimate for the BMA to demand and for the employer to agree to measures to partly offset the huge financial penalty associated with having children whilst working acute rotas There remains a large gender paygap in medicine bma.org.uk/pay-and-contra…

@BMA_James_Steen @tomayates I guess fundamentally as a bma member it's sad to know that as a day 1 consultant I'll be deemed less "valuable" than someone who came through LTFT. That's true discrimination. I may need to contact BMA to see what the position and justification is.

@toast36742904 @BMA_James_Steen 'Supposed gender pay gap'

@tomayates @BMA_James_Steen It's not about being financially better off it's really about fairness. I can't see any rational argument for starting at a higher band other than trying to reduce a supposed gender pay gap. Childcare etc is rubbish but is a choice individuals make

@toast36742904 @BMA_James_Steen That's one take on it, I suppose As one part of a two doctor couple, I can assure you that we are not financially better off for having gone LTFT to make childcare work Most of one salary goes on childcare that is flexible enough to accommodate us both working acute rotas

@BMA_James_Steen @tomayates Do they get paid the same as a y1 consultant as someone who has come through non LTFT. If not then this is massively unfair. Gender pay gaps because people have taken time off for whatever reason are gaps purely because of choice not discrimination.

@BMA_James_Steen Thanks Do you know whether delay to CCT caused by research time, e.g. ACF, ACL, are treated similarly? I am getting mixed messages I've had much more delay due to research time than due to LTFT working @BMA_Academics

@tomayates Hi there. It’s not a policy, it’s actually a contractual right in the consultant terms and conditions of service. So for any delay to your CCT that can be attributed to training LTFT, say 2 years, you should start that far up the consultant pay scale from day one.

@IDiots_pod @BMA_James_Steen Thanks. Your increment date as an SpR or as a consultant?

@tomayates @BMA_James_Steen The BMA LTFT pages have the details, but see the consultants 2003 contract, schedule 14 (para 6). I trained LTFT and had my increment date changed to I wasn’t penalised in terms of progression for going LTFT.

It takes a special kind of nonsense speak to claim the way to protect future generations of farmers is to provide a large tax incentive for non-farmers to buy up land, pricing actual would be farmers out. That is exactly what the status quo does

@gushamilton @GweeAmanda What numbers are we happy with here? 4 in 100 seems quite a lot for a CNS infection

@GweeAmanda @BradSpellberg This is the content I'm here for! I think overall R rate 4% given meningitis breakpoints right, which is MIC of 2. And your study suggested still getting decent drug/MIC for most time right, so I guess you'd probably be ok most of the time.

Interesting! 20% resistance to CRO. I wonder how much this resistance really affects tx for CNS infection. Suspect you'd still get enough drug and that R would be overcome. I think @BradSpellberg had a view on this (may be wrong)

@apsmunro @DiorIzzy @Zaydovudine @DrToddLee I should look at the data May differ between kids and adults (where trying to salvage a staph aureus line would, I think, be frowned upon) Could be a good RCT but would need long follow up, as running out of access is the main concern with pulling lines

@tomayates @DiorIzzy @Zaydovudine @DrToddLee We quite often attempt line salvage with S aureus in kids actually

Pt w short lived CA-SAB (1-2 d), neg TTE, no HW, seeded a native peripheral jt, had I&D. Would you be happy w 2 wks IV (for the SAB) then 2 wks of oral to complete 4 wks for the septic jt or would you do 4 wks IV coz it’s not technically “low risk” SAB? @BradSpellberg @DrToddLee