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Paul Howard

Paul Howard

@paulhoward.bsky.social

1.1K followers 810 following 170 posts

Consultant in Palliative Medicine (Isle of Wight, UK); Palliative Care Formulary Editor (neuropharmacology sections)

Medicine 31%

Public Health 30%

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Reposted by Paul Howard

Stefan Marciniak @profmarciniak.bsky.social · 4d

A terrible consequence of anti-vaccine untruths
www.theguardian.com/society/2026...

UK loses WHO status as measles-free after rise in deaths and fall in jab uptake

UN health body says Britain is one of six countries in Europe and central Asia where disease has become re-established

www.theguardian.com

Reposted by Paul Howard

Prof Danny Altmann @daltmann.bsky.social · 11d

Bacterial metabolites induce cell wall remodeling, antifungal resistance, and immune recognition of commensal fungi: Current Biology www.cell.com/current-biol...

Bacterial metabolites induce cell wall remodeling, antifungal resistance, and immune recognition of commensal fungi

Davis et al. demonstrate that common gastrointestinal bacteria secrete metabolites that induce global cell remodeling in Candida albicans. C. albicans uses the HOG cascade, a central stress pathway, t...

Paul Howard @paulhoward.bsky.social · 15d

This "real world" study in pancreatic cancer related VTE reported in a JCO meeting abstract found apixaban was associated with less bleeding, fewer strokes and lower overall mortality compared to rivaroxaban

ascopubs.org/doi/abs/10.1...

Real-world effectiveness and safety of apixaban versus rivaroxaban in pancreatic cancer–associated VTE.

739Background: Pancreatic cancer is highly associated with venous thromboembolism (VTE), requiring long-term anticoagulation. However, evidence comparing outcomes between apixaban and rivaroxaban in t...

Paul Howard @paulhoward.bsky.social · 21d

But at least I won't have to watch my own children go through what my trainee doctors have to face. The latter is hard enough.

If it was my own kids, I don't think I could bear it.

Paul Howard @paulhoward.bsky.social · 21d

We need palliative medicine now more than ever.
We could help the Neighbour Health Systems in their hope of taking complex care out into the community - we've been doing that for decades.
We provide a cheaper alternative when hospital care is no longer helping, and yet our funding is being cut.

Paul Howard @paulhoward.bsky.social · 21d

Even if they do, those in the @rcphysicians.bsky.social ivory tower will only allow them 3 years of specialty training, instead, insisting they spend their time in general hospital medicine.
Most people die outside of hospital; we need to be training community palliative care physicians.
I despair.

Paul Howard @paulhoward.bsky.social · 21d

I despair of the @bma.org.uk 's ineptitude; they've allowed the debate to focus purely on pay and failed to convey trainee's desperate situation.
Some trainees I meet want to follow me into palliative medicine. They would be fabulous; but will struggle to get onto general medical training.

Paul Howard @paulhoward.bsky.social · 21d

I enjoy medicine; obviously it can be stressful, but there's nothing I'd rather be doing.
But I am relieved that my own children do not want to follow me.
It's nothing to do with salary; it's because UK trainees have no job security, no stable training pathway, and little sway over where they work.

Reposted by Tim Bale, Elizabeth Stokoe, Michael Morris , and 3 more Tim Bale, Elizabeth Stokoe, Michael Morris, Graham Dutfield, Glen O’Hara, Paul Howard

Adam Schwarz @adamjschwarz.bsky.social · 24d

Farage: "I believe in vaccinations when they're vaccinations. I don't think what happened with Covid were vaccinations. You have to keep having them every 6 months."

Conspiratorial nonsense.

Some vaccinations like Covid shots require multiple/seasonal doses because immunity fades & viruses change.

Paul Howard @paulhoward.bsky.social · 27d

Link summarises why chlorination is concerning:
Is used to mask poor welfare standards, e.g. overcrowding, overuse of antibiotics (cause of antibiotic resistance)
Makes bacterial contamination harder to detect (by reducing bacterial load only on the surface)

www.rspcaassured.org.uk/blog/chlorin...

Chlorinated chicken and why it matters for animal welfare

Chlorinated chicken is banned in the UK because it masks low welfare standards. Choose RSPCA Assured for higher welfare chickens and safe, traceable food.

www.rspcaassured.org.uk

Reposted by Jonathan Portes, Martin McKee, Will Jennings , and 6 more Jonathan Portes, Martin McKee, Will Jennings, Becky Francis, Steve Peers, Andrew Scott, Tim Bale, Peter Holmes, Paul Howard

Charlotte Nichols MP @charlotte2153.bsky.social · 28d

There is, to my mind, no justification for the continued use by the UK Government of X as a platform for official comms. There hasn't been for some time, in fact, but if the latest developments around AI-generated image abuse and CSAM don't change the policy I really don't know what will.

Maggie Harrison Dupré @mharrisondupre.bsky.social · 28d

NEW: People are using Elon Musk's chatbot, Grok, to alter images to depict real women being sexually abused, humiliated, hurt, and even killed.

futurism.com/future-socie...

Grok Is Being Used to Depict Horrific Violence Against Real Women

People are asking Elon Musk's Grok chatbot to alter images to depict women being sexually abused, humiliated, and even killed.

Paul Howard @paulhoward.bsky.social · Jan 1

Partly. But I also want to know how to spot an individual service succumbing to misguided group think. You've followed many disasters, from maternity to Gosport: is there something in common? Maybe senior leaders dismissing recurrent complaints as "not knowing what they're talking about"?

Paul Howard @paulhoward.bsky.social · Dec 30

Thought note option 1, 3 and 4 are only realistically possible via a hospital pharmacy, which again highlights the desperate need to think about medicines supply if we're serious about moving more care out of hospitals

Paul Howard @paulhoward.bsky.social · Dec 30

Latest UK supply problem to impact drugs used to alleviate distress in the dying: parenteral clonidine.
Shortage predicted until start of February (though these estimates are too unreliable to plan with).
Options:
Import it
Use oral tablets sublingually
SC dexmedetomidine
Clonidine patch (import)

Paul Howard @paulhoward.bsky.social · Dec 26

Yes, I agree with all of that.
There's also a bias I'm struggling to articulate along lines of: demanding far higher level of evidence to adopt potential new option than needed to retain the existing option. Which reinforces "tradition-based medicine"

Paul Howard @paulhoward.bsky.social · Dec 26

A third blind spot is fitting care into what's convenient for the clinician. E.g. the harm caused by abrupt interruptions to established analgesia at admission to hospital. "Yes, I did tell them! But they said they didn't have any/couldn't prescribe it/had wrong colour socks/other excuse"

Paul Howard @paulhoward.bsky.social · Dec 26

A second is overestimating how well we understand the patient's experience. E.g. I'm often intrigued at how confidently colleagues pronounce "but that procedure isn't that painful", when I suggest better procedural analgesia after being called afterwards (again) to get their pain back under control

Paul Howard @paulhoward.bsky.social · Dec 26

I suspect one (of many) barriers is that clinicians often start from a "presumption of knowing best", so lean towards persuading rather than listening.
When I ask hospital inpatients open questions about their goals/aims, I so often find these just aren't aligned with the care being given

Reposted by The Lancet, Paul Howard

Donna Wakefield @donnawakefield.bsky.social · Dec 25

🏆 Its been the biggest honour of my life to win The Lancet 2025 Wakley Prize and have my essay published in the final @thelancet.com of the year 📖 🤩

It was the perfect #Christmas present to receive the paper edition, as a surprise delivery yesterday 🚚 📦

@wolfsonpallcare.bsky.social

Reposted by Paul Howard

North East Bylines @northeastbylines.co.uk · Dec 24

In 1800, around one in three children died before their fifth birthday, compared to four deaths per thousand births by 2020 | Amanda Ellison

Did Dickens murder Christmas?

In 1800, around one in three children died before their fifth birthday, compared to four deaths per thousand births by 2020

northeastbylines.co.uk

Reposted by Paul Howard

British Association for Psychopharmacology @bapsych.bsky.social · Dec 22

Registration is now open for #BAP2026 Summer Meeting in Birmingham, 19th - 22nd July. For more information, to register and submit your abstract -

The British Association for Psychopharmacology | 2026 Summer Meeting – Birmingham

The British Association for Psychopharmacology (BAP) promotes research and education in psychopharmacology, and brings together people in academia, health services, and industry

Reposted by Paul Howard

Kate Nautiyal @katenautiyal.bsky.social · Dec 21

New paper drop! 🧠💊 Our new paper out in Molecular Psychiatry shows that the serotonin 1B receptor is important for the neural and antidepressant/anxiolytic behavioral responses to psilocybin in mice.

www.nature.com/articles/s41...

The serotonin 1B receptor is required for some of the behavioral effects of psilocybin in mice - Molecular Psychiatry

Molecular Psychiatry - The serotonin 1B receptor is required for some of the behavioral effects of psilocybin in mice

Paul Howard @paulhoward.bsky.social · Dec 18

Interesting. What I'd add is that being in prominent journals is also no guarantee of quality; I've seen some really poor conclusions in the Lancet and BMJ. Particularly by pharmacoepidemiologists ignoring confounding by indication

PLOS Biology @plosbiology.org · Dec 18

Are authors fairly judged by assessing the #journals in which their work is published? @bihutchins.bsky.social &co reveal that most influential papers are published in lower tier journals, and more authors would be better recognized with #ArticleLevelMetrics #ALMs @plosbiology.org 🧪 plos.io/4oV58Ed

Standing on the shoulders of giants. Researchers (nodes) at early (red), mid (blue) and late (grey) career stage who have built on one another's work (edges). Large nodes are researchers whose work would not be recognized with journal level metrics but would be recognized with article level metrics. Credit: B. Ian Hutchins

Reposted by Paul Howard

PLOS Biology @plosbiology.org · Dec 18

Are authors fairly judged by assessing the #journals in which their work is published? @bihutchins.bsky.social &co reveal that most influential papers are published in lower tier journals, and more authors would be better recognized with #ArticleLevelMetrics #ALMs @plosbiology.org 🧪 plos.io/4oV58Ed

Standing on the shoulders of giants. Researchers (nodes) at early (red), mid (blue) and late (grey) career stage who have built on one another's work (edges). Large nodes are researchers whose work would not be recognized with journal level metrics but would be recognized with article level metrics. Credit: B. Ian Hutchins

Paul Howard @paulhoward.bsky.social · Dec 18

It might just be the NHS at the moment, but there are meetings where I long to be Zoom bombed.....where my professional civility hangs by a thread. Maybe you could export it as a service industry? Like, I could click an icon to call in Hawain zoom bombers?

Reposted by Paul Howard

Donna Wakefield @donnawakefield.bsky.social · Dec 17

📣Out now in Lancet’s @eclinicalmed.bsky.social
🫁The inverse #PalliativeCare law in advanced lung disease:mixed-methods #SystematicReview & #MetaAnalysis -1st paper from my #PhD provides evidence of #Inqualities in #lung disease
@wolfsonpallcare.bsky.social

www.sciencedirect.com/science/arti...

Paul Howard @paulhoward.bsky.social · Dec 9

This case series describes PCP pneumonia in older people immunocompromised by steroids, anti-cancer treatment etc.
Great summary of their clinical presentation (74% dyspnoea, 55% cough, 63% febrile, most tachypnoeic, whereas oxygen sats and neutrophil count mostly normal)

doi.org/10.1186/s414...

Pneumocystis pneumonia in older non-HIV-infected patients: a French, multicentre, retrospective, cohort study - Pneumonia

Pneumonia - Pneumocystis pneumonia (PCP) is well-described in younger and HIV-infected populations, but limited data are available for older non-HIV-infected patients. The aim was to describe the...

Carl Zimmer @carlzimmer.com · Dec 6

A study on 1.7 million people in Hong Kong shows superior hybrid immunity to Covid in people who got vaccinated before infection vs. people who got infected first. "Our findings are a direct rebuttal to arguments for natural immunity," the authors write. doi.org/10.1016/j.va...

Reposted by Paul Howard, Chris Parker

International Collaborative for Best Care for the Dying Person @careforthedying.bsky.social · Dec 1

Join our free webinar on Dec 11 2025 12-1pm GMT (1-2pm CET), as @drkathrynmannix.bsky.social explores the ways in which honest, compassionate conversations can reshape hope at the end of life ⬇️
🔗 www.bestcareforthedying.org/webinars

#eolc #PalliativeCare #hapc #hpm #hpmglobal
@eapcvzw.bsky.social

Reposted by Paul Howard

Dr Ben Bowers @drbenbowers.bsky.social · Nov 26

Sign up to hear about our latest research on improving end-of-life care and future projects and collaboration opportunities. Our research team is part of PELiCam in the Primary Care Unit, University of Cambridge.

Sign up here: cambridge.eu.qualtrics.com/jfe/form/SV_...