Being unable to pull their usual stunt of no-one to drive the train, Southern pulled a new stunt called landslip south of Dorking, far too far away to be able to check. Several trains had been cancelled, so I switched to the Vauxhall and tube option. Joined by a youngish man lugging around 40kg of something from the dying Maplin onto the train. He would have had fun at Earlsfield or Vauxhall in the absence of lift, but as it happened he was getting out at Stoneleigh. Then another youngish man was eating his crisps rather noisily, eating which for some reason irritated me to the point of moving - to find myself across the way from three young people talking in some very foreign language which I could not place at all. I almost asked them but desisted, settling for guessing some kind of middle eastern or north African. Unusual to have so little idea - from where I associate to my elder brother who was a wow at knowing what language was being spoken, even though he understood nothing but English.
Lots of police at Vauxhall, the ordinary sort rather than the ones all tooled up with machine guns. Yet again, offered a seat by a young lady on the tube, English for once, foreign being much more common in this department. Managed to get out of some shiny new exit to the wrong part of Victoria, right next door to the Portland House in Bressenden Place, a house where I once occupied a sort of glass chicken hutch, a far cry from the last office which I had up the road at GOGGS, before my comfortable privacy was swept away by refurbishment.
Notwithstanding, a little early for culture, so I took a stroll around Belgravia in search of where the servants took refreshment. With the answer seeming to be that they didn't, with my best effort being St. Paul's church, a rather handsome Gothic revival affair which I had, as it happens, been intending to visit for some time. Unfortunately there was some kind of a service going on, so I did not like to take a proper look, beyond noticing that there appeared to be some structural steel, not that far removed from that in a contemporary railway terminus. We also had the rather grand Caledonian Club, which probably did serve beverages, but not to non-members, other than at Hogmanay. Two armed policemen outside the Turkish Embassy and one Maserati parked in the Square, a marque last spotted back in lowly Epsom and noticed at reference 2.
The not particularly grand room at the front of the Cultural Institute contained about thirty people, mostly young and mostly Italian, but the chap next to me was a pharmacist, probably retired, from Winchester.
After some trouble with the projector, the Director of the Institute kicked off in Italian and kept it up for a few minutes until the chap in charge of the projector came and tapped him on the shoulder to tell him that the evening had been billed as being in English. Start again. Some paintings involving depression and some talk of the place of culture in Italy and the world. Then we had the President of the Society of Italian Scientists in the UK, then something from the Embassy proper. All three of them seemed very alive to the numbers of Italian scientists who chose to work away from the homeland, giving the impression that emigration was quite a hot topic with them.
Fourth or fifth up we had the speaker of the evening, in the hour or so of the two hours left, one Professor Cipriani, from Oxford, both academic and clinician, inter alia, an expert in the conduct of reviews of other people's studies into the effect of this or that drug. The lead author of an important review (reference 4) of the use anti-depressant drugs covering more than 500 trials involving more than 100,000 patients. Most of the trials were double blind trials of one drug against another, or against a placebo. 21 drugs altogether, with Prozac, aka fluoxetine, figuring largely. A review involving the use of something called network meta analysis to convert a set of pairwise comparisons into a global league table, providing some comparative information about all possible pairs.
The first take away was that all the drugs worked, at least after a fashion. Not taking a drug for depression was not a very good plan. The second take away was that the effect of any particular drug varied a good deal, from patient to patient and from time to time.
Price did not seem to be an issue, with the costs of these drugs being small relative to the costs of the complaint. That said, it was also said that drug companies were not above nudging the price up in the wake of a favourable review which was going to push demand up.
A modest amount of wine and nibbles afterwards. Some discussion with the pharmacist about the vagaries of warfarin INRs. And I shall return to Professor Cipriani in due course.
PS: perhaps if I go back in a few years I will be able to take refreshment at the hotel they look to be building at Hyde Park Corner, between Halkin Street and Grosvenor Crescent. Next door to the very grand looking Forbes House, once if not still owned by those scions of the far right, the Barclay Brothers. See snap above and reference 3. McAlpine's Fusiliers are still on the march!
PPS: I am pleased to be able to report that the Westminster planning system is as open and transparent as that at Epsom. Took me no time at all to get plugged into the many documents about this new hotel.
Reference 1: https://www.stpaulsknightsbridge.org/.
Reference 2: http://psmv3.blogspot.co.uk/2018/03/trolley-131.html.
Reference 3: http://www.peninsula.com/en/default.
Reference 4: Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis - Andrea Cipriani and others – 2018. Open access.
Reference 5: Comparative efficacy and acceptability of first-generation and second-generation antidepressants in the acute treatment of major depression: protocol for a network meta-analysis - Toshi A Furukawa and others – 2016. Methods foundations for reference 4. Open access.
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