Something has just happened that will almost certainly end the tyranny of impact factors and may well mark another step towards the extinction of most scientific journals. Did you notice it? Probably not, and even if you did you may not have understood what it was or what it may lead to.

It was the appearance of something called rather clunkily “article level metrics.” These are a variety of scores and other bits of information attached to each article in the publications of the Public Library of Science (where I’m on the board). They shift attention from journals to articles, particularly for the academic bean counters anxious to find a convenient and low cost way of ranking academics. more…

WHO is currently setting priorities for research in chronic or non-communicable disease, and generally the first research question is “Will what has worked in rich countries work in low and middle income countries?” We know, for example, what to do to reduce deaths from heart disease and how to reduce tobacco consumption. But interestingly when it comes to nutrition we don’t know what to recommend. The advice for rich countries may be wholly inappropriate for poor countries. more…

At last I have online access to my medical records. I wrote a blog some six months ago about how a talk by Harold Shipman’s successor had convinced me that I should get access.  I do most of my work online, complete my tax return online, make all my travel arrangements online, bank online, and buy books and CDs online, so surely I should be able to access my medical records online and ideally interact with my doctor and other specialists. more…

The most interesting, and certainly the most chilling, experience I had in four days in Buenos Aires was to visit the memorial to “the disappeared.” more…

Firsthand personal experience of a great crime can make it real in a way that full intellectual understanding will not. Spend two hours in close contact with an African AIDS orphan, and you’ll know what I mean. more…

Imagine being at the 60th anniversary of an organization and hearing from the first head of the organisation. It seems impossible, but I’ve just had that experience - listening to Nevin Scrimshaw, aged 91, describe the challenge and the excitement of the early days of the Institute of Nutrition of Central America and Panama (INCAP). Almost as remarkable, all six of the directors of INCAP are still alive - perhaps a tribute to their knowledge of nutrition. more…

Today I feel deeply the shame of a monoglot. I’m at a meeting in Guatemala, and the organisers of a meeting of perhaps 200 people have had to hire two translators—for the benefit of me and one American. And tomorrow he departs, meaning that the two translators will be working just for me. How pathetic. more…

I’m worried that in the highly charged atmosphere created by the extraordinary US debate on health care my published anxieties about the NHS might brand me as unpatriotic. Perhaps Fox News or some equally evil, right wing American media outlet will track down my words in the Journal of the Royal Society of Medicine and broadcast them. I will be obliged to go onto television in Britain and tearfully recant, rather like a hostage asking for release, saying that I’ve always adored the NHS and have no doubts that it is the best health care system in the world. more…

Recently in Bangladesh I had breakfast with a Harvard professor of economics who told me: “Economists pay no attention to what people say, only to what they do.” Now I know, as we all do, that there is a big gap between what people say and what they do, and consequently I’ve always been wary of surveys; but we did publish them in the BMJ when I was the editor. The more I think about it, however, the more I think that we should ignore all surveys. Life is too short. more…

The other night, as is my wont, I imagined myself dying, and I wondered as I came near the end whether I would suddenly fear that I might be going to hell. Even if it doesn’t happen to me, there must be huge numbers of people in the world facing that prospect as they die.

Almost two in three Americans believe in hell, accord to the Pew Forum on Religion and Public Life. Amusingly to me, three quarters believe in heaven. Believing in heaven but not hell seems like a great option. We could probably found a whole religion around that. more…