Early morning and a young lad, hooded, trainers, hugs his bottle as he staggers home. Last night it started early; cider, beer, and tonic wine. Blue bags on a Friday night. Party time in the park as teenage boys and girls huddle drunken in the dusk. Monday morning, at the surgery. Mother fraught and adolescent spite. School is bad, behaviour worse, out of control. “You must do something.”

Cans strewn around the room, thrown into the fireplace, crushed on the floor. Another on the wet formica table, collecting butts—an impromptu ashtray. And, all around the sweet rottenness of last nights drink. In the chair, an unshaven shadow of a man, yellowed fingers, greying shirt, mustard eyes and sallow skin, slurs rambling remnants of mixed up words. “He’s upsetting other residents.” The sheltered dwelling’s warden stands accusingly “You must do something.” more…

Advice on smoking is simple: don’t smoke. But what should be the advice on alcohol? It can’t be “don’t drink,” nor can it be “drink less.” Doctors and governments think that they need to give guidance to people on alcohol—and mostly they do that by suggesting “safe limits” based on units of alcohol. But is this advice scientifically sound and beneficial? These were the issues debated with considerable feeling at the recent Battle of Ideas meeting in London. more…

What’s the mood among delegates on the eve of the UN summit on non-communicable diseases as they gather in hotel bars and the confusion of side events in New York City?

Well, earlier in the day I went on a hike through Central Park with about 50 others in an event organised by the NCD Alliance to publicise that 300 million people are now caught up in the global diabetes epidemic. We waved helium balloons and cars honked in support from 5th Avenue. My walking partner was Allison Schauwecker, a graduate of international relations now working for a company which makes a weekly television show on US cable television for diabetic patients. It pulls in millions of viewers every week. Allison, diagnosed with Type 1 Diabetes when she was 25, carried a small bag of sweets “in case I go low.”  more…

After months of negotiations, lobbying from industry and NGOs and public health experts, international governments have finally agreed the political declaration that will form the spine of the UN’s summit on non-communicable diseases later this month.

The BMJ has seen a copy of the final declaration and for those who have been involved there are some highlights, lowlights and one or two surprises. more…

Tobacco companies clearly cause harm, and we will always need food companies. But what about alcohol companies? Can they produce net benefit?

 I’ve been pondering this question for three decades, but it’s a live issue for governments who must decide whether to include alcohol companies in programmes to reduce harm from alcohol and also for organisations, like some I belong to, which must decide whether to seek funding from them. more…

“See one, do one, teach one?”

Gone are the days when medical students did what they were told, learnt what was on the syllabus, and spoke when spoken to.

“See one, do one, teach one?” Not a chance.

Instead, they conscientiously object. more…

I am writing to you not from Bangladesh but rather from the Institute of Medicine’s workshop on country-level decision making for control of chronic diseases being held from 19-21 July at the House of Sweden in Washington, DC. On Wednesday I presented on “data availability and gaps in Bangladesh,” which I worked very hard to make as riveting as possible despite the snooze-inducing title.  The session was based on portions of a non-communicable disease case study I am completing for the Institute of Medicine (IOM).

more…

Does your research really matter? Most VIP introductions are bland and unchallenging. Not this time. When (Professor Sir) Peter Gregson, vice chancellor at Queen’s University Belfast, introduced the joint summer school of the UK Clinical Research Collaboration’s centres of public health and Health Research Board (Ireland), he pointed out how universities often fail to show the greater community why their research is important. Universities need to be able to justify research, especially in the current economic environment. Frank Kee (CoEfPHNI) continued, saying their international advisory committee endorsed their research output but wanted them to think more about added value – how did it actually benefit the community. There is a chasm between research and its impact and he encouraged young researchers to think about the meaning of what they do. more…

“Research highlights” is a weekly round-up of research papers appearing in the print BMJ. We start off with this week’s research questions, before providing more detail on some individual research papers and accompanying articles. more…

Being a self-sacrificing soul I recently enrolled myself in a critical piece of public health research: I gave up alcohol for January. If appetite is the new front-line in health, if our desires are becoming the death of us, then self-restraint must be the new penicillin, and, to squeeze the analogy a little, the Petri-dish is any human heart. Just how difficult could it be to up-end the glass for a month? more…