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Public Health

Nice People Take Drugs (Too)

The drug and human rights charity *Release* recently launched an advertising campaign in which the slogan ‘Nice People Take Drugs’ was displayed on the sides of London buses. Their aim was to encourage society to face up to the reality that a huge proportion of the population does at least experiment with drugs and to combat the popular assumption, which underlies a good deal of political rhetoric and media coverage, that since drugs are simply ‘evil’ there is no point in seriously debating drug policy. Those ads are now being withdrawn by the company that booked the space, after advice from the Committee of Advertising Practice: http://www.guardian.co.uk/media/2009/jun/09/nice-people-drugs-ads-pulled

Apparently, Release has been told that their strap-line would be more acceptable if it included the word ‘too’. This suggests that the CAP may have felt that the public would read the original claim as equivalent to ‘All those who take drugs are nice people’. But even adding the word ‘too’ may not be enough. For the new sentence might be read as: ‘All nice people take drugs, along with other things (such as holidays when they can, advice when they need it, offence when people are rude to them, etc.).’ Of course, no one would have understood either the new or the old sentence in these ways. But in fact, though it should be up to Release how they word their strap-line (the censorship charge they have made doesn’t seem far-fetched), adding ‘too’ does bring out more clearly what they want to say: that we should stop demonizing drug-takers and have an open, impartial, and well-informed debate.

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The flu paradox: is the WHO focusing too little on flu?

The WHO is in the news these days thanks to the H1N1 epidemic (alias the swine flu, or the Colbert flu), and it is doing an admirable job coordinating various national agencies in fighting a pandemic. Historically it has been at the forefront of fighting epidemic disease, whether tuberculosis or AIDS. However, since Gro Harlem Brundtland's director-generalship 1998-2003 there has been an increased emphasis on public health, in particular fighting alcohol and tobacco use but also traffic accidents. Has the WHO aimed at the right or wrong problems?

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Be mindful of results, not the method

David King warns that we should modify society, not childrens' brains. This is a response to a recent Radio 4 documentary on "the criminal mind", which discussed recent evidence for biological underpinnings of some forms of antisocial behaviour and the possibility of reducing it using vitamins, drugs or early interventions. Dr King quite rightly points out that the image given by the program tends to oversimplify things and promote a reductionistic view of the causes of crime. But he also appears to contend that complex social problems cannot be solved through biological interventions. In this he is likely wrong.

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Educating children on matters of food

As evidenced by recent declarations by the Children’s Secretary (see here and here),
the British government is determined to fight childhood obesity and to initiate
nothing less than a “lifestyle revolution”, resulting in more children leading
a healthy and active life. With this aim in view, a free cookbook was recently distributed to 11
year-olds by the Department for Children, Schools and Families.
In
addition to that, from 2011
cookery lessons will be compulsory in England's secondary schools for children
aged 11 to 14, and
£3.3 million will be invested in order to
recruit and train people capable of teaching cooking skills to children.
Parents are also urged to teach their children how to prepare meals from
scratch.

These are certainly sensible steps to take. With nine out of 10 British adults
and two-thirds of children expected to be overweight or obese by the year 2050
unless action is taken (http://www.guardian.co.uk/society/2008/jul/30/obesity),
we are clearly dealing with an important public health issue. And given the
significance of the link between excess weight and an unhealthy diet (lack of
exercise being another major contributing factor), it seems clear that we should
teach children what a healthy diet consists in and equip them not to be dependent on
the local fast-food chain when the time of the next meal comes. We can hope
that the government’s scheme will help to achieve this, and that parents will
follow the lead – though it is also necessary that the meals provided in school
canteens be in keeping with those aims. However, I would like to suggest that
these steps should form part of a wider project meant to educate children on
matters of food. We want our children to be healthy, but we should also want
them to become autonomous and ethically responsible eaters (and, more
generally, consumers).

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Travelling for Treatment

A BBC report today suggests that “many” UK couples are going overseas to choose the sex of their children. What seems most odd about this is that in some cases they go to places where sex selection is illegal.

What is interesting here is the fascination with what people do when they go overseas or why they go overseas. There are a whole range of stories about Britons going overseas to get things that they cannot get in the UK – or cannot get in the UK as cheaply. The obvious examples are sex selection, assisted suicide or treatments not available on the NHS.

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Knowledge may be power, but is it healing?

The
explosion of medical information on the internet is a good thing,
right?  Patients worried that their condition
is not being taken seriously, those who want a second opinion but are worried
about upsetting their GP by asking for it, and those with symptoms too trifling
or embarrassing to take to a doctor—all these people who, fifteen years ago, may
have felt at a dead end with the medical profession can now use
the internet to research their conditions from the comfort of their own homes.

Read More »Knowledge may be power, but is it healing?

The price of ignorance: the Durham study and research ethics

Ben Goldacre (who seems to be one of this blog’s favorite
sources) tears into the Durham fish oil trial. A while ago Durham County together with the company Equazen decided
to test whether giving omega-3 supplements would improve the GCSE scores of
children. Unfortunately there were clear problems with the trial design. In the
face of criticism the organisations involved refused to give out information on
the experimental setup and even claimed not to be running it as a trial (despite numerous statements to the
press). GCSE scores did not generally increase. Despite this, now positive results are claimed – largely because what is measured has been changed to suit
the data
. The most vexing thing about the whole affair is that the
trial could have been done in a proper manner for the same amount of money.

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Doctors or Resource Allocators?

A recent survey by Myeloma UK, and reported on the BBC website, suggests that many doctors do not tell patients about drugs that may be beneficial and which are licensed in the UK. The trouble is that the drugs have not yet been approved by NICE and so may be difficult to obtain on the NHS. This seems to suggest that something is wrong with the way in which NICE functions with respect to licensing and that doctors are in some way complicit.

Read More »Doctors or Resource Allocators?