Everyone else pitched baby carrots as an antidote to junk food. Where Crispin came out was almost the exact opposite. We want to be junk food.

This article from Fast Company describes a fascinating and (at least initially) successful approach to marketing carrots. I think it provides some interesting food for thought for public health people, like me.

This is “Cook’s Earth”, Andrew Burton’s globe and sextant sculpture outside the South entrance to the James Cook University Hospital in Middlesbrough, where I had a meeting this morning. I also did a few of my medical school rotations here.

It, of course, commemorates everybody’s favourite 18th century Middlesborian*, the seafaring discoverer of Australia. The globe used to be more clearly globe-like, with a blue sea, but that seems to have washed off. A replica of his most famous ship is down the road in Stockton, as I showed back in January.

James Cook’s violent death is captured in a famous Zoffany painting; so perhaps it’s appropriate that the hospital named after him is leading the country as a regional specialist trauma centre. Although, given the number of areas in which the hospiral’s highly respected, it’s hard to think of a mode of death for Captain Cook that would preclude me from drawing a tenuous link…!

*Marton, where James Cook was born and his eponymous hospital stands, was actually considered a village in Yorkshire in the 18th century, rather than a suburb of Middlesbrough, so I guess whether or not he was Middlesborian is a bit of a philosophical question!

I was given this at work today, along with a biodegradable drinks bottle and a desktop recycling tray, in celebration of today’s NHS Sustainability Day… the day after taking a domestic flight that could’ve been travelled by train. Clearly, I’m a bad eco-citizen, and must improve!

Somewhere at the top of the Hundred Acre Wood a little boy and his bear play. On closer examination, we find a forest where neurodevelopment and psychosocial problems go unrecognised and untreated.

Over the weekend, somebody (I forget who) posted this paper, which gives a neurodevelopment perspective on Winnie-the-Pooh, on Twitter. Wendy and I both really enjoyed reading it – it’s a brilliant piece of medical whimsy.

On Saturday, a rally was held in London against the Health and Social Care Bill. Tweets have suggested that this peaceful rally was somewhat over-policed, with armed riot police in attendance and protesters being kettled. There’s some coverage on Indymedia, but little coverage by the mainstream media.

There’s a Twitter meme stating that the reason for the lack of mainstream media coverage is because a “D-Notice” has been issued by the Government to prevent reporting. This meme appears to stem from Dr No’s blog.

I should state clearly at this point that I have no inside information about what the defence services have or haven’t done, and no inside information about the media. I’m neither a professional journalist nor a signatory to the Official Secrets Act. However, the idea that a D-Notice was issued to cover up a protest by a couple of hundred people about a Government bill seems utter crap.

D-Notices, which have been called DA-Notices since 1993, are controlled by the Defence, Press and Broadcasting Advisory Committee (DPBAC): they are not under the direct control of government. There are five government representatives on this committee, and 16 members of the media, nominated by bodies like the Press Association, Google, the BBC, and ITV. So for us to believe that a DA-Notice was used to cover up a protest, we must also believe that 16 members of the media – or, I guess, at least six members of the media to carry a majority on the committee – felt that this was appropriate action. Also, since DA-Notices are merely advisory, it must also be the case that not one journalist chose to break rank and shout to all and sundry about the most audacious UK government cover-up of a peaceful protest in history.

DA-Notices are very seldom used. Often, the existence of the DA-Notice itself is reported – these aren’t super injunctions. Back in 2009, the existence of a DA-Notice was extensively reported after Bob Quick accidentally flashed sensitive information to photographers when arriving at Downing Street. The photos were printed in many newspapers and shown extensively on news programmes, with the offending information blurred out and the DA-Notice cited as the reason. There was also discussion around DA-Notices and Wikileaks. So we must also believe that not only have media representatives voted for a DA-Notice to be implemented, but that journalists have also spontaneously agreed not to discuss the very existence of a surely controversial notice.

DA-Notices are so seldom used that in possibly the biggest temporary media blackout of recent years – when Prince Harry served in Afghanistan – a DA-Notice wasn’t issued, but merely a gentleman’s agreement by the press attempted (unsuccessfully) to ensure that the news wasn’t leaked in advance.

There are five standing types of DA-Notice, which relate to: the military; nuclear facilities; secure communications; sensitive installations; and security and intelligence services. I wonder which type of DA-Notice Dr No believes this protest falls under?

A quick Google search reveals that, in addition to Saturday’s relatively small NHS protest, a rally against climate change, an anti-workfare protest, a protest against the Assad regime in Syria, a protest against stop-and-search, and an anti-fur demo all took place in London on Saturday. I’m sure all feel that their protests were under-reported in the mainstream media.

Perhaps the media agreed to the issue of DA-Notices against all of these protests this weekend. Or perhaps it was felt that none of these protests was particularly newsworthy. Perhaps the protests were felt to be a little predictable – a restatement of a known position, rather than anything new. And I’d imagine that there were many complaints about perceived poor policing over the weekend, given the level of complaint against the police on any given day. Each incident in itself is unlikely to be newsworthy.

Perhaps I’m wrong. Perhaps there has been a cover-up and a media blackout about this protest. But that’s an extraordinary claim and, like Carl Sagan, it’ll take extraordinary evidence to convince me. Until that’s available, perhaps protestors should stick to the facts.

This is John Dobson’s 19th century “lying-in” maternity hospital for poor women. It’s located next to the Blue Carpet which I’ve previously featured. It opened in 1826, and remained in use until 1923.

Far from offering care to all-comers, like the modern NHS, this hospital wouldn’t admit those too poor to afford baby clothes, the homeless, those with infectious diseases, or those who had fallen pregnant outside of wedlock. And, yes, marriage certificates had to be presented prior to admission. It all seems so medicoethically bankrupt by the standards of today’s UK.

I understand that the building had a later life as the regional headquarters of the BBC, but I’m not quite sure what it houses these days.

In any one year one in four people in the United Kingdom have their thyroid function checked.

This grammatically erroneous and factually absurd statement from a 2009 BMJ paper remains uncorrected, as highlighted by this interesting paper about journals’ error handling in JRSM. It strikes me as alarming that the Guardian appears to have a more open and robust approach to highlighting and correcting errors than our leading medical journal; but then I guess correcting mistakes in emerging research fields is a trickier issue than correcting journalistic errors.

More irritatingly – how come other people can get such obvious slips though peer review, yet peer reviewers pick up on every dodgy comma in my work?

We found evidence of a reduced risk of death occurring among patients already in hospital on weekend days versus week days.

Given all the attention Dr Foster got for their finding that death rates in NHS hospitals were higher at weekends, it’s interesting that this huge study essentially suggests the opposite (though the full paper is worth reading, and is less encouraging than this single comparison might suggest).

This is (slightly modified) from a blog post by Marco Arment, writing about the entertainment industry:

Relying solely on yelling about what’s right isn’t a pragmatic approach to take. It’s unrealistic and naïve to expect everyone to do the “right” thing when the alternative is easier, faster and cheaper for so many of them. The pragmatic approach is to address the demand.

I came across this quote via Jonathan Rothwell’s blog post, and, in truth, I’m fairly ambivalent about the entertainment industry.

Yet the sentiment of the quote (perhaps better expressed in the full article) – the importance of marrying the “right” with the “pragmatic” – is applicable in so many areas of life, not least public health. And yet, it strikes me as an often forgotten, or perhaps often ignored, tenet.

It’s easy to say “lose weight”, “drink less”, or “stop smoking”, and we all know that such messages are right. But all have a multitude of maintaining habitual behaviours and causal factors, and maintaining the status quo is all-to-often “easier, faster and cheaper”. The secret of great public health interventions is to turn the “right” choice into the “pragmatic” choice – and, in truth, we’re not always great at doing that.

Marrying “right” with “pragmatic” can be hard, and requires seeing a problem from multiple points of view. It’s easier to concentrate on the “right”, but it rarely works. We all need to get better at making out solutions pragmatic, even if it means approaching problems in unfamiliar, unusual ways.

Here endeth the lesson.

I tweeted about this Times article yesterday – it’s really brilliant, like the plot of an off-beat West Wing episode.

Julian Glover (formerly of The Guardian) writes the following for Mr Lansley:

As I grew up, the NHS wasn’t some remote organisation. It was what we knew, what we cared about and what we wanted to make work. And that is every bit as true today. As a son, as a father, and as a patient, I know what it is to have the NHS at your side.

It is returned from Lansley’s office as:

Outcomes depend on integration across services. Opportunity of NHS/public health/and local authorities together. Like they do in Sheffield … Not structural integration but integration around families and children. Marmot (universal proportionalism) – early intervention.

Go and read the full thing, it’s fantastic.