A friend from Barcelona sent this, to illustrate just how much the establishment is against B12 treatment
From: Dr Ferran Gali
Sent: 25 February 2009 09:01

Subject: interesting article

I hope you all are well.
Several points:

I'm enclosing a very interesting article. Some comments:
1/ About allergic reactions page 2215, desensitivation, antihistamines and steroid have been useful- references 17, 18.
2/ "Controlled cobalamin trials... have called unethical by some investigators", page 2218, ref 42.
3/ "Low-normal... levels 250-350 ng/L... need to be pursued... page 2219, ref 3.

I'm impressed with the amount of pacients I'm diagnosing in my new Surgery... Some times is scaring!

Please give my warm regards to all of you.

--
Dr Ferran Galí

Letter to BMJ
Dear Editor
Back in 2006 I reviewed Payment by Results (PbR) in South Yorkshire, the Payment by Results laboratory for England (Minney 2006). My conclusions were that PbR did not in itself drive quality, but that the right leaders were able to use PbR to drive up quality. Hospitals could choose to spend more on ward nursing, since faster recovery to health resulted in shorter length of stay (LOS), which in turn gave greater patient throughput and higher income (Scholefield H, personal communication). Community Care could develop new pathways for patients since they could be funded out of the money saved from activity not carried out in secondary care.

The latest studies 3 years later don’t contradict this (Goodlee 2009, Farrar et al 2009, Øvretveit 2009). No system will be perfect, every system will be open to gaming, no matter how complicated the system. We are reliant on appointing the leaders and staff who have the right intent, and on the whole NHS achieves this. Quality will improve because it is the "right thing to do" in publicly funded or charitable healthcare, and quality will improve in privately funded healthcare only where the patient demands it (and they often don’t). Let’s not kid ourselves that we can create a system that anticipates every possible abuse in an area as complex as healthcare
See letter in BMJ and the article it referred to

What is the future for NHS, given all the U-turns?  Will we see Clinical Commissioning Groups (CCGs), and what will they really be like?  What role does the House of Commons Parliamentary Health Select Committee have in all of this?  

NHS has certain challenges just at the moment.  For 10 years under the New Labour government, NHS saw unprecedented investment, with not a lot to show for it.  The critics somehow forgot that it takes 25 years to turn out an experienced doctor and over 10 years to turn out an experienced nurse, so massive investment in training was always likely to take time to show through.

Waits reduced massively.  Let's put this into context - at the start of Tony Blair's government, waiting times for urgent surgery could be 18 months.  By the end, the 18 week rule meant that average waiting times were 9 weeks and maximum waits were 18 weeks - that means that over a period of 13 years the waits had reduced by nearly a month per year.  That means fitting 13 months' work into each 12 months (on average, in fact the change was much faster and more painful than this).  

The ConDem government has cut funding - drastically.  You may have noticed waiting times beginning to get longer. Now you know why this makes a difference - delay patients by 1 month and you only pay for 11 months' care in a 12 month period, an 8% cut in spend.

But what does the future hold?  Read my thoughts on Blogcritics

The cycle of NHS reform has come around again, just about on time. Past history shows that the whole thing is reorganised every three or four years . We don't know if it does any good, because it's never left alone for long enough to find out¹. Is this time any different?

Size is everything

Smaller PCT's have trouble negotiating with the much larger hospital trusts. In 2004, hospital trusts were tasked with ensuring that the contracts they established with PCT's were 'sustainable'. Meanwhile, PCT's were tasked to have the contracts completed and signed by mid April each year. The results were predictable and inevitable. Apart from anything else, hospitals typically negotiated with two or more PCT's, and argued that their form of the contract was the only one that everyone would agree to. Over the last six years, as PCTs developed community services and grew larger, contracting is a more balanced affair².

When we have 500 GP Commissioning Consortia, what can we expect?⁴

Disruption is always destructive

In 2006, the number of PCT's in England was reduced from 300 to 152, through merging 222 PCT's (to 72) and leaving 80PCT's unchanged. Every year, the Healthcare Commission Annual Health Check rates, amongst other things, 'quality of services' and 'use of resources'. Civitas, a UK social policy Think Tank, has compared those PCT's formed from mergers (72) with those that were unchanged (80) using these indicators. The analysis found that the mergers led to: an absolute drop in performance on 'quality of service' and 'use of resources' lasting at least one year, compared with improved performance on both indicators for PCT's that were not merged; and a period of three years before the relative performance of the PCT's that were merged reached premerger (i.e. 2005/06) levels of those that were not³.

What's on the agenda?

Could this be a way of finding a fall guy in a longer-term aim of making healthcare services accountable to the local population? Could it be that the GPs are "set up to fail" so that local authorities can take over the management of the commissioning of health care?

Wouldn't it be simpler to take the bits of the PCT that appear to be working (and now, after four years, it really dial does appear that the PCT's ARE working), and simply make them report into the local authority?

Oh, but that would mean that the NHS and Local Authorities would have to pay for TUPE and redundancies, and the whole point of this ConDem(n) exercise is to get people off the public sector-funded pension.

 

1 "The not-so magic roundabout of NHS reform" Health Care Manager (Autumn 2010) issue seven, p10 - 11, James Gubb

²"PCTs make a good shot at privatisation" Health Service Journal (9 Sept 2010) p12-13 Dave West

³"NHS Briefing on moves to GP Commissioning" Civitas: Data Briefing 10 July 2010 James Gubb

⁴"GP Consortium Pioneer says PCTs are a vital safety net" Health Service Journal 7 Oct 2010 Steve Ford

We think we are on the right road improvement because we are making experiments – Benjamin Franklin (1706 to 1790)

Last month I wrote about how to get information from PubMed on a particular subject.  This blog I’m describing how to make sense of what you’ve got.  Please follow through from last month’s blog to make sense of this one.

Getting the references into EndNote

You’ve collected a whole lot of academic references (and actually ,references of all kinds including web pages, pictures, video, newspaper articles, government reports and rules – EndNote can take it all). 

If they are in a file from PubMed, this is actually the easy bit.

In EndNote, open the Library where you want the references (if I’m starting a new project, I usually start a new library; if I need the references again I’ll copy them into a general library).

In EndNote, it is completely straightforward – on the menu line choose File / Import / File and select the file name.  If you’ve downloaded a few sets of references (eg on different days) from PubMed then you need to know which is the one you want to import – but you can tell because it is the newest one and has today’s date. 

If you have newspaper articles and pictures to add, then you will need to type the information (author, date etc) in by hand.  You may also want to attach all of the PDF files to each reference so you know where to find them in future.

Now comes the most important bit – reading and making notes.

Reading the articles and making notes

Many people take the short cut of believing what the abstract says.  This is very risky!  The abstract is often only enough to tell you that an article might be interesting, but not enough to give you the information you need.  My ratio is that I have to read about 1.5 articles for every article that is useful, and even then they may not all be useful to the subject I’m working on.

The very worst thing you can do is to take someone else’s opinion of what a document says.  It probably doesn’t – read it yourself, or ascribe the opinion to the paper you read it in.  Don’t go to the Cochrane Review and make a list of all of the references that they cite – you will come a cropper.  Say “this was quoted in the Cochrane review” or find the reference, if it appears to be particularly interesting, and read it in the original.

My way of taking notes has changed with technology.  In 1990, when I did my PhD, we obtained research papers as poorly photocopied documents in tatty brown envelopes.  I started sorting them by subject, but quickly realised that I wanted to refer to some original research in more than one place in my literature review – the choice was to make (and store) a second copy, or to find another way.  I went for 3” X 5” (7.5cm X 12.5cm) Index Cards, arranged by topic.  Each one contained notes from one reference (I’ve used the term “reference” to mean research papers or original sources) about a single topic, ie I might have more than one card for a single reference but only one original source per card.  It allowed me to re-organise the cards into new orders without shuffling tons of paper.

With EndNote, it is much easier.  Make notes in the section called  [Research Notes].  Make sure you will still understand your notes when you come to re-read them, so use abbreviations wisely.  When you come back to each reference, you probably won’t look at the references but just your notes, so they need to be good.

By the time you’ve read 50 or 100 or 150 different views on a subject, you probably understand it a whole lot better.  Now’s the time to put some structure into your thoughts.  I usually mind map for this.

For the Head and Neck Cancer study, the mind map I finally used is illustrated at the start of this blog post.  I say finally used, because I had a couple of false starts, attempts that didn’t present the subject in a properly balanced manner.

Notice that after laying out the Mind Map, I’ve numbered every branch (and added more on the left hand side).  EndNote sorts alphabetically (not numerically), so 1 comes before 10 which comes before 2.  The numbering is what makes this method work.  So number main branches 1, 2, 3; number sub-branches 11, 12, 13, 21, 22 and so on, and sub-sub branches 111 and so on.  If you think you may add extra ones, then number 12, 14 leaving space to add 13 later if you need.  How far you go depends on the complexity of the subject and the number of references you are sorting out – I’d recommend two digits (11) at first and then add extra “depth” where you have a more complex argument.  I had 35 topics for a 15 page report.

There’s one more trick that will make this really really easy, so stop and do it now.

Creating a Topic List

EndNote has a very useful feature called Term Lists.  You’ve already seen this with Authors and Journals – it means that when you start typing an author that you’ve used before, it attempts to complete the name which saves you a lot of time.  Hitting <Return> accepts EndNote’s suggestion.

You can create your own lists (though they are attached to only one library).  Create a “Labels” list ( menu Tools / Define Term Lists).  Then attach the new list (which hasn’t got any terms in it yet) to the Labels field ( menu Tools / Link Term Lists).  This will be your Topic list for the paper you are writing.

Sorting your references into topics

This is where the electronic method really shines.  Reference by reference, I open it, check my notes, go into the [Label] field (just before [Keywords] and [Abstract] and put the branch number.  I precede it with something to show my paper, for example for the Head and Neck Cancer paper I preceded each one with “HN”.  I’d recommend you use two letters only for this bit, no punctuation, because it’s slightly faster to type.

Type the full subject, from the branch on your mind map – for example “HN47 : Social Marketing  for STDs”.  Notice the “ “ space after the number and before the colon – this is vital for proper sorting. <<EndNote_Labels(2)>>

Once you’ve typed it once, the next time you type “HN47” it will automatically fill in the rest for you, in fact it will try “HN4 : HPV” when you type HN4, and change it when you add the 7 (and again when you add the next digit).

You can put more than one topic into the labels field – for clarity I always put them on separate lines.  You can do searches and put labels in automatically, but it is so important to get this right that I prefer to do each one by hand.

The next blog deals with actually writing your literature review.

 

This blog follows on from two previous ones, and may only make sense if you read them.

1. Read about how to do your research on PubMed, and

2. Getting the information into EndNote so you can use it.

Creating an Output Format

The Output Styles in EndNote are used to make sense of the masses of information that is stored.  After all, a journal or a client is not interested in your notes, but for the topic summary, the Research Notes are the most important thing.

So create a new Output Style, called say “Bibliography Summary”.  Output Styles are created, predictably, by selecting on the menu Edit / Output Styles / New Style.  You don’t need to base it on anything since it will be unlike anything anyone else has created.  It’s nice and simple, in the section on Bibliography/ Templates: insert fields [Author] [Year] [Title] [Research Notes].  Add suitable punctuation (I suggest brackets around the [Year]).  Add suitable format (I suggest making [Author] [Year] [Title] bold and making [Research Notes] smaller).  This is all private to you.  Add an extra line break or two at the end so you’ll be able to see where your notes on one reference end and the next one begins.

Now save this output style (close it – it should automatically save) and make it your default in EndNote (though not in Word).

Checking you have every topic covered – and not too much

I wish I’d had something like EndNote when I was writing my 120 page lit review!

This is where the fun really starts.  Check your topics by starting a Subject Bibliography (menu Tools / Subject Bibliography).  Select the [Label] field as this is the one you put the topics into.  It will bring up a list of your Topics, sorted into alphabetical order – that’s why you code them with a code number so they sort into the right order.

You can check, topic by topic, that each topic of your structure has between 1 and 10 references supporting it (of course you might not have any references for your conclusions, acknowledgements, executive summary etc, it depends on the document style).

If you don’t have enough evidence for one topic, then you know right away that you need to go away and find something.  You can add the Topics (in the [Label] section in EndNote at the same time as you write the [Research Notes], because by now you understand the structure of your document.

If you have too many references in one topic, it is going to give you a headache later (trust me, I had the headaches).    Consider splitting the topic up.  That doesn’t mean that you will have to have headings and sub-headings in your final document, it just means the references arrive already sorted.  For example, I created “HN4755 : Social Marketing for Young People, Sex behave” to gather together the references for a single sentence, that young people learnt their risk-taking behaviour from their peers, but listened to their parents and relatives (and usually not health professionals).  The sentence basically says “This is my assertion, and the evidence can be found in references 1 to 13 which are listed at the end”.

 Once your Subject Bibliography looks more balanced, you are ready to story weave – write what the references tell you, but in English so it makes sense.

The “bricks” of your wall of evidence

EndNote is going to write out all of your references, sorted by topic, with your research notes so you can make a sensible argument.  It’s fantastic!

Run the Subject Bibliography ( menu Tools / Subject Bibliography. Select Label. Select all of the labels that you want to output).  Note if you can’t see many labels, that may be because you are only picking up some of the references.  Check whether you have a small number of references selected, or you have a filtered view (eg Search Results).  Usually you will “Select All” labels, unless you’ve used these References before and have some old labels in there – that’s why I start each label with a couple of letters for its subject.

That will bring up a Preview.  Check the Output Style is “Bibliography Summary”, and scroll down to see what you get – enough information to know what Reference you’re reading, and all of your research notes (I hope).

Then “Save” to an .RTF (Rich Text Format) document and open in your favourite word processor.

Story Weaving

Pull your information together with wise and witty sentences.  You probably won’t use any of the text from your research notes (depends how you wrote your notes) but it’s useful to have the research notes there to remind you.

This is one fault with EndNote – because it can only output a Bibliography in Subject Bibliography, you have to go back to EndNote and insert each citation as you go – but with the Author, Year and Title already in your Word processor, it’s fairly easy.  It’s even easier if you type the Topic Reference into the search bar so you are only selecting between the References within that topic (eg type “HN47 “ to bring up a list of all references in this topic).

Don’t imagine it will be perfect.  I find as I write that I’ll look right through my research notes, wondering why on earth I decided to put it in that Topic.  I’ve gone back to the original PDF to check, but my research notes have summarised it accurately.  Then I might be in another topic and think “Oh, and this belongs in that topic I was working on earlier” and have to go back and type a new sentence or a couple of words, or just add it to a list of references which provide the supporting evidence for an assertion.  Now I realise that this is just human nature, and I get on with it without complaining.

It’s quite an interesting process.  You have masses of notes (I started with 51 pages of notes), and as you write your words and delete the Research Notes and Author/Title you see the number of pages drop (I ended up with 15 pages of text/ diagrams/ tables/ pictures) as your work becomes really concise and useful.  You may notice that a topic is a little bare and you may go back to the references to find some more evidence to fill it out – you don’t need to export again (though it is often useful to add the Topics as you add the reference to EndNote),  you can just add the citation as you go because by now you know what each paragraph is trying to say.

How does this compare with the old way of using 3” X 5” cards?

It’s very similar, only a lot faster.  You spend the same amount of time reading references, deciding what is relevant, preparing your research notes and sorting out your argument structure and individual topics.  You still have to understand your subject(!)

But you spend hardly any time (3 days instead of 20 for the Head and Neck cancer document, which was a small one) assembling your document and getting it to make sense.  In all, the Head and Neck cancer document took me around 16 days to write, and for that I read 269 abstracts, probably read 150 full academic papers, and used 101 in the final document.  I also had one false start (prepared a final report which the client and I agreed wasn’t balanced, so I had to go back and find more information) within those 16 days, plus a couple of discussions and a presentation.  It would have taken at least twice as long to write without EndNote, and if I write anything else on Head and Neck cancer then I have all of the references and research notes ready.

 

This book is deceptive.

It looks like a fairly brief (218 pages) hardback book, the kind where the world expert tells you about strategy, and you have to know a lot about the subject to make use of what they say.

I know a bit about facebook and youtube and twitter and marketing in general. I had no idea there is so much more to know. What's more, Newlands presents it in an incredible way - so many things to think about, and the way he presents it, it is so straightforward to think about these things.

It kicks off with the familiar - how exactly do you establish a presence in Social Networking sites? Seems straightforward; then Murray hits you with "what impression do you want to create?". Hmm, I should definitely have thought of this before I started. I am, yes, going to unpick my existing social media presence and redo it. Not because Murray said I should, but because it's obvious, when you stop to think about it!

Chapters (after Social Media) include Digital Branding, Company Web Sites, Blogging, Online PR (and why it is different from offline PR - it moves so much faster and you can discover opinion and respond to it), Video marketing, SEO, and three more. Each is presented in a very clear fashion, suitable for a complete novice, yet also completely accessible to a half-expert like me. The endorsements say it's also suitable for a real expert.

What really stands out?

Each chapter includes an Introduction, a brief explanation and how-to guide ("the basics") which means you can plan before you commit your first attempt to the public eye, a section on "the future" which really helps you understand how fast everything changes and how you need to keep an eye on your online presence, and concludes with a run through the Tools which you WILL need to make sure that you deliver an online presence to the best effect.

This is a book for marketing departments who want to understand what they buy from digital marketing companies. It's a book for companies that do it themselves, and even for companies that sell digital marketing as a product (yes it is that good - not to base your whole business on, but to make sure you understand everything before choosing where to specialise). For me, it's a book for small consultancies and individuals who have to do this for themselves, and want to do it well.

The Ten Commandments are 'guides for living in society', and apply just as much in any individual aspect of our life as they do as guides for the whole of our lives.

So how do the Ten Commandments relate to Professional Services?

By Professional Services, I'm referring to Management Consultancy, the use of knowledge and experience gained in one organisation or environment to help a client achieve something in another organisation or environment.   Perhaps not all Ten apply - let's see . . .

You shall have only one God

I prefer to set out the basic principles of the way I will work up front, during the scoping phase.  Of course my clients want to review any report before it is published.  But I also know that they want an independent and honest report, both because then they can make accurate decisions, and also because it will support the external persona they want to convey, of being transparent and honest. My clients select me, and I also select them.  I don't work for people or organisations that need to the truth distorted and require it of their external consultants.

What have I actually given away?  If I can't explain the situation in a clear and honest way, and then convince my client that it is in their interests to make the necessary changes, then I'm not worth the fee.  On this site you can see copies of the nationally relevant and published reports, including The ECP Report and Measuring the Benefits of the Emergency Care Practitioner, The South Yorkshire Laboratory and Payment by Results, The Ambulance Review, A Social Return on Investment Study of Quality Checkers.  All reports that tell the unvarnished truth, because with accurate information you can make accurate decisions.  It's worth sticking with truth.

You shall have no other Gods but Me

Many tempting shortcuts show up along the way.  I could earn more by fitting in a rush job for this client, which means I let my older client down by failing to meet their deadline.  I could do a fluff piece (talk up someone's product or initiative) to gain favour, and risk forever compromising my integrity.  I could fail to prepare, taking on a task that is outside my competence without allowing enough time to make myself competent at it.  So many temptations, so many little "gods" like money, like the adulation of the marketing company, like temporary influence.  But there really is only one God, and to turn away from the integrity of walking in God's way is to chase other "gods"

You shall not take the Lord's name in vain

Sometimes it is tempting to "blag" it.  I know I have a reputation for knowing a lot and for having an opinion on many things, and it is hard won by extensive reading, extensive studying, and extensive thinking and debating.  There are times when it is tempting to say "and the answer is . . ." knowing that some people will believe me.  But it wouldn't be right.

It is also tempting, when I'm frustrated, to blaspheme.  But this would be to undermine the commitment that I've made to serve the one God and to do everything that I do, well aware that He is watching.  Even if He isn't judging me, I am judging myself!

One day in seven you shall rest

There's a time to work, and a time to celebrate.  I know that for myself, if I work too much, if I do too many days in a row, then the quality of my work deteriorates.  When I was in a salaried job (before consulting), the times I worked as a contractor, I took a day of unpaid leave.  I kept my paid leave and my weekends to refresh myself so that I had the right rest and recreation to be able to give of my best for the company who paid my salary.  The same applies in consulting - I take the rest days, one day per week, which keep me refreshed.  I do my training and learning on the six days that I have available, and on the seventh I don't do paid work or tasks connected with paid work.

Napoleon tried to decimalise, and tried a 10 day week with one day rest (people got too exhausted), and a five day week with one day rest (not enough got done).  One day in 7 is about right.

Honour your father and mother

For most of us, that decade between when we were 16 and when we were 25 was the time when we knew the most in our lives.  Everything was an adventure; we knew all the answers and everyone else was just negative, trying to rain on our parade.  When something did happen, it struck out of the blue and could not have been predicted.

Now I understand that others have been there before me, and in many cases, can illustrate a clear line of cause and effect between what I'm planning and what will happen.  And I have learnt from this. I've been accused of being two years ahead in terms of seeing consequences and planning and choosing a different path, a path that manages or avoids risks and gives consistent, if a little boring, success.

I've learnt to honour my father and mother, my managers, my clients, my mentors, everyone older than me, everyone with a different experience, in fact everyone, since everyone is worthy of respect.  By so doing, I've learnt an enormous amount and I've avoided a lot of mistakes, instead of having to learn from each one.

The next 5 Commandments will follow in a few days

I don't normally get excited about anything to do with computers - they are there to make my life easier, not to get excited about!

But I installed this little gadget in MS Outlook and I'm hooked!  It is just brilliant!  (here's an email from my brother, complete with Outlook's version of his photo from Facebook a while ago, and Xobni's version from LinkedIn today)

How do you feel when you get an email from (or send an email to) someone you've never met?  Do you find that, because you don't know what they look like, your fingers start translating your thoughts into something far more formal than you mean to say?  What would it be like to have their photo there infront of you?  That's what Xobni does.

It searches Facebook, LinkedIn, and a few other places to find details such as photo, other email addresses, phone numbers etc.  It then displays them in Outlook in the right hand side of the screen (more and more laptops have a wide-screen format so it is easy to fit this in - though I don't know if the laptop manufacturers had Xobni in mind when they made wide-screen laptops).  I didn't think it would make any difference, but it does!

It also brings up a list of recent twitter feeds, and using its own very fast indexing, lists all of the correspondence you've had with that person recently and who else is usually on email cc: lists when you correspond.  That's how it got its name - it reverses Inbox by extracting the information!

So to describe the screen above:

On the left hand side is Outlook as normal, with a full email.

On the right hand in a sidebar is Xobni, where it has picked up the latest photo of Tom from LinkedIn, his email addresses from here, his Twitter feed (he doesn't tweet), and the conversations. Second conversation down "Dear Jim" i'd cc:d Tom into the email so it is really clever to find that.  All because I'm looking at an email from Tom and Xobni thinks I might want some further information.

It most amazed me when I had an email out of the blue from someone I knew nothing about, and it brought up phone numbers, photos etc.  It also shows of course how much information is publicly available - you may wish to choose who gets to see your phone number and alternative email addresses, for example.

This is what I want from Customer Relationship Management (CRM) - enough accurate and timely information to build a relationship.  It might not be able to tell me that I'm due to send out a mass mailing to 1000 long-suffering contacts (and I should use a proper "permission-based marketing" tool for that anyway, not some hotch-potch with Outlook), but it can tell me the hopes and fears of the person I'm writing to or hearing from.

Would you find this useful?  Hop over to www.xobni.com and tell them I sent you.

The Great North Run - one of the most iconic running races on the planet.  It's also the largest in UK, and one of the largest in the word, with 54,000 competitors!  But are they open to new ideas?It's a road race, and this year (18 Sept 2011) was its 30th year.  

In all those years, it appears that nobody has ever run it barefoot!  Vibram 5-fingers ("barefoot") yes, I mean I ran it in Vibrams last year and the year before.  People asked about the shoes and how I found them.  This year I ran it barefoot, and suddenly I was a pariah - of course there were humorous comments about madness, but at least one runner was a lot more forceful "we have St John's Ambulance for injuries, but we don't have anything on this course to treat your mind".  Did I really represent that much of a threat to the status quo?  Obviously so.

For 220,000 years, humans have run barefoot - maybe even for longer!  The toe provides the grip and drive, and the heel touches down and tests the ground so the runner can adjust their next step (is it slippery, sandy, soft, hard, hollow, springy, etc?).  Then around 1970 Nike invented the sports shoe, and coincidentally sports injuries started.

Somehow, over the next 40 years, modern "sports science" (based on very little evidence) became like Gospel - you couldn't challenge it.  Stock up on carbs, run like this, get rid of fat, etc etc.  And any deviation is a crime!

Back to the run.  

Gradually, people came around to the idea.  Bare feet make me run a different way - to watch where I'm putting my feet, search for more comfortable surfaces (eg the white line down the middle of the road, occasional grass verges), and even to hobble across particularly rough bits. But I put in a good time (1hr 53:37) and that won some respect and changed some minds, as well as raising money for charity (give more money here).

Why is this relevant?

Just because it is new, doesn't make it right!

We're always looking for the next brilliant way to run our businesses, to make a profit, to deliver efficiency.  But new isn't necessarily better.  Believing in the "New" led to the Dot.Com boom and bust.

Of course you need innovation and creativity.  But you need to apply common sense as well.

The Social Return Company is highly innovative - we look for the best approach, the approach that is going to work.  

What really distinguishes us is that we examine what has worked in the past, before doing the Blue Sky thinking.  We work out why it worked, and whether it is still relevant.  Barefoot running is still relevant (the Rift Valley is in many places harder than asphalt), and with a bit of care, is safer and nearly as fast as running in shoes costing hundreds of $$.  It works.  It requires a bit of planning (how long does it take to rebuild the muscles on my calves, and strengthen my ankles to take the strain of thousands of steps cushioned on my toes, instead of rolling along my whole foot; how long does it take to harden my soles; do I try to do both at once or one after the other?), but it works very well thank-you!

 

On 20 January 1961, President-elect J. F. Kennedy took office with words that are just as relevant today as they were then.  Here are a couple of extracts:

The world is very different now. For man holds in his mortal hands the power to abolish all forms of human poverty and all forms of human life. And yet the same revolutionary beliefs for which our forebears fought are still at issue around the globe--the belief that the rights of man come not from the generosity of the state but from the hand of God. 

We still have in our hands the power to abolish poverty (the United Nations may feel powerless, but Bill Gates as channeled funds to defeat Polio and now Malaria).  We still have in our hands the power to abolish all forms of human life - not just with the atom bomb, but now with climate change too.

To those new states whom we welcome to the ranks of the free, we pledge our word that one form of colonial control shall not have passed away merely to be replaced by a far more iron tyranny. We shall not always expect to find them supporting our view. But we shall always hope to find them strongly supporting their own freedom--and to remember that, in the past, those who foolishly sought power by riding the back of the tiger ended up inside. 

We would do well to remember that states and people seeking freedom from tyranny want freedom - their own freedom.  It is our duty to support them, but not to rule them with an "iron tyranny".  The tiger JFK refers to is bigger than any politics.

To that world assembly of sovereign states, the United Nations, our last best hope in an age where the instruments of war have far outpaced the instruments of peace, we renew our pledge of support--to prevent it from becoming merely a forum for invective--to strengthen its shield of the new and the weak--and to enlarge the area in which its writ may run. 

Is that really what the United Nations was then, a "forum for invective"?  Sometimes it seems as though not much has changed in 50 years!

Since JFK's speech, great men and women have transformed the world we live in.  Whether Tim Berners-Lee with the democratisation of long-distance communication, or Nelson Mandela with an end to state-sponsored slavery, or Barak Obama attempting to bring common sense and honour into politics, or Bill Gates with the ambition to make the world a better place, much has changed.

But much has not changed as well.  Change takes time and motivation, and I for one will continue the struggle even if it drags on for ever.

What does it mean, to own up to something deeply personal?

In the UK, the land of "stiff upper lip" and "don't reveal anything about yourself", this declaration is almost unheard-of. For hundreds of years, politics and religion were banned topics in polite (and impolite) society.  Pubs and inns had few rules, and this was usually one of them.  Dinner etiquette insisted against it. To admit you are agnostic, or Catholic, or Jedi, was to invite an argument or to be ejected – bodily – from the building.  Hey, it probably dates back to the reign of Queen Elizabeth! (1558-1603)

Not so the rest of the world.

"Belonging" to a Church, Temple, or Synagogue is a mark of your standing in the community in most of the rest of the world, including the US of A. My dad tells of attending a baptism (adult) in Kenya, and hearing two gents next to him discussing one of the candidates:

"I thought he would come for baptism soon"

"Yes. He's opened a shop in Kisumu”

“They wouldn't give him credit until he had his name on a Church Congregation"

“No. They wouldn't give him a building, or even give him trade".

In the UK it is almost the opposite. The closest you get is when people say "I believe in God but I don’t go to church because I don't like the people there. They're so hypocritical". Young men and (predominantly) women, baptised into the Church of England by default and in some cases even confirmed by default as teenagers, who never felt any desire to go to church, will suddenly convert to Islam for (I presume) the structure, the living faith, and the community.

So why me, why now, why this?

Nothing has really changed.  I do what I’ve always done.  But I went to a seminar last week and was disappointed – this hero of mine who produces a brilliant audio magazine was preparing to stop producing new material, and just start reselling archive material without really telling anyone clearly.  Making money was more important, to him, than doing a good job.  I do what I’m passionate about, I try to do my best and to get better and better.  The income is a byproduct (obviously I need the money to pay the bills).

I’m proud of my faith. I attend an ordinary Church of England church, the building a modern utilitarian hall, and the services shared with the Methodist Circuit because we can't both afford a full-time minister. The people at the kind of people you meet in any church up and down the land. We do care. We are not up our own backsides. We aren't forever raising funds to pay for the church tower, ‘though we are intensely aware of the cost of keeping the building open and the salaries paid.

But Christianity is about declaration. After all, I may be the only Bible that the people around me will ever read. Is my life worth reading? Is my character, my activities and habits, a clear declaration of my faith?

Pie in the sky when you die?

Not a bit of it – I’m not trying to gain merit for some after life (actually I probably am, but to quote the Wee Free Men, life is so great here that I may have already died and this is heaven). I believe we're here to learn and grow. Just like Jesus's parable of the talents (Matthew 25:14, Luke 19:12), we are here to take what we have, to invest and create more.  Not just money, but skills, abilities, conversations, and love.

I aspire to act honestly and truthfully, and I will also put the whole of my effort and ability into doing what I do, well. I'm good at putting a value on the outcomes of activities and change, and I do this to assess Return On Investment (ROI) and Social Return On Investment (SROI). So I'll do this to the very best of my ability.

I'm good at understanding what motivates people, and applying this to create mixed teams which complement each other and deliver the best results. So I'll do this to the very best of my ability.

And I love running (my favourite quote from Chariots of Fire - Eric Liddell: “I believe God made me for a purpose, but he also made me fast. And when I run I feel His pleasure.”), So I’ll strive to get better and better.

I'm not saying that I'm a good Christian, only that I am a Christian. I'm not saying I'm the best in my field, only that I'm prepared to try to be.  Evidence suggests that I’m one of the best at Benefits Management, but BM has to be applied to make a difference.

What sort of message does my life convey?  What sort of message does your life convey?