I'm at my friend Larry's flat in Glasgow.  We're doing one of our three-to-four monthly check-ins -  reviewing and planning how our lives are going.  I arrived here from Edinburgh yesterday evening and we spent time catching up and looking ahead.  This morning though, when I woke, I found it hard to think clearly about the time between now and early August when we next plan to meet like this.  The mountains of Glen Affric are beginning to grow closer and fill my immediate field of vision.

For many years my work split fairly evenly between helping people with psychological difficulties and helping people with pain problems.  Quite a few people were troubled with both.  In the last several years I have done much less work with pain, although I still see some people for overall pain management.  This has been partly because I was trying to keep up-to-date with too many fields, so stepping back from pain work made sense.  It has also been partly because the flourishing of research into happiness & wellbeing has fascinated me and taken up time.  Here are a collection of pain-associated assessment and information sheets that I accumulated over the years.  They are obviously relevant for work with pain, and some (e.g. one year symptom diary) can be adapted for work with stress & psychological difficulties. 

IBS severity score & background - this is a scale that was used by Professor Whorwell and his research team in Manchester.

Here are five papers mostly looking at aspects of overweight.  The first, published recently in the Lancet, is a huge study on the effects of body-mass index (BMI) on subsequent mortality in nearly 900,000 adults.  It shows progressive excess mortality above the BMI range 22.5-25 kg/m2.  (To calculate your BMI click here).  At 40-45 kg/m2, the reduction in life expectancy of 8-10 years is comparable to the effects of being a smoker.  The second paper, by Neovius et al, also involved large numbers - over 45,000 older adolescents.  Again it showed excess mortality at long term follow-up, and commented "Obesity and overweight were as hazardous as heavy and light smoking, respectively".  The third study by Katseva et al looked at modifiable risk factors in European patients with cardiac disease.  The findings were depressing with obesity, for example, increasing stepwise from 25% at first survey, to 32.6% at second, to 38% at third survey.  Overall the authors concluded "These time trends show a compelling need for more effective lifestyle management of patients with coronary heart disease ... To salvage the acutely ischaemic myocardium without addressing the underlying causes of the disease is futile; we need to invest in prevention." 

A recent article in the British Medical Journal (Kmietowicz 2009) reports that "The chief medical officer for England has called for a minimum price of 50 pence (0.54; $0.70) to be charged for a unit of alcohol to reduce excessive drinking and its associated harms.  Liam Donaldson said that antisocial drinking should be targeted in the same way as smoking in public places so that being drunk is no longer an aim or socially acceptable.  ‘England has a drink problem and the whole of society bears the burden,' said Professor Donaldson at the launch of his 2008 annual report. ‘The passive effects of heavy drinking on innocent parties are easily underestimated and frequently ignored. The concept of passive drinking and the devastating collateral effect that alcohol can have on others must be addressed on a national scale.'  He said that evidence shows that price and access are the two key factors that can help to change drinking habits, as they were for tobacco."