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EDITORIALS: Shifalika Goenka Preventing diabetes in Bangladeshi people in Britain BMJ 2008; 337: a2010 [Full text]

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Lack of vitamin D most likely a contributing factor

Helga M Rhein   (10 November 2008)

Obama lessons and baked samosas: a quantum leap for better health.

Vivian S Rambihar MD, Vanessa Rambihar BHSc. Med Student U Toronto.   (23 November 2008)

Lack of vitamin D most likely a contributing factor 10 November 2008
Helga M Rhein, GP Sighthill HC, 380 Calder Rd, Edinburgh EH11 4AU Send response to journal: Re: Lack of vitamin D most likely a contributing factor	Shouldn't replenishing an insufficient vitamin D serum level have been considered when discussing preventing diabetes in Bangladeshi people in Britain? It is well known that residents of Britain with dark skin types have frequently vitamin D insufficiency or even deficiency. There are also many studies linking diabetes mellitus and vitamin D. A Pub Med search for these last 4 words reveals 678 articles. Helga Rhein GP helga.rhein@blueyonder.co.uk Competing interests: None declared
Obama lessons and baked samosas: a quantum leap for better health. 23 November 2008
Vivian S Rambihar MD, Consultant cardiologist 3000 Lawrence Ave E, Suite 3302, Toronto, Canada. M1P2V1, Vanessa Rambihar BHSc. Med Student U Toronto. Send response to journal: Re: Obama lessons and baked samosas: a quantum leap for better health.	Goenka advises education for empowerment and resisting cultural norms for health (1). This is not easy, with resistance to change that defies the rational. Fried samosas, the staple at most South Asian functions, is my metaphor for deeply ingrained cultural norms we need to change, but don’t. It’s complex, and new change methods recognizing the complex dynamics involved may be necessary, while respecting the need to preserve valued social, cultural and other traditions (2). Umair Haque’s “Obama’s Seven Lessons for Radical Innovators” describes a complexity-type new rules new kind of 21st century institution and change - self-organization design, elasticity of resilience, minimize strategy, maximize purpose, broaden unity, thicken power, and the world- changing power of an ideal (3). We used a similar complexity-type multilevel collaborative campaign for health promotion in the South Asian community (4). Lessons from this and the Obama campaign, including extensive web use, may help to disrupt some cultural norms that impair health, with an ideal of “change we really need” and the optimism of “yes we can.” Resnicow and Page’s “Embracing Chaos and Complexity: A Quantum Leap for Public Health” describes nonlinear change from motivation and inspiration instead of rational weighing of pros and cons (5). Nonlinear change can inspire, producing a quantum leap for better health, starting with finding baked samosas. We stared down 700 fried samosas at a community event, there because fried samosas were expected, and were told that baked samosas were not possible, not considered, difficult to get and more expensive. Speaking on Health, I held up Goenka’s Editorial on diabetes in Bangladeshis and the award winning healthyindia.org web page in one hand. In the other, a dozen baked samosas, disrupting ever so briefly a cultural norm, proclaiming “Yes we can.” One small step for BAKED samosas, a quantum leap for better health? 1. Goenka S. Preventing diabetes in Bangladeshi people in Britain. Editorial. BMJ 2008:337:1065-66. 2. Rambihar VS, Rambihar SP, Rambihar VS Jr., Tsunami Chaos and Global Heart: using complexity science to rethink and make a better world. Toronto: Vashna, 2005. Available at http://www.femmefractal.com.libaccess.lib.mcmaster.ca/ (Accessed Nov 21, 2008. 3. Haque U. Obama’s Seven Lessons for Radical Innovators. http://www.businessweek.com.libaccess.lib.mcmaster.ca/managing/content/nov2008/ca2008117_183685.htm?chan=top+news_top+news+index+ -+temp_managing (accessed Nov 21, 2008). 4. Rambihar VS. Using complexity science in community health promotion: novel perspectives and a tool for change, in Complexity and Healthcare Organization. Ed Kernick D. Oxford: Radcliffe Medical Press, 2004. Available by Googling key words from title (accessed Nov 21, 2008). 5. Resnicow K, Page S. Embracing Chaos and Complexity: A Quantum Change for Public Health. Am J Public Health. 2008: 98: 1382-89. Competing interests: None declared