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SATURDAY 6. AUGUST, 2011
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FRIDAY 5. AUGUST, 2011
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Is it time to go to the pub now?
One of the many pathetic ways I shore up my self-esteem in the face of life's cosmic meaninglessness is by collecting anecdotes about the eccentric work habits of great historical figures. I love finding out that Churchill frequently stayed in bed till 11am, that Kafka was a time-management disaster, or that Friedrich Schiller tried to improve his concentration by inhaling the fumes from rotten apples he kept in a drawer. If even these paragons managed their lives in such peculiar ways, my theory goes, there's no need to worry that I do, too. One example: since university, I've been unable to start working except on the hour or the half-hour – or, on a good day, the quarter-hour. If I miss it, I have to wait. On a really bad day, not starting by 9am might see me procrastinate till noon, which somehow feels like a nice, clean-edged moment at which to try again.
Straw polls among friends suggest that this specific weirdness isn't widespread – but also that, more generally, clock time exerts some powerfully irrational effects: we're seemingly far more influenced by what time it is than we'd like to admit. By far the most troublesome, for anyone with any degree of control over their working hours, is the horrible lure of "calling off the day". In some inexpressible way, 3pm or thereabouts (when this demon usually attacks) just feels like a bad time to begin or recommence work on big projects. Best wait till tomorrow, you tell yourself: deal with minor matters for the rest of today, and get stuck in in the morning.
There can be good reasons for this, it's true. One persuasive criticism of traditional time-management techniques is how they wrongly assume that time is "fungible" – that one hour's the same as any other. In reality, by contrast, energy levels fluctuate. ("With all those hours you spend watching TV," the stereotypical motivational coach admonishes, "you could have written a novel!" But you probably couldn't, because those were hours of tiredness.) Maybe sometimes you really do lack the gumption to work past 3pm on anything except emails and desk-tidying. But the very fact of the time of day seems to possess its own power, too. And, like many procrastinatory urges, it's sneaky, because it masquerades as self-discipline: conserving your energy for a fresh start tomorrow feels virtuous, while in fact erecting an obstacle to getting down to the projects you care about most. The only workable antidote I've found is as geeky and eccentric as the behaviour itself: mentally, and often in a notebook, too, I divide the afternoon into two-hour slots: 12-2, 2-4, 4-6. That way, if my motivation collapses at 3, I can "call off" that block, then start afresh at 4.
Since far too much productivity advice these days seems to assume that productive work is all that matters in life, let's be clear: "calling off the day" to go and join friends in the local beer garden – or to do anything else that's similarly fun or enriching – is an actively good thing (providing it won't get you fired). You should do it a lot. What you shouldn't do is fail to make progress on what matters because of what it says on your wristwatch. Don't head to the beer garden because you're postponing the important stuff till tomorrow, in other words. Head to the beer garden because it's important in itself.
oliver.burkeman@guardian.co.uk
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Routine screening test for newborns could save lives of some born with congenital heart defects say researchers
A routine screening test for all newborn babies could save the lives of some born with congenital heart defects, say researchers . A number of babies' heart defects are spotted during a mid-pregnancy ultrasound scan and others may be picked up in the routine physical examination after delivery.
But sometimes the problem is not spotted until the baby becomes ill at home. Congenital heart defects are one of the main causes of of baby deaths in the developed world. A study published in the Lancet says lives could be saved if all newborn babies were given a cheap and simple test to establish the oxygen levels in their blood.
Small studies of the pulse oximetry test – in which sensors are placed on a hand and foot – have proved inconclusive, so the National Institute for Health Research funded the study by Andrew Ewer and colleagues from Birmingham University and Birmingham Women's hospital to determine whether it would be useful for the NHS. Their study in six maternity centres in the UK involved 20,000 babies between February 2008 and January 2009.
The test detected 75% of all critical cases (those that result in death or surgery within 28 days of birth) and 49% of major congenital heart defects (causing death without surgery within 12 months).
Some of these heart defects had already been spotted during the antenatal ultrasound scan, however. Excluding those, pulse oximetry identified 58% of unsuspected critical cases and 28% of major ones. It wrongly identified some babies as having congenital heart defects, but some of those were found to be suffering from other diseases.
The authors calculate that 264 out of 100,000 newborn babies would have major congenital heart defects‚ 130 of which would be identified by the test.
Around 120 babies would be critical cases, 90 of whom would be identified by pulse oximetry. Combining the test with ultrasound and the routine physical examination after birth, 92% of congenital heart defects were identified. No babies in the study died from undiagnosed heart disease. "Pulse oximetry is a safe, non-invasive, feasible and reasonably accurate test which has sensitivity which is better than that of antenatal screening and clinical examination. It adds value to existing screening and is likely to be useful for identification of cases of critical congenital heart defects that would otherwise go undetected," say the authors. The Department of Health said the UK national screening committee would consider the study.
"The NHS has a long and proud track record of innovation that has driven major improvements in patient care in the past, and we welcome the findings of this study. Currently all newborn babies undergo a routine screening, including careful assessment of cardiovascular system. This study shows the potential benefit of pulse oximetry screening as part of that."
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Some multiple sclerosis sufferers will have 'no effective treatment option' after decision by medicines watchdog
Campaigners have expressed disappointment after the National Institute for Health and Clinical Excellence (Nice) rejected the first pill to treat multiple sclerosis. The MS Society urged the medicines watchdog and drug firm Novartis to work together so that Gilenya – also called fingolimod – can be reappraised.
In draft guidance which is subject to consultation, Nice rejected the drug due to "uncertainties" over its effectiveness, a lack of appropriate data and concerns over cost-effectiveness.
It said it was unclear how much the drug would help the specific group of people for whom it was licensed – adults with relapsing-remitting multiple sclerosis (RRMS) who experienced at least one relapse a year despite being treated with beta interferon drugs. Another group of patients suitable for the drug were those with rapidly evolving severe RRMS, who experience two or more disabling relapses regardless of their treatment.
Nice said Novartis had submitted data mainly looking at a subgroup of patients with the former type of MS. The firm also only submitted data comparing Gilenya with a placebo and a type of beta interferon not believed to be widely prescribed on the NHS, according to Nice.
Professor Carole Longson, director of the health technology evaluation centre at Nice, said: "While it's important that people with multiple sclerosis have treatment options, Nice has to ensure that the NHS provides treatments that bring benefits that are value for money.
"Unfortunately, our independent committee wasn't given sufficient evidence to show that fingolimod could reduce relapses considerably better than the other treatments currently being used.
"Based on the available clinical evidence and economic analysis, our independent committee concluded that fingolimod would not be effective good use of NHS resources."
Simon Gillespie, chief executive of the MS Society, said: "This is disappointing news for people with MS and it will leave some people with no effective treatment option. Access to MS treatments in the UK is very poor – in fact, people with MS would be better off living almost anywhere else in Europe, and this decision will only deepen that inequality.
"We're concerned at how this decision has been reached and strongly encourage Nice and Novartis to work together to look at how the treatment can be better reconsidered and evaluated."
Novartis said Nice had suggested best supportive care – no active treatment at all – as the appropriate comparator for Gilenya. But it said this did not reflect current clinical practice in the UK according to neurologists.
A statement said: "Novartis believes that comparing fingolimod to best supportive care will unfairly restrict access to fingolimod, as well as any future new treatments. It will be very difficult for any new therapy to demonstrate cost-effectiveness against best supportive care.
"This approach is likely to restrict new treatment options in the UK to symptom management medicines only, which could result in continued relapses."
Around 100,000 people in the UK have MS. It has traditionally been treated with injectable drugs.
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The stoat scampers along the dry-stone wall, lightly cresting the lichen-covered coping stones. It has come to investigate my log pile, where split lengths of ash are seasoning, ready for the coming winter. The stacked wood, being undisturbed for the summer months, is a haunt of mice, and the stoat undulates over it, coming down headfirst like a nuthatch.
The daily sightings of this family of stoats are giving me great pleasure. These athletic hunters are handsome, with their rusty colouring and black-tipped tails. As a gardener I am glad of their presence as they help to keep down the myriad bank voles that live in the old walls and eat my bulbs. Whenever I walk on the flower borders the soil collapses beneath my feet, hollowed by vole runs that undermine plants, leaving them with roots exposed to air. A couple of weeks ago I watched an adult stoat carry a vole in its jaws back to the gap in the wall beneath the sycamore tree where I reckon its nest to be. Stoats have only one litter a year of between six and 12 kits, and I don't know how many live in the cavity of my garden wall. Now the young are venturing out, their fur paler than the auburn of the adults. Today, two are play-fighting among the lungworts and hellebores of my shady border. Tumbling over each other, standing on hind legs before pouncing, they are an exuberant sight.
Stoats are curious and one is examining me from the safety of the wall. Back between the stones it goes, before its head pops out from a different gap, black eyes alert as it studies me. The clatter of a pheasant call from the field beyond sends it into hiding. Now it runs along the path unaffected by voices as we work in the garden. As I bend down to weed under a hedge I get a strong whiff of musk, a reminder that I am in the stoat's territory, not the other way round.
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THURSDAY 4. AUGUST, 2011
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The Juno probe will plunge into the gas giant to reveal the secrets that lie below its clouds. Here's what we already know
From afar, the largest planet in the solar system is a swirl of brown, yellow and white clouds, topped off with a distinctive red blemish, the mark of a raging 300-year-old storm that would smother the Earth many times over.
Jupiter is a gas giant and, after the Sun, the most massive object in the solar system. The planet spins fast, making a day last only 10 hours and the equator bulge out to a diameter of 89,000 miles. All the planets in the solar system, or more than 1,300 Earths, would fit inside the space Jupiter occupies.
Jupiter is a distant planet, more than five times further from the sun than Earth. The orbit takes Jupiter 12 Earth years to complete.
Like all gas giants, Jupiter has no surface in the conventional sense, but the top of the cloud deck writhes with storms and hurricanes.
If a person could stand on the top of Jupiter's clouds, they would feel more than twice the gravitational pull of Earth. A person who weighed 80kg on our home planet would weigh nearly 200kg. High up the temperature is close to -145C (-229F), but near the centre this rises to 24,000C (43,232F), hotter than the surface of the sun.
The outer clouds are about 90% hydrogen and 10% helium, but further in the planet becomes richer in helium and the heavier elements. At the heart may be a rocky core.
The planet becomes denser and hotter deeper in as the pressure soars. The clouds thicken, then droplets begin to appear and, deeper than 600 miles, all gas is turned to liquid.
Even deeper, electrons are squeezed off hydrogen atoms to produce a substance never seen on Earth. Under such extreme conditions, the hydrogen behaves like liquid metal, conducting electricity as well as heat. The metallic hydrogen sea is tens of thousands of miles deep.
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