Archive for February, 2017

Waiting for the labour pains with a well-timed “I told you so” might seem like a good idea, but turns out not to be if you like your balls attached to your body.

The active birth movement has now been going for 50 years and is almost certainly here to stay. That makes sense. Research suggests that active birth reduces the number of complications and interventions, and allows the mother to recover quicker.

As with everything in pregnancy, though, there are benefits and there are also drawbacks.

First, labour can be really painful. It varies from person to person and from birth to birth, but often the amount of pain management required is going to be dictated by the situation.

Second, not everything goes to plan. So you may be planning to have an active birth but the situation could change quickly if there are any issues with labour. Therefore it is important to go in with a mindset of being ready to adapt to the changes required.

How should you handle it? The most important step is to be supportive. Active birth offers a lot more chance for the father to be involved, supporting your partner through the process and helping with non-drug based pain relief (such as massage, and helping her in and out of the bath).

It is also important to be supportive if things to not go to plan. If she decides she does need pain relief after all, remember to reassure her that almost everyone does, and there is no “failure” in resorting to it.

Overall, active birth is a great decision, especially for dads. The advantage is the reduced chance of intervention, and the disadvantages of additional pain are only felt by the father vicariously.

On average, men choose to marry women slightly younger than they are. But for would-be dads, this can have a profound impact on family life.

Most people enter relationships with people of a similar age. In western culture this is normal, and indeed doing anything other than this is considered abnormal. However, in different cultures, and at different times, this as not always been the case.

If we look at the 2013 US survey data, we find that a third of heterosexual married couples are within one year of each other. It is not an equal curve on each side though. Women are far more likely to marry older men. In 20% of marriages the man is 2–3 years old, and in 13% 4–5 years older. Compare this to 7% and 3% for women being older.

This makes sense. OK Cupid data, as documented in the book Dataclysm shows that men prefer younger women, and up until the age of 30, women prepare a slightly older man. As many relationships are formed before the age of 30, the older man younger woman setup is likely to have the broader appeal to both parties.

Why is it important, though?

I think it is important because it contributes to the imbalance of women staying at home to look after the children while men continue working. For would-be stay-at-home dads and passionate career women, this is not a desirable situation.

People who are further along in their career earn more money. Nothing controversial there. This means that if you enter into a relationship with someone a few years older than you, on average, they are going to earn more money than you.

When it comes to starting a family, it would be nice to think that childcare could simply be divided as you see fit. However, this is simply not the reality that most of us live in. Many of our decisions are driven by economic factors. That is to say, there are bills to pay and we need to earn enough money to pay them.

Therefore, when it comes to starting a family, many people are faced with the decision of giving up the father’s wage or giving up the mother’s. Unfortunately, for many would-be full-time dads, giving up their own higher wage is not financially viable for the family.

Exactly what can be done about this, I am not sure. You could say that if you want to be a stay-at-home-dad you should marry someone older, or in a more lucrative career than you. However, as most of us know, love does not work that way.

When it comes to stopping people throwing themselves off the bridge, the question is, can a one-time intervention really save lives?

When thinking of iconic places to take a suicidal jump from, the Golden Gate Bridge in San Francisco has to come pretty high up that list. In fact, 1,6000 have jumped to their death from the bridge since it opened. It is a fairly reliable way to do it. In that time 26 people have survived, a 98.4% “success” rate.

Now the Golden Gate Bridge are spending nearly £60,000 on installing suicide prevention nets. These wire nets will hang below the bridge, in an attempt to mostly hide them from public view, and be made of steel. It is not going to be a pleasant fall, but should at least save the life of the jumper.

But will it actually work?

According to The Bridge Rail Foundation, a group that has long been campaigning for suicide deterrents to be installed, there is no question that they will help the situation.

They argue that it is simply not the case that once someone has decided to take their own life, nothing can be done to stop them. In fact, most people who fail to take their own life do not try again. 90% of those who are stopped before they can jump go on to live our their remaining lives without suicide. This is a high suicide rate compared with the general population but suggests that intervening once is overwhelmingly successful in keeping people alive.

Experience from around the world suggests they will be effective as well. A similar scheme in Bern, Switzerland was put into place for bridges and city cathedral. Since the nets were installed at the later, nobody has decided to risk the jump. Since 1998 the only creatures to be pulled out of the nets were two dogs. Presumably, they ran over the ledge by accident.

Just going outside and running is simple. But for us adults, we often need something a little more structured to get started. Parkrun is a great option.

If you are thinking about getting started with running, Parkrun is a great way to go. Founded in the UK it was quickly spread to almost every town and is rapidly spreading across the rest of the world too.

So what is it? It is a timed 5km run that takes place every Saturday. It is free, so you can simply turn up and do the run. At most Parkruns there is a huge ability difference between runners: some will complete it in 15 minutes, others will take 50. Everyone goes at their own pace.

As a Yorkshireman, one of the major appeals to me are the free t-shirts. When you reach 50 runs, 100 runs and 250 runs you get access to a special t-shirt for that “Club”. Actually, it is not free, but all you pay for is a few pounds postage. There is also a “25 Club” for those who volunteer as marshals.

Here are the technical details. You register on the website and are given a unique barcode to print out. Take this along with you to the run and when you complete the course a volunteer will scan your barcode so that your time can be sent to you.

Men have an almost one in ten chance of having nobody to turn to. Could peer support fill a much-needed gap?

In June, mental health charity Mind published research suggesting that men were twice as likely to have nobody to rely on for emotional support. 9% of men, compared with 5% of women, said that they have nobody to turn to in times of need. The research also suggested men are less likely to feel comfortable talking to the people close to them about their problems, with 52% agreeing.

This is a big problem for a number of reasons.

As Susan Pinker explains in her book _The Village Effect_, having a strong social network and close emotional support is critical to both good mental and physical health. When you eliminate the bias for women to have a stronger circle of close friends to rely on, you find that the disparity between men’s and women’s life expectancies closes dramatically.

Second, with men three times more likely to take their own lives than women, having someone to turn to at the crisis point could mean the difference between an intervention that saves someone’s life, and a successful suicide attempt.

The question is, that can be done about this problem?

To an extent, the problem could lie with our gender itself. If we built stronger relationships and invested more time in building those relationships, we would have a wider circle. However, many men feel like they simply don’t have the connections to do this, that it would not be viewed upon as socially acceptable in their circle, or simply that they feel too uncomfortable to do this.

Another option would be to increase the number of peer support groups available. The advantage of being able to talk to people going through similar problems, and therefore being able to bypass the chance of people not understanding, or judging, may provide a critical avenue for men to get the emotional support they need.

Organic food sellers are constantly touting the superior taste and health benefits of their products. But can they back this up with any evidence?

Organic food can often cost far more than the “non-organic” alternative. But is it really worth paying more for it? Is it any better for you, or for the environment?

So far, the scientific consensus is clear: no. Organic food is not any more nutritious, does not taste any better, nor is any safer than traditionally grown crops. It does not seem to be any better for the environment either, especially compared to genetically engineered crops that, by design, require fewer pesticides that traditionally-grown or organic food.

In 2012, a study by Stanford University confirmed what the rest of the scientific community had already been saying. There is just no evidence that organic is better.

So why do some people swear by it? The most obvious reason is the placebo effect. Because the branding will typically make claims about it tasting better, and because people will almost certainly have paid more for it, they are likely to receive some placebo effect from expecting it to be better.

However, when it comes down to the option of buying a luxury brand or an organic brand, the choice is clear. Even if the luxury brand is no better either, the placebo will probably be even bigger. For the rest of us, it is time to save some money guilt free.

Paracetamol is widely viewed as an effective and safe painkiller. However, mounting evidence suggests that neither of these facts is true.

When it comes to painkillers, few are as prevalent as paracetamol. Safe, easy and effective it has become the first choice of painkiller for many people. But is all of this actually the case?

Increasingly, the evidence is no. Writing on Evidently Cochrane, Andrew Moore points out that a lot of the Cochrane reviews of paracetamol suggest there is a little evidence for its effectiveness.

Review after review seems to dismiss the effects. It does not help for acute or chronic back pain. It does not reduce pain in newborns. It only helps half of patients, or less, after an operation, and only when mixed with codeine.

Nor is a paracetamol without risks. Not only is it a drug you can overdose on, but even at non-overdose levels it is associated with liver damage, and can increase the risk of strokes, heart attacks and ulcers. One study suggested it was no worse than ibuprofen, but at least ibuprofen seems to work.

Ultimately, we may need to rethink our approach to paracetamol. For some, it may work. However, for others, it seems to have little or no effect. If so, other options are just as safe to explore.

BMI is much despised by the public. However, before it is written off completely, we should consider what the implications are for the medical world.

People are constantly railing against BMI. They insist that it is simply stupid and insulting to label them as obese and that BMI doesn’t mean anything anyway.

But is that the case?

The answer is somewhere in the middle. From a medical perspective, there is little doubt that BMI is useful. A 2016 study published in the British Medical Journal (BMJ) confirmed that a high BMI was indeed associated with an increased risk of death.

However, a 2006 paper by the U.S. National Bureau of Economic Research, points out that there are some serious flaws in the simplicity of BMI as it fails to distinguish between fat from muscle.

Another paper in the BMJ suggested that BMI was indeed useful, but that what was considered a “normal” weight should be redefined. A weight of 18.5 to 20, for example, is defined as normal, but could actually be correlated with higher mortality.

Therefore, it seems BMI is a useful tool, but only when taken as a guide. It could be that the normal weight needs to be adjusted upwards slightly and that those with high muscle density will find they have an inaccurate reading.

In an age when Theresa May seems determined to read every email you write, abolish human rights and arrest everyone on terror charges, it can feel like our freedoms are under threat (they are). However, on a more positive note, we British people enjoy some freedoms that a lot of the world does not.

Nothing on this list will be a surprise to you. However, what I think will be a surprise, is that the rest of the world does not have these freedoms. These are things we take for granted but are not always the norm.

Naming your child

In Britain, you can name a baby anything as long as the powers that be do not label it as offensive or rude. People take liberal advantage of this, regularly naming their babies after TV characters, inanimate objects or obviously incorrect spellings of real names.

This is not a freedom most of Europe enjoys: many countries have set lists of accepted names. You have to pick from the list and you cannot change the spelling.

Homeschooling

Only wacky religious people tend to homeschool. However, you do have the option if you so wish. If you are tired of the school forcing facts down your child’s throat, you can pretend to be a teacher and give them an education yourself. You will seriously damage the child’s intellectual and social skills, but at least you will feel better.

We and around half the countries in the world enjoy this freedom. Each country has different levels of restrictions. For the rest of the world, homeschooling is illegal.

Jaywalking

At some point in the history of the United States, the government and the people had the following conversation:

Government: “Can we take away some of the really big guns so that children stop getting massacred?”
People: “No! Keep your hands off our second amendment!”
Government: “Okay. Can we make it illegal to cross the street wherever you want?”
People: “Sure, that’s fine.”

It seems a bizarre way round to me. I like living in a culture where assault rifles are not allowed, but crossing an empty street when it is safe to do so is. But what do I know as a humble British person?

Germany also criminalises jaywalking. There is something odd about watching clearly inebriated Germans stumbling home, yet stopping at every crossing to wait for the green man.

Moving house without telling everyone

Do you find junk mail annoying? I do. When I move house, I do not want everyone to know that I have moved. I will tell the people I think are worthy of knowing: banks, utility companies, etc. For everyone else, I do not want your nuisance mail.

In Finland, when you move house, you tell the state. The state then tells everyone else. This is convenient because it means all of your banks know that you have moved house. However, what if you do not want to tell a bunch of for-profit companies about your new address?

Free healthcare, including birth control

We tend to think of free healthcare as something that all civilised countries have, with the notable exception of the United States. However, this is not always the case. Take Finland again, for example.

When you go into hospital, there is a charge per day. It is not the full cost of your hospital stay, but it is not insignificant. You also pay to visit your GP and pay higher prescription charges. For birth control, for example, you will be paying around €15 per month.

In the UK, we pay for prescriptions (not in Scotland or Wales) and dental, but these are both capped at relatively low amounts. Hospital treatment is without cost entirely (unless you want to watch the TV).

ID cards

Compulsory ID cards are overwhelmingly the norm. Britain is one of only nine countries^[ref] in the world that does not have any ID cards.

Flag burning

Flag desecration varies by countries. In many, it is illegal. In some, it is prosecuted under wider laws.

In the UK, we are pretty relaxed about it. If you want to burn the Union Jack, feel free. There is no law against it. There have been some moves to tighten up on it, but none have come to fruition.

Of course, you may struggle if it is made of fire-resistant material. As this EU flag was, for example:

Humble Inquiry: The Gentle Art of Asking Instead of Telling is a book by Edgar Schein. It is a relatively short book and the title gives most of it away: we need to do more asking and do less telling.

Making this change is tough. We live in a culture that celebrates task accomplishment, It is a world where the boss tells and the worker does not. Often, the subordinate will be too fearful to be honest with their superior. This is even true in emergency situations. Fatal mistakes during surgery, for example, or airline crashes can often be traced back to this.

I want you to be completely honest with me. Even if it costs you your job.

As a leader, it is your job to establish an atmosphere where people can speak up. You need to understand the cultural and generation differences regarding the risk of humiliation. People will try to avoid humiliating you at all costs. This is fine most of the time, but not when you are about to give the wrong medication or make a terminal mistake in business.

The best way to achieve this is to create a personal relationship. Professionalism will not win out: it would be unprofessional to embarrass your boss. Instead, you need to build a relationship where subordinates feel they can overcome these barriers. And, as the boss, it is up to you to set how much personal disclosure is appropriate.