Sunday, 28 August 2016

Paying the price of a mid-life crisis and the potential pleasure and pain of gardening

It's that really funny time of year for those of us who work in academia – it’s the lull between celebrating our completing students at the Graduation Ceremonies, and our new students starting. There is a kind of hedonistic rhetoric to this time which is about being, free from teaching and so on, can just get on with our research and and so doing get refreshed and ready for the new academic year. I may be totally out of order here, but most academics will prioritise taking the chance to re-connect with families and friends, take a holiday and chill out.

This lull, between being set free from the pain of an increasingly controlled academic life, and the pleasure of personal fulfillment, is a form of post-modernist academic hedonism.  It was the ancient philosopher Epicurus who set out the notion that pleasure is the only intrinsic good and pain is the only intrinsic bad. According to Epicurus, something (a tangible object), experience or a state of being becomes intrinsically valuable if it is good simply because of what it is. Intrinsic value is not the same as instrumental value. Last Friday my neighbours Lamborghini was delivered. It was second hand but still cost over £200k to buy.   

Now if I was having a mid-life crisis and fancied buying one of these magnificent cars, I would need to keep working for a few more years, and even forget about retiring in 2019. I like my job, but if for a moment we imagined I was in a job that I didn't like doing, to get my Lamborghini, I would need to continue working as my salary is instrumentally valuable only because of what I can gain by it. In simple terms, I will endure the pain of whatever in order to obtain and enjoy the pleasure. 

There were a couple of stories last week, which as they lingered in my consciousness, probably sparked this thinking around the pain and pleasure notion. One was a follow up to a story I first heard a couple of years ago in Australasia. It concerned an initiative aimed at reducing the rate of teenage pregnancy. Over 1000 teenage girls took part in the virtual infant parenting programme which included sexual health education, contraception and the examining the financial costs of having a baby. The programme also included caring for a lifelike model of baby which cried when it needed to be fed, burped or changed.

The 'reality pain' of looking after a baby as teenager was meant to modify the girl’s behaviour and choices. The story, update, published in the Lancet, showed that the girls that took part in the programme were more likely to get pregnant than those not taking part in the programme. When the girls were tracked up to the age of 20, 8% had given birth at least once and 9% had had an abortion. This compared to 4% of girls giving birth and 6% having an abortion in girls not taking apart in the programme. Such programmes are not common in the UK. In the UK, between 1998 and 2013 there was actually a fall of 48% in conception rates among under 18s from 47.1 per 1000 to 24.5 per 1000.

It's not clear what has caused this change, but a reduction in alcohol consumption leading to unprotected sex has perhaps helped, as has the rise in socialising on-line. And that’s the second story. I picked up on one Cara Delevingne's crusade last week. Before last week, I didn't know who she was – apparently a 24 year old model and film star (latest film, bizarrely entitled Suicide Squad). Well last week social media was alive with the news that she is raising awareness for gynaecological cancer by posing on the front cover of the Sunday Times Style magazine wearing a sun flower covering her vagina in support of the Lady Garden campaign. 

The Lady Garden campaign is a good one. It recognises that many women are too embarrassed to talk about such personal issues and many will avoid seeking access to screening services as a consequence. Current screening services are said to prevent up to 5000 deaths a year. Even so approximately 3,100 cases of cervical cancer (the commonest form of gynaecological cancer) are diagnosed in the UK each year. Nearly all of which are related to the human papilloma virus (HPV). Up to 8 out of 10 people will be infected with the virus at some point in their lives – and for most people the infection it causes will get better on its own and they will never know they had it.

Cara Delevingne's crusade is well timed. Last week the NHS announced that its cervical screening programme will switch to first testing women for signs of infection caused by HPV rather than looking for abnormal cells. This change in approach to screening should result in those women found to have a high risk HPV infection being identified and dealt with earlier. Since 2008, girls aged 12-13 have been offered a vaccination against the 2 most common 'high risk' types of HPV. The vaccination, is not currently available to men despite the risk of men developing cancer due to HPV. A truly avoidable Epicurean hedonistic pleasure /pain situation. 

Sunday, 21 August 2016

A level understanding of data can shape futures

For someone like me, whose mind resembles one of those dusty old shops selling an eclectic collection of second-hand goods, sometimes an idea for a blog comes from the most innocuous of conversations. Last week was A Level results week here in the UK. Well done if you or your child achieved what you/they wanted/needed to get that University place. If you are dealing with disappointment, my heart goes out to you. I’ve been there and it’s tough. What can also be tough is deciding what you might want as a career, and what subjects you need to study to get there. More so when you are aged 16/17.

In my time, and with all the self-confidence and wisdom of a 17 year old, I absolutely knew I wanted to be a ‘lumber jack’ when I left School. I didn’t, and I am really glad I eventually became a nurse. Last week I was talking to a colleague whose son was at that decision making point and didn’t know what he wanted to do. His son liked learning about the psychology of behaviour, he didn’t want to become a psychologist or work with people. He liked Maths but didn’t fancy working in accountancy and although he enjoyed English, he didn’t know whether studying it would help him get a job. I wasn’t much help in providing advice, mainly because my usually creative mind seemed entirely focused on very traditional career pathways, and of course that world of work is changing, and changing exponentially. 

Pondering on this conversation later I remembered that I had recently read of a conference held in Manchester last July, for digital marketing professionals. What caught my attention were the reports of how companies recognise the behaviour of digital users today and how they use that behaviour and the data it generates. From a behaviour point of view, it is estimated that by 2020 (but possibly by next year), the majority of searches on line will be undertaken by voice or image – indeed, 70% of the so called millennials use voice search regularly. So the massive surge in on-line sites providing goods and services will need to think what this means for their approach to marketing.

As a University, we will need to consider what this means for how we engage with our students. Some of the company data usage was quite amusing.  Have a look at this Carlsberg advertisement. It made me laugh out loud. Apparently it was said that many men felt it had been made with them in mind, whereas the men’s partners laughed as they recognised aspects of their men’s behaviour in the advert.

Whilst I and others might have found the advertisement  humorous, it absolutely had a bottom line motivation aimed at enhancing the Carlsberg reputation and increasing profit. Other information presented at the conference was equally interesting, although I am not sure how such information might be used. It appears that 40% of all baby product purchases are made by households with no children. Only 31% of people searching for paid on-line adult games are males aged between 21 and 35; and almost 50% of all home improvement searches and purchases are made by women.  

What’s clear though is, if research (that delivers hard facts) rather than perceptions is used creatively, it’s possible to consider a complete paradigm shift in opportunities. So in the case of my colleague’s son, perhaps there is a way to combine an interest in Psychology, a liking for Maths and English in working towards becoming a digital marketer. In any case, and new career opportunities aside, it’s the notion that it is research that delivers hard facts thats important. 

So I was upset on Friday to learn of the decision by Marie Stopes to suspend terminations undertaken using general anaesthetic and also to those under the age of 18 because of concerns raised by the Care Quality Commission (CQC). Of course I don’t know the detail of the CQC inspection of Marie Stopes services, but I have been involved, first hand, in one of their inspections. The subsequent report of the inspection was full of inaccuracies, not evidenced based, and was shaped by personal opinion. 70,000 women use Marie Stopes services every year. This decision will effect 250 women every week. It’s to be hoped that on this occasion, unlike so many others, the CQC have good data, and most importantly, really know how to use it.

Sunday, 14 August 2016

Made my monthly visit to the NMC: which is not a technological euphemism for being on my period

I went to London last Wednesday. I met with other colleagues to continue the work aimed at understanding what the graduate nurse practice in 2025 would look like and how we might set the educational standards for universities to design curricula around. It was great to have a discussion that was evidence based rather than a discussion shaped by the high expressed emotion of colleagues framing their opinions in defence of their various fields of practice (who came up with that term?). For all those interested, watch this space. We are getting closer to sending out the results of our work for wider consultation. I travelled to London by Virgin Trains, and was surprised to find that both the Eggs Florentine and the wi-fi were perfect. 

Actually I wasn't surprised about the Eggs Florentine. Experience has shown me that Virgin Train chefs consistently manage to deliver perfect poached eggs. No it was the fact that the wi-fi was working, which on past journeys I have often found to be frustratingly unreliable. It wasn't just nurse education I read up on last week. Technology featured in much of my reading, for example I was fascinated to read of the experiences of Flavio Garcia, a computer scientist from the University of Birmingham. Back in 2013 he and his team wanted to share with the world his work that showed he had a piece of technology that would allow them to remotely start the ignition of millions of VW cars. 

Due to VW taking out a lawsuit, the research wasn't published for a further 2 years. The research not only showed the vulnerability of the ignition system but also the keyless entry systems was insecure. Garcia used reverse engineering to extract a single cryptographic key (a signal sent each time a key fob button was pressed), and Hey Presto, he could open the car door and drive the car away. It appears that it’s not just VW cars that he could do this with. Some 100 million other cars are at risk from such technological attacks – Ford, Citroen, Fiat, Nissan, Audi, Alfa Romeo, Maserati, in fact most cars other than Jaguars – Phew.

Whilst the motivation of Garcia's work was driven in part by the inherent digital and technological challenges of responding to VW claims of safety and security, other technology based stories last week had more sinister implications. 'Jennifer' (not her real name) - a Mother living in Texas, US, was horrified to see a live feed of one of her young daughter's bedrooms being streamed on the internet. Hackers had used an app that allows viewers to gain live feeds from events and places from around the world, anywhere there is an on-line camera. Jennifer's house was fitted out with security cameras to 'protect' her family. It appears that one of the daughters had clicked on a malicious link while trying to play a game, allowing the hackers to gain access to her computer, phone and the security cameras. Like Emma in the film Ratter, I guess it would have been in a terrifying situation for the family to find themselves in.     

Just as chilling is that it's estimated that just this one malicious link could give hackers access to some 900 million phones. Considering what and how we use our phones in our everyday lives, the potential for direct harm is enormous. However, I was also interested to read another story about phone use that was equally concerning, but where the harm was slightly more hidden. It involved the apparent booming market in apps which offer women the opportunity to monitor their monthly period cycles. Apparently there have been some 200 million downloads of period tracking apps worldwide, and in the health and fitness category, period trackers come second only to those apps which monitor running.

Positive use of such apps have helped some women identify connections with changes in their emotions, eating habits, and other physical challenges. Some have used the apps to monitor their fertility, although the current advice is not to rely on the trackers for contraception.  And women in Mexico and Brazil have been downloading the app for fear of getting pregnant during the Zika virus outbreak. My concern was that every time someone used this app they would send all kinds of data to parties unknown, for uses that are also unknown. So be aware!

I also read about a different type of technology, which in slightly different way, was concerned with periods. It was the news that The Flex Company had, through a US$1 million loan, acquired the rights to Softcup, makers of menstrual disc products. Using a new type of technology means the discs are not linked to toxic shock syndrome, are hypoallergenic, latex free and disposable. Unlike tampons and menstrual cups, the discs can be left in during sex for those who would rather not interact too closely with blood. Interestingly 20% of customers are men.

And not surprisingly, there was no blood spilt at our village dog show yesterday. The show attracted many dogs of every breed, colour, and age. There were no fights and no trouble, and the dogs were also very well behaved. It was technology free and the weather was glorious. Cello was in fine form and picked up a 1st prize – for the dog with the happiest tail. The judge also thought Cello would have won 1st prize for the dog that most closely resembled their owner – unfortunately there was no such a category. 

Sunday, 7 August 2016

Getting Cold Feet On Holiday (and not through paddling in the sea)

Last week I was on holiday, a holiday spent at the House in Scotland. It was Regatta week and it was great to see the different boats and yachts go out with each tide ready for a few hours racing. I stayed firmly on land. The weather helped too – most day’s it was wall to wall sunshine, with just the occasional rain shower. It was half way through the week before I noticed my inner clock didn't recognise I was on holiday, and that I was habitually awake before 05.00 each day. Of course being on holiday meant I had many choices as to what to do once awake. Like this morning, I had a choice as to whether to write this blog or not as I was on holiday.

Not all choices we make are conscious ones, and most choices will be influenced by our unconscious mind. Freud (amongst others), described the unconscious mind as comprising of mental processes that are inaccessible to consciousness, but which influence our judgements, feelings and behaviour. It is the unconscious mind that is the primary source of shaping our behaviour – and our motives and decisions are powerfully influenced by our past experiences and stored in the unconscious.

This blog is not the place to indulge in a critical debate around the existence or not of Freud’s conscious and unconscious mind. It would be a good debate to have as Freud's theory remains a contested one particularly between those that practice psychoanalysis and those that practice psychology. However, to see the theory grounded in something familiar, take a look at my colleague Donna’s recent blog (see here). It is superbly written and her case is well argued. Whilst the context doesn’t resonate with my own politics, I think it is a blog that, in different ways, perhaps illuminates the complexity involved in the choices we make.

Some choices and decisions, once taken, can have far reaching consequences. We are for example, only just beginning to understand what Brexit might mean for us all. Likewise the individual decisions taken by others in less focused contexts can also have a collective impact, and yet the consequences of such choices might be completely unknown - for example, there are a record number of male nurses working in today's NHS. In a profession traditionally seen as the preserve of women, 1 in 10 nurses are now male. Some believe this trend speaks to the masculinisation of nursing (alongside the feminisation of medicine). I guess whether this is a good thing or not, remains to be seen.

Last week I read about how in today's increasingly digital world, people are taking the decision to step off the magic roundabout and learn to live once more without the internet. It was reported that 34% took the decision to take a 'month off' – a so called 'digital detox'. It is an amazingly high number of people given that 60% of us say we are permanently connected to the world through our various devices. With many of us spending 25 hours a week online, it is no wonder that nearly 40% of us feel we are increasingly being ignored by our significant others. Phones and all other digital devices are banned at meal times in this house. 

Being on holiday, also meant I could catch up on my reading, watch missed films, play music and do all the things that like our significant others, can sometimes be ignored in the busy-ness of our working lives. One of the things I chose to do was work my way through all 5 series (33 episodes) of the fabulous award winning programme Cold Feet – which for me, brilliantly captured social change, 'real people' and the consequences of choices that ‘real people’ make. There is a 6th series to be released later on this year. Although it is an amazingly funny programme, and of course not real life, rather like Donna's blog, the programme reminded me of the complexity and consequences of the choices and decisions we make. However, like the rest of my holiday, it was a very enjoyable experience, and a good choice to have made.