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Pregnancy, Group B Streptococcus and Bonkers NHS Policies

February 10, 2011 1 comment

Unfortunately the wife has it. It means that all plans for a water birth and a home birth have gone out the window. Monique, who dislikes both hospitals and needles, will have to be fed antibiotics intravenously through the labour. Bad though this all, the more we think about it the more grateful we are that it was discovered at all. We had gone to see a GP about an unrelated matter. The locum doctor, an older chap who seemed much more interested in treating patients rather than rushing them out the door, decided that Monique should have a precautionary swab taken. On reflection we think this doctor just used the other matter as a pretext to conduct a de facto screening for GBS. Which isn’t NHS policy.

In fact, the more  I read about it the more puzzled I’m becoming about the NHS policy regarding this disease. Here is what I’ve found about GBS;

Group B streptococcus is found naturally in the vagina of about 20-30% of pregnant women. It usually has no symptoms and no harmful effects to the carrier. However, a baby born to a woman with untreated GBS has a 1 in 300 chance of contracting a number of diseases through it. These included blood poisoning, pneumonia and meningitis. Of course these can be fatal or cause lasting damage to the baby. Treatment, IV antibiotics during labour, drastically reduces the risks, right down to 1 in 4,000 (or 1 in 6,000. Depends what you read).

With such a high incidence of latent GBS and such a dramatic lengthening of the odds on treatment, at first glance it seems this would be a prime candidate for screening. In fact in the US they already do this; at 36 weeks all pregnant women are screened for it. So why not here?

Apparently one argument it that the current screening process is unreliable; 50% of cases are not detected. Yes, OK NHS,  so what? 50% of cases would be detected! We’ve got the numbers; about 700,000 babies are born in the UK every year. At least 20% of these will be exposed to GBS, that’s 140,000 babies. 50% of those at risk, 70,000, could benefit from the treatment under a screening regime. 1 in 300 of 70,000 is 233. So screening could prevent 233 babies contracting life threatening illness’. If the problem is actually cost, then one wonders what the cost of care is for 233 seriously ill babies, or the lifetime cost of a person with meningitis (not just to the NHS, but to society as a whole). Then there is the human cost to consider. Now here’s the next argument for screening; the unreliable tests are being superseded by newer tests with much greater chance of detecting GBS.

So, there seems less and less reason for the NHS to not conduct screening of all pregnant women for Group B Streptococcus. Because not everyone will bump into a wile old doctor who cares more about patients than the NHS does.

Your Everyday Logistics Miracle

February 9, 2011 Leave a comment

There is a town in the centre of the United Kingdom that is, in most respects, so very normal. Most of the six thousand or so residents are neither rich nor poor, their houses neither grand nor falling down. It is, by almost any measure, completely ordinary.

But in this town is a prime example of the quiet miracle of our modern life. It is a supermarket. On it shelves sits the most amazing agglomeration of the World’s produce. Infusions from the sub-continent, fruits from South America and Africa, meats from the other side of the World. And all this is  freshly available seven days a week, 363 days a year, whatever the season, whatever the weather.

So perfected is this miracle, and so gradually has it been introduced, that the population of the town never, ever stop to consider the wonder that has appeared in their midst. Other peoples, in other points in history, would surely be staggered by this achievement. Such a vendor would be the pride of ancient Rome, the great Phoenician traders would be humbled by it’s choice and variety. They would then be dumb-founded to discover that stores like these could be found everywhere in the modern World.

To fully comprehend the amazing achievement of our modern transport system try this mental experiment; Imagine that this ability to move product around the globe happened suddenly. One moment we are relying on what can be made or grown just a few miles from home, then the next day we have everything the World has to offer, available cheaply and delivered right to our door. It would be a front page headline everywhere. It would be like man landing on the moon, or finding a cure for cancer.

If human society is a body then transport is it’s life blood. We already call our main transport routes arteries to reflect this. Indeed whenever a society faces acute need, like during a war or natural disaster, it has an urgent need for good transport, a rapid infusion of which can literally mean life or death. And like our blood, transport hides in plain sight. Ask most people to identify the organs of modern society they will talk about industry, government, science and public services, just as they would talk about the heart and lungs of the body. But all of this can only function with the life blood of transport. It’s always there, hardly noticed, ebbing and flowing through societies arteries, veins and capillaries. Whilst we are awake and during our sleep it brings both our essentials and our luxuries, then whisks the waste away after our consumption. We only notice it when it fails or appears in the wrong place. The vast majority of the time it does it’s job with such quiet equanimity that we don’t notice this miracle. This miracle that meets our needs and desires from all over the World.

And like all parts of society it is made of people. So this article is in praise of all those countless souls who make up our transport industry. It’s to say thank you to all those managers, planners and innovators, constantly working to hone the system. It’s to the warehouse workers and fork-lift drivers beavering through night and day. It’s to the pilots and captains of planes and ships, guiding the colossi of the transport World. And it’s to the drivers of the vans and trucks, the bedrock without whom there would be none of this wonderful, miraculous, everyday logistics miracle.

I just love it!

February 6, 2011 Leave a comment

New media that is. Or social media, the information super highway or whatever you want to call it. Fibre-optics by another name would transmit as much. Young people of today just won’t understand the miracle of it all. Being an information junky back in the 1980’s was hell. You had to rely on whatever some pompous writer or TV company deemed acceptable to tell you. There were no forums, there were no blogs, no wikis. Like some undiscovered bedouin tribe we lived in the desert without knowing anything different. For goodness sake, we had just three TV stations in the UK! Then the waters came. Not from the few stingy media gods, but channelled to us by people like us. Now we live with an abundance of information, a land flowing with megabytes and terabytes. If nothing else the plethora of information let’s us see the World in all it’s confusing glory. No longer do we have an excuse to simplify the World’s problems down to the level of our own prejudices.

And not only can all this information flood in, it can flood out as well. Whatever creativity we may have had needed to pass the scrutiny of editors and other naysayers. Before our work could even be available to receive public scrutiny it had to run the gauntlet of these people’s preoccupations, prejudices, corruptions or hang-ups. Nowadays we can post it, Tweet it, Press it or Blog it. However we choose to vent our creativity, ‘it’ can be out there instantly and with no interference, where it will live or die solely on it’s own merits.

So here is to Facebook, WordPress, Twitter, Blogger et al! Here is to Flickr, here is to Youtube. Here is for being allowed to judge for myself between trash and genius, and which information is right and which is wrong.

And here is to being able to publish, just by going… click.

Now it’s getting real!

February 3, 2011 2 comments

Whoaa! Life over the last few years has seldom been dull, but now things seem to be stepping up a gear. Shortly after trying to be Jeremy Clarkson I got the results of my CPC national freight exams and, I’m pleased to say, I passed. This allows me to be a transport manager (one that is actually required by law) for companies or individuals that have trucks. Not wanted to hang around, I got straight on the case and put up a website to offer myself in this capacity to the World. I can now report that SEO (search engine optimisation) is an extensive, complex and time consuming discipline.

Then there was the interview and driving assessment for Morrisons supermarket, which I’m also pleased to say I passed. So all I have to do now is to pass a medical and I’m in.

But of course all this is the side-show to the main event; the arrival of little Yasmin. Unless both scans were wrong, in which case it’s the arrival of little Patrick, and I have some re-painting to do. The midwife is still giving the thumbs up for a home birth, and Monique is doing so well. So now the room is painted, the Swedish furniture is assembled, the birthing pool is ready to go and the baby is due anytime in the next few weeks. Yeah, this is getting SO real!

Citizenship, Part 1

January 14, 2011 1 comment

When a baby comes into the World it is a citizen of nowhere. Until somebody submits the details of it’s birth to a national civil register that child is a stateless person. When that submission happens, what is written on that single sheet of paper will have the greatest consequences of any event in it’s life. From the point of view of that child that process is incontestable, arbitrary and, by even the loosest definition of the word, completely unfair.

Which of the World’s 193 sovereign states we are born into greatly affects our life expectancy and our access to health care and education. It could mean we are born into an environment where we have complete freedom of worship and expression, or one where we are subject to forced indoctrination and subjugation. It greatly influences our ability to receive and create wealth. Above all, it restricts our ability to remove ourselves from places where we face negative outcomes. The greener the grass is over there, the higher the fences will be preventing us from getting there. The biggest roll of the dice we face happens when we have the least possible chance of influencing the outcome, and, without reference to our free will, could place us in a mud hut in West Africa, or in Beverley Hills.

How arbitrary and unfair this is can be illustrated with a couple of examples. If an ethnic Russian is born in the town of Narva, that person is free to travel throughout western Europe. In many countries, Britain included, that person could find work in whatsoever industry he fancied, in whatsoever capacity they are willing to employ him in. He wouldn’t have to have a language test, pay for expensive visas or deal with any bureaucratic machinations. An identically ethnic Russian born two miles away in Ivangorod would have to contend with all of these things. Even if that Russian were a Phd level scientist the UK immigration quotas may prevent him from taking a top level research job, whilst the Narva Russian can freely come without even the need to show a high school diploma. Why is this? You’ve probably guessed; Narva is in Estonia and being born there usually means being born into EU citizenship. Ivangorod is short walk across the Narva river, and in the Russian Federation.

Or, an example a bit closer to home for me, take someone born in Brazil to a French father. Her grandfather and grandmother on her dad´s side were both thoroughly French, so her dad should be French and, under French citizenship laws, she could have been registered as a French citizen. However before she was born, her grandfather failed to register her father. So in the eyes of an EU country’s immigration officials she is  ‘Brazilian’ and has to contend with the full extent of the restrictions placed on immigration. If her grandfather hadn’t made that omission, before she was born and way outside of her control, then, with no change in who she is, the immigration system would happily see her as ‘French’ and she could come and go with absolutely no restriction whatsoever.

What do you hate about other people’s driving?

January 12, 2011 4 comments

Here’s one of mine. Picture this; I’m on a two lane motorway  (freeway for Americans) like the M11 and I’m in a 40ft semi truck driving at the speed that my speed limiter is set at, so 56 mph. I’m gaining on three or four cars, led inevitably by a Nissan Micra, that are bumbling along at about 53mph. I reach the rear of this little queue, check my mirrors, it’s clear, I pull into the outside lane to overtake. At first I’m doing OK, a few speeders have caught up and are stuck behind me, but I’ll soon be past the Micra and out of their way. Then…

I’ll contend that if you are driving up the M11 at 53 mph in your Nissan Micra your mind is probably not on driving so much. You’re deep in conversation with your passenger about your grand-kids, or are enthralled by Gardeners Question Time on Radio 4. You are almost certainly not ‘looking in the mirrors’ in the accepted sense, but your outer periphery detects a change, maybe a simple change from the bright Essex sky to a big dark shape. This fails to imprint a concious thought on the brain (e.g. a truck is overtaking), but does manage to reach deep into the sub-concious and find a little used fight or flight reflex. “Could be danger” the reflex whispers “put distance between you and it”. So, without  thought, interruption in conversation or disruption in gardening information, the right foot moves down just a few millimetres.  The black shape fails to get bigger, the flight reflex is sated and sub-concious goes back to sleep again.

Back to me in the truck.  The Micra is now doing 56.2 mph. My overtaking has had the same sub-concious effect on the other bumblers, and they’ve bunched up behind it leaving me stranded out in lane two with now a long queue of Audi’s and the like behind, all no doubt cursing ‘the truck driver’ for holding them up. I can’t accelerate because of the limiter, slowing up risks dangerously bunching up the traffic behind even more. After waiting a bit to see if the Micra driver wakes up (some hope) I put my left indicator on and wait for one of the other bumblers to realise that 44 tons of metal wants to be the space he is and lets me in. The Audi queue flashes past shaking their fists at me and everything is flowing again.

Then the Micra slows back to 53 mph…

Categories: Driving Tags: , , , ,

Being Cory Doctorow

January 9, 2011 2 comments

A name I’d never heard of until I discovered I Write Like, a website where you paste in some of your text and it tells you which famous writer you write like. Apparently.

I must say that I have no idea how they work this out, and for me the results weren’t exactly consistent.  According to which piece of writing I put in, I could also be Dan Brown or Vladimir Nabokov (I don’t even speak Russian). But more than a couple of times it claimed I was Cory Doctorow.

And to see what he writes like, what better to read but his interesting take on the internet slush pile (here is mine), as published here at the Guardian.