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Saturday, 7 January 2017

How to keep your resolutions (clue: it's not all about willpower)

Oliver Burkeman in The Guardian




The only way is up.  



It’s hard to think of a situation in which it wouldn’t be extremely useful to have more willpower. For a start, your New Year’s resolutions would no longer be laughably short-lived. You could stop yourself spending all day on social media, spiralling into despair at the state of the world, yet also summon the self-discipline to do something about it by volunteering or donating to charity. And with more “political will”, which is really just willpower writ large, we could forestall the worst consequences of climate change, or stop quasi-fascist confidence tricksters from getting elected president. In short, if psychologists could figure out how to reliably build and sustain willpower, we’d be laughing.

Unfortunately, though, 2016 was the year in which psychologists had to admit they’d figured out no such thing, and that much of what they thought they knew about willpower was probably wrong. Changing your habits is certainly doable, but “more willpower” may not be the answer after all.

The received wisdom, for nearly two decades, was that willpower is like a muscle. That means you can strengthen it through regular use, but also that you can tire it out, so that expending willpower in one way (for example, by forcing yourself to work when you’d rather be checking Facebook) means there’ll be less left over for other purposes (such as resisting the lure of a third pint after work). In a landmark 1998 study, the social psychologist Roy Bauermeister and his colleagues baked a batch of chocolate cookies and served them alongside a bowl of radishes. They brought two groups of subjects into the lab, instructing each to eat only cookies or only radishes; their reasoning was that it would take self-discipline for the radish-eaters to resist the cookies. In the second stage of the experiment, participants were given puzzles to solve, not realising that they were actually unsolvable. The cookie-eaters plugged away at the puzzles for an average of 19 minutes each, while the radish-eaters gave up after eight, their willpower presumably already eroded by resisting the cookies.

Thus was born the theory of “ego depletion”, which holds that willpower is a limited resource. Pick your New Year resolutions sparingly, otherwise they’ll undermine each other. Your plan to meditate for 20 minutes each morning may actively obstruct your plan to learn Spanish, and vice versa, so you end up achieving neither.

Except willpower probably isn’t like a muscle after all: in recent years, attempts to reproduce the original results have failed, part of a wider credibility crisis in psychology. Meanwhile, a new consensus has begun to gain ground: that willpower isn’t a limited resource, but believing that it is makes you less likely to follow through on your plans.

Some scholars argue that willpower is better understood as being like an emotion: a feeling that comes and goes, rather unpredictably, and that you shouldn’t expect to be able to force, just as you can’t force yourself to feel happy.
And, like happiness, its chronic absence may be a warning that you’re on the wrong track. If a relationship reliably made you miserable, you might conclude that it wasn’t the relationship for you. Likewise, if you repeatedly fail to summon the willpower for a certain behaviour, it may be time to accept the fact: perhaps getting better at cooking, or learning to enjoy yoga, just isn’t on the cards for you, and you’d be better advised to focus on changes that truly inspire you. “If you decide you’re going to fight cravings, fight thoughts, fight emotions, you put all your energy and attention into trying to change the inner experiences,” the willpower researcher Kelly McGonigal has argued. And people who do that “tend to become more stuck, and more overwhelmed.” Instead, ask what changes you’d genuinely enjoy having made a year from now, as opposed to those you feel you ought to make.

Lurking behind all this, though, is a more unsettling question: does willpower even exist? McGonigal defines people with willpower as those who demonstrate “the ability to do what matters most, even when it’s difficult, or when some part of [them] doesn’t want to”. Willpower, then, is a word ascribed to people who manage to do what they said they were going to do: it’s a judgment about their behaviour. But it doesn’t follow that willpower is a thing in itself, a substance or resource you either possess or you don’t, like money or muscle strength. Rather than “How can I build my willpower?”, it may be better to ask: “How can I make it more likely that I’ll do what I plan to do?”

One tactic is to manipulate your environment in such a way that willpower becomes less important. If you don’t keep your credit card in your wallet or handbag, it’ll be difficult to use it for unwise impulse purchases; if money is automatically transferred from your current account to a savings account the day you’re paid, your goal of saving won’t rely exclusively on strength of character. Then there’s a technique known as “strategic pre-commitment”: tell a friend about your plan, and the risk of mild public shame may help keep you on track. (Better yet, give them a cheque made out to an organisation you hate, and make them promise to donate it if you fail.) Use whatever tricks happen to fit your personality: the comedian Jerry Seinfeld famously marked an X on a wallchart for every day he managed to write, and soon became unwilling to break the chain of Xs. And exploit the power of “if-then plans”, which are backed by numerous research studies: think through the day ahead, envisaging the specific scenarios in which you might find yourself, and the specific ways you intend to respond when you do. (For example, you might decide that as soon as you feel sleepy after 10pm, you’ll go directly to bed; or that you’ll always put on your running shoes the moment you get home from work.)

The most important boost to your habit-changing plans, though, may lie not in any individual strategy, but in letting go of the idea of “willpower” altogether. If the word doesn’t really refer to an identifiable thing, there’s no need to devote energy to fretting over your lack of it. Behaviour change becomes a far more straightforward matter of assembling a toolbox of tricks that, in combination, should steer you well. Best of all, you’ll no longer be engaged in a battle with your own psyche: you can stop trying to “find the willpower” to live a healthier/kinder/less stressful/more high-achieving life – and just focus on living it instead.

I'm a junior doctor in the NHS, and I'm terrified for this winter

Aislinn Macklin-Doherty in The Guardian


Widespread concerns that the NHS will face the “toughest winter ever” are not exaggerated or unfounded – just look at the terrible news today from Worcestershire. We really should be worried for ourselves and our relatives. As a junior doctor and a researcher looking after cancer patients in the NHS, I am terrified by the prospect of what the next few months will bring. But we must not forget this is entirely preventable.




Three patients die at Worcestershire hospital amid NHS winter crisis


Our current crisis is down to the almost clockwork-like series of reshuffling, rebranding and top-down disorganisation of the services by government. It’s led to an inexorable decline in the quality of care.


I have also become aware of an insidious “takeover” by the private sector. It is both literal – in the provision of services – and ideological, with an overwhelming prevalence of business-speak being absorbed into our collective psyche. But the British public (and even many staff) remain largely unaware that this is happening.

Where the consultant physician or surgeon was once general, they now increasingly play second fiddle to chief executives and clinical business unit managers. Junior doctors such as myself (many of whom have spent 10-15 years practising medicine and have completed PhDs) must also fall in line to comply with business models and corporate strategy put forward by those with no clinical training or experience with patients.

It is this type of decision-making (based on little evidence) and seemingly unaccountable policymaking that means patient care is suffering. Blame cannot be laid at the feet of a population of demanding and ageing patients, nor the “health tourists” who are too often scapegoated.

The epitome of such changes is known as the “sustainability and transformation plans”. These will bring about some of the biggest shifts in how NHS frontline service are funded and run in recent history, and yet, worryingly, most of my own colleagues have not even heard of them. Even fewer feel able to influence them.

Sustainability and transformation plans will see almost a third of regions having an A&E closed or downgraded, and nearly half will see numbers of inpatient bed reductions. This is all part of the overarching five-year plan to drive through £22bn in efficiency savings in the NHS. But with overwhelming cuts in social services and community care and with GPs under immense pressure, people are forced to go to A&E because they quite simply do not have any other options.

I have been on the phone with patients with cancer who need to come into hospital with life-threatening conditions such as sepsis, and I have been forced to tell them, “We have no beds here you need to go to another local A&E.” Responses such as, “Please doctor don’t make me go there – last time there were people backed up down the corridors,” break my heart.

According to the Kings Fund, our NHS leaders are choosing to spend less year-on-year on healthcare (as a proportion of GDP) than at any other time in NHS history and yet we are the fifth richest economy in the world. Simultaneously private sector involvement increases and astronomical interest rates from private finance initiatives must be paid, with hospitals such as St Bartholomew’s in London having to pay up to £2m per week in interest alone. No wonder nearly all hospitals are now in dire straits.

This is all the result of intentional policies being made at the top with minimal consultation of those on the frontline. With such policies accumulating over the years we are now seeing the crisis come to a climax. The UK has fewer beds per person and fewer doctors per person than most countries in Europe. Fewer ambulances are now able to reach the highest-category emergencies, which means people having asthma attacks, heart attacks and traffic accidents are being left to wait longer in situations where minutes really matter.

The sustainability and transformation plans for my local area in south-west London show that they plan to cut 44% of inpatient bed stays over the next four years . This is dangerous. It is likely that St Helier hospital in Sutton, which takes many emergencies in the area, will close and patients will then not only have access to critically reduced services, they will then have to travel longer to hospital, having waited longer for the ambulance to get to them.

This will be the straw that broke the camel’s back. I cannot stand by while patients’ lives are put at unnecessary risk this winter. And neither should you.

Thursday, 5 January 2017

Japanese company replaces office workers with artificial intelligence

Justin McCurry in The Guardian

A future in which human workers are replaced by machines is about to become a reality at an insurance firm in Japan, where more than 30 employees are being laid off and replaced with an artificial intelligence system that can calculate payouts to policyholders.

Fukoku Mutual Life Insurance believes it will increase productivity by 30% and see a return on its investment in less than two years. The firm said it would save about 140m yen (£1m) a year after the 200m yen (£1.4m) AI system is installed this month. Maintaining it will cost about 15m yen (£100k) a year.

The move is unlikely to be welcomed, however, by 34 employees who will be made redundant by the end of March.

The system is based on IBM’s Watson Explorer, which, according to the tech firm, possesses “cognitive technology that can think like a human”, enabling it to “analyse and interpret all of your data, including unstructured text, images, audio and video”.

The technology will be able to read tens of thousands of medical certificates and factor in the length of hospital stays, medical histories and any surgical procedures before calculating payouts, according to the Mainichi Shimbun.

While the use of AI will drastically reduce the time needed to calculate Fukoku Mutual’s payouts – which reportedly totalled 132,000 during the current financial year – the sums will not be paid until they have been approved by a member of staff, the newspaper said.

Japan’s shrinking, ageing population, coupled with its prowess in robot technology, makes it a prime testing ground for AI.

According to a 2015 report by the Nomura Research Institute, nearly half of all jobs in Japan could be performed by robots by 2035.

Dai-Ichi Life Insurance has already introduced a Watson-based system to assess payments - although it has not cut staff numbers - and Japan Post Insurance is interested in introducing a similar setup, the Mainichi said.

AI could soon be playing a role in the country’s politics. Next month, the economy, trade and industry ministry will introduce AI on a trial basis to help civil servants draft answers for ministers during cabinet meetings and parliamentary sessions.

The ministry hopes AI will help reduce the punishingly long hours bureaucrats spend preparing written answers for ministers.

If the experiment is a success, it could be adopted by other government agencies, according the Jiji news agency.

If, for example a question is asked about energy-saving policies, the AI system will provide civil servants with the relevant data and a list of pertinent debating points based on past answers to similar questions.

The march of Japan’s AI robots hasn’t been entirely glitch-free, however. At the end of last year a team of researchers abandoned an attempt to develop a robot intelligent enough to pass the entrance exam for the prestigious Tokyo University.

“AI is not good at answering the type of questions that require an ability to grasp meanings across a broad spectrum,” Noriko Arai, a professor at the National Institute of Informatics, told Kyodo news agency.