Working long and hard? It may do more harm than good

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Argyro Avgoustaki, ESCP Europe and Hans TW Frankort, City, University of London

Nearly half of people in the EU work in their free time to meet work demands, and a third often or always work at high speed, according to recent estimates. If you are one of them, have you ever wondered whether all the effort is really worth it?

Employees who invest more effort in their work report higher levels of stress and fatigue, along with lower job satisfaction. But they also report receiving less recognition and fewer growth opportunities. And they experience less job security. So increased work effort not only predicts reduced well-being, it even predicts inferior career-related outcomes.

These are some of the results of our recent study forthcoming in the Industrial and Labor Relations Review. We examined data on almost 52,000 employees representing the European workforce in 2010 and 2015, with the objective of comparing the well-being and career-related implications of their work effort. The data set is not perfect (the ideal data may not exist), but it facilitated a systematic approach to a question far too urgent to postpone.

The finding that excessive work effort predicts unfavourable well-being and career-related outcomes held true after accounting for a wide range of differences across employees, including their gender, age, occupation, education, and level of authority. It even held true in employees with discretion over when and how to perform their work. In other words, excessive work effort broadly predicts unfavourable outcomes.

Why does more effort not pay?

If you were aware that overtime is more common among higher-income occupations, then our results might surprise you. However, just because overtime is more common among high-income occupations, does not automatically mean that there are career benefits to expending more effort than your peers. And because your boss will compare you to your peers, we honed in on exactly this, comparing people within rather than between occupations.

So why does more effort not pay? Overtime reduces day-to-day recovery, while work intensity (the amount of effort you put in during the time you spend at work) reduces opportunities for recovery during the working day. This lack of recovery accumulates and ultimately decreases your ability to perform at adequate levels and deliver quality work.

Working long and hard takes its toll on your physical and mental health.

Examples abound linking excessive effort with bad outcomes. Investment bankers and similar professionals, notorious for working long hours under intense pressure, are often believed to suffer disproportionally from symptoms of stress and depression.

Of course, these might be extremes. The point is that sustained excessive effort rapidly reduces employee well-being. By implication, it also reduces the ability to function adequately.

Work intensity is worse

We found that overtime and work intensity do not relate to poor outcomes in equal measure. Increased work intensity is a much stronger predictor both of reduced well-being and of inferior career-related outcomes. Work intensity typically comes from a persistent exposure to tight deadlines, which is often accompanied by constant work at high speed.

To us, this finding stands out. Employers and policymakers are commonly aware of the limits of overtime and long hours. For example, the Boston Consulting Group, a top consultancy firm, experimented with ensuring staff had planned, uninterrupted time off. In the US, the Accreditation Council for Graduate Medical Education mandated a reduction in resident work hours. And France offered its citizens a legal right to disconnect from work.

In sharp contrast, concerns over work intensity seldom seem to make the news. We believe that they should.

Costs vs benefits

People can benefit from greater awareness of the potential harm from excessive work effort, and particularly work intensity. On average, it is just not clear that the benefits offset the well-being costs of excessive effort. Even in environments where hard work is the norm and people constantly brag about it – Wall Street comes to mind – our research suggests that pushing yourself to work harder than the norm is not wise.

Our results also show that employers can offer discretion over how and when work should be done. This wouldn’t fully resolve the harm done by excessive effort. But it can sometimes attenuate such effects, which might be particularly beneficial in jobs with unpredictable tasks or schedules, in which overtime is more common.

Plus, employers and governments also can benefit from greater awareness, which is important in order to stimulate productive and sustainable effort in the workforce. Beyond the existing initiatives to limit the duration of work, we emphasise that strategies to reduce the harms of intensive work merit greater consideration.

In 2017, Uber reportedly changed its internal mantra from “work smarter, harder, and longer” to “work smarter” and “harder”. Could such a mantra perhaps productively evolve into something as crisp as just “work smarter”?The Conversation

Argyro Avgoustaki, Assistant Professor of Management, ESCP Europe and Hans TW Frankort, Senior Lecturer in Strategy, City, University of London

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Taking the knife to crap carveries

A decent carvery can be wonderful

John Fraser

It is dry. It is brown. It is nasty. And you find it at mass-catering events almost everywhere.

I am not talking about dog poo, although my current complaint is about something which almost as unappetising.

I am talking about carvery cremations.

Recently, I have noshed at a few large-scale events, the most recent being a disorganised energy conference at the Cape Town International Convention Centre.

Lunch break on Day 1 came after a horribly-tiresome morning and an insultingly late start. After sprinting from the hall, we were told the grub could not be served until some unknown God of the buffet table had given the all-clear.

This is an immensely irritating trend which one sees at several conferences.

Presumably, it is the view of the organisers that if there is a choice between almost-digestible food and horrid, tedious, morale-sapping speeches, the delegates will vote with their stomachs and head early for the nosh. So no food is allowed until there is confirmation that the food for thought is halted.

Q: Please Sir? I want my lunch.

A: Fxxx off

So what of the carvery itself? Well, after a frustrating wait, we were given permission to eat. There were rolls. There were relishes. And then there was the meat. Dry, chewy, way, way, way, way overcooked. Such a waste. Horrid.

In contrast, the curry was good. So they can cook. If they try.

I have been to great carveries. To magnificent ones. Not recently though. If done well, a roast of beef or lamb will retain some pink shading, some moisture, some taste. Will belong on a plate, not in an urn.

It could be the incompetence or inattention of the chefs at so many SA events; it cannot be that people actually want to eat this shit.

So a plea, please? Learn the cooking times for meat. If you are working in a professional kitchen and can’t cook a joint of beef or lamb or pork properly, then you should go back to catering school. Or be thrust into an oven and yourself be charred to a blistered, inedible mess.

Of course, the catering industry does not just get away with murder; sometimes it gets away with genocide.

Many great cuisines of the world involve delicious stuff on sticks – the succulent satays of Malaysia and its neighbours, the oregano-flavoured kebabs of the Mediterranean, the assortment of braai delights on sticks which you will find at all good butcher’s shops in SA.

But I recently endured the horrid, tasteless, gristle-infused, burnt offerings at the AVI analysts’ presentation at the JSE. I honestly think that the sticks on which the once-meat had been brutalised would have been nicer and more digestible than the meat, if it deserves that description.

And this occurred at a (booze-free) buffet hosted by one of SA’s largest food industry companies. How could they let this happen? Yet they did.

Why was the chef not summoned to be hung, drawn and quartered in front of the much-abused guests?

In my case, I spat out the crap on the kebab, phoned for a huff and left in it.

Sadly, this sort of gastronomic horror happens time after time after time after time. I remember a Tiger Brands’ presentation at the same venue where they were showcasing some of their sliced breads.

Had I done the catering, I would have ensured that the fillings of the sandwiches were 1) tasty and 2) identifiable. The best thing on sliced bread, so to speak.

They were neither tasty nor identifiable. A marketing mishmash of shameful proportions. The worst thing Tiger did before dozens of its customers were poisoned in the recent listeriosis scare.

So one bit of advice to hosts everywhere. Instead of delegating the supervision of the catering to the least-experienced, sensory-deprived intern, the one who does not know nuffin, instead take some pride, some care. Put a proper chef or experienced organiser in charge.

And if you dare to risk staging a carvery, ensure they cook the stuff properly, and not for too long. In a nation of meat lovers, we should expect nothing less.

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CT hopes to ease water restrictions. At last.


During a meeting with the National Department of Water and Sanitation on Friday, 24 August 2018, the City of Cape Town proposed that there should be a gradual relaxation of restrictions

The City has advocated for a conservative relaxation of the restriction levels, which would pave the way for the associated relaxation of the restriction tariffs

Dam levels have again improved over the past week, rising by 1,9% to 62% of storage capacity

The average water consumption for the past week was 513 million litres per day, down from the previous week’s 527 million litres per day

As dam levels have now exceeded 60% the City, on a risk-based analysis, has proposed to the National Department of Water and Sanitation (DWS) that the water restriction levels should be conservatively and marginally relaxed.

This proposal was made during a meeting with the DWS and other users within the Western Cape Water Supply System on Friday 24 August 2018 to review the current status of water in the dam system.

The City’s proposal is that the urban restriction be relaxed from 45% to 40% and the agricultural restriction be relaxed from 60% to 50%.

These restriction levels were imposed by the DWS as part of the response to the severe drought in order to preserve the water in the dams supplying Cape Town, the Western Cape and the agricultural sector.

This means, for instance, that Cape Town is required to reduce usage by 45% of what it would normally be allocated. This is also how the City’s target of reaching 450 million litres of water per day, or 50 litres per person per day, was calculated.

The City has been advocating a risk-based and conservative adjustment of restriction levels for some time now.

This proposal was supported by the other municipalities in the system. Agriculture representatives motivated for a greater relaxation for agriculture.

The DWS undertook to give a response by Friday 31 August 2018.

As the water supply situation has improved adequately, it is essential that an appropriate relaxation of restrictions takes place as soon as possible, not only so that economic activity can be improved, but also so that water tariffs can be relaxed from the current high levels to give the necessary tariff relief to households and businesses.

The City thanks its water users for continuing to use as little water as possible in an effort to preserve the water in our dams. This effort is helping to build a buffer against the summer months ahead. As always, we are grateful to our water users for all of the effort and sacrifices that have been made to get us all through this extreme phenomenon.

The City continues all programmes and initiatives to ensure that water usage remains as low as possible.

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Michael Jordaan on wine innovation


Michael Jordaan is one of the most impressive people in the SA wine scene, so it seemed apt to feature the speech he recently made to the Nederburg Auction:

It will come as no surprise to anyone here that South Africa’s wine-producing regions are, without exception, presented as beautiful, lush, fertile and prosperous. Wine and the landscapes that produce them have a timeless aura about them that only the most hardened cynic can resist.

But scratch a little below the surface, and you’ll find a grim reality.

Only 14% of South African wine producers are sustainably profitable. Half struggle by with very low or no profit, at the mercy of every shock in the weather, the vines or the market. Almost four in ten wine producers run at an outright loss.

Against prices that have been declining in real terms, wine production costs have soared relentlessly, and there appears to be no end in sight.

The area of land under wine grape vineyards in South Africa has declined by 7% over the last ten years, and that decline has accelerated since 2015.

South Africa has lost almost a quarter of its primary grape producers, and the number of cellars has also been trending downwards.

Because of the severe drought in the Western Cape, there was a sharp decline in South Africa’s production for 2018. According to VinPro, production was down 15% year-on-year.

And globally, wine production is also at its lowest ebb this century.

So far, the state of the wine industry, both in South Africa and overseas, looks pretty dismal.

On the upside, however, worldwide wine consumption has remained stable, and South African consumption has been on a steep rise.

We drank 21.6% more wine last year than we did five years ago. Don’t tell (Health Minister) Aaron Motsoaledi, but sin taxes don’t work. In fact, they just encourage us.

While drought has slashed production, it has also increased grape quality, which makes for less, but better, wine.

According to Nicolò Pudel of Port2Port, almost all the future growth in the South African wine industry will come from the premium segment. That is, wines that retail above R65 a bottle.

Although about 60% of South Africa’s exports still consist of bulk wine, the quality of the country’s wines has risen steadily since 1994. The premium wine segment is ripe for exploitation by local winemakers.

Wine is a complicated thing. And to be fair, I’m just an ordinary wine enthusiast so this is a very daunting audience for me. You are far better qualified in all aspects of wine from production to taste to marketing.

When I sniff a glass of wine, I’m likely to say, “Mmm, do I detect a hint of grapes?”

Show me a wine stopper, and I think, “Why would you want to stop the wine?”

But not only are you better qualified than I am, you also all have strong and widely varying views on wine and what should be happening in the SA wine industry.

To give you just a few examples of the advice offered to me by a few wine fundis who’ve crossed my path in the last few days:

Jan-Boland Coetzee from Vriesenhof told me that optimal wine production is all about understanding the light intensity on every block of the vineyard. The idea is to plant the right varietals according to sunshine and then treating blocks, and even vines, in each vineyard individually.

Amanda Barnes, a leading wine journalist, told me that South African reds are still harvested too early and we should not worry about higher alcohol levels, but rather get the slight green taste to go away.

Johan Olivier from Beau Constantia says the problem with our wines is the same problem that most people have: namely that they are trying to hard to be someone else. We should stop trying to be like, say, the French wines and produce our own style of wine.

My wife Rosemary – from Bartinney – tells me many things all the time: mostly to do more stuff at home. But she too has strong views on everything from women in wine to making gin out of wine grapes infused with seasonal fynbos.

Nicolò Pudel makes the point that the future is all about data and that wine producers have very little data about who exactly bought their wine, what did they pay, how it is stored, when and where it was drunk, whether it was paired with food , and which food, and how consumers felt about the wine.

I respect all these opinions, as well as those that I am likely to hear later today. I think this diversity of viewpoints is exactly what makes us strong, together. And I know better than to take you on.

So instead of talking about wine directly, I’m going to talk about innovation. Innovation is all about challenging the status quo, sometimes disruptively so, in order to achieve not only high revenue growth, but, more importantly, profit growth. This is an area that I know a bit better than wine on its own.

There are complex ways in which innovation interacts with tradition, and that is especially true in a grand old industry like viniculture.

Innovation is easy to do, in principle. Just change something. Anything. Come up with ideas, even if they look ridiculous at first.

The computer pioneer Howard Aiken used to say, “Don’t worry about people stealing your ideas. If your ideas are any good, you’ll have to ram them down people’s throats.”

Some people would say if you understand it, it isn’t innovation. It’s very fashionable to say if you’re not failing, and failing often, you’re not innovating.

Innovation has become a necessity for good business, but it has also become a bit of a cult, even spawning gurus that claim to be able to teach you how to innovate, just like maharishis will teach you how to meditate.

But there is plenty of innovation that isn’t worth a damn, because the innovator did not understand what they were doing, or why they were doing it. My background is in banking. In my business, innovation that goes wrong can literally break the bank.

The same is true for the wine industry. Innovation for the sake of innovation can be a bigger risk to the business than not innovating at all.

Digital disruption is happening in many industries.

The world’s largest taxi company owns no taxis.

The world’s largest accommodation provider owns no real estate.

The world’s largest phone companies own no telecommunications networks.

The world’s most valuable retailer owns no inventory.

The world’s largest media company creates no media.

The world’s largest movie house owns no cinemas.

The world’s largest software vendors don’t write the apps.

According to Tim Atkins, the master wine critic from the UK, a similar thing is already happening in South African winemaking. In the current depressed economic circumstances, barriers to entry for new winemakers are very low, and some of South Africa’s best winemaking talents, such as Duncan Savage, Donovan Rall, David & Nadia Sadie, Ginny Povall, Hannes and Ernst Storm, Pieter Walser and Stompie Meyer, don’t own any vineyards at all.

So, let’s consider some innovations that do and don’t make sense in this environment. As a wine consumer, I see an awful lot of fads pop up. Most disappear overnight. A lot of effort goes into marketing to a younger, poorer sort of customer. Most of these ideas are gimmicks, at best, and some are quite off-putting to the more sophisticated and more traditional wine consumer.

In 2013, William Fèvre released a Limited Edition Hipster Chablis, which lit up under ultra-violet light. Aimed at the clubbing market, it came complete with a QR code that would launch a 360° animation, and a level indicator to monitor how much of the wine had been drunk.

This is straight out of the book of trying too hard. Most millennials look upon hipsters with disdain, and would only use the term ironically to describe themselves. When you’re clubbing, you don’t exactly need 360° animations of anything. And who needs a level indicator to tell them how much wine is left in a bottle?

The McCann advertising agency in Lithuania thought it might be a cool idea to package wine in a paint tin. On the back, it had a colour swatch showing how stained your teeth would get, depending on how many glasses of wine you drink.

Because that’s why people drink red wine. To stain their teeth.

According to Forbes, it has become a bit of a thing, in highly fashionable circles on both sides of the Atlantic, to pair wines with insects such as mealworms and fried scorpions. Apparently, hosting a bug and wine pairing is perfect for team building, sustainability programmes, classrooms, wellness centres, foodies and promotions.

Except, of course, it isn’t perfect for these events at all. You try to feed your staff insects. I can assure you, you’ll quickly become a very unattractive employer, which will be a problem, because most of your staff won’t come back to work.

Then there’s this wine. The label comes off, and serves as a paper cup. Let’s be generous and assume that (using) a paper cup is better than swigging straight from the bottle, as debatable as that might be.

Would you really want a tiny paper cup that you cannot even put down? This idea won a design competition. I’ll bet none of the judges were wine drinkers.

Here’s another one from the “I didn’t know I needed that. Wait, I really don’t,” department.

And before you say USB sticks are great for putting promotional material on, they aren’t. People who get USB sticks delete the marketing junk as soon as they get them. And then they’re going to want to use the USB stick. Ever tried to squeeze an entire cork into the space available for USB sticks on your computer?

From the crazy-rich neighbourhoods of Los Angeles comes the idea of yoga-and-wine retreats. The New York Times even ran an article about it. Write this up as an appeal to people who take neither yoga nor wine seriously. A few of the yogis the New York Times spoke to said, “well, whatever floats your boat”. But most were appalled that people would do yoga drunk, because alcohol totally messes with the vibrations of your astral being.

Shock labels were pioneered 20 years ago by French winemaker Thierry Boudinaud and British wine importer Guy Anderson. The concept was a roaring marketing success, and has been widely copied. Traditional labels almost seem a rarity, these days.

Even in the early days, however, they caused controversy. Advertising leaflets for Fat Bastard were banned in Iceland, because they were considered inappropriate for children. The brand was banned in Texas, because despite their boastful talk about liberty, they’re actually quite narrow-minded under their ten-gallon hats.

Of course, if you want to continue to shock, you have to keep pushing the envelope. And soon, instead of growing your potential market, you risk offending it.

Until you get to ideas that seemed funny at the time, perhaps because you sampled a little too much of your own tipple. This label drew so much public outrage that it had to be withdrawn from the market altogether.

This is not the sort of innovation that will help South Africa’s wine industry. Innovation is not about creating the most ridiculous new fad. In fact, in wine, innovation often means going back to traditional roots, while solving modern problems with innovative production methods, new distribution channels, and marketing that targets broad audiences instead of niche markets. And there’s little point to innovation if it cannot find ways to address the economic challenges of operating in the wine industry.

The challenges for the South African industry include a lack of profitability, a global perception as a value-priced bulk wine exporter, and an over-complicated supply chain that largely fails to create a connection between consumers and wineries.

An innovator would look at what would seem like relentless bad news, such as the critical production shortage caused by the weather in 2018, or the fact that the rand is circling the proverbial drain, and consider how they might present opportunities.

With lower volumes and a weaker rand, winemakers now have an excuse to focus on higher-quality wine, and to raise their wholesale prices. Even as the quality of South African wine continues to improve, they are still inexpensive by global standards, and the weak rand will mitigate higher prices in export markets. And even a small increase in prices can make a large difference in income at the farm gate.

After years of stagnant prices, VinPro is now anticipating sustained price increases. These projections were made before taking into account the production shortage of 2018, so the future might well be even brighter.

South Africa was a pioneer in producing sustainable wines. Two decades ago, the industry established the Integrated Production of Wine scheme, a world first, administered by the Wine and Spirit Board.

IPW certification complies with international sustainability standards, and builds on the older Wine of Origin certification process. Almost all South African producers are IPW certified.

Local winemakers have also been pro-active in developing fair labour practices and obtaining certification for doing so. According to VinPro, 66% of wine by volume in 2017 was accredited by organisations such as Fair Trade or the Wine and Agricultural Ethical Trade Association. This is up from only 20% in 2015, which deserves congratulations. At this rate, the target of 100% ethical wine will be achieved long before the target date of 2025.

But at the high end, sustainability and ethical labour practices aren’t enough anymore. Premium wine consumers are increasingly attracted by organic and biodynamic wines. Just in the last three years, the number of organic and biodynamic wines entered into the Concours Mondial de Bruxelles has grown by 80%.

Organic wines are produced without any synthetic chemicals, fertilisers or additives. Biodynamic wines are often organic, but go further, by considering the vineyard as a complete ecosystem, and farming within that ecosystem’s physical and natural limits.

Producing organic wine is difficult, as this leaves grapes more vulnerable to the vagaries of the weather, and wine quality can be hit and miss. You have to be a good winemaker to produce decent organic wine.

Only the best winemakers are able to pull off the production of biodynamic wines. The restrictions these disciplines impose on the winemaking process are daunting, and can dramatically influence quality and consistency.

Only a small number of South African wine producers have taken the bold and innovative step into organic or biodynamic winemaking. There are only 17 certified organic producers in South Africa, and a mere two certified biodynamic producers.

So this is an unexploited potential growth area in which to create and market higher-value products for both the domestic and international market.

Another area in which innovative thinking is required is transformation. Although there has been a little growth in the last few years, the number of hectares of vineyard under at least 25% black ownership is a measly 2.5% of the industry total. The tonnage produced by farms with at least 25% black ownership is only 1.9% of the total tonnage.

There is huge political pressure on land ownership, right now, with outright expropriation looming very large on the horizon. Finding ways to introduce black partners into both viticulture and viniculture, not just as owners but as active participants, is a crucial matter of self-preservation for the wine industry.

The wine distribution chain, especially for export wines, is largely old-fashioned and opaque. Winemakers cannot see their customers. They don’t know what their customers like, which wines are being recommended to them, what food it is being paired with, on what occasions it is being drunk, and even at what price the wine is being sold.

Conversely, consumers are often presented with a wall of labels and brands, without getting much of a feel for who the winemaker is, what goes into a particular wine, or why they should select one brand over another, even if the price is higher.

Companies like Port2Port use technology to try to bridge this gap. It enables wineries to market directly to consumers, enables consumers to buy directly from wineries, and delegates shipping and logistics to dedicated courier companies.

It provides a single, integrated online platform that brings together premium wineries, importers, retailers, restaurants and private buyers, facilitating not only physical trade, but also online sales.

The rise of the internet has caused disintermediation in many industries, and it is happening in the wine industry too. Innovators won’t fight this trend. Innovative business models will take advantage of the power of technology to carve unnecessary cost overheads out of the supply chain and enhance the winemaker’s relationship with customers.

Our changing climate also brings about a need for innovation in wine. South Africa’s wine growing regions are perilously close to the 20°C line, above which few, if any, wine grape varietals grow. For the foreseeable future, it is likely that the climate of the Western Cape will get a little warmer, and possibly a little drier.

One of the standout success stories of the South African wine industry has been the development of the Swartland and the region around the Olifants River even further north. Innovative winemakers like Charles Back, Eben Sadie, Donovan Rall, Adi Badenhorst, Andrea and Chris Mullineux, Callie Louw, David Sadie and Marc Kent have turned the region from a producer of rough, rustic wines suitable only for blending, to a producer of some of the most exciting new wines the country has seen.

The Swartland can be as much as 5°C warmer than Paarl or Stellenbosh, and it is also much drier, yet the region’s innovative winemakers are producing wines that critics describe as complex, flavourful and elegant.

According to the famous US wine critic Stephen Tanzer, Swartland vintners replaced most of the traditional stock with varieties from the south of France and the Mediterranean that were better suited to the climate.

Many of these winemakers are also pioneers in naturally produced wines, as members of the Swartland Independent Producers association. They also host events around the country to market the unique wines of the region, along with other local products and food pairings.

This is the kind of innovation that promises to lift South African wine to internationally competitive quality, while being resistant to the vagaries of both the climate and the economy that await us.

Innovation is not just about the latest marketing fad. True innovation is aimed at long-term success. It builds on economic realities, scientific knowledge, traditional values, and new market trends.

Innovation doesn’t just create a product that is briefly trendy. It meets market needs that are far broader than taste and price, to embrace ecological, social and economic sustainability. It creates a closer relationship between winemakers and customers, makes objectively better wines, and supports profitability for years to come.

That’s why innovation will decide who the winners are, even in the most traditional of arts.

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Thousands of mental health professionals agree with Woodward and the New York Times op-ed author: Trump is dangerous


President Donald Trump, August 30, 2018. Reuters/Kevin Lamarque

Bandy X. Lee, Yale University

Bob Woodward’s new book, “Fear,” describes a “nervous breakdown of Trump’s presidency.” Earlier this year, Michael Wolff’s “Fire and Fury” offered a similar portrayal.

Now, an op-ed in The New York Times by an anonymous “senior White House official” describes how deeply the troubles in this administration run and what effort is required to protect the nation.

None of this is a surprise to those of us who, 18 months ago, put together our own public service book, “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President.”

My focus as the volume’s editor was on Trump’s dangerousness because of my area of expertise in violence prevention. Approaching violence as a public health issue, I have consulted with governments and international organizations, in addition to 20 years of engaging in the individual assessment and treatment of violent offenders.

The book proceeded from an ethics conference I held at Yale, my home institution. At that meeting, my psychiatrist colleagues and I discussed balancing two essential duties of our profession. First is the duty to speak responsibly about public officials, especially as outlined in “the Goldwater rule,” which requires that we refrain from diagnosing without a personal examination and without authorization. Second is our responsibility to protect public health and safety, or our “duty to warn” in cases of danger, which usually supersedes other rules.

Our conclusion was overwhelmingly that our responsibility to society and its safety, as outlined in our ethical guidelines, overrode any etiquette owed to a public figure. That decision led to the collection of essays in the book, which includes some of the most prominent thinkers of the field including Robert J. Lifton, Judith Herman, Philip Zimbardo and two dozen others. That decision was controversial among some members of our field.

We already know a great deal about Trump’s mental state based on the voluminous information he has given through his tweets and his responses to real situations in real time. Now, this week’s credible reports support the concerns we articulated in the book beyond any doubt.

Author Bob Woodward’s new book on Trump.
AP/Mark Lennihan

The psychology behind the chaos

The author of the New York Times op-ed makes clear that the conflict in the White House is not about Trump’s ideology.

The problem, the author sees, is the lack of “any discernible first principles that guide his decision making … his impulsiveness [that] results in half-baked, ill-informed and occasionally reckless decisions that have to be walked back, and there being literally no telling whether he might change his mind from one minute to the next.”

These are obviously psychological symptoms reflective of emotional compulsion, impulsivity, poor concentration, narcissism and recklessness. They are identical to those that Woodward describes in numerous examples, which he writes were met with the “stealthy machinations used by those in Trump’s inner sanctum to try to control his impulses and prevent disasters.”

They are also consistent with the course we foresaw early in Trump’s presidency, which concerned us enough to outline it in our book. We tried to warn that his condition was worse than it appeared, would grow worse over time and would eventually become uncontainable.

What we observed were signs of mental instability – signs that would eventually play out not only in the White House, as these accounts report, but in domestic situations and in the geopolitical sphere.

There is a strong connection between immediate dangerousness – the likelihood of waging a war or launching nuclear weapons – and extended societal dangerousness – policies that force separation of children from families or the restructuring of global relations in a way that would destabilize the world.

Getting worse

My current concern is that we are already witnessing a further unraveling of the president’s mental state, especially as the frequency of his lying increases and the fervor of his rallies intensifies.

I am concerned that his mental challenges could cause him to take unpredictable and potentially extreme and dangerous measures to distract from his legal problems.

Mental health professionals have standard procedures for evaluating dangerousness. More than a personal interview, violence potential is best assessed through past history and a structured checklist of a person’s characteristics.

These characteristics include a history of cruelty to animals or other people, risk taking, behavior suggesting loss of control or impulsivity, narcissistic personality and current mental instability. Also of concern are noncompliance or unwillingness to undergo tests or treatment, access to weapons, poor relationship with significant other or spouse, seeing oneself as a victim, lack of compassion or empathy, and lack of concern over consequences of harmful acts.

The Woodward book and the New York Times op-ed confirm many of these characteristics. The rest have been evident in Trump’s behavior outside the White House and prior to his tenure.

That the president has met not just some but all these criteria should be reason for alarm.

Other ways in which a president could be dangerous are through cognitive symptoms or lapses, since functions such as reasoning, memory, attention, language and learning are critical to the duties of a president. He has exhibited signs of decline here, too.

Furthermore, when someone displays a propensity for large-scale violence, such as by advocating violence against protesters or immigrant families, calling perpetrators of violence such as white supremacists “very fine people” or showing oneself vulnerable to manipulation by hostile foreign powers, then these things can promote a much more widespread culture of violence.

The president has already shown an alarming escalation of irrational behavior during times of distress. Others have observed him to be “unstable,” “losing a step” and “unraveling.” He is likely to enter such a state again.

Violent acts are not random events. They are end products of a long process that follow recognizable patterns. As mental health experts, we make predictions in terms of unacceptable levels of probability rather than on the basis of what is certain to happen.

Trump’s impairment is a familiar pattern to a violence expert such as myself, but given his level of severity, one does not need to be a specialist to know that he is dangerous.

What next?

I believe Woodward’s book and the revelations in the New York Times op-ed have placed great pressure on the president. We are now entering a period when the stresses of the presidency could accelerate because of the advancing special counsel’s investigations.

The degree of Trump’s denial and resistance to the unfolding revelations, as expressed in a recent Fox interview, are telling of his fragility.

From my observations of the president over extended time via his public presentations, direct thoughts through tweets and accounts of his close associates, I believe that the question is not whether he will look for distractions, but how soon and to what degree.

At least several thousands of mental health professionals who are members of the National Coalition of Concerned Mental Health Experts share the view that the nuclear launch codes should not be in the hands of someone who exhibits such levels of mental instability.

Just as suspicion of crime should lead to an investigation, the severity of impairment that we see should lead to an evaluation, preferably with the president’s consent.

Mental impairment should be evaluated independently from criminal investigations, using medical criteria and standardized measures. A sitting president may be immune to indictments, but he is subject to the law, which is strict about public safety and the right to treatment when an individual poses a danger to the public because of mental instability. In the case of danger, the patient does not have the right to refuse, nor does the physician have the right not to take the person as a patient.

This evaluation may have been delayed, but it is still not too late. And mental health professionals have extensive experience assessing, restraining and treating individuals much like Trump – it is almost routine.The Conversation

Bandy X. Lee, Assistant Clinical Professor, Yale School of Medicine, Yale University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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To zero-rate, or not to zero-rate: why the VAT debate is more complex than it appears

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EPA/Nic Bothma

Imraan Valodia, University of the Witwatersrand and David Francis, University of the Witwatersrand

The one percentage point increase in South Africa’s Value Added Tax (VAT) rate, which was implemented in April this year, has raised important questions about how the tax system can and should address inequality. In response to the increase, Nhlanhla Nene, the minister of finance, appointed an expert panel to look into ways that zero rating can better tackle inequality. The panel made recommendations about additional items which should be zero rated.

It’s important that the recommendations of the panel be considered within the framework of a larger conversation about tax policy in South Africa. This is particularly true because the tax system is key to addressing the extremely high levels of inequality in South Africa.

To be both fair and to address inequality, tax systems need to do two things. First, they should treat people with the same income and circumstances in the same way. Secondly, they should treat people with different incomes and different circumstances appropriately differently – rich people should both pay a greater amount of taxes and also a larger portion of their income in taxes.

But South Africans should also be realistic about what tax policies can achieve. Zero rating isn’t a panacea: it should be accompanied by policies that help poor people access essential products. In addition, its unintended consequences should be noted: by providing relief for the poor, it also provides a large amount of relief for the rich. The rich consume far more than the poor, and thus benefit in absolute terms to a far greater degree than the poor.

The example of sanitary pads

The panel’s recommendation about sanitary products is a good example of the limitations of VAT in addressing inequality.

The panel agreed that it was important to include sanitary products on the zero-rated list. But addressing the issue only through tax policy effectively subsidises the consumption of women from higher-income households, but does very little to address the fact that most poor women are simply unable to afford sanitary pads, whether they are zero rated or not.

The panel therefore argued that it was imperative that free sanitary pads should be given to women and girls who can’t afford to buy them. It found that women in the poorest 70% of households are able to meet only 8% of their needs for sanitary products. Zero rating won’t help them much.

If South Africa is to address the problem of access to sanitary pads, zero rating has to be accompanied by policies that make sanitary pads available, free of charge, to those who cannot afford to purchase them.

The case of books

A number of submissions to the panel argued for zero rating books to promote access to reading material. But unlike sanitary pads, the case for zero rating books is not a strong one.

Books are very expensive and bought almost entirely by the richest 10% of households. Zero-rating books would be symbolically good, but it would, in effect only subsidise the consumption of high-income households and do very little to actually promote a culture of reading among low-income households. Better provision of books in schools and access to libraries are likely to have a much bigger impact.

This highlights that targeted expenditure programmes can ensure that the relief reaches those who need it most. This is not to say that one or the other of these options must prevail. But tax collection tools should always be weighed against expenditure policy options.

Unintended consequences

It’s also important to be aware that changes in tax policies often generate changes in economic behaviour. That’s why there are “sin” taxes on products like alcohol and tobacco. The assumption is that a higher tax will result in reduced consumption. Zero-rating may change economic behaviour which could result in unintended consequences.

Take the example of zero rating frozen chicken pieces. The argument for zero rating them is that poor people buy chicken in pieces, so exempting them from VAT will make them more affordable.

But high-cost chicken (including organic or free range) consumed mainly by the rich could also be sold in pieces. The fact that they also enjoyed the benefits of zero rating would allow wealthy consumers to benefit. This highlights the related issue of demarcation – how can we define items for zero rating in a way that is efficient and practicable?

The zero rating of school uniforms is the best example of this challenge. School uniforms consist, say, of white shirts, grey skirts and trousers, black shoes, and blazers or jackets. But these items are also consumed by wealthy people many of whom wear white shirts and black shoes with their business attire. What distinguishes a business shirt from a school shirt, and how do we ensure only the latter is VAT exempt? If we are unable to do this in an effective manner, the benefit of the zero rating will be enjoyed both by the intended group – parents of school children – but also by the wealthy.

Another problem is that those who have economic power are often able to pass on the costs of a tax to others. For example, if company taxes are increased, a firm that has a monopoly may be able to pass on the full costs of the tax to consumers by increasing the price of the goods.

In the case of zero rating, the problem is reversed – how do we ensure that any benefit from zero rating is passed on to the consumer and not captured by producers, wholesalers and retailers? In markets where producers or retailers are in a powerful position, we can’t assume that the zero rating benefit will be passed on to the consumer.

Simplicity is key

Issues of administrative ease and efficiency are very important for tax policy. Issues of demarcation must be easy to define and implement at the risk or passing an administrative and therefore financial burden onto both business and the receiver of revenue. In addition, the more complex a tax system is, the more the incentive there is for evasion and the greater the resources needed for enforcement and collection.

Our argument is that while issues of zero rating are very important, it’s vital to understand them in the context of the larger tax policy universe. This includes how revenue is allocated, how consumers respond to changes, and the importance of being realistic and pragmatic about implementation.The Conversation

Imraan Valodia, Dean of Commerce, Law and Management, University of the Witwatersrand and David Francis, Research Manager at the Southern Centre for Inequality Studies, University of the Witwatersrand

This article is republished from The Conversation under a Creative Commons license. Read the original article.


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Health Check: why do I get a headache when I haven’t had my coffee?

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A study found the headache went away when participants were given decaf but didn’t know.
nathan dumlao unsplash

Merlin Thomas, Monash University

Caffeine is our favourite drug. But if we miss out on our fix, it can be a real headache, in more ways than one.

Caffeine is a stimulant. It quickly enters our brain and blocks the (adenosine) receptors that are responsible for dulling brain activity. By blocking the dulling of our brain, we feel a sense of invigoration, focus and subtle euphoria. These feelings can also enhance our performance of certain focused tasks, like driving or staying awake through the whole lecture.

This is the upside of caffeine. The downside is how we feel when we are not getting our usual dose. Because of the anticipated highs of brain activity after our cup, the lows without it seem longer and deeper.

The other problem is that caffeine is addictive. When we aren’t getting what we’re used to, we can feel tired, inattentive, irritable and moody. This is known as withdrawal. Many people regularly drink caffeinated beverages just to avoid feeling this way.

By far the most common symptom of caffeine withdrawal is headaches. These are typically mild and short-lived, usually only lasting for a day or two, although they can sometimes last for up to week. They usually feel a bit like a tense band wrapped across your head and are sometimes called tension-type headaches as a result. However, caffeine withdrawal can also trigger a full-on migraine in some sufferers.

Why we get headaches with withdrawal (as well as many other causes) is mostly because our face and head is the most active as well as the most sensitive part of our body. For our brain to accurately know what’s happening, the signals it receives from the senses have to be spot on.

Any distortion of the signal and the message can become lost in translation, or even result in the wrong message being received. One theory for headaches is our fuzzy brain misinterprets some of the innocuous signals it gets from our head, and calls them a headache.

Some level of caffeine withdrawal would be experienced by maybe half of all regular tea or coffee drinkers, if their regular drug supply would be completely cut off. The more we drink and the more regularly we drink caffeine, the more likely we’d experience withdrawal symptoms if we were to go without.

However, withdrawal can happen even in people who usually drink just a single cup every day who then forego caffeine. Equally, only three days of continuous coffee drinking is enough to make you feel bad when the coffee runs out.

Only three days of continuous coffee drinking is enough to make you feel bad when the coffee runs out.
Tyler Nix/Unsplash

Caffeine withdrawal only occurs with abstinence. Small amounts of caffeine (just a quarter of a cup) will keep the headaches at bay. Even if the espresso machine is broken and you have to have a (half-less caffeinated) latte, you won’t go into withdrawal.

But if you’re going cold turkey, withdrawal headaches typically peak a day or two after removing all caffeine from the menu. Withdrawal does not happen within a few hours of the last cup, despite the protestation of the habitual coffee drinker.

Of course, if withdrawal is really the problem, the remedy is simple. Any headache caused by lack of caffeine is rapidly and often completely relieved within 30 minutes to an hour of drinking a cup of tea or coffee.

Some of this is the fix and the anticipation of it. In fact, Australian researchers have found giving someone experiencing caffeine withdrawal a de-caf, but telling them it’s caffeinated, is enough to make them feel better. Of course this trick won’t work if you buy the coffee yourself.

Surprisingly though, caffeine also has some painkiller properties. Simple pain-killers such as non-steroidal anti-inflammatories, aspirin or paracetamol can be more effective when formulated with some caffeine (in each dose about two to three times that in a regular cup of coffee).

For hypnic “alarm clock” headaches that wake sufferers at night, hangover-headaches and some migraine-sufferers, a cup of tea or coffee can be an effective pain-killer on its own.

This analgesia is not just because we feel less stressed or less distracted by pain after a cup of tea or coffee. It turns out the same adenosine receptors blocked by caffeine are also implicated in the origin of headache as well as other kinds of pain.

More than 90% of all adults drink coffee or tea, rousing us from our slumber and providing the revitalising energy to do the things that need to be done. It’s not hard to imagine the headaches without it.The Conversation

Merlin Thomas, Professor of Medicine, Monash University

This article was originally published on The Conversation. Read the original article

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Dti’s not so 99% auto deal

Alec Erwin.   Building an African Auto industry

by John Fraser

When Trade and Industry Minister Rob Davies was a no-show at an auto conference last week, as he had been taken-away to China by his boss Cyril, the dti Director-General Lionel October stood in.

Many in the motoring world had hoped that the dti would use the conference – held in an awful, noisy room next to the Kyalami racetrack – to announce an agreement on a new blueprint for support for the auto industry, to replace the highly-successful support programmes which have driven billions of rand in investment into SA.

October said they are 99% there, and just a few technical issues need to be sorted out.

He said that the auto industry is central to a wider strategy of boosting manufacturing.

“The manufacturing base makes up 13-15% of GDP.  We need it to be at least 20% or above,” he suggested.

“Manufacturing really matters.  It is the real economy that drives anything – agriculture, mining and manufacturing.”

He explained that the big goal of the new auto masterplan is to increase production volumes.

He said SA has reached a key point with annual production of 600 000 vehicles, but the country must expand production a lot more to reach the “critical barrier” of one million vehicles annually.

October said that both government and the industry have reached a consensus “on heading to 60% local content, and value-added localisation.”

This ambitious target is certainly on the government’s agenda, but auto industry insiders suggest that there is not yet the 99% consensus the dti believes it has achieved.

One big challenge in transforming the industry is the refusal of the global auto giants to hand over equity to local BEE partners, and other strategies are being pursued to compensate for this – for instance through an “equity equivalent” empowerment fund, paid for by the auto giants.

October made it clear that he expects better transformation from an industry, which he accused of “lagging behind.”

A big theme of the auto session is the strategy to build a credible auto industry in Africa.

SA former trade and industry minister Alec Erwin is leading the charge on this, and argued passionately that protectionist walls are needed to foster the growth of auto firms in the continent.

He suggested that any moves towards implementing an African Free Trade Area must allow exceptions for effective industrialisation to take place.

“How is Nigeria to start an auto industry if our (South African) cars come in at zero tariffs?  You can’t industrialise behind zero tariffs,” he suggested.

“Everywhere else in the world, you establish Free Trade Areas after you industrialise.”

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