New Office Hours Aim for Well Rested, More Productive Workers

A few years ago, scientists conducted a real-world experiment at a ThyssenKrupp steel factory in Germany. They assigned the day shift to early risers and the late shift to night owls.

Soon the steel workers, many of whom had been skeptical at the outset, were getting an extra hour of sleep on work nights. By simply aligning work schedules with people’s internal clocks, the researchers had helped people get more and better rest.

“They got 16 percent more sleep, almost a full night’s length over the course of the week,” said Till Roenneberg, a chronobiologist at Ludwig-Maximilian University in Munich, who headed the study. “That is enormous.”

In recent years, American educators have been paying increased attention to their students’ sleep needs, with growing debate about delaying school start times. Now a number of businesses are following suit, encouraging their employees to work when their bodies are most awake.

“It’s a huge financial burden not to sleep properly,” Dr. Roenneberg said. “The estimates go toward 1 percent of gross national product,” both in the United States and Germany.

Emerging science reveals that each of us has an optimal time to fall asleep and wake up, a personalized biological rhythm known as a “chronotype.” When you don’t sleep at the time your body wants to sleep — your so-called biological night — you don’t sleep as well or as long, setting the stage not only for fatigue, poor work performance and errors but also health problems ranging from heart disease and obesity to anxiety and depression.

A full 80 percent of people have work schedules that clash with their internal clocks, said Céline Vetter, an assistant professor at the University of Colorado at Boulder and director of the university’s circadian and sleep epidemiology lab. “The problem is huge,” Dr. Vetter said. “If we consider your individual chronotype and your work hours, the chances are very high that there’s quite a bit of misalignment.”

Put it this way: If you rely on an alarm clock to wake up, you’re out of sync with your own biology.

Studies on workers in the call center of a mobile phone company, a packaging manufacturer and an oil transportation company show that these employees are more stressed and may experience more work-related discomfort and pain. It’s the mismatch — not the hours themselves — that matters. A 2015 Harvard Medical School study found that for night owls, working during the day increases diabetes risk.

Among the companies seeking to remedy the problem is Southwest Airlines, which allows pilots to choose between morning and evening flight schedules. The United States Navy recently traded an 18-hour submarine shift schedule for a 24-hour one that more closely matches sailors’ biological rhythms. And at some pharmaceutical, software and financial companies, managers expect employees to come to the office for only a few hours in the middle of the day — or to work off site entirely.

“I think circadian rhythms will be a huge issue for human resources in the future,” said Camilla Kring, a Danish consultant who has helped employees at AbbVie, Roche, Medtronic and other companies learn to respect their natural sleep cycles. “It really makes sense to think about when people have the most energy and when they’re peaking mentally.”

Worker fatigue has played a role in many workplace accidents, most famously the Challenger space shuttle explosion and the Exxon Valdez oil spill, but no doubt countless more on the commute to and from work. The National Highway Traffic Safety Administration estimates that drowsy drivers cause 16.5 percent of fatal crashes.

A survey released last year by the National Safety Council found that 97 percent of workers have at least one risk factor for fatigue, with 27 percent reporting having unintentionally fallen asleep on the job in the previous month and 16 percent that they had experienced at least one safety incident because of fatigue.

“We have a 24/7 society, so we knew fatigue was definitely affecting part of our work force,” said Emily Whitcomb, senior program manager of the council’s fatigue initiative. “But we did not anticipate that fatigue was going to be affecting almost 100 percent of our work force.”

Sleep deprivation may even lead to ethical breaches at work. In a 2014 experiment, Christopher Barnes of the University of Washington and colleagues asked 142 people with extreme chronotypes to show up at their laboratory either at 7 a.m. or at midnight for a dice-rolling game that offered a $500 prize. Reporting was on the honor system. Morning people lied 18 percent more when they did the task at midnight than when they did it in the morning, whereas night owls lied 16 percent more when doing the task at 7 a.m.

Dr. Roenneberg has collected data from 300,000 people and found that chronotypes plot as a bell-shaped curve, with a few individuals at each extreme and most falling somewhere in the middle. According to Dr. Roenneberg’s research, the most frequent chronotype — held by about 13 percent of the population — sleeps from around midnight to 8 a.m. Thirty-one percent of people have an earlier natural bedtime, and 56 percent have a later one. That means for at least 69 percent of the population, getting to the office by 8 or 9 a.m. requires waking up before their body is ready.

Not all experts acknowledge such fine-grained distinctions, instead grouping people into morning, evening and “intermediate” types. Regardless, while true “larks” and “owls” tend to dominate the conversation, they make up a small percentage of the population.

To determine your chronotype, imagine that you have two weeks of vacation to spend as you like, with no evening or morning commitments and no pets or children to wake you. Chronotypes reflect habits as well as biology, so you would also need to eliminate caffeine and avoid artificial light at night, which pushes a person’s chronotype later. At what time would you tend to fall asleep and wake up? Don’t be surprised if you’re unsure. After years spent accommodating work, family and social commitments at the expense of sleep, “a lot of people don’t know what rhythm they have,” Ms. Kring said.

Chronotypes shift in a predictable way over the course of a lifetime. Between the ages of 12 and 21, everyone’s natural sleep schedule gets about 2 1/2 hours later — which is why adolescents have so much trouble waking up for school. After that, chronotype creeps in the other direction, which is why older people typically find themselves waking earlier than they used to.

But chronotype determines more than when you sleep and wake. It orchestrates predictable peaks and troughs of energy over the course of the 24-hour day. The so-called “window of circadian low” — the hours when the body is least adapted for wakefulness — typically occurs between 2 a.m. and 6 a.m. There’s another, smaller dip 12 hours later, in the midafternoon.

There are also two high points, when thinking is sharp and reaction times quick. One occurs within an hour or two after waking, and the other after the daytime dip. This cycle is shifted earlier in a morning person and later in an evening or night person.

At the Denmark offices of the pharmaceutical company AbbVie, employees design work schedules that take advantage of their biological strengths. A nine-hour training program helps them identify when they are ripe for creative or challenging projects, typically mornings for early risers and afternoons for late risers. Lower-energy periods are meant for more mundane tasks, like handling emails or doing administrative chores. Workers save commuting time by avoiding rush hour traffic, and can better mesh their personal and professional lives — for example, by getting their children from school in the afternoon, then working from home in the evening after the kids are in bed.

Employee satisfaction with work-life balance has risen from 39 percent 10 years ago, when the program launched, to nearly 100 percent today, according to company surveys. Last year the Denmark division of Great Place to Work, a global organization that ranks companies based on employee satisfaction, named AbbVie the top middle-size company in the country. “The flexibility actually empowers people to deliver the best possible results,” said Christina Jeppesen, the company’s general manager.

A 2018 survey by the Society for Human Resource Management, which represents 300,000 H.R. professionals in more than 165 countries, found that 57 percent of its members offer flexible hours, 5 percent more than in 2014. “Managers who give it a try often find that employees’ morale, engagement and productivity all go up, because they are working at a time that works best for them, and able to get the most work done,” said Lisa Horn, the group’s vice president of congressional affairs.

Some companies restrict meetings to “core hours,” between, say, 10 a.m. and 3 p.m., to accommodate various schedules. Others build flextime into the workweek. At Phase 2, a software development firm in Oklahoma City, each week ends with “productivity Friday,” when employees are expected to work remotely in a place of their choice — whether that be from home, a coffee shop or at a weekend house at the lake.

Stefan Volk, a senior lecturer at the University of Sydney Business School, has suggested that businesses can leverage chronotypes to maximize team success. For example, members of a surgery team should have similar chronotypes because they need to be in top form simultaneously. But at a nuclear power plant, workers should have different energy peaks, so that someone is always on the alert.

But while lots of corporations promise flexibility, veering from the traditional 9 to 5 work hours requires a cultural shift. A 2014 study led by Dr. Barnes found that many managers have an ingrained prejudice in favor of early birds, whom they perceived as more conscientious simply because they arrived at work early, a view that could dissuade some workers from using flextime.

But sticking to traditional hours can be counterproductive, leading to “presenteeism” — employees showing up and being only minimally functional. “Companies are wasting the potential of their people,” Dr. Volk said. “You have someone sitting there from 7 til 9 a.m. sipping coffee, being completely unproductive, and then you send them home at 4 when they actually start getting productive.”

For many office workers, the answer may be as simple as delaying work start times an hour or two — say until 9:30 or 10 a.m. Since many people are in the middle of the chronotype continuum and wake naturally around 8 or 9 a.m., such a modest shift could provide widespread relief. “We’re talking about one hour,” Ms. Kring said, “not a revolution.”

Alabama Defeats Oklahoma to Advance to 4th Consecutive Title Game

MIAMI GARDENS, Fla. — The Alabama Crimson Tide moved closer to its third national championship in four seasons with a difficult but authoritative 45-34 win over Oklahoma on Saturday in a College Football Playoff semifinal, a result that surprised just about nobody.

Alabama, ranked No. 1 with a perfect record (now 14-0), did what Alabama does, ultimately subduing a tough opponent to earn a chance to defend the title it won last season against Georgia.

On Saturday at the Orange Bowl here in Hard Rock Stadium, that opponent was the Oklahoma Sooners (12-2), ranked No. 4, with one of the most explosive offenses in college football. But Oklahoma could not overcome its most glaring problem: a defense ranked among the worst of the 130 top-level college teams.

Alabama earned its fourth consecutive trip to the title game, setting up a Jan. 7 rematch of its two recent championship showdowns with the Clemson Tigers (14-0), who defeated Notre Dame in the other semifinal Saturday.

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Alabama wide receiver DeVonta Smith breaking a tackle during the Orange Bowl on Saturday.CreditJamie Squire/Getty Images

“I’m sure it will be a real challenge for us, and I’m sure we’ll need to play better than we did today,” Alabama Coach Nick Saban said on the field after the game.

Clemson lost the title matchup with the Tide three seasons ago but prevailed a year later, winning, 35-31, with a touchdown in the final second of the game. Last year, Clemson lost in a semifinal to Alabama, which then beat Georgia, 26-23, in overtime, for the championship.

Alabama quarterback Tua Tagovailoa, who has been recovering from an ankle sprain, showed little sign of the injury, which occurred Dec. 1 in the Southeastern Conference championship game against Georgia. He completed 24 of 27 passes for 318 yards and four touchdowns against Oklahoma after saying earlier in the week that he was “80 to 85 percent” healthy.

“Our offense really controlled the tempo of the game,” Saban said. “The only times we got stopped in the game, we stopped ourselves.”

Alabama started with four drives that led to four touchdowns and was up by 28-0 just two minutes into the second quarter. By halftime, the score was 31-10, and Tagovailoa had thrown for 224 yards and two touchdowns. Damien Harris ran for two scores.

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Alabama’s Jerry Jeudy scoring on a reception in the fourth quarter. Oklahoma quarterback Kyler Murray answered that play with an 8-yard run to cut the Sooners’ deficit to 11.CreditStreeter Lecka/Getty Images

Oklahoma continued to rally, though, outscoring the Tide by 20-3 during one stretch of the second and third quarters. Sooners quarterback Kyler Murray threw a 49-yard touchdown pass to Charleston Rambo late in the third to make the score 31-20. The two teams then traded touchdowns, making it 38-27 with 8 minutes 31 seconds left in the game.

With just over six minutes remaining, a Tagovailoa touchdown pass to Jerry Jeudy gave Alabama a 45-27 lead. The Sooners brought the game back to 11 points with 4:23 left, when Murray scored on a keeper from the 8. That made it two touchdowns in the air and one on the ground for the Heisman Trophy winner. He finished with 417 yards total offense (308 passing, 109 rushing).

Oklahoma came closer to Alabama than any other team but Georgia, which lost to the Tide by 7 in the SEC championship game, 35-28. Going into Saturday’s semifinal, the Tide led the country in scoring margin, with an average of 33.1 points.

Alabama will be seeking its sixth national championship under Saban, who took over the program in 2007. That would match the number of titles won by the legendary Alabama coach Bear Bryant in 25 seasons. (Saban also won the 2003 national title with Louisiana State.)

Three of Saban’s titles with the Tide came in the Bowl Championship Series system, which yielded to the current format, the four-team College Football Playoff, in the 2014 season. Alabama has reached the semifinals in all five years of the playoff.

Thousands of Brits going to Spain could be affected by new Ryanair strikes

RYANAIR cabin crew in Spain have called three strike days in January, which could affect thousands of passengers.

The walkouts have been called by the two unions, USO and SITCPLA, which claim Ryanair is "refusing to abide by the Spanish constitution" and provide work contracts according to the Spanish law.

 Ryanair cabin crew have planned three strike days in January

AFP
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Ryanair cabin crew have planned three strike days in January

The strikes are currently planned for January 8, 10 and 13.

However, the unions have given the airline ten days to "avoid" the industrial action. A union spokesperson said: "There is a period of ten days for the management of Ryanair to reconsider and follow, once and for all, the legality in Spain." SITCPLA and the USO say they have called the three strike days after failing to reach an agreement in mediation.

Ryanair flight to Lisbon forced to return to London after take-off when fight breaks out between passengers

The unions are calling for Ryanair cabin crew at all Spanish bases to join in the strikes.

Jairo Gonzalo, USO secretary of organisation at Ryanair, said: "After everything that has already been said and done by the courts, the Labour Inspectorate and the European Commission during this 2018, it is a disgusting act that Ryanair continues to refuse to accept the national law with all its consequences, as already in Germany and France.

"It's up to them to comply."

 A strike earlier this year affected around 30,000 people

PA:Press Association
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A strike earlier this year affected around 30,000 people

The unions say they are willing to accept a transitional period to convert contracts into Spanish law.

There is a period of ten days for the management of Ryanair to respond to the strike call. Earlier this year, Ryanair cabin crew was involved in a one-day strike, which took place across five European countries.

Weeing in the galley and other bizarre things passengers did on flights in 2018

THIS year has seen some truly bizarre behaviour from airline passengers.

But while some of it can be attributed to being in confined spaces for too long, it's hard to justify others.

 Sometimes passengers do stuff that's plain weird

Getty – Contributor
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Sometimes passengers do stuff that's plain weird

Couples doing yoga together in the back row and a passenger reading porn are just some of the weird examples.

So as the year draws to an end, we look at some of the strangest things people have done during a flight:

Couples yoga

 This couple were doing some next level yoga moves

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This couple were doing some next level yoga moves

 Not content with just regular lifts

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Not content with just regular lifts

 Some passengers seemed oblivious to the acrobatics

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Some passengers seemed oblivious to the acrobatics

Flyers are often advised to do stretches while in the air to boost circulation.

Perhaps that's why we've seen so many instances of people doing yoga on flights recently.

But one couple took it to the next level when they started doing yoga poses together.

As well as doing various stretches, the pair were also seen pulling some seriously hardcore lifts.

Reading a porno mag

 One man had no qualms about flicking through a porno mag

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One man had no qualms about flicking through a porno mag

Sex may be everywhere but looking at porn is another matter.

Earlier this year, one passenger spotted a man reading a porno mag next to him on a morning flight.

As well as flicking through Japanese cartoon porn, the the passenger was also seen looking at pictures of naked women.

Bare feet on tray table

 This passenger took a relaxed approach to flying

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This passenger took a relaxed approach to flying

Passenger shaming websites never see a shortage of photos of people sticking their feet on the armrests or even headrests of the seats in front of them.

But one woman was called out for putter her bare feet onto a tray table, she refused to take them down.

The woman had apparently argued that she needed to rest her feet because she had injured it "during ballet practice".

Picking off dead skin from feet

Revolting moment plane passenger picks dead skin off her bare feet during flight

If having someone else's bare feet near you is enough to make you sick, you might want to look away now.

One traveller had the misfortune of being seated next to someone who was picking the dead skin off their feet.

The woman was apparently playing on her phone at the same time, completely oblivious to her revolting actions.

Giving someone else a pedicure

Passenger spotted giving her sleeping neighbour a pedicure on a flight

If giving yourself a pedicure on a flight isn't bad enough, giving someone else one seems even more unbelievable.

But one passenger spotted a woman doing just that.

Perhaps even more weirdly, the recipient appeared to be sleeping at the time.

Helping a child to vandalise

 One passenger gives her child a helping hand in drawing on the tray tables

Instagram/Passanger shaming
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One passenger gives her child a helping hand in drawing on the tray tables

 The child managed to cover all the tray tables with pencil marks

Instagram/Passanger shaming
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The child managed to cover all the tray tables with pencil marks

One passenger was spotted helping a child vandalise some tray tables just last week.

The unidentified woman was seen guiding the toddler's hand as he scribbled over a whole row of tray tables.

The viral video sparked outrage after it was posted to social media.

Letting a child use the potty in the aisle

In another example of bizarre parental behaviour, a woman was spotted letting her child use the potty in the middle of an aisle.

The woman reportedly said "I don't give a sh*t" when she was asked to use the toilets on the plane instead.

The post on Instagram sparked over a thousand comments with many calling the incident "disgusting".

Gallery: 23 pretty tops to pair with jeans on New Year's Eve

Passengers share the most disgusting things they’ve seen on flights

EVERYONE who has flown knows that planes are cramped spaces where strangers are often forced to get up close and personal with fellow passengers.

But for some unfortunate travellers, they sometimes get more than they're bargained for.

 This Santa look-alike decided to strip off for his flight

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This Santa look-alike decided to strip off for his flight

As this set of images show, some flyers just don't seem to care about etiquette when they're in the air.

The most frequent offender is the passenger who put their feet up in communal spaces – or a bit too close for comfort to their neighbours.

It's made even worse when they're not wearing socks, especially when their feet are filthy.

However, some go as far as taking off their clothes and even airing their laundry in public.

 One passenger reveals all and sundry in business class

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One passenger reveals all and sundry in business class

 Sometimes, there just isn't enough room in business class

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Sometimes, there just isn't enough room in business class

 Is there anything worse than chewed gum?

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Is there anything worse than chewed gum?

 Of course, socks are the perfect barrier to germs

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Of course, socks are the perfect barrier to germs

 One passenger makes full use of the empty row

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One passenger makes full use of the empty row

 Is there anything worse than grubby feet next to your arm rest?

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Is there anything worse than grubby feet next to your arm rest?

 When the grubby feet is next to your /figcaption/figure figure class=

 One passenger takes advantage of a whole empty row

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One passenger takes advantage of a whole empty row

 A flyer spots the bizarre moment a passenger decided to dry their laundry

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A flyer spots the bizarre moment a passenger decided to dry their laundry

 Man spreading in the air

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Man spreading in the air

 Extra legroom?

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Extra legroom?

 Is this traveller trying to wave down a cabin crew?

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Is this traveller trying to wave down a cabin crew?

 A hairy toe peeps through the gaps to reach this passenger

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A hairy toe peeps through the gaps to reach this passenger

 One traveller appears to be doing a spot of stretching

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One traveller appears to be doing a spot of stretching

 This will put you off reading the magazines on flights

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This will put you off reading the magazines on flights

 One passenger taking advantage of sitting in the front row

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One passenger taking advantage of sitting in the front row

 Everywhere is fair game when it comes to rubbish

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Everywhere is fair game when it comes to rubbish

Congratulations on the Promotion. But Did Science Get a Demotion?

A number of recent news articles have brought renewed attention to financial conflicts of interest in medical science. Physicians and medical administrators had financial links to companies that went undeclared to medical journals even when they were writing on topics in which they clearly had monetary interests.

Most agree such lapses damage the medical and scientific community. But our focus on financial conflicts of interest should not lead us to ignore other conflicts that may be equally or even more important. Such biases need not be explicit, like fraud.

“I believe a more worrisome source of research bias derives from the researchers seeking to fund and publish their work, and advance their academic careers,” said Dr. Jeffrey Flier, a former dean of Harvard Medical School who has written on this topic a number of times.

How might grant funding and career advancement — even the potential for fame — be biasing researchers? How might the desire to protect reputations affect the willingness to accept new information that reverses prior findings?

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In 2018, Cornell University removed Brian Wansink from all teaching and research positions, saying he had committed academic misconduct. He had gained a measure of fame as a food researcher. CreditMike Groll/Associated Press

I’m a full professor at Indiana University School of Medicine. Perhaps the main reason I’ve been promoted to that rank is that I’ve been productive in obtaining large federal grants. Successfully completing each project, then getting that research published in high-profile journals, is what allows me to continue to get more funding.

A National Institutes of Health regulation sets a “significant financial interest” as any amount over $5,000. It’s not hard to imagine that being given thousands of dollars could influence your thinking about research or medicine. But let’s put things in perspective. Many scientists have been awarded millions of dollars in grant funding. This is incredibly valuable not only to them but also to their employers. Journals and grant funders like to see eye-catching work. It would be silly not to think that this might also subtly influence thinking and actions. In my own work, I do my best to remain conscious of these subtle forces and how they may operate, but it’s a continuing battle.

Getting positive results, or successfully completing projects, can sometimes feel like the only way to achieve success in research careers. Just as those drivers can lead people to publish those results, it can also nudge them not to publish null ones.

As a pediatrician, I’ve been acutely aware of concerns that relationships between formula companies and the American Academy of Pediatrics might be influencing policies on feeding infants. But biases can occur even without direct financial contributions.

If an organization has spent decades recommending low-fat diets, it can be hard for that group to acknowledge the potential benefits of a low-carb diet (and vice versa). If a group has been pushing for very low-sodium diets for years, it can be hard for it to acknowledge that this might have been a waste of time, or even worse, bad advice.

There are things we can do to help mitigate the effects of biases. We can ask researchers to declare their methods publicly before conducting research so that they can’t later change outcomes or analyses in ways that might influence the results. Think of this as a type of disclosure.

A 2015 study published in PLOS ONE followed how many null results were found in trials funded by the National Heart, Lung and Blood Institute before and after researchers were required to register their protocols at a public website. This rule was introduced in 2000 in part because of a general sense that researchers were subtly altering their work — after it was begun — to achieve positive results. In the 30 years before 2000, 57 percent of trials published showed a “significant benefit.” Afterward, only 8 percent did.

Moves toward open science, and for a change in the academic environment that currently incentivizes secrecy and the hoarding of data, are perhaps our best chance to improve research reproducibility Recent studies have found that an alarmingly high share of experiments that have been rerun have not produced results in line with the original research.

We could also require disclosure of other potential conflicts just as we do with ties to companies. In early 2018, the journal Nature began requiring authors to disclose all competing interests, both financial and nonfinancial. The nonfinancial interests could include memberships in organizations; unpaid activities with companies; work with educational companies; or testimony as expert witnesses.

When results are clear and methods are robust, we probably don’t need to worry too much about the subtle biases affecting researchers. When the results are minimally significant, however, and interpretations among experts differ, the biases of those who discuss them probably do matter.

Unfortunately, many results fall into this group. A new drug is minimally better than another, so anyone’s associations with the companies that produce them matter when people are making decisions about their use or in writing guidelines. The overall effect of individual nutrient changes is small, but it might have built careers, so it’s easy for groups to be too dismissive of new findings that might ask them to change their tunes.

If someone has built a body of research investigating which drugs are better for treating certain infections, that person may discount research that argues we shouldn’t use antibiotics at all.

These conflicts aren’t all the same. Academic researchers are arguably running in many directions with the hope of generally heading toward the truth. Companies are, for the most part, interested in making money. That’s not a moral judgment; it’s economics. Because of this, it might make sense to put in some hard rules regarding companies. For example, people with financial connections to companies that make medications for high blood pressure should not write guidelines on the treatment of that condition, or be on boards or in positions where they are in charge of policies that could be influenced by those ties.

Even with those rules in place, however, we may need some additional guardrails for scientists and physicians to make sure all research is as unbiased as possible. Such moves would protect us not only from financial conflicts, but also from other types as well.

Hearing Loss Threatens Mind, Life and Limb

The earsplitting sound of ambulance sirens in New York City is surely hastening the day when I and many others repeatedly subjected to such noise will be forced to get hearing aids. I just hope this doesn’t happen before 2021 or so when these devices become available over-the-counter and are far less expensive and perhaps more effective than they are now.

Currently, hearing aids and accompanying services are not covered by medical insurance, Medicare included. Such coverage was specifically excluded when the Medicare law was passed in 1965, a time when hearing loss was not generally recognized as a medical issue and hearing aids were not very effective, said Dr. Frank R. Lin, who heads the Cochlear Center for Hearing and Public Health at the Johns Hopkins Bloomberg School of Public Health.

Now a growing body of research by his colleagues and others is linking untreated hearing loss to several costly ills, and the time has come for hearing protection and treatment of hearing loss to be taken much more seriously.

Not only is poor hearing annoying and inconvenient for millions of people, especially the elderly. It is also an unmistakable health hazard, threatening mind, life and limb, that could cost Medicare much more than it would to provide hearing aids and services for every older American with hearing loss.

Currently, 38.2 million Americans aged 12 or older have hearing loss, a problem that becomes increasingly common and more severe with age. More than half of people in their 70s and more than 80 percent in their 80s have mild to moderate hearing loss or worse, according to tests done by the National Health and Nutrition Examination Survey between 2001 and 2010.

Two huge new studies have demonstrated a clear association between untreated hearing loss and an increased risk of dementia, depression, falls and even cardiovascular diseases. In a significant number of people, the studies indicate, uncorrected hearing loss itself appears to be the cause of the associated health problem.

In one of the studies that covered 154,414 adults 50 and older who had health insurance claims, researchers at Johns Hopkins found that untreated hearing loss increased the risk of developing dementia by 50 percent and depression by 40 percent in just five years when compared to those without hearing loss.

An analysis of the voluminous data by Nicholas S. Reed and colleagues linked untreated hearing loss to more and longer hospitalizations and readmissions and more visits to an emergency room.

Within 10 years, untreated hearing loss accounted for 3.2 percent of all cases of dementia, 3.57 percent of people significantly injured in a fall, and 6.88 percent of those seeking treatment for depression. The percentages may seem small, but given how common these conditions are, they affect a very large number of individuals, resulting in great personal, financial and societal costs.

About 85 percent of those with hearing loss are untreated, Dr. Lin said. For older adults alone, this increased health care costs by 46 percent over a period of 10 years, compared with costs incurred by those without hearing loss, the authors reported in November in JAMA Otolaryngology Head and Neck Surgery.

One of the authors, Jennifer A. Deal, an epidemiologist and gerontologist at the Johns Hopkins Bloomberg School of Public Health, said that while “hearing loss itself is not very expensive, the effect of hearing loss on everything else is expensive.”

Unfortunately, people tend to wait much too long to get their hearing tested and treated with hearing aids, and the longer they wait, the harder it is to treat hearing loss, Dr. Lin told me.

Age-related hearing loss comes on really slowly, making it harder for people to know when to take it seriously, he said. He cited two good clues to when to get your hearing tested: Family members or close friends say you should, or you notice that you often mishear or don’t know what others are saying.

But even when people are tested and spend thousands of dollars to purchase needed hearing aids, the devices often sit in a drawer. People may complain that the sound quality is poor, too static-y or otherwise annoying, and that the aids merely amplify all sound, making it still hard to hear in a noisy environment. All aids are not created equal, Dr. Lin said, and even expensive, properly fitted aids can require multiple adjustments. Some people give up too readily to get the best results.

“Unrealistic expectations are a big part of this problem,” Dr. Lin said. “It’s not like putting on a pair of glasses that immediately enables you to see clearly,” he said. “Hearing loss is not fixed as easily as eyesight. The brain needs time — a good month or two — to adjust to hearing aids. And the earlier hearing loss is treated, the easier it is for the brain to adapt.”

The new studies give ample cause for taking hearing loss seriously. Consider, for example, the link to dementia. People who can’t hear well often become socially isolated and deprived of stimuli that keep the brain cognitively engaged. As input lessens, so does brain function.

There’s also a heavier load on the brain when it’s forced to use too much of its capacity to process sound. Despite what you may think, our brains are not designed for multitasking.

“Hearing loss is not a volume issue,” Dr. Deal said. “It’s a quality-of-sound issue. Certain parts of words drop out and speech sounds like mumbling. A garbled message is sent to the brain that it has to work harder to decode.”

In addition, when information is not heard clearly, it impedes memory. “A good clear auditory signal is more easily remembered,” Dr. Deal said. “The key to memory is paying attention. The brain can’t stay focused on the words when it is working overtime to decode the signal.”

With respect to falls, she said, hearing loss often goes hand-in-hand with balance issues. “Even when we don’t realize it, we’re using our ears to position ourselves in space,” she explained. Also, when people can’t hear well, they are less aware of sounds around them. They may fall when startled by someone or something that seems to come silently from behind.

Dr. Deal said she and her co-authors were surprised to find a link between poor hearing and cardiovascular disease. “It could be that vascular disease is common to both,” she said, but added that social isolation and stress resulting from hearing loss are also likely to play a role.

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There’s good news for New York City residents, among whom noise pollution is the leading municipal complaint. By 2011, all of the more than 10,000 police department vehicles were switched to lower-frequency “rumbler” sirens, which are 10 decibels quieter, and the fire department has begun using them too.

The next step is to get less shrill sirens for the more than 2.5 million ambulance calls in the city every year. The Mount Sinai Health System is testing the two-tone sirens that make an “ee-aw” sound commonly heard in Europe, and the Greater New York Hospital Association has begun testing rumbler sirens for its ambulances.

London's best new restaurant openings for 2019

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Rumours are flying about forthcoming openings – is or isn’t Eleven Madison Park coming to Claridge’s? – but we won’t know more until the New Year. Until then, let’s stick with copper-bottomed certainties.

We know, for example, that André Garrett makes his return to London after five years at Cliveden House. He’ll join his fellow West-Countryman Tom Kerridge at the Corinthia Hotel London in January and will bring a Mediterranean touch to the new look Northall.

Cornish chef Nathan Outlaw has plans too: the Goring in Belgravia has signed him up for a seafood restaurant, launching in late spring, to complement the hotel’s more formal Dining Room. We’re promised an ‘eccentric, uplifting’ space by…

Dr Rangan Chatterjee's simple, four-step plan for a less stressful 2019

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When I arrive at Dr Rangan Chatterjee’s Wilmslow home, I walk in to his kitchen to find him strumming the guitar. “I love playing,” he explains, “and it’s great for de-stressing.”

Stress is exactly what I’m here to talk about. Dr Chatterjee, who has been a GP for over 17 years, has just written his second book, The Stress Solution – the follow up to last year’s Amazon #1 bestseller, The 4 Pillar Plan: How to Relax, Eat, Move and Sleep your way to a Longer, Healthier Life.

“When I wrote the first book, the pillar nearly everybody spoke to me about was the stress and relaxation one,” Chatterjee says. “Around the same time I was noticing that nearly all the problems I was seeing in my surgery were…