DEAR HEALTHCARE PROVIDER: FLU Powder INSUFFLATION (2) HEADLINE OF THE DAY: Relenza (zanamivir) Inhalation Powder

Relenza (zanamivir) Inhalation Powder

Audience: Infectious disease healthcare professionals, hospital risk managers

[Posted 10/09/2009] GlaxoSmithKline (GSK) and FDA notified healthcare professionals of a report of the death of a patient with influenza who received Relenza (zanamivir) Inhalation Powder which was solubilized and administered by mechanical ventilation. Relenza (zanamivir) Inhalation Powder is not intended to be reconstituted in any liquid formulation and is not recommended for use in any nebulizer or mechanical ventilator.

GSK is aware that Relenza Inhalation Powder is being removed from its FDA-approved packaging and dissolved in various solutions for the purpose of nebulizing zanamivir for inhalation by patients with influenza who are unable to take oral medications or unable to inhale Relenza Inhalation Powder using the Diskhaler. Relenza or zanamivir for nebulization have not been approved by the FDA. The safety, effectiveness, and stability of zanamivir use by nebulization have not been established.

Relenza Inhalation Powder should only be used as directed in the prescribing information by using the Diskhaler device provided with the drug product. Relenza Inhalation Powder is a mixture of zanamivir active drug substance and lactose drug carrier. This formulation is not designed or intended to be administered by nebulization. There is a risk that the lactose sugar in this formulation can obstruct proper functioning of mechanical ventilator equipment.

[10/09/2009 - Dear Healthcare Professional Letter - GlaxoSmithKline]

Relenza (zanamivir) Inhalation Powder

HARD-TO-CLASSIFY MUSICIAN ? HEADLINE OF THE DAY: Tom Waits gives the devil his due | Film | The Guardian

Tom Waits gives the devil his due

At 59, Tom Waits has finally landed the role he was born to play: the devil. He reveals how his part in Terry Gilliam's The Imaginarium of Doctor Parnassus was informed by a lifetime's fascination with beatniks, stories and lonely old men

'I'm an honest-to-God old man' … Tom Waits and Christopher Plummer in The Imaginarium Of Doctor Parnassus. Photograph: Everett/Rex

All thoughts of conducting a straightforward interview with Tom Waits turn to steam within seconds of his arrival in the Soho hotel suite. I come in through one door, carrying a notepad and a tape recorder. He comes through the other, carrying the exact same equipment. "Now OK," he says, arranging his effects on the table. "You have your questions for me, and then I have some questions for you." Introductions complete, he whips off his porkpie hat to let the hair stream up. He could be a conjurer unveiling a rabbit.

1. The Imaginarium of Doctor Parnassus
2. Production year: 2009
3. Country: Rest of the world
4. Cert (UK): 12A
5. Runtime: 122 mins
6. Directors: Terry Gilliam
7. Cast: Andrew Garfield, Christopher Plummer, Colin Farrell, Heath Ledger, Johnny Depp, Jude Law, Lily Cole, Tom Waits, Verne Troyer
8. More on this film

One does not so much interrogate Waits as be granted an audience, a private performance. Talking to the press, he once confessed, is like talking to the cops. You only do it when you have to, and it is always better to bear false witness. So he will claim he was raised by a pair of circus acrobats, or that he met his wife after busting her out of a convent, or that he trained as a doctor and still occasionally practises on the kids. "Most of the time I just tell 'em stories," he allows. "And if the stories are entertaining, who cares whether or not they're true?"

Waits is in town to discuss his role as the devil in Terry Gilliam's film The Imaginarium of Doctor Parnassus. I tell him Gilliam has said this is the role he was born to play, and he chuckles and says he can't think why; he was raised in the church. I mention this is actually his 25th screen role and he shrugs and says that Oh Lord, he wasn't keeping track. In person, Waits looks much the same as he always did: the same hunched, simian posture and weathered Dustbowl features; the same wispy, rust-coloured bouffant. This, perhaps, is the benefit of a life spent play-acting the wily, disreputable old puck. At the age of 59, he has finally grown into the costume.

Now look, he says. He figured I would probably ask him about some movies he likes, so he has done his homework and written them down. He crouches over his notepad and reads out the names. Putney Swope. The Pawnbroker. The Ox-Bow Incident. "Did you ever see a movie called Dirty Little Billy?" he asks, squinting up at me. "Starred Michael J Pollard. Made right around the same time as McCabe & Mrs Miller."

The jump-rope test
Acting, he points out, is merely a sidebar. He has been fortunate enough to work with the likes of Coppola and Altman, Jarmusch and Gilliam, and yet this has always been secondary to the music. Music was his first love – but then everybody loves music. "What you want is for music to love you back. That's why you pay your dues. You want to feel like you belong and are part of this symbiosis, metamorphosis, whatever you want to call it. That one day … " He coughs and regroups. "I used to imagine that making it in music – really making it in music – is if you're an old man going by a schoolyard and you hear children singing your songs, playing jump-rope, or on the swings. That's the ultimate. You're in the culture."

Is that what motivated him? The quest for immortality? "I guess, to a certain degree. Whether you say it or not, that's what you're thinking. You want to feel ongoing, because it's like getting extra time." He glances at the page. "Now, what do you think of Zatoichi? The blind samurai."

'We're all insects crawling on the shiny hood of a Cadillac'
Waits was born not to circus performers but to a pair of teachers in Pomona, California. He was, by his own account, a strange little boy: bookish, overwound and with a tendency to be spooked by untoward noises. He did not thrive at school, he says, because he did not like the little holes they drilled in the cork-board ceiling, or the hooked stick they used to open the windows. He did not like being young, and took to shuffling around with his granddad's hat and cane.

Later, he fell under the spell of Charles Bukowski and the beat generation, and took to hanging out amid the flotsam of downtown LA. He was fascinated, he said, by "the great American loneliness", a loneliness that stretched from coast to coast and was as elusive and mysterious as ground fog. "Yeah, that all came from Bukowski and Kerouac," he recalls. "I always liked the idea that America is a big facade. We are all insects crawling across on the shiny hood of a Cadillac. We're all looking at the wrapping. But we won't tear the wrapping to see what lies beneath."

Throughout the 70s, Waits viewed the fog at eye-level. He lived semi-rough at the Tropicana motel, where he would set his piano up in the kitchen and fish his songs from the old men who sat in the lobby. "You know how it is," he says. "If you're a writer you know that the stories don't come to you, you have to go looking for them. The old men in the lobby: that's where the stories were. And then when the record label would send me on tour, I always resisted checking into the usual places. I'd step off the bus and look for the hotels named after presidents." Hotels named after presidents, he argues, guarantee a certain grubby authenticity. "The Taft!" Waits says with relish. "You could usually rely on finding a Taft in every town. Take me to the Taft! You walk in and there they are: the old men in the lobby."

Bourbon and rumba
Waits's musical output falls into two distinct categories. The songs on those early albums arranged themselves like the patrons of a seedy lounge bar. They were woozy, jazzy offerings, marinated in bourbon, and spinning tales of loss and longing and half-chances that never quite came good.

Then, with 1983's Swordfishtrombones, a curious transformation occurred, and these barflies grew wings. They began hammering on the lamp-shades and rattling the optics. They learned rumba, gospel and delta blues. They became wilder, richer, more radical.

I confess that I like the early songs as well. But it's too late, they're gone, disowned like bad relations. "I'm embarrassed by them," he admits. "It was a time when I was trying to find my place within the business. I was figuring out who I was and where that person intersected with the world of commerce. It was like I was sitting there with a ventriloquist's dummy on my knee. And the dummy is made out of wood. And after a while you start to hate each other."

Then whoops, it's back to the notebook. "Cantinflas," he says, bent low over the page. "You know Cantinflas?" Cantinflas was Mexico's answer to Charlie Chaplin and a comic beloved by Waits's own father. "Oh Cantinflas, he was something else. He had the hair and the walk. Looking back, I now see that I lifted a lot of my act from Cantinflas."

Who's steering the ship?
The catalyst, however, came courtesy of his wife. Waits met Kathleen Brennan on the cusp of the 1980s, when she was working as a script consultant on Coppola's One from the Heart. It was Brennan who broadened his range, knocked him out of his rut. Without her, he says, he would probably be playing in a steakhouse today.

"She rescued me. Maybe I rescued her too; that's often how it works. Upshot is that we both got into the same leaky boat. Maybe the weight drags it down, because now you've two people sitting in it. Sorry, baby! But on the other hand you've also got two peoples' imagination to patch it up again."

The fact is, women are just that bit smarter than men. "Everybody knows she's the brains behind Pa, as Dylan might have said. I'm just the figurehead. She's the one who's steering the ship."

Specifically, she has steered it all the way from downtown LA to a home amid the hills of northern California. Brennan helped Waits to clean up his act. He quit smoking, embraced sobriety and went on to raise three children who are now all but grown, except the singer argues no one ever really grows, they just become different. In the meantime, the albums have kept coming, even if they wash in at a slower rate these days. Real Gone, in 2004, was his last collection of original material. Since then, he has put out Orphans, a collection of offcuts and offshoots, and has a live album, Glitter and Doom, set for release next month. "I'm almost 60," he marvels. "An honest-to-God old man. I'll write you from there and tell you what it's like."

Do we have time for one last trip to the notebook? It transpires that we do. Waits loves Toby Damnit, a short film by Fellini, and the opening scene from Once Upon a Time in the West, when the tin windmill turns around and says "Weaargh! Weaargh!" He loves Central Station and City of God; all those fresh films out of Latin America. I tell him about Tony Manero, a Chilean black comedy that came out earlier this year. He likes the sound of that one and duly jots it down.

"You know what one of my favourite movies of all time is? And if I'm at home with my kids and say, 'What do you want to see?', the big joke is, 'Aw Dad! Not Pig in the City!' But I love that movie. I'd see that any time."

I tell him I like the Babe sequel myself, but am now struggling to recall the details. Wasn't there some scene in a vivisectionist lab? A tragic orangutan who won't leave his cage because he is not properly dressed? "Oh, I know," groans Waits, raising a hand as if to ward off evil spirits. "Oh God," he says. "Don't." Nothing pierces his heart so keenly, it seems, as a monkey that has spent too long in the world of men.

'When you're in hell, keep going'
I ask whether he ever feels nostalgic for the wild years, when he lived at the Tropicana and laid his head at the Taft. "I can't say that I miss it," he says with a shrug. "We're all eating our way through the potato. Like they say: when you're in hell, keep going. Don't look back, because someone might be gaining on you."

In any case, he says, so what if he no longer holds court at the Tropicana? The world is different, but it is not entirely different. There are still dark pockets to explore, so long as you know where to look. If he wants to spend a night out on the railroad tracks he still can: he just has to plan it in advance. And if he cares to check in at the Taft then hey, he can do that too. "I kept hold of the room key," he confides. "I can go back anytime I want." And at this point, Waits dissolves into an emphysemic cackle. "That's the key," he says. "The key is the key."

Tom Waits gives the devil his due | Film | The Guardian

YouTube Roundup of the Day: Maverick headers, potty-mouthed sportsmen and Roy Keane's laser-stare | Classic YouTube | Sport | guardian.co.uk

Maverick headers, potty-mouthed sportsmen and Roy Keane's laser-stare

The Republic of Ireland v Italy at USA 94, a young Kevin Keegan and Brett Favre's miracle also feature in this week's round-up

1) If you're scoring your 200th goal in the Argentinian top flight, you might as well mark the occasion in style. What better way to do so than by nodding home the winner for Boca Juniors in a five-goal thriller at La Bombonera against Velez Sarsfield ... from 40 metres out. Martin Palermo take a bow.

2) Another remarkable header, albeit less intentional. A young Steve Waugh scones Arjuna Ranatunga on the back of the head whilst throwing for a run-out. Here are some more comedy cricket injuries (unless you're on the receiving end), plus a nasty collision/astonishing catch combo.

3) The only things missing are the red beams, as a BBC reporter is subjected to Roy Keane's most gimlet-eyed laser-stare for having the brass neck to ask if the Ipswich Town manager might walk away from his latest managerial post. Those toes you can hear curling are your own. We're not sure why Keano took umbrage at the question - it's not as if the former Manchester United midfielder is without form in the field of messy, unexpected break-ups. To see a more cherubic, cuddly and - let's face it - infinitely less entertaining Keane, click here.

4) On the subject of former Republic of Ireland internationals, Keane's old team entertain Italy this weekend in a crunch World Cup qualifier. Italy may be hot favourites, but a win for the Irish wouldn't be unprecedented in World Cup history, as this footage from the finals at USA 94 attests. Marvel at the tears of joy, marvel at Terry Phelan's facial expression, marvel at the American commentators referring to Ireland as "England" before describing Ray Houghton's shots as "a chipper".

5) We don't feature table tennis very often on Classic YouTube for fairly obvious reasons: because it's rubbish. At least that's what we thought until we saw this rally, followed by this wizardry. Finally, would the last two nerds with far too much time on their hands please turn off the lights.

6) Parental advisory alert! It may not be his mother tongue, but Heerenveen potty-mouth Christian Grindheim is able to tell this cameraman where to go in perfect English. Elsewhere, Sir Alex Ferguson gets a ticking-off for dropping the b-bomb, while an umpire gives former Baltimore Orioles coach Earl Weaver as good as he gets in a breathtakingly foul-mouthed tirade.

The best from last week's blog

1) English football's decidedly unimaginative pitch invaders could learn a thing or two from this bloke.

2) The title of this clip is "If You Watch 100 Times You Will Still Laugh". Whoever named it isn't exaggerating. We hope you like the pain.

3) Man on skis and under helmet-cam gets caught in avalanche. Scary stuff.

4) An innocent, fresh-faced young teenager who's just broken into the Scunthorpe first team does his first ever TV interview. His name? Kevin Keegan.

5) With two seconds left on the clock, Minnesota Vikings quarterback Brett Favre, age 66, throws a miracle pass to stun the San Francisco 49ers.

6) If basketball players get three points for shooting a basket from "down town", how many do they get for scoring from the other side of a big house or halfway down a waterslide?

Maverick headers, potty-mouthed sportsmen and Roy Keane's laser-stare | Classic YouTube | Sport | guardian.co.uk

WRITERS WHO ARE ONE LETTER AWAY FROM COCAINE INSUFFLATING SUPERMODELS HEADLINE OF THE DAY: Kate Mosse: the woman with the golden touch | Life and style | The Guardian

Kate Mosse: the woman with the golden touch

Novelist Kate Mosse talks about feminism, family and founding the Orange prize

Author and founder of the Orange prize Kate Mosse. Photograph: Linda Nylind

On more than one occasion in our interview, Kate Mosse shakes her head, and says, "Obviously you can't write that. It sounds too gooey." It's a recognition of just how charmed her life can sound; looked at from a distance, it could easily make bitter eyes burn green. There are her two bestselling adventure novels, Labyrinth and Sepulchre; her steering of the Orange prize from scandal to success; the long, happy relationship with her first love, Greg; the two kids she clearly adores. In fact, if you are a troubled writer, or just a troubled person, a part of me recommends you look away now: this story won't necessarily make you feel better.

Full disclosure: I first met her some months ago, when I was a judge on the Orange prize. She immediately made me want to confide my darkest secrets – perhaps a result of her growing up as one of three tight-knit sisters. She has been described as having "indefatigable enthusiasm and steely charm", but while the former is certainly true, her manner is not really steely, but head-girlishly straight- forward. (She is the eldest sister; she knows that this shows.) Mosse was from Chichester, moved to London, and then back. Her success is big town; her chosen life is small town.

At 47, she has just published her latest novel, The Winter Ghosts. She is modest to a fault about her writing – regularly referring to her books as "yarns", which lowers expectations alarmingly. Yet The Winter Ghosts is a deftly written tale, propelling you compulsively through the story of Freddie, a young man adrift in the late 1920s, after his beloved brother has been killed in the first world war.

Mosse says the starting point for the story, "was really the nature of grief, and how incredibly hard it was for everybody, but particularly young men, to be allowed to grieve after the first world war. What would it be like if you idolised your older brother, and you'd never quite been the wanted child, but he made it all right – then he was gone?"

The answer is that you might have a breakdown, head to southern France, crash your car, and become embroiled in a woodland community suffering its own terrible loss. Like the two novels that precede it, The Winter Ghosts knits together eras, combines a strong historical story with a more modern one, and makes it clear that, while times and values may shift, people's deepest concerns don't change much.

It looks likely to be another success – surprising, in some ways, since Mosse never set out to be a writer. Growing up with a solicitor father and amateur archaeologist mother, she was determined to be a musician, practising her violin constantly, until, at about 16, she realised she "wasn't good enough. Well," she revises, "I was good enough to be in an orchestra, but I wasn't any better than that." She couldn't have been a soloist? "Exactly. And I knew that I would not be happy."

After her all-girls' comprehensive, she studied English at Oxford, and discovered feminism. Between her sisters and her school, Mosse had grown up in a strong female environment; she had never considered anything off-limits to women. On joining a consciousness-raising group in the early 80s, she started discussing the issues of the era, "Reclaim the Night, pornography, rape . . . Some of what was said was just jolly silly, but some gave me pause. I began to call myself a feminist – and still absolutely do – because it was the first time that I'd consciously thought that things might be different for someone just because they were a woman. Before that I had thought, rather naively, that we were all judged, very straightforwardly, on what we did."

After temping at the publisher Hodder & Stoughton, she landed a permanent job and began racing through the ranks. By her early 30s, she was an editorial director at Hutchinson, and was offered a promotion. She didn't take it. Pregnant with her second child, she had been "whingeing" to an agent friend about the contradictions this prompted – she'd always thought herself free of body image worries, for instance; now she found herself in the thick of them. He encouraged her to write about it. She left her job, and the book, Becoming a Mother, led to another non-fiction book, and then, following more encouragement from a friendly editor, her first two novels, Eskimo Kissing, and Crucifix Lane.

Along the way she became a founder of the Orange literary prize for women, prompted by an all-male Booker prize shortlist in 1991. To Mosse, the argument was, to repeat one of her favourite words, straightforward: the industry knew that a large proportion of what they published was by women, who also made up a majority of their audience, yet book awards didn't reflect this at all. Mosse genuinely thought, "that everybody who loved books would be throwing their hats in the air!" about the new prize, but instead there was a wave of accusations that it was sexist, unnecessary, a lame duck. A headline above photos of the six shortlisted authors read, "Obscene, brutal, boring and dreary drivel".

Did Mosse consider jacking it in? "No. If the critics who said that it was sexist [to exclude men] had also been campaigning when women weren't allowed to be ordained, I would have respected that, but they weren't. The other criticism that was interesting was that it's a second-rate prize because men aren't included. I thought, 'They don't think that the Booker is second-rate because only certain countries – based on a very old, imperial system – are eligible.'" (While the Orange prize is open to all English language novels written by women, the Booker excludes US authors.) The moment that she knew it would be fine was when Iris Murdoch turned up at the first Orange prize party; when Anne Michaels's brilliant Fugitive Pieces won the prize in its second year – having sold only 800 copies beforehand – the carping calmed.

Mosse sometimes describes herself, her politics, as woolly – she says that her husband, who took her surname, is a far more hardline feminist than she is. But with her forthright dedication, her 4am starts, her clear devotion to family (her mother, father and mother-in-law all live with her), she has achieved a huge amount.

The Orange prize, for which she is the honorary director, seems to have changed the culture: since it launched, the number of female Booker nominees has soared, a significant shift. And, having only really seen herself as a proper writer since starting Labyrinth, she has come into her own on the page. It might seem "gooey" to say it, but Kate Mosse's success is thoroughly deserved. Don't hate her for it.

The Winter Ghosts by Kate Mosse, published by Orion, is out now, price £14.99. To order a copy for £13.99 with free UK p&p, go to guardian.co.uk/bookshop or call 0330 333 6846.

The women's page invites your comments. Do we still need women-only awards and prizes? Post below or email women@guardian.co.uk

Kate Mosse: the woman with the golden touch | Life and style | The Guardian