Quotulatiousness

October 16, 2014

The trouble with “parenting” in 2014

Filed under: Bureaucracy, Health, Law, Liberty — Tags: , , , — Nicholas @ 00:02

Jan MacVarish discusses the problems facing today’s parents that inhibit natural parenting instincts and replace them with the diktats of the bureaucracy:

Here are two scenes which illustrate contemporary parenting culture.

In the first, I am called into my son’s primary school by the ‘family-liaison officer’. I am surprised to learn that she is investigating the concerns of a teacher who has overheard my son and his friends discussing their mothers’ favourite punishment methods. Whereas one of the mothers (who I know) reportedly kicks her boy in the privates with her stilettos, and another (who I also know) prefers to administer an ‘African slap’, my chosen method is, apparently, to hit my son with a frying pan. Visions of Tom and Jerry immediately spring to mind, and I laugh at the ridiculousness of the schoolboys’ conversation. The family-liaison officer admits that it is highly unlikely that a mother such as me (white and middle class) would engage in such behaviour, but, she tells me, she is nevertheless obliged to ask if I have ever deployed the family skillet as a weapon. I am now amused, bemused and starting to see that this could have played out very differently if I were perceived to be one of those ‘other’ parents.

Scene two: While swimming in the local pool with frying-pan boy, I notice a mother engage in an exhausting 20-minute argument with her one-year-old baby boy. He had slapped her, so she was asking him in a quiet, controlled voice to look her in the eye and apologise for ‘hurting mummy’. Being a baby, he refused to comply, and became more and more upset as the request was repeated again and again. My sympathy was equal for both mother and child: he was sobbing and she seemed forlornly trapped in some kind of ‘good parenting’ ritual, in which the parent conveys to the child the emotional consequences of their actions – ‘you hurt mummy, that makes mummy feel sad’ – and expects the child to take ‘ownership’ of their actions.

Both of these scenes demonstrate the abandonment of common sense and, indeed, any kind of ‘instinct’ when it comes to adults relating to children. When you remove any element of instinct from parenting, you replace trust, care, love and joy with empty rituals of ‘safeguarding’ or ‘good parenting’. The family-liaison officer’s dutiful yet hollow investigation makes clear just how corrosive the institutionalisation of parent-blaming in schools has become, while the mother’s exchange with her baby in the pool showed how futile and joy-draining following abstract, good-parenting guidelines can be.

October 14, 2014

Reason.tv – 3 Reasons the US MILITARY Should NOT Fight Ebola

Filed under: Africa, Health, Military, USA — Tags: , , — Nicholas @ 17:30

Published on 14 Oct 2014

President Obama is sending thousands of U.S. troops to West Africa to fight the deadly Ebola virus. Their mission will be to construct treatment centers and provide medical training to health-care workers in the local communities.

But is it really a good idea to send soldiers to provide this sort of aid?

Here are 3 reasons why militarizing humanitarian aid is a very bad idea

October 13, 2014

The Royal Navy’s “weirdest” ship

Filed under: Africa, Britain, Health, Military — Tags: , , — Nicholas @ 10:31

David Axe on what he describes as the weirdest ship in the Royal Navy:

Royal Fleet Auxiliary vessel RFA Argus pictured supporting Operation Herrick in Afghanistan (via Wikipedia)

Royal Fleet Auxiliary vessel RFA Argus pictured supporting Operation Herrick in Afghanistan (via Wikipedia)

The British Royal Navy is deploying the auxiliary ship RFA Argus to Sierra Leone in West Africa in order to help health officials contain the deadly Ebola virus.

If you’ve never heard of Argus, you’re not alone. She’s an odd, obscure vessel — an ungainly combination of helicopter carrier, hospital ship and training platform.

But you’ve probably seen Argus, even if you didn’t realize it. The 33-year-old vessel played a major role in the 2013 zombie movie World War Z, as the floating headquarters of the U.N.

[...]

The 575-foot-long Argus launched in 1981 as a civilian container ship. In 1982, the Royal Navy chartered the vessel to support the Falklands War … and subsequently bought her to function as an aviation training ship, launching and landing helicopters.

Argus’ long flight deck features an odd, interrupted layout, with a structure — including the exhaust stack — rising out of the deck near the stern.

Weirdly, the deck’s imperfect arrangement is actually an asset in the training role. Student aviators on Argus must get comfortable landing in close proximity to obstacles, which helps prepare them for flying from the comparatively tiny decks of frigates and other smaller ships.

RFA Argus photographed off the coast at Devonport (via Wikipedia)

RFA Argus photographed off the coast at Devonport (via Wikipedia)

Statistical sleight-of-hand on the dangers of texting while driving

Filed under: Health, Media, USA — Tags: , , , , — Nicholas @ 10:15

Philip N. Cohen casts a skeptical eye at the frequently cited statistic on the dangers of texting, especially to teenage drivers. It’s another “epidemic” of bad statistics and panic-mongering headlines:

Recently, [author and journalist Matt] Richtel tweeted a link to this old news article that claims texting causes more fatal accidents for teenagers than alcohol. The article says some researcher estimates “more than 3,000 annual teen deaths from texting,” but there is no reference to a study or any source for the data used to make the estimate. As I previously noted, that’s not plausible.

In fact, 2,823 teens teens died in motor vehicle accidents in 2012 (only 2,228 of whom were vehicle occupants). So, my math gets me 7.7 teens per day dying in motor vehicle accidents, regardless of the cause. I’m no Pulitzer Prize-winning New York Times journalist, but I reckon that makes this giant factoid on Richtel’s website wrong, which doesn’t bode well for the book.

In fact, I suspect the 11-per-day meme comes from Mother Jones (or whoever someone there got it from) doing the math wrong on that Newsday number of 3,000 per year and calling it “nearly a dozen” (3,000 is 8.2 per day). And if you Google around looking for this 11-per-day statistic, you find sites like textinganddrivingsafety.com, which, like Richtel does in his website video, attributes the statistic to the “Institute for Highway Safety.” I think they mean the Insurance Institute for Highway Safety, which is the source I used for the 2,823 number above. (The fact that he gets the name wrong suggests he got the statistic second-hand.) IIHS has an extensive page of facts on distracted driving, which doesn’t have any fact like this (they actually express skepticism about inflated claims of cell phone effects).

[...]

I generally oppose scare-mongering manipulations of data that take advantage of common ignorance. The people selling mobile-phone panic don’t dwell on the fact that the roads are getting safer and safer, and just let you go on assuming they’re getting more and more dangerous. I reviewed all that here, showing the increase in mobile phone subscriptions relative to the decline in traffic accidents, injuries, and deaths.

That doesn’t mean texting and driving isn’t dangerous. I’m sure it is. Cell phone bans may be a good idea, although the evidence that they save lives is mixed. But the overall situation is surely more complicated than the TEXTING-WHILE-DRIVING EPIDEMIC suggests. The whole story doesn’t seem right — how can phones be so dangerous, and growing more and more pervasive, while accidents and injuries fall? At the very least, a powerful part of the explanation is being left out. (I wonder if phones displace other distractions, like eating and putting on make-up; or if some people drive more cautiously while they’re using their phones, to compensate for their distraction; or if distracted phone users were simply the worst drivers already.)

October 8, 2014

Something is wrong when your “data adjustment” is to literally double the reported numbers

Filed under: Health, USA — Tags: , , — Nicholas @ 10:32

In Forbes, Trevor Butterworth looks at an odd data analysis piece where the “fix” for a discrepancy in reported drinks per capita is to just assume everyone under-reported and to double that number:

“Think you drink a lot? This chart will tell you.”

The chart, reproduced below breaks down the distribution of drinkers into deciles, and ends with the startling conclusion that 24 million American adults — 10 percent of the adult population over 18 — consume a staggering 74 drinks a week.

Time for a stiff drink infographic

The source for this figure is “Paying the Tab,” by Phillip J. Cook, which was published in 2007. If we look at the section where he arrives at this calculation, and go to the footnote, we find that he used data from 2001-2002 from NESARC, the National Institute on Alcohol Abuse and Alcoholism, which had a representative sample of 43,093 adults over the age of 18. But following this footnote, we find that Cook corrected these data for under-reporting by multiplying the number of drinks each respondent claimed they had drunk by 1.97 in order to comport with the previous year’s sales data for alcohol in the US. Why? It turns out that alcohol sales in the US in 2000 were double what NESARC’s respondents — a nationally representative sample, remember — claimed to have drunk.

While the mills of US dietary research rely on the great National Health and Nutrition Examination Survey to digest our diets and come up with numbers, we know, thanks to the recent work of Edward Archer, that recall-based survey data are highly unreliable: we misremember what we ate, we misjudge by how much; we lie. Were we to live on what we tell academics we eat, life for almost two thirds of Americans would be biologically implausible.

But Cook, who is trying to show that distribution is uneven, ends up trying to solve an apparent recall problem by creating an aggregate multiplier to plug the sales data gap. And the problem is that this requires us to believe that every drinker misremembered by a factor of almost two. This might not much of a stretch for moderate drinkers; but did everyone who drank, say, four or eight drinks per week systematically forget that they actually had eight or sixteen? That seems like a stretch.

We are also required to believe that just as those who drank consumed significantly more than they were willing to admit, those who claimed to be consistently teetotal never touched a drop. And, we must also forget that those who aren’t supposed to be drinking at all are also younger than 18, and their absence from Cook’s data may well constitute a greater error.

Pakistan’s public health emergency

Filed under: Asia, Health — Tags: , , , , , — Nicholas @ 10:07

The number of reported cases of polio is now the highest it has been for more than a decade, and at least some of the blame has to go to the CIA for using health workers as a cover for some of their covert operations.

As world health officials struggle to respond to the Ebola epidemic, Pakistan has passed a grim milestone in its efforts to combat another major global health crisis: the fight against polio.

Over the weekend, Pakistan logged its 200th new polio case of 2014, the nation’s highest transmission rate in more than a dozen years. The spread has alarmed Pakistani and international health experts and is prompting fresh doubt about the country’s ability to combat this or future disease outbreaks.

By Tuesday, the number of new polio cases in Pakistan stood at 202, and officials are bracing for potentially dozens of other cases by year’s end. Pakistan now accounts for 80 percent of global cases and is one of only three countries at risk of exporting the disease outside its borders, according to the World Health Organization.

[...]

In far-flung areas of the country, some parents and religious leaders are skeptical of the vaccine, requiring considerable face-to-face outreach by vaccination teams.

But the Pakistani Taliban and other Islamist militants have waged a brutal campaign against those teams, killing more than 50 health workers and security officials since 2012. The attacks began after it was discovered that the CIA had used a vaccination campaign to gain information about Osama bin Laden’s whereabouts.

October 2, 2014

The Aral Sea, Uzbek cotton, forced labour, and the clothing industry

Filed under: Asia, Environment, Health — Tags: , , , , , — Nicholas @ 09:07

As reported the other day, what was once the world’s fourth largest lake, the Aral Sea, has almost completely dried up due to Soviet water diversion projects of the late 1950s and early 1960s:

In the early 1960s, the Soviet government decided the two rivers that fed the Aral Sea, the Amu Darya in the south and the Syr Darya in the east, would be diverted to irrigate the desert, in an attempt to grow rice, melons, cereals, and cotton.

This was part of the Soviet plan for cotton, or “white gold”, to become a major export. This temporarily succeeded, and in 1988, Uzbekistan was the world’s largest exporter of cotton.

The Soviet government made a deliberate choice to sacrifice the Aral Sea to create a vast new cotton-growing region in Uzbekistan. It was clearly quite successful, depending on how you choose to measure success.

The disappearance of the lake was no surprise to the Soviets; they expected it to happen long before. As early as 1964, Aleksandr Asarin at the Hydroproject Institute pointed out that the lake was doomed, explaining, “It was part of the five-year plans, approved by the council of ministers and the Politburo. Nobody on a lower level would dare to say a word contradicting those plans, even if it was the fate of the Aral Sea.”

The reaction to the predictions varied. Some Soviet experts apparently considered the Aral to be “nature’s error”, and a Soviet engineer said in 1968, “it is obvious to everyone that the evaporation of the Aral Sea is inevitable.”

The drying-out of the Aral was not just bad news for the fishermen of the region: it was a full-blown environmental disaster, as the former lake bottom was heavily polluted:

The receding sea has left huge plains covered with salt and toxic chemicals – the results of weapons testing, industrial projects, and pesticides and fertilizer runoff – which are picked up and carried away by the wind as toxic dust and spread to the surrounding area. The land around the Aral Sea is heavily polluted, and the people living in the area are suffering from a lack of fresh water and health problems, including high rates of certain forms of cancer and lung diseases. Respiratory illnesses, including tuberculosis (most of which is drug resistant) and cancer, digestive disorders, anaemia, and infectious diseases are common ailments in the region. Liver, kidney, and eye problems can also be attributed to the toxic dust storms. Health concerns associated with the region are a cause for an unusually high fatality rate amongst vulnerable parts of the population. The child mortality rate is 75 in every 1,000 newborns and maternity death is 12 in every 1,000 women. Crops in the region are destroyed by salt being deposited onto the land. Vast salt plains exposed by the shrinking Aral have produced dust storms, making regional winters colder and summers hotter.

The Aral Sea fishing industry, which in its heyday had employed some 40,000 and reportedly produced one-sixth of the Soviet Union’s entire fish catch, has been devastated, and former fishing towns along the original shores have become ship graveyards. The town of Moynaq in Uzbekistan had a thriving harbor and fishing industry that employed about 30,000 people; now it lies miles from the shore. Fishing boats lie scattered on the dry land that was once covered by water; many have been there for 20 years.

"Waterfront" of Aralsk, Kazakhstan, formerly on the banks of the Aral Sea. Photo taken Spring 2003 by Staecker. (Via Wikipedia)

“Waterfront” of Aralsk, Kazakhstan, formerly on the banks of the Aral Sea. Photo taken Spring 2003 by Staecker. (Via Wikipedia)

So, tragic as all this is, what does it have to do with the clothing industry? The Guardian‘s Tansy Hoskins points out that due to the murky supply chains, it’s almost impossible to find out where the cotton used by many international clothing firms actually originates, and the Uzbek cotton fields are worked by forced labour:

The harvest of Uzbek cotton is taking place right now — it started on the 5 September and is expected to last until the end of October. The harvest itself is also a horror story, on top of the environmental devastation, this is cotton picked using forced labour. Every year hundreds of thousands of people are systematically sent to work in the fields by the government.

Under pressure from campaigners, in 2012, Uzbek authorities banned the use of child labour in the cotton harvest, but it is a ban that is routinely flouted. In 2013 there were 11 deaths during the harvest (pdf), including a six year old child, Amirbek Rakhmatov, who accompanied his mother to the fields and suffocated after falling asleep on a cotton truck.

Campaigners have also managed to get 153 fashion brands to sign a pledge to never knowingly use Uzbek cotton. Anti-Slavery International have worked on this fashion campaign but acknowledge that despite successes there is still a long way to go.

“Not knowingly using Uzbek cotton and actually ensuring that you don’t use Uzbek cotton are two completely different things,” explains Jakub Sobik, press officer at Anti-Slavery International.

One major problem that Sobik points out is that much of the Uzbek cotton crop now ends up in Bangladesh and China — key suppliers for European brands. “Whilst it is very hard to trace the cotton back to where it comes from because the supply chain is so subcontracted and deregulated, brands have a responsibility to ensure that slave picked cotton is not polluting their own supply chain.”

September 16, 2014

When the “best nutrition advice” is a big, fat lie

Filed under: Government, Health, Media, Science — Tags: , , , , — Nicholas @ 10:17

Rob Lyons charts the way our governments and healthcare experts got onboard the anti-fat dietary express, to our long-lasting dietary harm:

… in recent years, the advice to eat a low-fat diet has increasingly been called into question. Despite cutting down on fatty foods, the populations of many Western countries have become fatter. If heart-disease mortality has maintained a steady decline, cases of type-2 diabetes have shot up in recent years. Maybe these changes were in spite of the advice to avoid fat. Maybe they were caused by that advice.

The most notable figure in providing the intellectual ammunition to challenge existing health advice has been the US science writer, Gary Taubes. His 2007 book, Good Calories, Bad Calories, became a bestseller, despite containing long discussions on some fairly complex issues to do with biochemistry, nutrition and medicine. The book’s success triggered a heated debate about what really makes us fat and causes chronic disease.

The move to first discussing and then actively encouraging a low-fat diet was largely due to the work of Dr. Ancel Keys, who is to the low-fat diet movement what Karl Marx is to Communism. His energy, drive, and political savvy helped get the US government and the majority of health experts onboard and pushing his advice. A significant problem with this is that Keys’ advocacy was not statistically backed by even his own data. He drew strong conclusions from tiny, unrepresentative samples, yet managed to persuade most doubters that he was right. A more statistically rigorous analysis might well show that the obesity crisis has actually been driven by the crusading health advisors who have been pushing the low-fat diet all this time … or, as I termed it, “our Woody Allen moment“.

Rob Lyons discussed this with Nina Teicholz, author of the book The Big Fat Surprise:

Once the politically astute Keys had packed the nutrition committee of the AHA and got its backing for the advice to avoid saturated fat, the war on meat and dairy could begin. But a major turning point came in 1977 when the Senate Select Committee on Nutrition, led by Democratic senator George McGovern, held hearings on the issue. The result was a set of guidelines, Dietary Goals for the United States [PDF], which promoted the consumption of ‘complex’ carbohydrates, and reductions in the consumption of fat in general and saturated fat in particular.

By 1980, this report had been worked up into government-backed guidelines — around the same time that obesity appears to have taken off in the US. The McGovern Report inspired all the familiar diet advice around the world that we’ve had ever since, and led to major changes in what food manufacturers offered. Out went fat, though unsaturated fat and hydrogenated oils were deemed less bad than saturated fat, so vegetable oils and margarines became more popular. In came more carbohydrate and more sugar, to give those cardboard-like low-fat ‘treats’ some modicum of flavour.

Yet two recent reviews of the evidence around saturated fat — one led by Ronald Krauss, the other by Rajiv Chowdhury — suggest that saturated fat is not the villain it has been painted as. (The latter paper, in particular, sparked outrage.) As for fat in general, Teicholz tells me: ‘There was no effort until very late in the game to provide evidence for the low-fat diet. It was just assumed that that was reasonable because of the caloric benefit you would see from restricting fat.’

Teicholz also debunks the wonderful reputation of the Mediterranean Diet (“a rose-tinted version of reality tailored to the anti-meat prejudices of American researchers”), points out the role of the olive oil industry in pushing the diet (“Swooning researchers were literally wined and dined into going along with promoting the benefits of olive oil”), and points out that we can’t even blame most of the obesity problem on “Big Food”:

Which leads us to an important third point made by Teicholz: that the blame for our current dietary problems cannot solely, or even mainly, be placed at the door of big food corporations. Teicholz writes about how she discovered that ‘the mistakes of nutrition science could not be primarily pinned on the nefarious interests of Big Food. The source of our misguided dietary advice was in some ways more disturbing, since it seems to have been driven by experts at some of our most trusted institutions working towards what they believed to be the public good.’ Once public-health bureaucracies enshrined the dogma that fat is bad for us, ‘the normally self-correcting mechanism of science, which involves constantly challenging one’s own beliefs, was disabled’.

The war on dietary fat is a terrifying example of what happens when politics and bureaucracy mixes with science: provisional conclusions become laws of nature; resources are piled into the official position, creating material as well as intellectual reasons to continue to support it; and any criticism is suppressed or dismissed. As the war on sugar gets into full swing, a reading of The Big Fat Surprise might provide some much-needed humility.

QotD: The real value of work

Filed under: Health, Quotations — Tags: , , — Nicholas @ 00:01

People without meaningful work and copious free time don’t write symphonies or create great works of art. They don’t live a life of the mind. They drink too much, or get in fights, or watch a lot of internet porn, or commit crimes. They don’t contribute to the economy or culture, as a rule. They just…exist. And it goes on like that, sometimes for generations.

Labor is the fate of all humankind. Always has been. We work to live. Work gives shape and meaning to our lives. It’s not just the income we derive from it; it’s the knowledge that we are able to function as adults in the wider world, and provide for ourselves and our families. It’s feeling the satisfaction of having contributed something to the maintenance of civilization, even if it means we haul trash away or keep the grass mowed. It’s all honorable work, necessary work, and not something to be ashamed of.

It’s not an outrage, it’s just the way things are. To try and embitter people about that, to make them feel that the natural order of things is unfair, is just to do an enormous amount of harm to the very people you’re claiming to want to help.

Monty, “We’re now living in a post-labor Utopia. Have you heard about this?”, Ace of Spades HQ, 2014-02-06

September 10, 2014

QotD: Smoking and drinking

Filed under: Health, Quotations, Wine — Tags: , — Nicholas @ 00:01

Apart from all the other arguments, you’re a fool to smoke if you like the taste of drink. It isn’t the cigarette you smoke with your glass of wine or whisky that damages the taste of it it’s all the ones you smoked yesterday and the day before and last week. Your senses are chronically anaesthetized. Really, smokers could afford to consider what they’re certainly missing as well as what they’re in danger of getting.

After much pondering I think I understand a basic reason why a glass of something reviving is so welcome in the early evening. Partly, of course, it’s just that, to revive, to relax, but its also a convenient way of becoming a slightly different person from your daytime self, less methodical, less calculating — however you put it, somebody different, and the prospect of that has helped to make the day tolerable. And, conversely, it’s not having that prospect that makes the day look grim to the poor old ex-boozer, more than missing the alcohol as such.

Changing for dinner used to be another way of switching roles. Coming home from work has a touch of the same effect. Writers haven’t got that advantage — when they finish work they’re at home already. So perhaps they need that glass of gin extra badly. Any excuse is better than none.

Kingsley Amis, Everyday Drinking: The Distilled Kingsley Amis, 2008.

September 2, 2014

The suddenly unsettled science of nutrition

Filed under: Government, Health, USA — Tags: , , — Nicholas @ 14:58

After all the salt uproar over the last year or so, perhaps it was inevitable that other public health consensus items would also come under scrutiny. Here’s Ace having a bit of fun with the latest New York Times report on fat and carbohydrates in the modern diet:

One day there will be a book written about this all — how a “Consensus of Experts” decided, against all previous wisdom and with virtually no evidence whatsoever, that Fat Makes You Fat and you can Eat All the Carbohydrates You Like Because Carbohydrates Are Healthy.

This never made a lick of sense to me, even before I heard of the Atkins diet.

Sugar is a carbohydrate. Indeed, it’s the carbohydrate, the one that makes up the others (such as starches, which are just long lines of sugar molecules arranged into sheets and folded over each other).

How the hell could it possibly be that Fat was Forbidden but SUGAR was Sacred?

It made no sense. A long time ago I tried to get a nutritionist to explain this to me. “Eat more fruit,” the nutritionist said.

“Fruit,” I answered, “is sugar in a ball.”

But the nutritionist had an answer. “That is fruit sugar,” the she told me.

“Fruit sugar,” I responded, “is yet sugar.”

“But it’s not cane sugar.”

“I don’t think the body really cares much about which particular plant the sugar comes from.”

“Sugar from a fruit,” the nutritionist now gambited, “is more natural than processed sugar.”

“They’re both natural, you know. We don’t synthesize sucrose in a lab. There are no beakers involved.”

“Well, you burn fruit sugar up quicker, so it actually gives you energy, instead of turning into fat!”

“Both sugars are converted into glycogen in the body. There can be no difference in how they produce ‘energy’ in the body because both wind up as glycogen. I have no idea where you’re getting any of this. It sounds like you’re making it all up as you go.”

This is Science,” the nutritionist closed the argument.

Eh. It’s all nonsense. Even cane sugar contains, yes, fructose, or fruit sugar, and fruits contain sucrose, or cane sugar.

August 31, 2014

Politispeak – describing a slower rate of increase as an absolute cut in funding

Filed under: Cancon, Government, Health, Politics — Tags: , , , — Nicholas @ 11:20

Paul Wells says the almost forgotten leader of Her Majesty’s loyal opposition in Parliament is doing his job, but illustrates it with a great example of how political rhetoric sometimes warps reality in favour of a more headline-worthy claim:

Here’s what he said: “After promising to protect all future increases to provincial transfers, Conservatives announced plans to cut $36 billion, starting in 2016,” Mulcair told the CMA. “This spring, Conservatives will announce, with great fanfare, that there is now a budget surplus. I’m here today to tell you that an NDP government would use any such surplus to, first and foremost, cancel those proposed cuts to health care.”

This needs parsing, but first, let’s let Mulcair finish: “Mr. Harper, it’s time to keep your word to protect Canadian health care. After giving Canada’s richest corporations $50 billion in tax breaks, don’t you dare take $36 billion out of health care to pay for them!” He said that part in English, then repeated it in French, which has become the way a Canadian politician delivers a line in italics.

Well. Let’s begin with the $36 billion. In December 2011, Jim Flaherty, then the federal finance minister, met his provincial colleagues to announce his plans for health transfers after a 10-year deal set by Paul Martin ran out in 2013-14. The 2004 Martin deal declared that cash transfers to the provinces for health care would increase by six per cent a year for 10 years. Harper simply kept implementing the Martin scheme after he became Prime Minister.

What Flaherty announced, without consulting with the provinces first, was that health transfers would keep growing at six per cent through 2016-17. Then, they would grow more slowly — how slowly would depend on the economy. The faster GDP grows, the faster transfers would grow. But, if the economy tanked, the rate of growth could fall as low as three per cent per year. Flaherty said this scheme would stay in place through 2023-24.

Add up all the shortfalls between three per cent and six per cent over seven years and you get a cumulative sum of $36 billion. Despite what Mulcair said, this isn’t a “cut,” it’s a deceleration in increases. And $36 billion is the gap’s maximum amount. If the economy shows any health, the gap will be smaller.

We could have fun complaining that Mulcair calls something a “cut” when it extends what is already the longest period of growth in federal transfer payments in Mulcair’s lifetime. But it’s more fun to take him at his word. He promises to spend as much as $6 billion a year in new tax money on health care. Mulcair couldn’t buy much influence over health policy with that money; he would simply send larger cheques to provincial governments. If he has other plans for the federal government, he’d have to pay for them after he’d sent that up-to $6-billion cheque to the provinces.

Emphasis mine.

August 30, 2014

QotD: We are slaves to our stomachs

Filed under: Health, Humour, Quotations — Tags: , , — Nicholas @ 00:01

How good one feels when one is full — how satisfied with ourselves and with the world! People who have tried it, tell me that a clear conscience makes you very happy and contented; but a full stomach does the business quite as well, and is cheaper, and more easily obtained. One feels so forgiving and generous after a substantial and well-digested meal — so noble-minded, so kindly-hearted.

It is very strange, this domination of our intellect by our digestive organs. We cannot work, we cannot think, unless our stomach wills so. It dictates to us our emotions, our passions. After eggs and bacon, it says, “Work!” After beefsteak and porter, it says, “Sleep!” After a cup of tea (two spoonsful for each cup, and don’t let it stand more than three minutes), it says to the brain, “Now, rise, and show your strength. Be eloquent, and deep, and tender; see, with a clear eye, into Nature and into life; spread your white wings of quivering thought, and soar, a god-like spirit, over the whirling world beneath you, up through long lanes of flaming stars to the gates of eternity!”

After hot muffins, it says, “Be dull and soulless, like a beast of the field — a brainless animal, with listless eye, unlit by any ray of fancy, or of hope, or fear, or love, or life.” And after brandy, taken in sufficient quantity, it says, “Now, come, fool, grin and tumble, that your fellow-men may laugh — drivel in folly, and splutter in senseless sounds, and show what a helpless ninny is poor man whose wit and will are drowned, like kittens, side by side, in half an inch of alcohol.”

We are but the veriest, sorriest slaves of our stomach. Reach not after morality and righteousness, my friends; watch vigilantly your stomach, and diet it with care and judgment. Then virtue and contentment will come and reign within your heart, unsought by any effort of your own; and you will be a good citizen, a loving husband, and a tender father — a noble, pious man.

Jerome K. Jerome, Three Men in a Boat (to say nothing of the dog), 1889.

August 24, 2014

QotD: Hypochondria

Filed under: Health, Humour, Quotations — Tags: , , , — Nicholas @ 00:01

It is a most extraordinary thing, but I never read a patent medicine advertisement without being impelled to the conclusion that I am suffering from the particular disease therein dealt with in its most virulent form. The diagnosis seems in every case to correspond exactly with all the sensations that I have ever felt.

I remember going to the British Museum one day to read up the treatment for some slight ailment of which I had a touch — hay fever, I fancy it was. I got down the book, and read all I came to read; and then, in an unthinking moment, I idly turned the leaves, and began to indolently study diseases, generally. I forget which was the first distemper I plunged into — some fearful, devastating scourge, I know — and, before I had glanced half down the list of “premonitory symptoms,” it was borne in upon me that I had fairly got it.

I sat for awhile, frozen with horror; and then, in the listlessness of despair, I again turned over the pages. I came to typhoid fever — read the symptoms — discovered that I had typhoid fever, must have had it for months without knowing it — wondered what else I had got; turned up St. Vitus’s Dance — found, as I expected, that I had that too, — began to get interested in my case, and determined to sift it to the bottom, and so started alphabetically — read up ague, and learnt that I was sickening for it, and that the acute stage would commence in about another fortnight. Bright’s disease, I was relieved to find, I had only in a modified form, and, so far as that was concerned, I might live for years. Cholera I had, with severe complications; and diphtheria I seemed to have been born with. I plodded conscientiously through the twenty-six letters, and the only malady I could conclude I had not got was housemaid’s knee.

I felt rather hurt about this at first; it seemed somehow to be a sort of slight. Why hadn’t I got housemaid’s knee? Why this invidious reservation? After a while, however, less grasping feelings prevailed. I reflected that I had every other known malady in the pharmacology, and I grew less selfish, and determined to do without housemaid’s knee. Gout, in its most malignant stage, it would appear, had seized me without my being aware of it; and zymosis I had evidently been suffering with from boyhood. There were no more diseases after zymosis, so I concluded there was nothing else the matter with me.

I sat and pondered. I thought what an interesting case I must be from a medical point of view, what an acquisition I should be to a class! Students would have no need to “walk the hospitals,” if they had me. I was a hospital in myself. All they need do would be to walk round me, and, after that, take their diploma.

Then I wondered how long I had to live. I tried to examine myself. I felt my pulse. I could not at first feel any pulse at all. Then, all of a sudden, it seemed to start off. I pulled out my watch and timed it. I made it a hundred and forty-seven to the minute. I tried to feel my heart. I could not feel my heart. It had stopped beating. I have since been induced to come to the opinion that it must have been there all the time, and must have been beating, but I cannot account for it. I patted myself all over my front, from what I call my waist up to my head, and I went a bit round each side, and a little way up the back. But I could not feel or hear anything. I tried to look at my tongue. I stuck it out as far as ever it would go, and I shut one eye, and tried to examine it with the other. I could only see the tip, and the only thing that I could gain from that was to feel more certain than before that I had scarlet fever.

I had walked into that reading-room a happy, healthy man. I crawled out a decrepit wreck.

Jerome K. Jerome, Three Men in a Boat (to say nothing of the dog), 1889.

August 18, 2014

Salt studies and health outcomes – “all models need to be taken with a pinch of salt”

Filed under: Health, Science — Tags: , , , — Nicholas @ 08:41

Colby Cosh linked to this rather interesting BMJ blog post by Richard Lehman, looking at studies of the impact of dietary salt reduction:

601 The usual wisdom about sodium chloride is that the more you take, the higher your blood pressure and hence your cardiovascular risk. We’ll begin, like the NEJM, with the PURE study. This was a massive undertaking. They recruited 102 216 adults from 18 countries and measured their 24 hour sodium and potassium excretion, using a single fasting morning urine specimen, and their blood pressure by using an automated device. In an ideal world, they would have carried on doing this every week for a month or two, but hey, this is still better than anyone has managed before now. Using these single point in time measurements, they found that people with elevated blood pressure seemed to be more sensitive to the effects of the cations sodium and potassium. Higher sodium raised their blood pressure more, and higher potassium lowered it more, than in individuals with normal blood pressure. In fact, if sodium is a cation, potassium should be called a dogion. And what I have described as effects are in fact associations: we cannot really know if they are causal.

612 But now comes the bombshell. In the PURE study, there was no simple linear relationship between sodium intake and the composite outcome of death and major cardiovascular events, over a mean follow-up period of 3.7 years. Quite the contrary, there was a sort of elongated U-shape distribution. The U begins high and is then splayed out: people who excreted less than 3 grams of salt daily were at much the highest risk of death and cardiovascular events. The lowest risk lay between 3 g and 5 g, with a slow and rather flat rise thereafter. On this evidence, trying to achieve a salt intake under 3 g is a bad idea, which will do you more harm than eating as much salt as you like. Moreover, if you eat plenty of potassium as well, you will have plenty of dogion to counter the cation. The true Mediterranean diet wins again. Eat salad and tomatoes with your anchovies, drink wine with your briny olives, sprinkle coarse salt on your grilled fish, lay it on a bed of cucumber, and follow it with ripe figs and apricots. Live long and live happily.

624 It was rather witty, if slightly unkind, of the NEJM to follow these PURE papers with a massive modelling study built on the assumption that sodium increases cardiovascular risk in linear fashion, mediated by blood pressure. Dariush Mozaffarian and his immensely hardworking team must be biting their lips, having trawled through all the data they could find about sodium excretion in 66 countries. They used a reference standard of 2 g sodium a day, assuming this was the point of optimal consumption and lowest risk. But from PURE, we now know it is associated with a higher cardiovascular risk than 13 grams a day. So they should now go through all their data again, having adjusted their statistical software to the observational curves of the PURE study. Even so, I would question the value of modelling studies on this scale: the human race is a complex thing to study, and all models need to be taken with a pinch of salt.

Update: Colby Cosh followed up the original link with this tweet. Ouch!

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