It’s interesting that psychiatric hospitals are used as a cliche for “a situation of total chaos” – I think I’ve already mentioned the time when the director of a psych hospital I worked at told us, apparently without conscious awareness or irony, that if Obamacare passed our hospital would have too many patients and “the place would turn into a madhouse”. There’s a similar idiom around “Bedlam”, which comes from London’s old Bethlehem psychiatric hospital.
In fact, psych hospitals are much more orderly than you would think. Maybe 80% of the patients are pretty ‘with it’ – depressed people, very anxious people, people with anger issues who aren’t angry at the moment, people coming off of heroin or something. The remaining 20% of people who are very psychotic mostly just stay in their rooms or pace back and forth talking to themselves and not bothering anyone else. The only people you really have to worry about most of the time are the manic ones and occasionally severe autistics, and even they’re usually okay.
For a place where two dozen not-very-stable people are locked up in a small area against their will, violence is impressively rare. The nurses have to deal with some of it, since they’re the front-line people who have to forcibly inject patients with medication, and they have gotten burned a couple of times. And we doctors are certainly trained to assess for it, defuse it, and if worst comes to worst hold our own until someone can get help.
Yet in the two years I’ve worked at Our Lady Of An Undisclosed Location, years when each doctor has talked to each of their patients at least once a day, usually alone in an office, usually telling them things they really don’t want to hear like “No, you can’t go home today” – during all that time, not one doctor has been attacked. Not so much as a slap or a poke.
I am constantly impressed with how deeply the civilizing instinct has penetrated. When I go out of the workroom and tell Bob, “I’m sorry, but you’re disturbing people, you’re going to have to stop banging on the window and shouting threats, let’s go back to your room,” then as long as I use a calm, quiet, and authoritative voice, that is what he does. With very few exceptions, there is nobody so mentally ill that calmness + authority + the implied threat of burly security guards won’t get them to grumble under their breath but generally comply with your requests, reasonable or otherwise.
Scott Alexander, “Reflections From The Halfway Point”, Slate Star Codex, 2015-06-29.
June 26, 2017
QotD: Psychiatric hospitals
June 22, 2017
The EU regulators want to get rid of a Belgian food tradition
Carol Off reports for CBC Radio’s As It Happens:
Belgian Fries, traditionally served with mayonnaise
(photo by vokimberly at Flickr)
Belgium’s government says a new proposal by the European Union could spell disaster for the country’s world-famous fries.
“We adore our fries the way we make them, so just let us do so for the next 100 years, because the last hundred years it wasn’t a problem, so why should it be a problem now?” Flemish Tourism Minister Ben Weyts told Carol Off, host of CBC Radio’s As It Happens.
Traditionally, Belgian fries, are twice fried in fat. First, they go in raw to generate a soft, fluffy interior. Then they are refried at a higher temperature to create a crispy, golden exterior.
This process sets Belgian fries apart from soft and chunky British chips, or the sleek and thin fries preferred by the French.
But the European Commission is proposing that all potatoes be blanched — briefly cooked in boiling water — before they hit the fat.
It’s part of an EU effort to curb exposure to acrylamide, a chemical that can form in foods cooked at high temperatures, and has been linked to cancer in animal tests.
[…]
On the heels of the Belgian backlash, the European Commission has insisted the proposal is a suggestion, not a ban.
“The commission has no intention whatsoever to ban Belgian frites — or any other frites, for that matter,” spokesperson Margaritis Schinas said on Tuesday.
“Instead, the commission is preparing a new regulatory measure to oblige food business operators to apply a code of practice to reduce acrylamide in food, as it is carcinogenic.
“We are all very attached to the rich culinary heritage we find in our member states.”
For more information on Belgian Fries, see The One and Only Original Belgian Fries Website (which hadn’t been updated with this latest existential threat when I checked it).
H/T to Chris Myrick for the link.
June 17, 2017
What Happens When You Take Steroids? – Earth Lab
Published on 8 Jun 2017
Have you ever wondered what happens to a human body when it takes anabolic steroids? Well, Greg Foot is here to explain all the science you need to know about steroids and why people use them for muscle growth.
June 3, 2017
The Government Hates Boobs
Published on 2 Jun 2017
From nipple censorship to breast milk regulation, the government is making it hard to have breasts. The FCC maintains oversight of how much and what kind of breasts can grace public airwaves. Its decisions have ripple effects, since cable broadcasters often voluntarily comply with FCC guidelines.
A more dire issue than strategic anatomical censorship is the issue of breast milk. Between one and five percent of American women aren’t able to produce breast milk, and some babies can’t drink formula. When the two overlap the demand for breast milk is life or death. But acquiring breast milk from donation-based milk banks can be difficult and prohibitively expensive. So some women buy their breast milk on an online “gray market” that stifles suppliers.
In this week’s Mostly Weekly Andrew Heaton explains why the government should get its hands off our boobs.
Performed by Andrew Heaton
Written by Sarah Rose Siskind with writing assistance from Andrew Heaton and David Fried.
Edited by Austin Bragg and Sarah Rose Siskind.
Produced by Meredith and Austin Bragg.
QotD: Gay, Lesbian, and Bisexual
Fascinating. This NYT article bears out a suspicion I’ve held for a long time about the plasticity of sexual orientation. The crude one-sentence summary is that, if you go by physiological arousal reactions, male bisexuality doesn’t exist, while female bisexuality is ubiquitous.
I’ve spent most of my social time for the last thirty years around science fiction fans, neopagans, and polyamorists — three overlapping groups of people not exactly noted for either sexual inhibitions or reluctance to explore sexual roles that don’t fit the neat typologies of the mainstream culture. And there are a couple of things it’s hard not to notice about them:
First, a huge majority of the women in these cultures are bisexual. To the point where I just assume any female I meet in these contexts is bi. This reality is only slightly obscured by the fact that many of these women describe themselves and are socially viewed by others as ‘straight’, even as they engage in sexual play with each other during group scenes with every evidence of enjoyment. In fact, in these cultures the operational definition of ‘straight female’ seems to be one who has recreational but not relational/romantic sex with other women.
Second, this pattern is absolutely not mirrored in their male peers. Even in these uninhibited subcultures, homoerotic behavior involving self-described ‘straight’ men is rare and surprising. Such homeoeroticism as does go on is almost all self-describedly gay men fucking other self-describedly gay men; bisexuality in men, while an accepted and un-tabooed orientation, is actually less common than gayness and not considered quite normal by anybody. The contrast with everybody’s matter-of-fact acceptance of female bisexual behavior is extreme.
It is also an observable fact that many women in these cultures change either their sexual orientation or their sexual presentation over time, but that this is seldom true of men. That is, a woman may move from being sexually involved mostly with other women to being mostly involved with men, and back, several times during her adolescent and adult lifetime; nobody considers this surprising and it doesn’t involve much of a change in either self-image or social identity. Not so for men in these cultures; they tend to start out as straight or gay and stay that way, and on the unusual occasions that this changes it tends to involve a significant break in both self-image and social identity.
Eric S. Raymond, “Gayness is hard, lesbianism soft”, Armed and Dangerous, 2005-07-06.
June 2, 2017
How does deodorant work? I James May Q&A I Head Squeeze
Published on 11 Oct 2013
Get a whiff of this! James May delves in to the mechanics of deodorant.
Did you know that our sweat doesn’t smell? Made up of various things like our diet and genetics, it actually does not pong. Rather it’s when your sweat mixes with the bacteria on your skin that it releases an odor that can sometimes clear a room. Your armpits and pubic areas contain thousands of hairs which then hold on to your sweat and bacteria.
Us humans aren’t alone in smelling, many animals have some serious BO too. It’s not such a bad thing for them, it helps them mark out territory, repelling enemies and, most importantly, attracting mates.
Deodorants work by killing the bacteria on your skin and they also work as an anti-perspirant by reducing the amount of sweat. No more BO!
May 30, 2017
QotD: The uses of IQ
Suppose that the question at issue regards individuals: “Given two 11 year olds, one with an IQ of 110 and one with an IQ of 90, what can you tell us about the differences between those two children?” The answer must be phrased very tentatively. On many important topics, the answer must be, “We can tell you nothing with any confidence.” It is well worth a guidance counselor’s time to know what these individual scores are, but only in combination with a variety of other information about the child’s personality, talents, and background. The individual’s IQ score all by itself is a useful tool but a limited one.
Suppose instead that the question at issue is: “Given two sixth-grade classes, one for which the average IQ is 110 and the other for which it is 90, what can you tell us about the difference between those two classes and their average prospects for the future?” Now there is a great deal to be said, and it can be said with considerable confidence — not about any one person in either class but about average outcomes that are important to the school, educational policy in general, and society writ large. The data accumulated under the classical tradition are extremely rich in this regard, as will become evident in subsequent chapters.
[…]
We agree emphatically with Howard Gardner, however, that the concept of intelligence has taken on a much higher place in the pantheon of human virtues than it deserves. One of the most insidious but also widespread errors regarding IQ, especially among people who have high IQs, is the assumption that another person’s intelligence can be inferred from casual interactions. Many people conclude that if they see someone who is sensitive, humorous, and talks fluently, the person must surely have an above-average IQ.
This identification of IQ with attractive human qualities in general is unfortunate and wrong. Statistically, there is often a modest correlation with such qualities. But modest correlations are of little use in sizing up other individuals one by one. For example, a person can have a terrific sense of humor without giving you a clue about where he is within thirty points on the IQ scale. Or a plumber with a measured IQ of 100 — only an average IQ — can know a great deal about the functioning of plumbing systems. He may be able to diagnose problems, discuss them articulately, make shrewd decisions about how to fix them, and, while he is working, make some pithy remarks about the president’s recent speech.
At the same time, high intelligence has earmarks that correspond to a first approximation to the commonly understood meaning of smart. In our experience, people do not use smart to mean (necessarily) that a person is prudent or knowledgeable but rather to refer to qualities of mental quickness and complexity that do in fact show up in high test scores. To return to our examples: Many witty people do not have unusually high test scores, but someone who regularly tosses off impromptu complex puns probably does (which does not necessarily mean that such puns are very funny, we hasten to add). If the plumber runs into a problem he has never seen before and diagnoses its source through inferences from what he does know, he probably has an IQ of more than 100 after all. In this, language tends to reflect real differences: In everyday language, people who are called very smart tend to have high IQs.
All of this is another way of making a point so important that we will italicize it now and repeat elsewhere: Measures of intelligence have reliable statistical relationships with important social phenomena, but they are a limited tool for deciding what to make of any given individual. Repeat it we must, for one of the problems of writing about intelligence is how to remind readers often enough how little an IQ score tells about whether the human being next to you is someone whom you will admire or cherish. This thing we know as IQ is important but not a synonym for human excellence.
Charles Murray, “The Bell Curve Explained”, American Enterprise Institute, 2017-05-20.
May 28, 2017
QotD: Nostalgia
Nostalgia has been shown to counteract loneliness, boredom and anxiety. It makes people more generous to strangers and more tolerant of outsiders. Couples feel closer and look happier when they’re sharing nostalgic memories. On cold days, or in cold rooms, people use nostalgia to literally feel warmer.
Nostalgia does have its painful side — it’s a bittersweet emotion — but the net effect is to make life seem more meaningful and death less frightening. When people speak wistfully of the past, they typically become more optimistic and inspired about the future.
“Nostalgia makes us a bit more human,” Dr. Sedikides says. He considers the first great nostalgist to be Odysseus, an itinerant who used memories of his family and home to get through hard times, but Dr. Sedikides emphasizes that nostalgia is not the same as homesickness. It’s not just for those away from home, and it’s not a sickness, despite its historical reputation.
Nostalgia was originally described as a “neurological disease of essentially demonic cause” by Johannes Hoffer, the Swiss doctor who coined the term in 1688. Military physicians speculated that its prevalence among Swiss mercenaries abroad was due to earlier damage to the soldiers’ ear drums and brain cells by the unremitting clanging of cowbells in the Alps.
John Tierney, “What Is Nostalgia Good For? Quite a Bit, Research Shows”, New York Times, 2013-07-08.
May 26, 2017
QotD: The coming of the sexbots
Recently I saw online a documentary on sex robots. The reporteress, a short-haired woman seething with quiet indignation, Viewed With Alarm the very idea. Progress is rapid on these love assistants, she said. They move. Some do, anyway. They talk, but not too much. Before long they will have skin-temperature silicone. Today we have all those deplorable men sitting home, lonely and isolated, choking their chickens and pondering suicide. Soon they will instead be rocking and rolling with Robo-Barbie. This worried her. She said.
If this be true, then why, one wonders, do men want sexbots? Aren’t there already women all over the place at skin temperature? Sez me, it’s because women have lived too long in a monopoly economy and so let down quality. It used to be that men had jobs and money, and women had that, so they married to let each get some of what the other had. The woman had to be agreeable as a selling point. Now women have jobs and don’t need men, or to be pleasant. Some are nice anyway, but it’s no longer a design feature. Of course they often end up old and alone with a cat somewhere on upper Connecticut Avenue, but they don’t figure this out until too late. Anyway, they stopped being agreeable. They learned from feminists that everything wrong in their lives was the fault of men.
It is a real problem: American women are inoculated from birth with angry misandry insisting that men are dolts, loutish, irresponsible, and only want sex. (To which a response might be, “Uh…What else have you got?”)
[…]
OK, back to sexbots. The short-aired reporteress wondered why men could be interested in such confections instead of real women, the tone being one of elevated moralism and horror. Beneath the usual factitious objectivity one could hear, “How could…what is wrong with….?” and so on.
In the documentary, the short-haired reporteress talked to an ugly anti-sexbot crusader woman who said testily that using sexbots “objectified women.” (To me it sounded more like womanizing objects, but never mind.) These two dragons continued to the effect that sex was about intimacy and closeness and bonding. I wondered how they knew. But understand: They weren’t worried about competition. Oh no. They wanted to preserve intimacy and bonding. They were worried about those poor miserable men.
Uh…yeah.
In modern America I see no sign that women are concerned about masculine misery, and indeed that most of them rather like the idea.
Fred Reed, “Sally Cone Hits the Dating Scene”, The Unz Review, 2017-05-11.
May 22, 2017
QotD: The nanny state’s ever-expanding reach
The Royal Society for Public Health is suggesting that unusual, unhealthy or minority pursuits should be criminalised in order to set a good example to others. They want people to be arrested, fined and possibly even imprisoned for being poor role models. In a liberal society, the only appropriate response can be made with two words or two fingers.
Chris Snowdon, “A smoking ban in pub beer gardens? Stop persecuting smokers”, City A.M., 2015-08-14.
May 19, 2017
QotD: Outpatient psychiatry
Now I am halfway done with my residency. I will be switching to outpatient work. Everyone who sees me will be there because they want to see me, or at worst because their parents/spouses/children/friends/voices are pressuring them into it. I will be able to continue seeing people for an amount of time long enough that the medications might, in principle, work. It sounds a lot more pleasant.
I have two equal and opposite concerns about outpatient psychiatry. The first is that I might be useless. Like, if someone comes in complaining of depression, then to a first approximation, after a few basic tests and questions to rule out some rarer causes, you give them an SSRI [Selective serotonin re-uptake inhibitors]. I have a lot of libertarian friends who think psychiatrists are just a made-up guild who survive because it’s legally impossible for depressed people to give themselves SSRIs without paying them money. There’s some truth to that and I’ve previously joked that some doctors could profitably be replaced by SSRI vending machines.
The second concern is that everybody still screws it up. There’s an old saying: “Doctors bury their mistakes, architects cover theirs with vines, teachers send theirs into politics.” Well, outpatient psychiatrists send their mistakes to inpatient psychiatrists, so as an inpatient psychiatrist I’ve gotten to see a lot of them. Yes, to a first approximation when a person comes in saying they’re depressed you can just do a few basic tests and questions and then give them an SSRI. But the number of cases I’ve seen that end in disaster because their outpatient psychiatrist forgot to do the basic tests and questions, or decided that Adderall was the first-line medication of choice for depression – continues to boggle my mind. So either it’s harder than I think, or I’m surrounded by idiots, or I’m an idiot and don’t know it yet. In which case I’m about to learn.
Still, if it’s a disaster, it will be a different type of disaster.
Scott Alexander, “Reflections From The Halfway Point”, Slate Star Codex, 2015-06-29.
May 13, 2017
Psychedelic Drugs: The Future of Mental Health
Published on 12 May 2017
LSD, mushrooms, and ecstasy are finally getting attention from serious medical researchers. And their findings are astounding.
—-
A recent study found that MDMA-assisted therapy could help veterans suffering from PTSD. Another paper from Johns Hopkins presented evidence that therapy in conjunction with psilocybin mushrooms can help ease the mental suffering of terminal cancer patients.These findings, among others, were presented at the 2017 Psychedelic Science Conference in Oakland, California, where researchers gather every few years to discuss the potential medical applications of psychedelics, including LSD, psilocybin mushrooms, and MDMA. The field has exploded thanks to reforms at the Food and Drug Administration that allow researchers, for the first time in decades, to study the effects of these drugs.
The organizer of the conference was the Multidisciplinary Association for Psychedelic Studies (MAPS), which is also funding much of this breakthrough research.
“It’s a fundamental right to explore one’s own consciousness,” says MAPS founder Rick Doblin. “We have the freedom of the press, the freedom of assembly, and the freedom of religion, and all those are based on the freedom of thought.”
At this year’s conference, Reason talked to researchers about the past, present, and future of this controversial and promising area of medical research.
Produced by Zach Weissmueller. Shot by Alex Manning and Weissmueller. Music by Kai Engel, Selva de Mar, and Lee Rosevere.
May 7, 2017
Deadly Africa
Kim du Toit reposted something he wrote back in 2002 about the dangers to life and limb people face in Africa before you factor in dysfunctional governments, terrorists, and continuing ethnic disputes from hundreds of years ago:
When it comes to any analysis of the problems facing Africa, Western society, and particularly people from the United States, encounter a logical disconnect that makes clear analysis impossible. That disconnect is the way life is regarded in the West (it’s precious, must be protected at all costs etc.), compared to the way life, and death, are regarded in Africa. Let me try to quantify this statement.
In Africa, life is cheap. There are so many ways to die in Africa that death is far more commonplace than in the West. You can die from so many things: snakebite, insect bite, wild animal attack, disease, starvation, food poisoning… the list goes on and on. At one time, crocodiles accounted for more deaths in sub-Saharan Africa than gunfire, for example. Now add the usual human tragedy (murder, assault, warfare and the rest), and you can begin to understand why the life expectancy for an African is low — in fact, horrifyingly low, if you remove White Africans from the statistics (they tend to be more urbanized, and more Western in behavior and outlook). Finally, if you add the horrifying spread of AIDS into the equation, anyone born in sub-Saharan Africa this century will be lucky to reach age forty.
I lived in Africa for over thirty years. Growing up there, I was infused with several African traits — traits which are not common in Western civilization. The almost-casual attitude towards death was one. (Another is a morbid fear of snakes.)
So because of my African background, I am seldom moved at the sight of death, unless it’s accidental, or it affects someone close to me. (Death which strikes at total strangers, of course, is mostly ignored.) Of my circle of about eighteen or so friends with whom I grew up, and whom I would consider “close”, only about eight survive today — and not one of the survivors is over the age of fifty. Two friends died from stepping on landmines while on Army duty in Namibia. Three died in horrific car accidents (and lest one thinks that this is not confined to Africa, one was caused by a kudu flying through a windshield and impaling the guy through the chest with its hoof — not your everyday traffic accident in, say, Florida). One was bitten by a snake, and died from heart failure. Another two also died of heart failure, but they were hopeless drunkards. Two were shot by muggers. The last went out on his surfboard one day and was never seen again (did I mention that sharks are plentiful off the African coasts and in the major rivers?). My experience is not uncommon in South Africa — and north of the Limpopo River (the border with Zimbabwe), I suspect that others would show worse statistics.
The death toll wasn’t just confined to my friends. When I was still living in Johannesburg, the newspaper carried daily stories of people mauled by lions, or attacked by rival tribesmen, or dying from some unspeakable disease (and this was pre-AIDS Africa too) and in general, succumbing to some of Africa’s many answers to the population explosion. Add to that the normal death toll from rampant crime, illness, poverty, flood, famine, traffic, and the police, and you’ll begin to get the idea.
My favorite African story actually happened after I left the country. An American executive took a job over there, and on his very first day, the newspaper headlines read:
“Three Headless Bodies Found”.
The next day: “Three Heads Found”.
The third day: “Heads Don’t Match Bodies”.You can’t make this stuff up.
April 30, 2017
[p-hacking] “is one of the many questionable research practices responsible for the replication crisis in the social sciences”
What happens when someone digs into the statistics of highly influential health studies and discovers oddities? We’re in the process of finding out in the case of “rockstar researcher” Brian Wansink and several of his studies under the statistical microscope:
Things began to go bad late last year when Wansink posted some advice for grad students on his blog. The post, which has subsequently been removed (although a cached copy is available), described a grad student who, on Wansink’s instruction, had delved into a data set to look for interesting results. The data came from a study that had sold people coupons for an all-you-can-eat buffet. One group had paid $4 for the coupon, and the other group had paid $8.
The hypothesis had been that people would eat more if they had paid more, but the study had not found that result. That’s not necessarily a bad thing. In fact, publishing null results like these is important — failure to do so leads to publication bias, which can lead to a skewed public record that shows (for example) three successful tests of a hypothesis but not the 18 failed ones. But instead of publishing the null result, Wansink wanted to get something more out of the data.
“When [the grad student] arrived,” Wansink wrote, “I gave her a data set of a self-funded, failed study which had null results… I said, ‘This cost us a lot of time and our own money to collect. There’s got to be something here we can salvage because it’s a cool (rich & unique) data set.’ I had three ideas for potential Plan B, C, & D directions (since Plan A had failed).”
The responses to Wansink’s blog post from other researchers were incredulous, because this kind of data analysis is considered an incredibly bad idea. As this very famous xkcd strip explains, trawling through data, running lots of statistical tests, and looking only for significant results is bound to turn up some false positives. This practice of “p-hacking” — hunting for significant p-values in statistical analyses — is one of the many questionable research practices responsible for the replication crisis in the social sciences.
H/T to Kate at Small Dead Animals for the link.
April 29, 2017
“Don’t count fat; don’t fret over what kind of fat you’re getting, per se. Just go for walks and eat real food”
Earlier this week, Colby Cosh rounded up some recent re-evaluations of “settled food science”:
Their first target was the Sydney Diet Heart Study (1966-73), in which 458 middle-aged coronary patients were split into a control group and an experimental group. The latter group was fed loads of “healthy” safflower oil and safflower margarine in place of saturated fats. Even at the time it was noticed that the margarine-eaters died sooner, although their total cholesterol levels went down: the investigators sort of shrugged and wrote that heart patients “are not a good choice for testing the lipid hypothesis.” Their data, looked at now, shows that the increased mortality in the margarine group was attributable specifically to heart problems.
The team’s reanalysis of the Minnesota Coronary Experiment (1968-73) is more hair-raising. This study involved nearly 10,000 Minnesotans at old-age homes and mental hospitals. The investigators had near-complete control of the subjects’ diets, and were able to autopsy the ones who died. But much of their data, including the autopsy results, ended up misplaced or ignored. Some of it disappeared into a master’s thesis by a young statistician, now a retired older chap, who helped with the 2016 paper and is named at its head as one of the authors.
In the Minnesota study, replacement of saturated fats with corn oil led, again, to reductions in total cholesterol. This finding was touted at major conferences, and it became one of the key moments in the creation of the classic diet-heart myth. This time nobody but the guy who wrote the thesis even noticed that the patients in the corn oil group were, overall, dying a little faster. The 2016 re-analysis uncovered a dose-response relationship: the more the patients’ total cholesterol decreased, the faster they died.
The Sydney and Minnesota studies themselves may have caused a few premature deaths, which is a possibility we accept as the price of science. But the limitations and omissions of the researchers, and the premature commitment of doctors to a total-cholesterol model, helped create a suspicion of saturated fats. This flooded into frontline medical advice and the wider culture, and it put margarine on millions of tables, pushed consumers toward deadly trans fats, and put millions of people with innately high cholesterol levels through useless diet austerity. The scale of the error is numbing, unfathomable.
