Over on Conservative Home, Tim Montgomerie is coming out as a caring Conservative.
My 2p (or, if Weggis prefers, 2d):
Tim
Very interesting. If government is about promoting the interests of the ones who go to work, as per George Osborne's definition, this raises the question of whether there is enough work for all to do.
All due credit to IDS for looking at how to spring the Unemployment Trap, but this will not help much if George's policies bring on a double dip (DD) recession. If, as seems likely, that does come about, Conservatives, no matter how caring, will have caused even more people to lie in bed in miserable contemplation of their empty lives.
The alternative to this scenario is for Conservatives to open their eyes to market externalities, (a.k.a the real world), and implement the Green New Deal, which will act as a valid investment by creating thousands of jobs, protecting us from energy insecurity, helping our balance of payments (by reducing future energy imports), reducing the impact of Peak Oil, and (pace Tory AGW deniers) contribute to reducing global warming.
Saturday, August 07, 2010
Friday, August 06, 2010
Spirit Level: new Fischer yawns in the Boston Review
David Aaronovitch tweets approvingly of this review of the Spirit Level in the Boston review. The reviewer, Claude S Fishcer, is a sociologist, and is vaguely critical of the thesis that equality is better for social functioning.
He starts by setting up a straw man - if we exiled the richest 5% of a country, the level of social functioning would improve. Nuff said.
Next, the criticises Wilkinson&Pickett's (W&P) chosen indicator - income. There are other measures of wealth, and he mentions capital ownership and consumption patterns, which might produce different results. OK, but income inequality is what W+P have been studying, and what this book and its thesis is about. If people think distribution of possessions would produce a different picture, let them amass evidence for this point of view.
Fischer points out that suicide rates and births outside of marriage are inversely proportional to inequality. W+P are not suggesting that all social problems (assuming for a moment that unmarried mothers are such a problem) are related to inequality - only the ones for which they find positive evidence. Which are quite enough.
Fischer disses W+P's explanation of suicide rates - that in unequal societies people project their status anxiety outward, blame others rather than themselves, and thus end up killing others rather than themselves, but suicide rates also go down in times of war, which tends to back them up. As a sociologist, Fischer should have remembered this.
His next objection is remarkable. He complains that average rates of outcomes hide the fact that individuals within nations may buck the trend. Although the average Japanese life span is longer than the average US citizen, some US peeps may live longer than some Japanese. Well, and the Pope is a Catholic.
Here's a more valid criticism, which I will throw in : recently we find that some long-lived Japanese are only living longer virtual lives, for social security purposes, and that their physical bodies have signed off years ago. A critic will seize on this as a crowning objection; a scientist will see it as just a cause for another necessary adjustment to the dataset.
Fischer's next objection is more interesting. Other equality sceptics have asserted that the observed differences are racial, and that the more equal and more healthy Scandinavian societies are perhaps genetically predestined to be more equal and healthy. He points out that the international differences between healthy Nordic cultures and unhealthy Anglo-Saxon cultures is also reflected in the US state pattern, with Nordic Minnesota being more healthy than Anglo-settled states.
Tellingly, he says: The Nordic-British contrast also corresponds to the difference between social democratic and neoliberal states, which can confuse cause and effect even more. Is there something about the Nordic region’s history or culture that leads those nations to be welfare states, relatively equal, and healthy, and something about Anglo-Saxon history or culture that does the opposite—with varying levels of inequality being simply a byproduct?
Is there Something Else? Please? Any explanation will do, except the idea that more social democracy type equality is good for people?
W&P back the claim that the correlation is causal with several lines of evidence, two relating to developments over time. After WWII, Japan was unequal and unhealthy, the US was more equal and more healthy. Over time, those positions have reversed. Secondly (and Fischer has the grace to air this) after the reunification of Germany, East Germans, moving into a more unequal society, developed some of the problems that W&P would predict.
Fischer counters with a fall in US homicides over a period when inequality increased. Fair enough. Social affairs are complex, multifactorial things, and Fischer acknowledges that inequality plays a part in social problems; he just wants it to be less than W&P would have.
Finally, he takes W&P to task for not setting out their plan for remediation of inequality, apart from their endorsement of workers cooperatives. W&P make no claim for setting out a full political programme. Unlike some. It is the job of politicians to pick up the equality issue and develop economic policies designed to reduce the Rich Poor Gap. The Green Party is on the case (though we still need to adopt the Green Wage Subsidy)
David Aaronovitch's tweet that led me to this read: "Excellent centre-left US critique of The Spirit Level here - http://bit.ly/bbNpXv Not the basket where the Mili-eggs should be put."
Clearly, he wants Labour to avoid any commitment to equality. He needn't worry. Milliband D is going to win the Labour leadership, and carry on the tattered, bloodstained banner of NuLabour. But the Green Party will continue to pursue economic policies that tend to greater equality and therefore greater social cohesion and health.
What strikes me is the central robustness of the Spirit Level thesis. We must expect attacks from the Right, because it threatens their core ideology. I find the objections from the centre left, both from the Rawlsians on openDemocracy, and now from sociologist Fischer, both puzzling and illuminating. Puzzling because they do not accept it as a seminal new addition to the field. Illuminating because it suggests the central problem with centre-left intellectuals. They are suffering from cognitive sclerosis.
He starts by setting up a straw man - if we exiled the richest 5% of a country, the level of social functioning would improve. Nuff said.
Next, the criticises Wilkinson&Pickett's (W&P) chosen indicator - income. There are other measures of wealth, and he mentions capital ownership and consumption patterns, which might produce different results. OK, but income inequality is what W+P have been studying, and what this book and its thesis is about. If people think distribution of possessions would produce a different picture, let them amass evidence for this point of view.
Fischer points out that suicide rates and births outside of marriage are inversely proportional to inequality. W+P are not suggesting that all social problems (assuming for a moment that unmarried mothers are such a problem) are related to inequality - only the ones for which they find positive evidence. Which are quite enough.
Fischer disses W+P's explanation of suicide rates - that in unequal societies people project their status anxiety outward, blame others rather than themselves, and thus end up killing others rather than themselves, but suicide rates also go down in times of war, which tends to back them up. As a sociologist, Fischer should have remembered this.
His next objection is remarkable. He complains that average rates of outcomes hide the fact that individuals within nations may buck the trend. Although the average Japanese life span is longer than the average US citizen, some US peeps may live longer than some Japanese. Well, and the Pope is a Catholic.
Here's a more valid criticism, which I will throw in : recently we find that some long-lived Japanese are only living longer virtual lives, for social security purposes, and that their physical bodies have signed off years ago. A critic will seize on this as a crowning objection; a scientist will see it as just a cause for another necessary adjustment to the dataset.
Fischer's next objection is more interesting. Other equality sceptics have asserted that the observed differences are racial, and that the more equal and more healthy Scandinavian societies are perhaps genetically predestined to be more equal and healthy. He points out that the international differences between healthy Nordic cultures and unhealthy Anglo-Saxon cultures is also reflected in the US state pattern, with Nordic Minnesota being more healthy than Anglo-settled states.
Tellingly, he says: The Nordic-British contrast also corresponds to the difference between social democratic and neoliberal states, which can confuse cause and effect even more. Is there something about the Nordic region’s history or culture that leads those nations to be welfare states, relatively equal, and healthy, and something about Anglo-Saxon history or culture that does the opposite—with varying levels of inequality being simply a byproduct?
Is there Something Else? Please? Any explanation will do, except the idea that more social democracy type equality is good for people?
W&P back the claim that the correlation is causal with several lines of evidence, two relating to developments over time. After WWII, Japan was unequal and unhealthy, the US was more equal and more healthy. Over time, those positions have reversed. Secondly (and Fischer has the grace to air this) after the reunification of Germany, East Germans, moving into a more unequal society, developed some of the problems that W&P would predict.
Fischer counters with a fall in US homicides over a period when inequality increased. Fair enough. Social affairs are complex, multifactorial things, and Fischer acknowledges that inequality plays a part in social problems; he just wants it to be less than W&P would have.
Finally, he takes W&P to task for not setting out their plan for remediation of inequality, apart from their endorsement of workers cooperatives. W&P make no claim for setting out a full political programme. Unlike some. It is the job of politicians to pick up the equality issue and develop economic policies designed to reduce the Rich Poor Gap. The Green Party is on the case (though we still need to adopt the Green Wage Subsidy)
David Aaronovitch's tweet that led me to this read: "Excellent centre-left US critique of The Spirit Level here - http://bit.ly/bbNpXv Not the basket where the Mili-eggs should be put."
Clearly, he wants Labour to avoid any commitment to equality. He needn't worry. Milliband D is going to win the Labour leadership, and carry on the tattered, bloodstained banner of NuLabour. But the Green Party will continue to pursue economic policies that tend to greater equality and therefore greater social cohesion and health.
What strikes me is the central robustness of the Spirit Level thesis. We must expect attacks from the Right, because it threatens their core ideology. I find the objections from the centre left, both from the Rawlsians on openDemocracy, and now from sociologist Fischer, both puzzling and illuminating. Puzzling because they do not accept it as a seminal new addition to the field. Illuminating because it suggests the central problem with centre-left intellectuals. They are suffering from cognitive sclerosis.
Thursday, August 05, 2010
The Great Global Warming Blunder.
A tweet leads me to a James Delingbole article extolling a book by AGW sceptic Dr Roy Spencer. The book is called The Great Global Warming Blunder.
It seems that his central argument is that decreasing low-level cloud cover (which has been shown to be associated with increasing sea surface temperatures in the Pacific) is not a feedback from the higher temperature, but a cause of the higher temperature.
Which raises the question of what is causing the decreased cloud cover. It was suggested that cosmic ray fluctuations could cause variations in cloud cover. However, more recent work suggests that the cosmic ray concentrations are 100 times too small to affect cloud formation.
Which leaves the question of the cause of the decreasing cloud cover. So I have emailed Roy Spencer asking for his thoughts. So far, all I have to go on is that Spencer puts it down to Natural Variation.
How nice to be able to dismiss the whole body of climate science in two words. Roy Spencer is an anti-evolutionist, and stands accused of fiddling graphs.
I'll let you know in due course.
That tweet has cost me about 2 hours. Still, it was fun, revisiting the old climate debate.
It seems that his central argument is that decreasing low-level cloud cover (which has been shown to be associated with increasing sea surface temperatures in the Pacific) is not a feedback from the higher temperature, but a cause of the higher temperature.
Which raises the question of what is causing the decreased cloud cover. It was suggested that cosmic ray fluctuations could cause variations in cloud cover. However, more recent work suggests that the cosmic ray concentrations are 100 times too small to affect cloud formation.
Which leaves the question of the cause of the decreasing cloud cover. So I have emailed Roy Spencer asking for his thoughts. So far, all I have to go on is that Spencer puts it down to Natural Variation.
How nice to be able to dismiss the whole body of climate science in two words. Roy Spencer is an anti-evolutionist, and stands accused of fiddling graphs.
I'll let you know in due course.
That tweet has cost me about 2 hours. Still, it was fun, revisiting the old climate debate.
Resisting the CleggerOsborne Cuts
Today's Guardian headline: Fears Grow of double dip recession. The service sector - 40% of our ill-balanced economy - is not doing smiley faces.
Just another straw in the wind that is blowing us onto the rocks, with The Boy George at the helm, crying "Steady as She Goes, we may hit the Rocks of Recession, but at least we will avoid the Hard Place of Lost Credit Rating".
Up to now, I have just been sitting waiting for it to happen, getting ready to market an I Told You So t-shirt.
But others are made of better stuff. Fair play to the Fawcett Society, which has filed papers with the High Court seeking a Judicial Review of the government's recent emergency budget.. The word is that they have a strong legal argument. Good. They'll need it. The Government will need a judge of the calibre of Lord Hutton on its side. No doubt they will find one.
Now Tony Benn, Caroline Lucas and 70 others have signed a letter to the Guardian calling for organised resistance to the cuts. Sign up here.
Osborne says that it is vital to reduce the budget deficit in order to preserve our AAA credit rating. It is, and it isn't.
Here for my global assessment of the UK economy.
We do have one of the biggest deficits of comparable countries, but other factors place us about 7th in line to be chomped by the money markets, behind an illustrious list that goes,from memory, Greece, Portugal, Spain, Japan and - wait for it - the USofA. (The most creditworthy nations, interestingly, are the egalitarian Nordic countries) So if the man-eaters in the money markets want to get busy, they will be burping and groaning before they get to us. Either that, or politicians will have worked out a way of controlling them.
Always remember that the prats in spats who deal out nations' credit ratings are the same morons who gave the sub-prime mortgages their AAA rating.
So. Resist the Cuts. But how? As well as feet on streets (to oppose the prats in spats), we need a credible alternative strategy to reduce the deficit. We need a slow, steady, non-destructive approach to cutting public sector waste, based on Roots up Efficiency and Demand Side management.
Which are in my Parlous Situation blogpost, further down the page.
Just another straw in the wind that is blowing us onto the rocks, with The Boy George at the helm, crying "Steady as She Goes, we may hit the Rocks of Recession, but at least we will avoid the Hard Place of Lost Credit Rating".
Up to now, I have just been sitting waiting for it to happen, getting ready to market an I Told You So t-shirt.
But others are made of better stuff. Fair play to the Fawcett Society, which has filed papers with the High Court seeking a Judicial Review of the government's recent emergency budget.. The word is that they have a strong legal argument. Good. They'll need it. The Government will need a judge of the calibre of Lord Hutton on its side. No doubt they will find one.
Now Tony Benn, Caroline Lucas and 70 others have signed a letter to the Guardian calling for organised resistance to the cuts. Sign up here.
Osborne says that it is vital to reduce the budget deficit in order to preserve our AAA credit rating. It is, and it isn't.
Here for my global assessment of the UK economy.
We do have one of the biggest deficits of comparable countries, but other factors place us about 7th in line to be chomped by the money markets, behind an illustrious list that goes,from memory, Greece, Portugal, Spain, Japan and - wait for it - the USofA. (The most creditworthy nations, interestingly, are the egalitarian Nordic countries) So if the man-eaters in the money markets want to get busy, they will be burping and groaning before they get to us. Either that, or politicians will have worked out a way of controlling them.
Always remember that the prats in spats who deal out nations' credit ratings are the same morons who gave the sub-prime mortgages their AAA rating.
So. Resist the Cuts. But how? As well as feet on streets (to oppose the prats in spats), we need a credible alternative strategy to reduce the deficit. We need a slow, steady, non-destructive approach to cutting public sector waste, based on Roots up Efficiency and Demand Side management.
Which are in my Parlous Situation blogpost, further down the page.
How to undermine Big Pharma's influence on the NHS
There is an ongoing debate on Bright Green Scotland about Caroline's backing for homoeopathy.
The question of Big Pharma has come up.
Now I am not proposing that the solution to corporatised medicine is to give everyone homoeopathy.
But one pathway to undermining the power of the pharma corporations is
(a) to understand the financial bias that is pushing medics to prescribing expensive patented medicines.
(b) to find out whether promising lines of CAM (Complementary and Alternative Medicines) are in fact more cost – effective.
I am thinking of
Before the opposition start accusing me of being anti-scientific, I am proposing that these things should be examined scientifically.
All of these lines I incorporated into my practice, and I had low prescribing costs. All of these CAMs have a poor evidence base, because of the economic problem associated with research - you cannot get a patent on a traditional medicine, therefore there is no incentive to spend £loadamoney investigating it.
It is up to the Government, through the MRC, to assess these treatment modalities.
On homoeopathy, the key point, as comedians and scientists never tire of pointing out, is that there is no *material* apart from sugar in the pills. If matter is the only effective agent, H cannot work, therefore it does not work, therefore studies that show it does work are erroneous. QED. Which is a scholastic argument, not a scientific one. Scholasticism argues from authoritative principles, science argues from observation.
As I link on an earlier blog , there is some evidence from physical experiments that ultra high dilutions, if prepared in a certain way, may retain unexpected properties. If this can be established, homoeopathy could be re-examined more objectively, with less examiner bias.
Its a small point, this Homoeopathy debate, and I think Caroline is doing the right thing, especially if she calls for an audit of homoeopathic practice in the NHS.
While on the subject of undermining the influence of Big Pharma, there is the matter of preventive health too. About 1/5th of NHS spending is down to treating ill-health caused by non-green policies – unemployment, poor housing, pollution and poverty. Maybe more if social disintegration were counted. This is in my book.
Now, let’s all get going on the Resistance to the Cuts. http://bit.ly/deApQe
The question of Big Pharma has come up.
Now I am not proposing that the solution to corporatised medicine is to give everyone homoeopathy.
But one pathway to undermining the power of the pharma corporations is
(a) to understand the financial bias that is pushing medics to prescribing expensive patented medicines.
(b) to find out whether promising lines of CAM (Complementary and Alternative Medicines) are in fact more cost – effective.
I am thinking of
- acupuncture,
- magnetotherapy,
- some herbs (not “herbalism” as a whole entity),
- clinical ecology (=food intolerance, indoor air quality &c),
- acupuncture, and
- certain forms of psychotherapy, (hypnosis for PTSD, Cutting the Ties to deal with toxic relationships),
- food supplements like glucosamine, and
- homoeopathy.
Before the opposition start accusing me of being anti-scientific, I am proposing that these things should be examined scientifically.
All of these lines I incorporated into my practice, and I had low prescribing costs. All of these CAMs have a poor evidence base, because of the economic problem associated with research - you cannot get a patent on a traditional medicine, therefore there is no incentive to spend £loadamoney investigating it.
It is up to the Government, through the MRC, to assess these treatment modalities.
On homoeopathy, the key point, as comedians and scientists never tire of pointing out, is that there is no *material* apart from sugar in the pills. If matter is the only effective agent, H cannot work, therefore it does not work, therefore studies that show it does work are erroneous. QED. Which is a scholastic argument, not a scientific one. Scholasticism argues from authoritative principles, science argues from observation.
As I link on an earlier blog , there is some evidence from physical experiments that ultra high dilutions, if prepared in a certain way, may retain unexpected properties. If this can be established, homoeopathy could be re-examined more objectively, with less examiner bias.
Its a small point, this Homoeopathy debate, and I think Caroline is doing the right thing, especially if she calls for an audit of homoeopathic practice in the NHS.
While on the subject of undermining the influence of Big Pharma, there is the matter of preventive health too. About 1/5th of NHS spending is down to treating ill-health caused by non-green policies – unemployment, poor housing, pollution and poverty. Maybe more if social disintegration were counted. This is in my book.
Now, let’s all get going on the Resistance to the Cuts. http://bit.ly/deApQe
Wednesday, August 04, 2010
Pakistan floods could lead to global nuclear disarmament
Just a quick note about Pakistan: natural disasters tend to turn people against Governments, especially if they do not deliver an efficient relief response. Wobbly rulers are vulnerable when they are out of the country, especially when there is an emergency on, especially if they are out of the country to launch their son's political career. Especially if their opposition makes big and well-publicised efforts to help disaster victims.
So there is an enhanced possibility that there will be a regime change in Pakistan, even a possibility that an Islamist Pakistan Government may control Pakistan's nuclear deterrent/WMD.
Just another reason for the Cameron Government to initiate a strong international diplomatic effort to get all nuclear nations round the table, and agree to get rid of the bloody things once and for all. Not too much to ask, is it, in these straitened economic times?
So there is an enhanced possibility that there will be a regime change in Pakistan, even a possibility that an Islamist Pakistan Government may control Pakistan's nuclear deterrent/WMD.
Just another reason for the Cameron Government to initiate a strong international diplomatic effort to get all nuclear nations round the table, and agree to get rid of the bloody things once and for all. Not too much to ask, is it, in these straitened economic times?
Pakistan floods: anything to do with global warming?
The present tragic and politically dangerous flooding in Pakistan raises the question - Is it due to global warming?
No one single weather event can be taken as evidence of global warming. We have to look at the whole picture (something that global warming sceptics seem to find particularly difficult). However, global warming theory predicts that floods and droughts will increase in frequency as the planet heats up.
The data on flooding is difficult to interpret, since they have to define what is meant by floods, and other factors, such as population numbers, land use changes (e.g. building on an area will reduce the ability of the ground to absorb water), flood defence measures, and ability to report events come in to play.
Researchers are conscious of these factors, and try to estimate or allow for them.
Having said that, here are a few findings:
The costs due to extreme weather events have certainly shot up. This figure covers 1950-99:
Source IPCC, who say: Part of the observed upward trend in historical disaster losses is linked to socioeconomic factors—such as population growth, increased wealth, and urbanization in vulnerable areas—and part is linked to climatic factors such as observed changes in precipitation, flooding, and drought events. Precise attribution is complex ...
The UK's Centre for Ecology and Hydrology says: "The latest research from the UK Climate Projections team (UKCP09) indicates that winter rainfall has increased in the north-west of the UK since the early 1960s. Other research suggests that extreme rainfalls have also increased in frequency in northern and western areas of the UK, and one recent study which involved CEH scientists found that, over the last 50 years, the daily maximum rainfall has increased by 25% in northern and western areas relative to the previous 50 years. "
In Scotland: "It has been shown that river flows in the Clyde Catchment have increased at nearly twice the rate of increase in rainfall in the past 30 years." [.pdf]
Osborne and Hulme 2002: Over 100 weather stations with daily precipitation totals for the last four decades provide a record of precipitation characteristics across most of the UK. They indicate increased precipitation totals and increased frequency and contribution of heavy precipitation events during winter, and decreases in these characteristics during summer. These trends are consistent with changes in the full precipitation probability distributions and are spatially coherent across most of the UK. In relation to the entire 20th century, there is an indication that recent winter increases in heavy precipitation are unusual, while recent summer decreases may not be.[ ]..The sign of the change is consistent with the simulated climate-change signal due to increasing greenhouse gas concentrations, though the magnitude of the observed change is greater than that expected from the model simulations.
USA figures suggest an upward trend in large flood events:
source
Interestingly, deaths from flooding in the USA are falling over the same time frame. Better flood warnings?
In Asia: "Overall, results showed an increasing likelihood of extreme floods [in the Mekong] during
the last half of the century, although the probability of an average flood decreased
20 during the same period." Source
A few straws in the wind, gathered from a quick Google search. Professional hydrologists will make cautious noises, but I, having no professional reputation to protect, would dare to say that events in Pakistan, and other flooding events brought to our attention by the news, are part of a global trend consistent with the predictions of global warming theory.
No one single weather event can be taken as evidence of global warming. We have to look at the whole picture (something that global warming sceptics seem to find particularly difficult). However, global warming theory predicts that floods and droughts will increase in frequency as the planet heats up.
The data on flooding is difficult to interpret, since they have to define what is meant by floods, and other factors, such as population numbers, land use changes (e.g. building on an area will reduce the ability of the ground to absorb water), flood defence measures, and ability to report events come in to play.
Researchers are conscious of these factors, and try to estimate or allow for them.
Having said that, here are a few findings:
The costs due to extreme weather events have certainly shot up. This figure covers 1950-99:
The UK's Centre for Ecology and Hydrology says: "The latest research from the UK Climate Projections team (UKCP09) indicates that winter rainfall has increased in the north-west of the UK since the early 1960s. Other research suggests that extreme rainfalls have also increased in frequency in northern and western areas of the UK, and one recent study which involved CEH scientists found that, over the last 50 years, the daily maximum rainfall has increased by 25% in northern and western areas relative to the previous 50 years. "
In Scotland: "It has been shown that river flows in the Clyde Catchment have increased at nearly twice the rate of increase in rainfall in the past 30 years." [.pdf]
Osborne and Hulme 2002: Over 100 weather stations with daily precipitation totals for the last four decades provide a record of precipitation characteristics across most of the UK. They indicate increased precipitation totals and increased frequency and contribution of heavy precipitation events during winter, and decreases in these characteristics during summer. These trends are consistent with changes in the full precipitation probability distributions and are spatially coherent across most of the UK. In relation to the entire 20th century, there is an indication that recent winter increases in heavy precipitation are unusual, while recent summer decreases may not be.[ ]..The sign of the change is consistent with the simulated climate-change signal due to increasing greenhouse gas concentrations, though the magnitude of the observed change is greater than that expected from the model simulations.
USA figures suggest an upward trend in large flood events:
source
Interestingly, deaths from flooding in the USA are falling over the same time frame. Better flood warnings?
In Asia: "Overall, results showed an increasing likelihood of extreme floods [in the Mekong] during
the last half of the century, although the probability of an average flood decreased
20 during the same period." Source
A few straws in the wind, gathered from a quick Google search. Professional hydrologists will make cautious noises, but I, having no professional reputation to protect, would dare to say that events in Pakistan, and other flooding events brought to our attention by the news, are part of a global trend consistent with the predictions of global warming theory.
Spirit Level : John Rawls, relative poverty and so much the worse for the facts
Over at openDemocracy, there is a debate about John Rawls and the idea that inequality causes social and health problems.
My 2p:
If we accept for the sake of argument that Wilkinson&Pickett's thesis about equality is correct (which is a good bet as things stand - the criticisms have been pretty underwhelming), the next step is to look for a plausible causal pathway.
Kate Pickett suggested in a talk at the Green Party Conference that the phenomon might be rooted in the time we spent as tribes. Tribal economies are based on sharing - hunters hunt, gatherers gather, and in the evening, there is a communal meal. Equality, sharing even , comes naurally to us.
Let's take things a bit further. Imagine Tribe A rubbing along as above, who suddenly they find themselves dominated by a more powerful Tribe B, who live among them, albeit a little apart, with more and beter food, and in much larger tents.
Tribe A is going to be in a perpetual state of stress, secreting more cortisol among other things. This might provide a clue to the observed health effects, and at least some of the social effects.
Marmot's findings about the health of civil servants meshes in with this idea that it is the relative positions of rich and poor which is the operative factor. It's a relationship. We are part of a system.
So, whatever the correct interpretation may be of Rawls' idea, the weight of evidence points to the desirability of reducing inequality.
The point was made: "Rawls makes a moral proposition. No empirical data can prove it "wrong"." That reminds me of the don, who, on being told "The facts are otherwise" responded with "So much the worse for the facts".
My 2p:
If we accept for the sake of argument that Wilkinson&Pickett's thesis about equality is correct (which is a good bet as things stand - the criticisms have been pretty underwhelming), the next step is to look for a plausible causal pathway.
Kate Pickett suggested in a talk at the Green Party Conference that the phenomon might be rooted in the time we spent as tribes. Tribal economies are based on sharing - hunters hunt, gatherers gather, and in the evening, there is a communal meal. Equality, sharing even , comes naurally to us.
Let's take things a bit further. Imagine Tribe A rubbing along as above, who suddenly they find themselves dominated by a more powerful Tribe B, who live among them, albeit a little apart, with more and beter food, and in much larger tents.
Tribe A is going to be in a perpetual state of stress, secreting more cortisol among other things. This might provide a clue to the observed health effects, and at least some of the social effects.
Marmot's findings about the health of civil servants meshes in with this idea that it is the relative positions of rich and poor which is the operative factor. It's a relationship. We are part of a system.
So, whatever the correct interpretation may be of Rawls' idea, the weight of evidence points to the desirability of reducing inequality.
The point was made: "Rawls makes a moral proposition. No empirical data can prove it "wrong"." That reminds me of the don, who, on being told "The facts are otherwise" responded with "So much the worse for the facts".
Tuesday, August 03, 2010
The BMA Homoeopathy (homeopathy) debate
The BMA is calling for homoeopathy to be removed from the NHS.
OK. I'm going to put my head above the parapet, ready for a hail of machine gun products from the anti-homoeopathy activists.
I confess that I have prescribed a few homoeopathic remedies in my in my 30 years as a GP. Just a few - pulsatilla, arnica, rhus tox, aconite. I found aconite especially useful for patient self-management of panic attacks (backed by good information) - very much more useful, and less problematic, than diazepam. I saw no harm from it.
I saw some dramatic recoveries - coincidental, naturally. I saw a particularly impressive coincidence with an adolescent whose problematic asthma disappeared after one dose of a powder prescribed by a proper homoeopathic doctor.
I have huge respect for homoeopathic physicians. They are old-school. They engage with their patients, get to know them, and form a therapeutic relationship. The patient feels understood, and if the personal physician gives them a powder, they feel confident that they will get better. So they do.
At very least, homoeopath physicians in their natural habitat get an enhanced placebo effect.
Which would explain why published homoeopathic trials tend to show show positive effect, while randomised double blind trials tend not to show any effect. Or are reported as not showing any effect.
With the notable exception of David Reilly's work. David did an RCT on homoeopathic preparations in nasal allergy, and got a positive effect. His methods were criticised, so he repeated the work, taking on board the criticisms, and still got a positive effect.
Reilly has a .doc summary of the debate that can be downloaded from this page. It is fairly heavy going, with closely argued statistics so do not waste disc space if you do not do odds ratios and 95% CI's. But it does give another side to the picture about the scientific study of homoeopathy. For instance, the same device is used by H sceptics as has used by detractors of the Spirit Level - discarding unusually positive data.
He shows a picture of two clusters of placebo controlled trials, one of orthodox drugs, and one of homoeopathic remedies. It is impossible to tell the difference in terms of significance. So the analysts (whose abstract begins with the words "Homoeopathy is widely used, but specific effects of homoeopathic remedies seem implausible." ) proceed to extract 8 homosopathic trials and 6 orthodox trials, and conclude "When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions". This was then reported in an editorial under the headline as The End of Homoeopathy, a report duly amplified in the mainstream media. I confess that I picked up on this. Which just shows that if you want to really know something, you have to trace it right back to source.
I have always asked, when in the right company, that Reilly's work be replicated using two identical ultra-dilute solutions, one prepared by succussion, and one by turbulent mixing. The hypothesis is that the turbulent mix solution will perform less well if succussion is having an effect.As far as I know, this has never been done. It should be.
The response of the objectors is that it just cannot work, because there is no atom present of the original molecule. Homoeopaths respond that the succussion (passing shock waves through the solution) process creates a "memory" in the water. Objectors ask for evidence of this memory.
Beneveniste thought he had found it, in demonstrating an effect on white cells from antibodies at homoeopathic dilutions. It seems that his effects were not replicated.
However, Louis Rey found this : Ultra-high dilutions of lithium chloride and sodium chloride (10−30 g cm−3) have been irradiated by X- and gamma-rays at 77 K, then progressively rewarmed to room temperature. During that phase, their thermoluminescence has been studied and it was found that, despite their dilution beyond the Avogadro number, the emitted light was specific of the original salts dissolved initially.
The scientific method requires that this work be replicated. It may have been; I don't know. I am coming late to this debate.
Next, this: "We discovered a previously unknown phenomenon in liquid water, which develops over time when water is left to stand undisturbed, and which made precise gravimetric measurement impossible. We term this property autothixotropy (weak gel-like behaviour developing spontaneously over time) and propose a possible explanation. The results of quantitative measurements, performed by two different methods, are presented. We also report the newly discovered phenomenon of autothixotropy-hysteresis and describe the dependence of autothixotropy on the degree of molecular translative freedom. A very important conclusion is that the presence of very low concentration of salt ions, these phenomena do not occur in deionized water. Salt ions may be the determinative condition for the occurrence of the phenomena". VybÃral + Vorácek2007
Reilly quotes Professor Luc Montagnier, a French virologist who co-discovered HIV and who won the Nobel Prize in 2008, made the radical claim ( 2009 ) that some bacterial DNA sequences are able to induce electromagnetic (EM) waves at high aqueous dilutions - if they were 'strongly agitated', a step 'critical for the generation of signals'.
He also cites "evidence of ultramolecular dilutions of histamine ability to inhibit basophil activation “in a reproducible fashion”" [ Belon P, Cumps J, Ennis M, Mannaioni PF, Roberfroid M, Ste-Laudy J, Wiegant FAC. Histamine dilutions modulate basophil activity. Inlfamm Res 2004; 53:181-8]
These are the tip of the iceberg of papers relating to the micro-structure of water. I have a strong suspicion that water is far more sophisticated than the simple image that we have in our textbooks of tiny bouncy balls flying around at random.
Here is a simple starter on the micro structure of water.
The study of the micro-structure of water deserves scientific study. The trouble is that, because it is outside the mainstream, the people who do it tend to work on their own, and sometimes maybe their work leaves a little to be desired in terms of perfection. But the medical profession should never forget, and never, never repeat, what we did to poor Semmelweiss.
The essence of science is to say dogmatically, not "This is the case", but to ask, "Is this indeed the case?" In this debate, the question is, "Is it indeed the case that water has no nano-structure which is worthy of investigation?"
So there is something to the micro-structure of water that needs scientific investigation. Whether this will have any relevance to homoeopathic medicines we will have to wait and see.
What we do know is that homoeopathic physicians do meet a need. They have high patient satisfaction. Their medicines are not expensive. Above all, their medicines do not (cannot, in the view of the sceptics) cause side effects.
I do not agree with the request from my union, the BMA, to remove homoeopathy from the NHS. It should be allowed to continue, but under conditions of audit, covering all aspects of their practice: what diagnoses they are presented with, the success rates that they achieve, and their cost-effectiveness. When this evidence is collected, we will be able to make an evidence based decision on whether or not it is worthwhile for the NHS to continue to fund homoeopathic physicians.
This would seems a reasonable way to move forward on this issue.
Later blog on this.
OK. I'm going to put my head above the parapet, ready for a hail of machine gun products from the anti-homoeopathy activists.
I confess that I have prescribed a few homoeopathic remedies in my in my 30 years as a GP. Just a few - pulsatilla, arnica, rhus tox, aconite. I found aconite especially useful for patient self-management of panic attacks (backed by good information) - very much more useful, and less problematic, than diazepam. I saw no harm from it.
I saw some dramatic recoveries - coincidental, naturally. I saw a particularly impressive coincidence with an adolescent whose problematic asthma disappeared after one dose of a powder prescribed by a proper homoeopathic doctor.
I have huge respect for homoeopathic physicians. They are old-school. They engage with their patients, get to know them, and form a therapeutic relationship. The patient feels understood, and if the personal physician gives them a powder, they feel confident that they will get better. So they do.
At very least, homoeopath physicians in their natural habitat get an enhanced placebo effect.
Which would explain why published homoeopathic trials tend to show show positive effect, while randomised double blind trials tend not to show any effect. Or are reported as not showing any effect.
With the notable exception of David Reilly's work. David did an RCT on homoeopathic preparations in nasal allergy, and got a positive effect. His methods were criticised, so he repeated the work, taking on board the criticisms, and still got a positive effect.
Reilly has a .doc summary of the debate that can be downloaded from this page. It is fairly heavy going, with closely argued statistics so do not waste disc space if you do not do odds ratios and 95% CI's. But it does give another side to the picture about the scientific study of homoeopathy. For instance, the same device is used by H sceptics as has used by detractors of the Spirit Level - discarding unusually positive data.
He shows a picture of two clusters of placebo controlled trials, one of orthodox drugs, and one of homoeopathic remedies. It is impossible to tell the difference in terms of significance. So the analysts (whose abstract begins with the words "Homoeopathy is widely used, but specific effects of homoeopathic remedies seem implausible." ) proceed to extract 8 homosopathic trials and 6 orthodox trials, and conclude "When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions". This was then reported in an editorial under the headline as The End of Homoeopathy, a report duly amplified in the mainstream media. I confess that I picked up on this. Which just shows that if you want to really know something, you have to trace it right back to source.
I have always asked, when in the right company, that Reilly's work be replicated using two identical ultra-dilute solutions, one prepared by succussion, and one by turbulent mixing. The hypothesis is that the turbulent mix solution will perform less well if succussion is having an effect.As far as I know, this has never been done. It should be.
The response of the objectors is that it just cannot work, because there is no atom present of the original molecule. Homoeopaths respond that the succussion (passing shock waves through the solution) process creates a "memory" in the water. Objectors ask for evidence of this memory.
Beneveniste thought he had found it, in demonstrating an effect on white cells from antibodies at homoeopathic dilutions. It seems that his effects were not replicated.
However, Louis Rey found this : Ultra-high dilutions of lithium chloride and sodium chloride (10−30 g cm−3) have been irradiated by X- and gamma-rays at 77 K, then progressively rewarmed to room temperature. During that phase, their thermoluminescence has been studied and it was found that, despite their dilution beyond the Avogadro number, the emitted light was specific of the original salts dissolved initially.
The scientific method requires that this work be replicated. It may have been; I don't know. I am coming late to this debate.
Next, this: "We discovered a previously unknown phenomenon in liquid water, which develops over time when water is left to stand undisturbed, and which made precise gravimetric measurement impossible. We term this property autothixotropy (weak gel-like behaviour developing spontaneously over time) and propose a possible explanation. The results of quantitative measurements, performed by two different methods, are presented. We also report the newly discovered phenomenon of autothixotropy-hysteresis and describe the dependence of autothixotropy on the degree of molecular translative freedom. A very important conclusion is that the presence of very low concentration of salt ions, these phenomena do not occur in deionized water. Salt ions may be the determinative condition for the occurrence of the phenomena". VybÃral + Vorácek2007
Reilly quotes Professor Luc Montagnier, a French virologist who co-discovered HIV and who won the Nobel Prize in 2008, made the radical claim ( 2009 ) that some bacterial DNA sequences are able to induce electromagnetic (EM) waves at high aqueous dilutions - if they were 'strongly agitated', a step 'critical for the generation of signals'.
He also cites "evidence of ultramolecular dilutions of histamine ability to inhibit basophil activation “in a reproducible fashion”" [ Belon P, Cumps J, Ennis M, Mannaioni PF, Roberfroid M, Ste-Laudy J, Wiegant FAC. Histamine dilutions modulate basophil activity. Inlfamm Res 2004; 53:181-8]
These are the tip of the iceberg of papers relating to the micro-structure of water. I have a strong suspicion that water is far more sophisticated than the simple image that we have in our textbooks of tiny bouncy balls flying around at random.
Here is a simple starter on the micro structure of water.
The study of the micro-structure of water deserves scientific study. The trouble is that, because it is outside the mainstream, the people who do it tend to work on their own, and sometimes maybe their work leaves a little to be desired in terms of perfection. But the medical profession should never forget, and never, never repeat, what we did to poor Semmelweiss.
The essence of science is to say dogmatically, not "This is the case", but to ask, "Is this indeed the case?" In this debate, the question is, "Is it indeed the case that water has no nano-structure which is worthy of investigation?"
So there is something to the micro-structure of water that needs scientific investigation. Whether this will have any relevance to homoeopathic medicines we will have to wait and see.
What we do know is that homoeopathic physicians do meet a need. They have high patient satisfaction. Their medicines are not expensive. Above all, their medicines do not (cannot, in the view of the sceptics) cause side effects.
I do not agree with the request from my union, the BMA, to remove homoeopathy from the NHS. It should be allowed to continue, but under conditions of audit, covering all aspects of their practice: what diagnoses they are presented with, the success rates that they achieve, and their cost-effectiveness. When this evidence is collected, we will be able to make an evidence based decision on whether or not it is worthwhile for the NHS to continue to fund homoeopathic physicians.
This would seems a reasonable way to move forward on this issue.
Later blog on this.
Monday, August 02, 2010
Spirit Level: the causation question
One of the common objections of consrevatives to Wilkinson and Pickett's book, the Spirit Level, which provides evidence that more economic equality is better for a society, is to accept that they have found a correlation, but that does not prove causation.
Of course, "proof" does not happen in science, it is a matter of pattern recognition, but there is a body of evidence to back up W+P, and nothing (afaik) to back the argument that the arrow of causation runs the other way, that social problems cause economic inequality.
Several lines of argument that inequality leads to social dysfunction rather than the reverse. One of the clearest is the history of the US and Japan since WWII. In 1946 the US was more equal than Japan, and head better health. These positions are now reversed.
There are other lines of argument which support this view, not least primate experiments where social status is changed and material conditions do not.
I do not know of any studies which have supported the view of reverse causation.
Of course, "proof" does not happen in science, it is a matter of pattern recognition, but there is a body of evidence to back up W+P, and nothing (afaik) to back the argument that the arrow of causation runs the other way, that social problems cause economic inequality.
Several lines of argument that inequality leads to social dysfunction rather than the reverse. One of the clearest is the history of the US and Japan since WWII. In 1946 the US was more equal than Japan, and head better health. These positions are now reversed.
There are other lines of argument which support this view, not least primate experiments where social status is changed and material conditions do not.
I do not know of any studies which have supported the view of reverse causation.
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