Steady As She Goes

Published by Anonymous (not verified) on Fri, 23/03/2018 - 12:44pm in

Feel smarter after a drink or two? Well, you just might be right!

Several things you WON’T BELIEVE about Marijuana Legalization and Traffic Fatalities

Published by Anonymous (not verified) on Mon, 19/03/2018 - 10:04pm in



From the moral panic division of ClubTroppo.

Early Evidence on Recreational Marijuana Legalization and Traffic Fatalities

Over the last few years, marijuana has become legally available
for recreational use to roughly a quarter of Americans. Policy
makers have long expressed concerns about the substantial
external costs of alcohol, and similar costs could come with the
liberalization of marijuana policy. Indeed, the fraction of
fatal accidents in which at least one driver tested positive for
THC has increased nationwide by an average of 10 percent from
2013 to 2016. For Colorado and Washington, both of which
legalized marijuana in 2014, these increases were 92 percent and
28 percent, respectively. However, identifying a causal effect
is difficult due to the presence of significant confounding
factors. We test for a causal effect of marijuana legalization
on traffic fatalities in Colorado and Washington with a synthetic
control approach using records on fatal traffic accidents from
2000-2016. We find the synthetic control groups saw similar
changes in marijuana-related, alcohol-related and overall traffic
fatality rates despite not legalizing recreational marijuana.

by Benjamin Hansen, Keaton S. Miller, Caroline Weber – #24417 (HE LE)


Published by Anonymous (not verified) on Fri, 16/03/2018 - 11:19pm in



I have prostate cancer, but I’m happy. Here’s how.

By George Monbiot, published in the Guardian 14th March 2018


It came, as these things often do, like a gunshot on a quiet street: shocking and disorienting. In early December, my urine turned brown. The following day I felt feverish and found it hard to pee. I soon realised I had a urinary tract infection. It was unpleasant, but seemed to be no big deal. Now I know that it might have saved my life.

The doctor told me this infection was unusual in a man of my age, and hinted at an underlying condition. So I had a blood test, which revealed that my prostate specific antigen (PSA) levels were off the scale. An MRI scan and a mortifying biopsy confirmed my suspicions. Prostate cancer: all the smart young men have it this season.

On Monday, I go into surgery. The prostate gland is buried deep in the body, so removing it is a major operation: there are six entry points and it takes four hours. The procedure will hack at the roots of my manhood. Because of the damage that will be caused to the surrounding nerves, there’s a high risk of permanent erectile dysfunction. Because the urethra needs to be cut and reattached to the bladder, I will almost certainly suffer urinary incontinence for a few months, and possibly permanently. Because the removal of part of the urethra retracts the penis, it appears to shrink, at least until it can be stretched back into shape.

I was offered a choice: radical surgery or brachytherapy. This means implanting radioactive seeds in the parts of the prostrate affected by cancer. Brachytherapy has fewer side effects, and recovery is much faster. But there’s a catch. If it fails to eliminate the cancer, there’s nothing more that can be done. This treatment sticks the prostate gland to the bowel and bladder, making surgery extremely difficult. Once you’ve had one dose of radiation, they won’t give you another. I was told that the chances of brachytherapy working in my case were between 70 and 80%. The odds were worse, in other words, than playing Russian roulette (which, with one bullet in a six-chambered revolver, gives you 83%). Though I have a tendency to embrace risk, this was not an attractive option.

It would be easy to curse my luck and start to ask “why me?”. I have never smoked and hardly drink; I have a ridiculously healthy diet and follow a severe fitness regime. I’m 20 or 30 years younger than most of the men I see in the waiting rooms. In other words, I would have had a lower risk of prostate cancer only if I had been female. And yet … I am happy. In fact, I’m happier than I was before my diagnosis. How can this be?

The reason is that I’ve sought to apply the three principles which, I believe, sit at the heart of a good life. The first is the most important: imagine how much worse it could be, rather than how much better.

When you are diagnosed with prostate cancer, your condition is ranked on the Gleason Score, which measures its level of aggression. Mine is graded at 7 out of 10. But this doesn’t tell me where I stand in general. I needed another index to assess the severity of my condition, so I invented one: the Shitstorm Scale. How does my situation compare to those of people I know, who contend with other medical problems or family tragedies? How does it compare to what might have been, had the cancer had not been caught while it is still – apparently – confined to the prostate gland? How does it compare to innumerable other disasters that could have befallen me?

When I completed the exercise, I realised that this bad luck, far from being a cause of woe, is a reminder of how lucky I am. I have the love of my family and friends. I have the support of those with whom I work. I have the NHS. My Shitstorm Score is a mere 2 out of 10.

The tragedy of our times is that, rather than apply the most useful of English proverbs – “cheer up, it could be worse” – we are constantly induced to imagine how much better things could be. The rich lists and power lists with which the newspapers are filled, our wall-to-wall celebrity culture, the invidious billions spent on marketing and advertising, create an infrastructure of comparison that ensures we see ourselves as deprived of what others possess. It is a formula for misery.

The second principle is this: change what you can change, accept what you can’t. This is not a formula for passivity. I’ve spent my working life trying to alter outcomes that might have seemed immovable to other people. The theme of my latest book is that political failure is, at heart, a failure of imagination. But sometimes we simply have to accept an obstacle as insuperable. Fatalism in these circumstances is protective. I accept that my lap is in the lap of the gods.

So I will not rage against the morbidity this surgery might cause. I won’t find myself following Groucho Marx who, at the age of 81, magnificently lamented, “I’m going to Iowa to collect an award. Then I’m appearing at Carnegie Hall, it’s sold out. Then I’m sailing to France to pick up an honour from the French government. I’d give it all up for one erection.” And today there’s viagra.

The third principle is this: do not let fear rule your life. Fear hems us in, stops us from thinking clearly and prevents us from either challenging oppression or engaging calmly with the impersonal fates. When I was told that this operation has an 80% chance of success, my first thought was “that’s roughly the same as one of my kayaking trips. And about twice as good as the chance of emerging from those investigations in West Papua and the Amazon”.

There are, I believe, three steps to overcoming fear: name it, normalise it, socialise it. For too long, cancer has been locked in the drawer labelled Things We Don’t Talk About. When we call it the Big C, it becomes, as the term suggests, not smaller, but larger in our minds. He Who Must Not Be Named is diminished by being identified, and diminished further when he becomes a topic of daily conversation.

The super-volunteer Jeanne Chattoe, whom I interviewed recently for another column, reminded me that, just 25 years ago, breast cancer was a taboo subject. Thanks to the amazing advocacy of its victims, this is almost impossible to imagine today. Now we need to do the same for other cancers. Let there be no more terrible secrets.

So I have sought to discuss my prostate cancer as I would discuss any other issue. I make no apologies for subjecting you to the grisly details: the more familiar they become, the less horrifying. In doing so, I socialise my condition. Last month, I discussed the remarkable evidence suggesting that a caring community enhances recovery and reduces mortality. In talking about my cancer with family and friends, I feel the love that I know will get me through this. The old strategy of suffering in silence could not have been more misguided.

I had intended to use this column to urge men to get themselves tested. But since my diagnosis, we’ve discovered two things. The first is that prostate cancer has overtaken breast cancer to become the third biggest cancer killer in the UK. The second is that the standard assessment (the PSA blood test) is of limited use. As prostate cancer in its early stages is likely to produce no symptoms, it’s hard to see what men can do to protect themselves. That urinary tract infection was a remarkably lucky break.

Instead, I urge you to support the efforts led by Prostate Cancer UK to develop a better test. Breast cancer has attracted twice as much money and research as prostate cancer, not because (as the Daily Mail suggests) men are the victims of injustice, but because women’s advocacy has been so effective. Campaigns such as Men United and the Movember Foundation have sought to bridge this gap, but there’s a long way to go. Prostate cancer is discriminatory: for reasons unknown, black men are twice as likely to suffer it as white men. Finding better tests and treatments is a matter of both urgency and equity.

I will ride this out. I will own this disease but I won’t be defined by it: I will not be prostrated by my prostate. I will be gone for a few weeks but when I return, I do solemnly swear I will still be the argumentative old git with whom you are familiar.

End-of-Life Care – We Can and Must Do Better

Published by Anonymous (not verified) on Thu, 15/03/2018 - 9:20am in



As the debate about euthanasia rages, end-of-life and palliative care is neglected, with both quality and availability lacking. And yet, that's what the majority of dying people need so they can die at home without pain.

Why we should be questioning ‘natural’ medicines

Published by Anonymous (not verified) on Tue, 13/03/2018 - 9:37am in



Claims made about a product being natural doesn’t necessarily make it safer or appropriate.

Cartoon: Beyond the Paleo

Published by Anonymous (not verified) on Tue, 06/03/2018 - 11:50pm in


Food, gender, Health

[This post has been updated.]

I know a lot of people are going to argue with this one, but you have to admit the caveman thing is getting just a little ridiculous. For example:


Dark chocolate almond coconut nutrition bars… just like early homo sapiens used to eat when they needed an energy boost on the big mastodon hunt!

At the same time that lots of scientific evidence was accumulating about the health benefits of the Mediterranean diet, Americans were embracing the Paleo diet – a diet ridiculed by nutritionists (even back in 2011), and consistently ranked near or at the bottom of expert diet recommendations. Wikipedia provides some criticism of the caveman fantasy. In some ways, Paleo is healthier than Americans’ normal terrible diets (particularly where it intersects with the Mediterranean diet), but that’s thin praise.

So why has it been such a big fad? Part of its popularity probably stems from the fact that meat-eating is encouraged, and the “primal man” narrative has a certain easy-to-grasp truthiness. But also, I suspect because it ties into the macho gender politics, a search for tough-guy authenticity, and conspiracy theorizing (the nutritionists are lying to you!) that have consumed American pop culture and politics for the last twenty years. One might say that Americans chose the wrong diet for many of the same reasons that they chose the wrong president.

Which brings us to the all-meat diet in the third panel, inspired by this fascinating Motherboard article on the trendlet of Bitcoin carnivores. It’s well worth your time!

Follow Jen on Twitter at @JenSorensen

Me on forecasting

Published by Anonymous (not verified) on Thu, 01/03/2018 - 4:41pm in

Above is my presentation to CEDA’s Outlook conference in Brisbane a couple of weeks ago. I came after a McKinsey’s consultant talking about digital disruption which is always a fun thing to present or listen to because there are lots of ‘wow’ moments when you wheel out the cool ways people are using data and so on. Anyway, I was pleasantly surprised when people said that they’d found my presentation very enjoyable and instructive – which is what I was hoping for. If you’re interested, the original powerpoint slides can be downloaded from this link.

I was also on a panel the video of which I reproduce below. I certainly didn’t intend to take the discussion towards one of my hobby horses of deliberative democracy, but the occasion seemed to call for it. Several people told me how ‘inspiring’ it was – so there you are. Would I lie to you? Would they lie to you? No. We wouldn’t. Will you be inspired? As Lady Brackness says, statistics are sent for our guidance and if they were inspired, of course you will be inspired? 1  The video is over the fold. 

  1. This forecast is certified to the 3% accuracy level plus or minus the usual statistical margin error.


Published by Anonymous (not verified) on Mon, 26/02/2018 - 10:24pm in



A remarkable experiment suggests that emergency admissions to hospital can be reduced by tackling loneliness

By George Monbiot, published in the Guardian 21 February 2018


It could, if the results stand up, be one of the most dramatic medical breakthroughs of recent decades. It could transform treatment regimes, save lives, and save health services a fortune. Is it a drug? Is it a device? Is it a surgical procedure? No, it’s a newfangled intervention called community.

This week, the results from a trial in the Somerset town of Frome are published informally, in the magazine Resurgence & Ecologist. (A scientific paper has been submitted to a medical journal and is awaiting peer review). We should be cautious about embracing data before they are published in the academic press, and must always avoid treating correlation as causation. But this shouldn’t stop us feeling a shiver of excitement about the implications, if the figures turn out to be robust, and the experiment can be replicated.

What these provisional data appear to show is that when isolated people who have health problems are supported by community groups and volunteers, the number of emergency admissions to hospital falls spectacularly. While across the whole of Somerset, emergency hospital admissions rose during the three years of the study by 29%, in Frome they fell by 17%. Julian Abel, a consultant physician in palliative care and lead author of the draft paper, remarks that “no other interventions on record have reduced emergency admissions across a population.”

Frome is a remarkable place, run by an independent town council famous for its democratic innovation. There’s a buzz of sociability, a sense of common purpose and a creative, exciting atmosphere quite different from that of many English market towns, and, for that matter, quite different from the buttoned-down, dreary place I found when I first visited, 30 years ago.

The Compassionate Frome project was launched in 2013 by the town’s GP, Helen Kingston. She kept encountering patients who seemed defeated by the medicalisation of their lives: treated as if they were a cluster of symptoms rather than a human being who happened to have health problems. Staff at her practice were stressed and dejected by what she calls “silo working”.

So, with the help of the NHS group Health Connections Mendip and the town council, her practice set up a directory of agencies and community groups. This let them see where the gaps were, which they then filled with new groups, for people with particular conditions. They employed “health connectors” to help people plan their care and, most interestingly, trained voluntary “community connectors” to help their patients find the support they needed.

Sometimes this meant handling debt or housing problems, sometimes joining choirs or lunch clubs or exercise groups or writing workshops or men’s sheds (where men make and mend things together). The point was to break a familiar cycle of misery: illness reduces people’s ability to socialise, which leads in turn to isolation and loneliness, which then exacerbates illness.

This cycle is explained by some fascinating science, summarised in a recent paper in the journal Neuropsychopharmacology. Chemicals called cytokines, which function as messengers in the immune system and cause inflammation, also change our behaviour, encouraging us to withdraw from general social contact. This, the paper argues, is because sickness, during the more dangerous times in which our ancestral species evolved, made us vulnerable to attack. Inflammation is now believed to contribute to depression: people who are depressed tend to have higher cytokine levels.

But, while separating us from society as a whole, inflammation also causes us to huddle closer to those we love. Which is fine – unless, like far too many people in this age of loneliness, you have no such person. One study suggests that the number of Americans who say they have no confidant has nearly tripled in two decades.

In turn, the paper continues, people without strong social connections, or who suffer from social stress (such as rejection and broken relationships) are more prone to inflammation. In the evolutionary past, social isolation exposed us to a higher risk of predation and sickness. So the immune system appears to have evolved to listen to the social environment, ramping up inflammation when we become isolated, in the hope of protecting us against wounding and disease. In other words, isolation causes inflammation, and inflammation can cause further isolation and depression.

Remarkable as Frome’s initial results appear to be, they shouldn’t be surprising. A famous paper published in PloS Medicine in 2010 reviewed 148 studies, involving 300,000 people, and discovered that those with strong social relationships had a 50% lower chance of death across the average study period (7.5 years) than those with weak connections. “The magnitude of this effect,” the paper reports, “is comparable with quitting smoking”. A celebrated study in 1945 showed that children in orphanages died through lack of human contact. Now we know that the same thing can apply to all of us.

Dozens of subsequent papers reinforce these conclusions. For example, HIV patients with strong social support have lower levels of the virus than those without. Women have better chances of surviving colorectal cancer if they have strong connections. Young children who are socially isolated appear more likely to suffer from coronary heart disease and type II diabetes in adulthood. Most remarkably, older patients with either one or two chronic diseases have no greater death rates than those who are not suffering from chronic disease – as long as they have high levels of social support.

In other words, the evidence strongly suggests that social contact should be on prescription, as it is in Frome. But here and in other countries, health services have been slow to act on such findings. In the UK, we have a minister for loneliness, and social isolation is an official “health priority”. But the silo effect, budget cuts and an atmosphere of fear and entrenchment ensure that precious little has been done.

Helen Kingston reports that patients who once asked “what are you going to do about my problem?” now tell her, “this is what I’m thinking of doing next”. They are, in other words, no longer a set of symptoms, but people with agency. This might lead, as the preliminary results suggest, to fewer emergency admissions and major savings to the health budget. But even if it doesn’t, the benefits are obvious.



Well Being and Trauma

Published by Anonymous (not verified) on Wed, 14/02/2018 - 3:08am in



A national guide to addressing trauma, and an assessment of how we are doing.

Nurses latest target of PC brigade

Published by Anonymous (not verified) on Tue, 13/02/2018 - 9:20am in



Their new code now eye wateringly says '...cultural safety provides a decolonising model of practice based on dialogue, communication power-sharing and negotiation, and the acknowledgement of white privilege'.