Monday, July 09, 2007

Caution or prejudice?

I am pregnant. The baby is due on Christmas Day. Because of this, I have been looking into the choices available for childbirth. My local maternity unit has a birthing pool, so I've been looking into water birth as a possibility.

This study, published in 2000, disturbed me a little. The results section of the abstract, which was all I had access to, seemed to suggest a whole host of benefits from labouring and/or giving birth in water: less injury to the mother, less pain relief needed, happier mothers, healthier babies… and yet the conclusion is a very underwhelming 'Waterbirths … do not demonstrate higher birth risks for the mother or the child than bedbirths'.

Why the vote of unconfidence? I started looking for more recent articles, and for articles which described drawbacks to water birth. I found that many of the latter appeared to be published in a single journal, Pediatrics. One article in particular, a description of four case reports of water births with complications, had a comment appended by the editor of the journal. 'Editor’s Note: I’ve always considered underwater birth a bad joke, useless, and a fad, which was so idiotic it would go away. It hasn’t! It should!' Speak your mind, why don't you, don't be shy!

Further searching in this journal revealed a more recent article, from 2004, whose main thesis appeared to be that water births shouldn't be used because they had not been subject to randomised controlled trials. Yet a Cochrane review from 2002, two years earlier, found eight such trials, and confirmed that water immersion did reduce the pain levels and the need for pain relief.

So, when such information is so easily available, why should an article that denied it be published? Could it be that the editor's opinions lead him to selectively publish articles that reflect his own viewpoint, rather than making up his mind on the available evidence? The latter is surely the point of evidence-based medicine, and the gold standard of randomised controlled trials.

Sunday, June 24, 2007

Nanotechnology ethics journal

Springer has launched a new journal, NanoEthics, to concentrate on ethical issues in the area of nanotechnology. The first issue is freely available.

There are many ethical issues to discuss in this emerging technology, though many if not most are just the same ethical issues we see elsewhere (informed consent, wise use of discoveries, ends versus means). But it's worth discussing these issues for nanotechnology in specific, if only because so many people are ignorant of what nanotechnology is about or is likely to become.

Thursday, April 26, 2007

Food aid: GM or not, it's still dumping

Sudan has agreed to take a shipment of food aid after all. The shipment, from the US, had previously been rejected on the grounds that it was genetically modified; the World Food Programme claimed that this was impossible.
It's not unreasonable to assume that food aid from the US might be contaminated with genetically modified food (if you don't know that GM sorghum hasn't been developed); 60% of the land that is used worldwide to grow GM crops is in the US, and a lot of this harvest ends up in food aid (source). But the problem, as the BBC article suggests, may not be the presence of genetically modified material as such, but rather the policy of dumping food in the guise of aid.
Sudan has had a bumper crop this year. It would be well capable of supplying food to the refugees. What it needs is a purchaser and a distribution network. The WFP is well placed to do this. Except it's not.
Donors, particularly rich countries like the US, tend to give food rather than money. It's a great way of getting rid of the excess food produced by the over-subsidised agricultural industry. So the WFP doesn't have any money to buy Sudan's food. Instead, it has to distribute the foreign food, which ends up driving the local farmers out of business when they can't sell their crops.
Jennifer Clapp's paper The Political Economy of Food Aid in
An Era of Agricultural Biotechnology
suggests the US also has another motivation for distributing GM material as food aid: in the developing world, countries are generally hesitant to approve the growing of GM food. As they don't have the resources to do extensive testings, they tend to follow the European model of caution rather than the US one of 'innocent until proven guilty'. This means that the market for GM crops outwith North America is very small – unless they can break the resistance by presenting people with a fait accompli.Equally, the developing countries have an economic motivation for refusing GM foods: they might lose their export licences to the EU if any of the food grain is found to have been sown and crossed with local varieties.
Ultimately, of course, the problem is with all food aid, not just that involving GM material, where the food is the result of Western subsidised excess rather than having been sourced as locally as possible. In general, it's better to give money in such situations rather than food.

Saturday, January 13, 2007

Funding bias affects all fields

We've known for a while that the results of pharmaceutical trials are influenced by the source of funding. Now two separate studies have been published showing that the same is true in the fields of nutrition and technology. I suppose it's unsurprising. The results you get out of research depend on the questions you ask. And the questions you ask depend on why you're asking them. I think all we can do is make the sources of funding as explicit as possible, and do regular comparisons along the lines of the studies linked to here in order to be able to correct for any bias that results.

Thursday, January 11, 2007

This is just plain scary

I don't think I'll trust the Times again.
As the author points out, it's impossible that the authors of the article in the Times couldn't have known that they were writing falsehoods; that is, if they were doing any research into the subject at all.

How many more such articles are there out there? Mark Liberman at the Language Log points out that calling foul on news articles in the mainstream media is becoming more possible with the possibility for everyone to publish through blogs. And this is a good thing.

We've seen this before, of course. It's called peer review'. Philica even offers a very similar system of review to that of the blogosphere, with articles being published first and then reviewed. But there's a lot of drivel there, and who is going to have time to look through it all? Nature has recently given up on a test of open peer review for lack of uptake. I don't see academia moving over to this system any time soon. But as for popular reports, take everything you read with a pinch of salt. Or, in the case of the Times, empty the whole bag in.

DaimlerChrysler climbdown

I see that DaimlerChrysler has issued a statement, in response to the BBC news article claiming that their chief economist dismissed the notion of climate change as 'Chicken Little' behaviour. Apparently he just said that other people said that, not that he agreed with it.

I would tend to wonder why, if he didn't agree with what he was saying, he said so much of it (the BBC article quotes quite extensively). But it is in car and oil companies' interests to at least appear in public to be green. The New Scientist points out that companies like BP, who market themselves strenuously on their green credentials, are doing much better than ExxonMobil. And this is especially important when, as the BBC article points out, the US economy is struggling. So the damage limitation people are out in force.

At the same time, there is a petition against the proposal to introduce mileage charges instead of the current flat-rate road tax. This follows the fuel tax protests in 2005. Personally, I would prefer fuel tax to a GPS-based system, simply because the former is so much easier to administer. But either way, the protests are about the increased cost of driving around per se.

I would love the facts about pollution to turn out to be wrong. I would be very happy to continue my current profligate Western lifestyle. But I think that it would be fooling myself to ignore the warnings. It's not a matter of Chicken Little yelling that the sky is falling because an acorn fell on his head. Chicken Little has been pointing out, at length, for several years that the sky is now measurably lower than it was in the past, and although estimates disagree on the rate of descent, they all agree that it will fall further, that we know what is causing the sky to fall, and that the consequences of falling sky are already visible. Since people aren't going to change by themselves, we need legislation, such as higher taxes on fuel. So it's time to go and see the King.

Tuesday, January 09, 2007

I can't imagine why

I really cannot fathom why any doctor would refuse to inform a patient of their diagnosis. For years. Of a serious illness for which such treatment as there is needs to be started as early as possible.

Thursday, January 04, 2007

Medical journalism corruption still rife

This week's New Scientist has an article showing that drug companies have not stopped their attempts to influence the media in favour of their products, attempting to cover over controversies and suppress reporting of inconvenient results.

Nine years old forever

I was surprised, though pleased, to see the general response to the Ashley treatment. I was expecting much more of a knee-jerk reaction, but people have for the most part been very understanding in their comments. Maybe this is a UK/US thing, since US boards seem to have a much harsher take on it. Or maybe this is because the story broke in the US first, and so the UK people, posting later, have a fuller view of the case?

In case it's not clear, my sympathies, too, are with the parents. It would be nice if such decisions didn't have to be made, but the world isn't like that.