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March 22, 2006

Drug Use & Performance

BusinessWeek author Michael Mandel comments briefly on attitudes toward steroid use. (via Dynamist Blog) He states that strong views against steroids exist in certain camps only because those groups have no need for such substances. If there were a drug that could enhance other characteristics, opinions may be moderated.

But would we be quite so horrified, I wonder, if we were talking about "smart pills" or memory pills instead of steroids? Suppose that a pharmaceutical company was selling a pill that would improve your memory by 30% or your IQ by 30%, with the same sort of side effects as steroids. Would you be willing to take them for 3 or 5 critical years in your career? What if you knew that everyone else was taking them? What if you knew that the Chinese or the French were taking them?

Read the post here.

An initial reaction may be to deem a hypothetical ‘smart pill’ a form of cheating; a dishonest way of getting ahead. However the playing field in the real world isn’t equal. If the ability of others to speak multiple languages, play multiple instruments and excel in sport wasn’t earned, why should anyone feel guilt over taking a pill that merely improves the cards dealt by the Gods?

Similarly with competitive sport. Many team games are appealing because of the competitive element. It’s enjoyable to see not just exceptional individual performances, but how a group cooperates to achieve some goal. So long as the mismatch between the opposing teams isn’t too great, and the result remains unpredictable, all is well. The use of anabolic steroids wouldn’t eliminate that competitive element. Ronaldinho wouldn’t be any less exciting to watch if his talent derived from a pill as opposed to natural talent.

As Mandel states, the problem lies in the potential coordination problems and averse health effects. We could end up in a world where everyone is taking performance enhancing pills yet each individual would like to stop – IF they could be sure others would do otherwise. This unfortunate state of affairs requires some critical level of people to begin using such pills in the first place. Below this level, one isn't disadvantaged enough to make the pill worthwhile. If the health effects are significant, one would expect pills to be used by a small group of die-hards. The lower the health risk the more widespread the use and the more likely we are to see a coordination problem. But with lower health risk, the harm done by this coordination problem is lessened anyway. I’d guess that for a given level of risk, a ‘smart pill’ would be less prevalent than anabolic steroids in the sporting world. After all, there aren’t million pound contracts and sponsorship deals riding on the job performance of most academics, writers and students. There’s less at stake from poor performance relative to others, and less to gain from superior performance.

March 20, 2006

Patents on Nature

Author Michael Crichton writes about the practise in patent law of assigning ownership of observed scientific patterns or fact. He describes an upcoming Supreme Court case against medical firm who used a patented fact in a publication. What was the patented fact? – "Homocysteine (an amino acid associated with heart disease) is correlated with a vitamin B-12 deficiency."

Crichton says,

But what the Supreme Court will focus on is the nature of the claimed correlation. On the one hand, courts have repeatedly held that basic bodily processes and "products of nature" are not patentable. That's why no one owns gravity, or the speed of light. But at the same time, courts have granted so-called correlation patents for many years. Powerful forces are arrayed on both sides of the issue.

He goes on

For example, the human genome exists in every one of us, and is therefore our shared heritage and an undoubted fact of nature. Nevertheless 20 percent of the genome is now privately owned. The gene for diabetes is owned, and its owner has something to say about any research you do, and what it will cost you. The entire genome of the hepatitis C virus is owned by a biotech company. Royalty costs now influence the direction of research in basic diseases, and often even the testing for diseases. Such barriers to medical testing and research are not in the public interest. Do you want to be told by your doctor, "Oh, nobody studies your disease any more because the owner of the gene/enzyme/correlation has made it too expensive to do research?"

Read in full here. (via Reddit)

There are no doubt ways to justify this. However, besides the cost of time and effort required to uncover some facts or products of nature, nothing obvious comes to mind. Intuition suggests patent claims should require some value-added; some element of novelty or creativity. For example, you shouldn’t be able to point to a worm and claim it as your own. You perhaps verify the existence of a worms, then go on to devise a novel way of testing for their presence. Or maybe you could patent a unique manipulated form of worm (and the process that allowed the manipulation). But to claim rights over observations/facts/naturally occurring matter without going any further seems pretty opportunistic.

February 27, 2006

Hospitals and Misdiagnosis

The NYT writes about how rates of misdiagnosis in US hospitals haven’t fallen over time despite great improvements in technology.

With all the tools available to modern medicine — the blood tests and M.R.I.'s and endoscopes — you might think that misdiagnosis has become a rare thing. But you would be wrong. Studies of autopsies have shown that doctors seriously misdiagnose fatal illnesses about 20 percent of the time. So millions of patients are being treated for the wrong disease.
How can this be happening? And how is it not a source of national outrage?A BIG part of the answer is that all of the other medical progress we have made has distracted us from the misdiagnosis crisis. Any number of diseases that were death sentences just 50 years ago — like childhood leukemia — are often manageable today, thanks to good work done by people like Dr. Bergsagel. The brightly painted pediatric clinic where he practices is a pretty inspiring place on most days, because it's just a detour on the way toward a long, healthy life for four out of five leukemia patients who come here.

But we still could be doing a lot better. Under the current medical system, doctors, nurses, lab technicians and hospital executives are not actually paid to come up with the right diagnosis. They are paid to perform tests and to do surgery and to dispense drugs.

Read in full here (Free subscription) (via Reddit)

My knowledge of medicine is limited to Scrubs, Grey’s Anatomy & House M.D. In any case, the real world must deal with which medical practitioners who are stressed, limited by the finances of hospitals and limited in the time they can devote to any one case. This necessitates shortcuts and thus errors. Consistency in errors doesn’t in itself signal a crisis. However, the article’s claim that doctors should receive greater feedback seems fair. That feedback may be produced internally (e.g. internal audits), or via the market (e.g. payment by results). Without feedback, incentives to learn and correct mistakes are limited. Autopsies are a means of generating feedback; a means of comparing causes of death to prior diagnoses. This article states that autopsy rates in the US need to be increased significantly so as to uncover systematic errors. I don't know details, but this piece from the president of the Royal College of Pathologists suggests the UK isn't too dissimilar.

Despite the obvious value of autopsies, the proportion of deaths (disregarding those investigated at the request of a coroner) subjected to this highly informative medical investigation has fallen steadily during the last few decades. Now, even in UK teaching hospitals, the autopsy rate is usually below five per cent. This has serious implications for clinical governance and audit, for the detection of unexpected adverse effects of medical interventions, and for undergraduate and postgraduate medical education. Regrettably, many doctors are now graduating from UK medical schools without ever having witnessed an autopsy.

February 09, 2006

Worker Shortages

Lew Rockwell comments on statements from business groups and politicians about shortages of scientists, engineers and mathematicians.

Think of how jobs have changed. We have fewer people around today who know how to farm because fewer people are necessary to do the job. More kids than ever are going into computer sciences because of the perception that these fields will be lucrative in the future. In neither case was a government program necessary. People entering the job market find out quickly what is in demand and what isn't and compare that to their own capacity for doing the job.

The reason the whole math and science racket bamboozles us again and again has to do with our own limitations and our perceptions of foreign countries. We think: heck I know nothing of these subjects, so I can believe that there is a shortage! And surely math and science are the keys to just about everything.

Read in full here.

The word ‘shortage’ may be used a little loosely in the media when applied to jobs and skills. Not every instance of lack deserves to be taken seriously. It makes no sense for me to say there’s a shortage of Ferraris merely because my student budget would get me laughed out of a dealership. I’m simply not willing to pay what its worth. If I say there's a shortage of Ferraris it should be qualified with a statement of a) why I don't think they're worth what I'm willing to pay, and/or b) why it is impossible to pay the going rate. Even when the latter is the case, the harm being done must be considered before declaring a crisis or deciding active intervention is needed.

Take the issue of teachers. The DfES recognises the obvious (albeit not instant) solution to shortages, as evidenced by generous training bursaries of up to £7000 and Golden Hellos of up to £5000 for PCSE candidates hoping to teach maths and science. Given that it knows the solution, the government couldn't blame poor quality education in certain areas on a lack of staff if it refuses to go further with it’s recruitment efforts.

If there are strong financial constraints on their ability to do this (beyond obstinacy), like an unwillingness amongst the populace to pay more tax, then claims of shortages are more credible. Here we’d need to accept that teachers in state schools aren’t necessarily going to hold degrees in their teaching field. Lower expertise may be a suitable trade-off for lower wages given the difficulty of the material being taught. Perhaps the expectations of teacher expertise are too high.

That said, I doubt the constraints faced are insurmountable. Sure, you may not be able to hike taxes, but I bet there are reasonable sacrifices to be made within government. Could policymakers genuinely say that education is important, but not important enough to warrant sacrificing other schemes, and cutting salaries in other areas? Such reorganisation is difficult politically, but probably not operationally. Shifts in resource use needn’t be radical to have a beneficial impact. As long as reasonable sacrifices exist, claims that poor education is down to a shortage of skilled staff is inaccurate. Like my Ferrari, policymakers just doesn’t want to pay what good (by its own definition) teachers are worth.

January 16, 2006

Environment: Different paths

Madeleine Bunting writes in today’s guardian on Kyoto protocol and the environmental movement in general. She thinks too much attention has been focused debt and trade issues relative to the EU emissions trading scheme and post Kyoto terms.

Looked at objectively it makes no sense. Climate change will dwarf the damage the common agricultural policy subsidies wreak on African farmers; it is already costing at least 150,000 lives a year as warmer temperatures encourage disease, and erratic rainfall will starve millions in coming years. Here is an issue that makes all the aid and debt deals of 2005 look like an afternoon parlour game. Yet such was the momentum of the Make Poverty History campaign that climate change slipped off the public radar and environmental groups felt they couldn't compete.

Contrast with the supposed pro-growth, pro-technology stance of the Asia-Pacific Partnership for Clean Development and Climate. From

The first meeting of the Asia-Pacific Partnership on Clean Development and Climate, which comprises Australia, the United States, Japan, South Korea, India and China, was hosted in sunny Sydney this week. Together the countries came up with a scheme to address climate change that they say will be good for both the economy and the planet.

Their plan focuses on the creation of eight government-business task forces, which will concentrate on cleaning up power generation and distribution, the building trade, and the industries of steel, aluminium, cement and coal mining. These task forces are to devise action plans, time frames and performance indicators, but details are vague at present. The plan does not specifically mention nuclear power.

January 12, 2006

Working on Important Problems

Just finished reading though an essay from Richard Hamming called ‘You and Your Research’ (linked to within this good Paul Graham article on the benefits of procrastination). A sample –

Now, why is this talk important? I think it is important because, as far as I know, each of you has one life to live. Even if you believe in reincarnation it doesn't do you any good from one life to the next! Why shouldn't you do significant things in this one life, however you define significant? I'm not going to define it – you know what I mean. I will talk mainly about science because that is what I have studied. But so far as I know, and I've been told by others, much of what I say applies to many fields. Outstanding work is characterized very much the same way in most fields, but I will confine myself to science.

In order to get at you individually, I must talk in the first person. I have to get you to drop modesty and say to yourself, ``Yes, I would like to do first-class work.'' Our society frowns on people who set out to do really good work. You're not supposed to; luck is supposed to descend on you and you do great things by chance. Well, that's a kind of dumb thing to say. I say, why shouldn't you set out to do something significant. You don't have to tell other people, but shouldn't you say to yourself, ``Yes, I would like to do something significant.''

Read it in full here.

The essay is geared towards researchers and how they should be concerned with the most important problems in their field. Those problems should be ones for which concrete progress is realistic; time spent on pie-in-the-sky issues isn’t so useful.

Clearly, most people aren’t professional academics and couldn’t directly solve important problems in psychology or engineering. But there are other important problems to be solved. In a broader sense these include how to ensure peace in a given region, how to secure energy availability for future generations, how to improve the welfare of society’s most vulnerable, etc.

The future for many of us involves jobs that may be interesting and necessary, but not important in the sense that they’re directly aimed at solving one a big global or theoretical problem. Though we may still face job-specific problems like how best to interact with clients or how best to structure a firm, they aren’t on the same scale and won’t win you universal acclaim or put you in contention for a Nobel Prize.

That’s not necessarily a bad thing. Choosing to work in other fields for motivations other than saving the world is fine. Not everyone is suited, or even interested in working in academia, politics, an R&D department or a think tank. The yearly financial reward for working in such places isn’t necessarily great and the work carried out isn’t guaranteed to yield concrete results any time soon if at all. Whilst others are working on saving the world, the rest of us must get on with the every day production and consumption that ultimately bankrolls them.

Still, there there’s something alluring about working on something that could have a genuine impact on others for years to come. Those who take an interest in important problems but choose not to work on them directly can make an impact by simply donating funds to relevant organisations. Over the course of a year most people will make many one-off charitable donations to disaster relief funds and television appeals. Perhaps it would be better to take a more structured approach to charitable giving and to make a long term commitment to some organisation that is helping solve whatever you think society’s most important problem is. An indirect contribution is better than none at all.

January 05, 2006

What is your dangerous idea?

What is your dangerous idea?

That’s the question has posed to leading scientists, journalists and cultural figures for 2006. Last year’s question was “What do you believe is true even though you cannot prove it?" which I commented on here. With 119 entries, there’s plenty to look through. Here’s a clip from Oliver Morton of Nature magazine who disagrees with those who think Earth itself is at threat from climate change.

many people in the various green movements feel compelled to add on the notion that the planet itself is in crisis, or doomed; that all life on earth is threatened. And in a world where that rhetoric is common, the idea that this eschatological approach to the environment is baseless is a dangerous one. Since the 1970s the environmental movement has based much of its appeal on personifying the planet and making it seem like a single entity, then seeking to place it in some ways "in our care". It is a very powerful notion, and one which benefits from the hugely influential iconographic backing of the first pictures of the earth from space; it has inspired much of the good that the environmental movement has done. The idea that the planet is not in peril could thus come to undermine the movement's power. This is one of the reasons people react against the idea so strongly. One respected and respectable climate scientist reacted to Andy Revkin's recent use of the phrase "In fact, the planet has nothing to worry about from global warming" in the New York Times with near apoplectic fury.

See the entries in full here.

December 16, 2005

Interview with Richard Dawkins

Biologist Richard Dawkins answers various questions on religion and evolution in an interesting interview on (via Arts & Letters Daily ). A short sample –

What are your thoughts about the despair some people feel when they ponder natural selection and random mutation? The idea of evolution and natural selection makes some people feel that everything is meaningless--people’s individual lives and life in general.

If it’s true that it causes people to feel despair, that’s tough. It’s still the truth. The universe doesn’t owe us condolence or consolation; it doesn’t owe us a nice warm feeling inside. If it’s true, it’s true, and you'd better live with it.

However, I don’t think it should make one feel depressed. I don’t feel depressed. I feel elated. My book, "Unweaving the Rainbow," is an attempt to elevate science to the level of poetry and to show how one can be—in a funny sort of way—rather spiritual about science. Not in a supernatural sense, but there are uplifting mysteries to be solved. The contemplation of the size and scale of the universe, of the depth of geological time, of the complexity of life—these all, to me, have an inspirational quality. It makes my life worthwhile to study them.

Read it in full here

November 22, 2005

Markets & Risk

James Hamilton comments on fund managers promising sky-high returns on investments. He describes a hypothetical fund “which would have turned $100 million into $2.7 billion, a 41% annual compounded return, with a positive return in every single year”.

"Capital Decimation Partners", a hypothetical fund created by Professor Lo in order to illustrate the potential difficulty in evaluating a fund's risk if all you had to go on was a decade of stellar returns. The strategy whereby CDP would have amassed a hypothetical fortune was amazingly simple— it simply sold put options on the S&P 500 stock index..Of course, if you play that game long enough, eventually the market will make a big enough move against you that your capital used to meet margin requirements gets completely wiped out, giving you a long-run guaranteed return on your investment of -100%. But over the 1992–99 period, Lo's hypothetical fund dodged that bullet and ended up turning in a whopping performance.

Read the article in full here.

Nassim Taleb makes the same point in his book 'Fooled by Randomness' which talks about our tendency to ignore low probability, high magnitude occurrences: ‘black swans’. Funds yielding spectacular returns year on year always have the sceptre of unexpected shocks on the horizon. Hang around for long enough and they may well catch up with you. Prices needn't display the textbook distributions seen elsewhere. Here, Taleb says –

A black swan is an outlier, an event that lies beyond the realm of normal expectations. Most people expect all swans to be white because that's what their experience tells them; a black swan is by definition a surprise. Nevertheless, people tend to concoct explanations for them after the fact, which makes them appear more predictable, and less random, than they are. Our minds are designed to retain, for efficient storage, past information that fits into a compressed narrative. This distortion, called the hindsight bias, prevents us from adequately learning from the past.

When thinking about what I’ll do with my life after university, becoming a trader at a global bank seemed like a fairly sexy career path. However, the more one reads about experienced fund managers who fail to match the performance of market indices (including Nobel prize winners ), mental biases that hinder judgements about probability, and the inability to distinguish competence from pure luck, the less appealing the industry seems.

November 21, 2005

Medical Schools

The Times comments on the increased popularity of foreign universities in the light of high domestic competition for places and impending top-up fees. It focuses on those hoping to study dentistry or medicine.

British medical students are heading for eastern European universities to beat fierce competition for places in the UK and the prospect of rising fees. They calculate that the chances of being accepted on courses in countries such as the Czech Republic are better than at UK universities and that the cost, including living expenses, is lower. The option has become increasingly attractive since the admission of more countries to the European Union last year. Doctors and dentists with degrees from within the EU are able to practise in Britain without taking conversion courses.
Komel Ali, 20, a medical student from Preston, Lancashire, studying medicine, studied at the independent Kirkham Grammar, a girls’ school near Preston. She chose Prague because of the strong competition for places in British medical schools. The latest figures in Britain show that 17,826 students applied to UK medical schools in 2004, but only 7,955 were accepted. Some of the most popular universities had 17 applications per place.

Read it in full here.

It seems crazy that the health sector, so in need of qualified staff is managing without so many eager applicants. The lucky few who are selected and make it though years of study are clearly very able. However, highly intelligent doctors are of little use if their efficiency is hampered by long hours and strict targets, or if waiting lists prevent you from seeing a specialist and getting treatment for weeks or months. I'm sure many would be happy with a merely average doctor if it meant they could get treatment immediately.

The capacity of the country’s medical schools is constrained by the availability of government funds. Private medical schools exist though I’m not sure what hoops must be jumped though to set one up. The low prominence of private schools may reflect the high fees charged or the fact that they’re hard to create in the first place. If it’s unambiguously the former you could say that state subsidising of medical study is all that’s preventing an even greater shortage. However, it’s the government that ultimately sets the salaries that determine whether a large investment in education will be worth it years down the line.

I don’t know what the solution to the ‘doctors crisis’ is. Yet there must be an option that doesn’t involve turning away willing medical students on our doorstep whilst we poach much needed staff from developing nations.

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