Interesting Links for 25-11-2011

[andrewducker]

• IPv6 for consumers on DSL at last
  (tags: ipv6 adsl isp uk internet broadband )
• Apple is the UK's second most popular shopping site (after Amazon)
  (tags: apple shopping uk )
• Google and Samsung confirm Galaxy Nexus volume bugs - glad I'm not upgrading until January!
  (tags: google samsung android )
• Badoo - the billion pound social network you've never heard of (massive in Brazil, Spain, France...)
  (tags: business socialnetworking sex culture badoo )
• Genetic Study Confirms: First Dogs Came from East Asia
  (tags: dogs asia genetics )
• Britain has had a record-breaking freakishly warm autumn
  (tags: autumn weather uk )
• Courts cannot force ISPs into broad filtering and monitoring for copyright-infringing traffic, ECJ rules
  (tags: law privacy internet copyright EpicWin )
• Offshore unit launched to tackle international tax avoidance
  (tags: tax uk )
• UK switching cervical cancer vaccine to one which also protects against genital warts
  (tags: uk nhs vaccine women )
• Seeing nude people tunes up the brain
  (tags: nudity brain psychology )
• Some very interesting stats on home births, midwives, etc.
  (tags: birth children healthcare )
• Ethical bank Triodos opens its first UK branch (in Edinburgh)
  (tags: uk scotland edinburgh bank ethics )
• Organising movie posters by different tropes they use. Strangely hypnotic.
  (tags: posters design cinema movies art poster )
• It's nice to know that there's at least one class out there getting decent sex education
  (tags: sex education sexuality society )
• Willpower Is more than a metaphor: Self-control relies on glucose as a limited energy source.
  (tags: glucose sugar willpower self-control )
• Journalists tried to reach JK Rowling through her five-year-old daughter. Can we shoot them now?
  (tags: journalism uk media jkrowling )
• 50p tax rate not actually causing a massive problem.
  (tags: tax uk )

Comments

[dalglir.livejournal.com]

Actually, I thought the GMC had given guidance that everyone can drink as long as they do it in moderation. Sadly, the general drinking populace are generally incapable of understanding 'in moderation' and come up with things like 'alcopops don't count' etc. So it's easier for government to say 'don't drink at all'. Of course, government also has an agenda to reduce NHS costs which are hammered by heavy drinking related illness and injury every Friday and Saturday night...

[andrewducker]

Sadly, the general drinking populace are generally incapable of understanding 'in moderation' and come up with things like 'alcopops don't count'

I'm not convinced that a majority of people are like that. Certainly there's a loud cohort who make people's lives a misery on a Saturday night, but I don't think that's that many people out of the whole population.

The GMC aren't bad - but you end up with some doctors advocating tougher and tougher measures on alcohol pricing, because of the alcoholics they see, without seeming to realise that this is have a large affect on ordinary people, without making much of a difference to the actual alcoholics.

(Don't get me started on the "You shouldn't be allowed to smoke in your car..." stuff that came out a couple of weeks ago.)

[dalglir.livejournal.com]

The anecdote is to illustrate that even with statistics on your side, shit still happens.

In that scenario, where would you rather your wife and child be?

[andrewducker]

If you step outside of your door you could be instantly shot and killed by a rogue police marksman.

In that scenario, would you go outside?


(Less flippantly, Julie gets to make the call, and I'm sure she'll do oodles of research before deciding anything. First child will almost certainly be born in a hospital, and choices about further ones will depend on what happens then...)

[dalglir.livejournal.com]

I correct 'general drinking populace' to 'loud cohort who make people's lives a misery on a Saturday night'.

And agreed re GMC. The problem here is that some members have a political and ambition agenda that they can only further by spouting heavy handed garbage.

[momentsmusicaux.livejournal.com]

> PDF support is built-in to the OS,

Yup.

> In Firefox, I just set it to automatically open them in Preview.

Yeah, but I'd rather be warned upfront that I'm going to have a bouncy dock icon and then a download window open and then another application opening and then a file to trash from my downloads folder...

Chrome on the other hand opens them in a browser tab. I'm sure FF used to do that too -- I possibly removed the Adobe PDF browser plugin because it was crappy and crashed.

[andrewducker]

This is true. I do think that doctors get a negative view of people, because they only see the ones that have fucked up in some way (or are unlucky). I know a few GPs who have ended up thinking largely of the general population as incompetent idiots who can't be trusted to look after themselves.

And I think that _sometimes_ they have a point, but I'd rather that most people got to make their choices than we restrict everyone because of a few people.

[dalglir.livejournal.com]

I not sure that question is a fair comparison. They do not carry like for like possibilities of 'complications'.

Now: if i lived in a 200 window building and I knew that a rogue police marksman was aiming at a random window and was going to shoot whoever opened it, would I open my window? Probably not. I'd find a less risky way of getting fresh air.

.

[andrewducker]

Aaah, so it comes down to probabilities.

In which case, what _are_ the odds of a situation occurring which gives different outcomes depending on whether you're at home or in the hospital?

Because I read a study earlier today that said the differences were statistically insignificant (for second child and onwards).

[dalglir.livejournal.com]

Let's see how far we can take this analogy :)

Let's say risk of 'complication' from rogue police sniper is 1% in an apartment block 45 minutes from the hospital and a hospital block being terrorised by another rogue police sniper.

What the statistics of the study say is that, for people who have already been shot by a rogue police sniper once before ~45% of the unlucky 1% who get shot back at the apartment block end up have to go to hospital anyway (albeit mostly for flesh wounds). Critically, the statistics say that the risk of dying from being shot by a rogue police sniper the second time around is the same whether your at the apartment block (a 45 minute ambulance journey from the hospital) or at the hospital block (where all the surgeons are).

You know what? I'd still rather be shot by a rogue police sniper at the hospital block.

[andrewducker]

And I am absolutely fine with you making decisions that aren't backed up by data. Tis your right!

[dalglir.livejournal.com]

Reading more on this. It's quite fascinating seeing the different studies from different groups with different agendas.

[andrewducker]

Oooh, more data please!

[kerrypolka.livejournal.com]

Of course a statistically insignificant outcome feels more important when you're in the middle of it.

This is why anecdotes make for awful recommendations

LIKE THIS COMMENT

[andrewducker]

Thank you

[anton-p-nym.livejournal.com]

Apparently there's a saying going around Microsoft now; bowdlerized, it's, "the average person has one breast and one testicle." It's a caution against relying on statistical models without examining the context.

I strongly suspect that the reason second-child home-births have the same complication rate as hospital births is that those who were most prone to complications (as demonstrated the first time) went to the hospital. This skews the result heavily... indeed, I'm surprised that home-birth for second children doesn't show a greater safety rate because of that bias.

Of course I haven't seen the study design or how they controlled for this so perhaps I'm being unfair.

-- Steve's not a stats genius in any case.

[andrewducker]

Yup, that's what I'd expect.

Which means that the sensible thing to do is to have your first child in a hospital, and then make a decision about the second child based on the results of that experiment.

[naath.livejournal.com]

Ah, but you forget the other side of the coin - for a birth that has no complications and proceeds in the normal and expected manner to produce a healthy child and healthy mother a hospital setting carries additional risks (generally speaking simply being in a hospital carries risks such as increased exposure to MRSA; specifically speaking many women experience hospital births as involving more stress, and more unnecessary/unwanted medical intervention during their birth).

There are many women and babies whose health post partum are vastly improved by not being in a hospital setting, and simplifying that to "home comfort" is unfair; it is desperately unpleasant to think about but, yes, I would venture to suggest that for most people there is a number of people in perfect rather than slightly-dodgy health that "makes up for" a single death collaterally caused. What you feel that number is, and how it fits into the evidence presented here, are things that I obviously do not know.

The risk equation also requires further information which is non-obvious (although presumably covered in this report) - exactly what procedures are there which you are very likely to be able to access in hospital but not at home? Home births supervised by NHS midwives are not the same thing as a birth free of medical intervention or assistance; not all hospitals are able to guarantee to offer all types of intervention that are theoretically available (that is, that exist, are approved etc); what is the likelihood of experiencing unexpected complications? Further - how far is your home from the hospital, how long will it take you to get there in an emergency situation, which you should compare with how long you would have to wait in the hospital for the appropriate teams and equipment to be available to you when you are considering what risk you are actually running by having a home birth.

So; yes. It's news. Just because the answer turns out to agree with your gut-feeling about the risks doesn't mean that you were correct to trust your gut-feeling rather than go out (well, send someone out) and collect evidence about the question.

[naath.livejournal.com]

There's a strong chance you would have to hang about by a hospital bed with wife in agony/baby dying - waiting for the right doctor to be found, the OR to be prepared, the team to scrub up, etc etc. There is a usually a delay between requesting even the most emergency of emergency procedures (especially ones involving complicated kit/specific people; which is what we are talking about because midwives have the easy kit with them and lots of training) and actually receiving the procedure.

How that delay compares to the time spent waiting for / in an ambulance depends of course on where exactly you live.

[alitheapipkin.livejournal.com]

Yes this. By their nature these things miss out the personal experience bit. I know two women who opted to give birth at home for their first child. Neither of them are stupid, they both did their research and decided the added comfort and reduced medicalisation outweighed the extra risk. They were both lucky enough to have no complications and found birth a more positive experience than several other women I know, who had a horrible time in hospital. Including one who still had to wait for an ambulance and be transferred because the hospital she was in couldn't perform the necessary intervention.

By which I mean that if we rely on people's gut feelings and personal experience, we get a story based entirely on who is in our sample.

[channelpenguin.livejournal.com]

:-) now that has been MY choice. I have no desire for children, and never have - BUT I think that even *if* I did, the risks of death, injury and long standing and profoundly unpleasant health problems for myself (diabetes, lost teeth, single or double incontinence, fistula(e), prolapse...etc. etc..) would STILL probably convince me otherwise.

[erratio.livejournal.com]

If you're interested in reading more about the glucose/motivation stuff, Roy Baumeister keeps a lovely page where you can get pdfs of his papers emailed to you. He's also looked at sex drive.

[dalglir.livejournal.com]

It turns out that I am an opinionated old fart, lucky enough to have friends like Andy who are patient enough to keep arguing their corner. The result was that I went away, read some more around the topic and am now more sympathetic to other point of view.

Hurray!

[alitheapipkin.livejournal.com]

I can entirely sympathise with your position given your experience, it's very hard to be objective about medical statistics when it's you or your family whose lives are saved (I made a similar point here about mammograms).

[andrewducker]

I should point out that I think your approach is absolutely defensible, that 0.5/100 is perfectly common enough to be worried about, and that I'm sure there are cases where being right next to a bunch of doctors has saved people's lives.

Which leads me to think that either there _is_ something wrong in the statistics or there must be cases where being in a hospital is actively bad for your health (like increased chance of catching something nasty, or passing doctor's deciding to run experiments on you).