Crackdown on victims of sex crimes

Police have launched a new campaign which targets criminals who traffick women and force them into the sex trade.
...
Home Secretary Jacqui Smith said today that some of the women rescued from sex slavery by a new police operation will still face the risk of deportation.

We can only hope that this will be followed by a crackdown on other victims of sex crimes.

Genetics and IQ

Crooked Timber has a thread on a post by Cosma Shalizi that concludes that currently the heritability of IQ cannot be calculated.

I don't want to disagree with Shalizi in general, as I think he's broadly right, but the comments in the Crooked Timber article are enlightening. The question of how heritable IQ is seems to be posed almost entirely in terms of race - as if that is the only way that the question of heritability can be framed.*

Many of the commenters have picked up on Shalizi's claim that the question of IQ heritability is "not a well-posed question". I disagree with this, strictly speaking, given that IQ is ultimately a measure, however poor, of neural function then, at some level of environmental equality, it will be substantially heritable (and thus 'genetic') - this doesn't tell us that current differences in IQ between racial groups are substantially due to genetic differences, but it also doesn't rule out the possibility a priori. Nor does it assume that IQ measures any really extant thing, rather than just being a grab-bag of questions that challenge the brain to a greater or lesser extent.

It is perfectly respectable to think that the evidence for racial (or gender) differences in IQ is poor, as are estimates of heritability, and confounded by environmental factors that are not, and perhaps cannot be controlled for, that IQ tests are not measuring any single unitary thing, and that there is substantial genetic overlap between groups we identify by ethnic labels. You could also note that many of the most vocal proonents of such positions appear to do so for less than savoury reasons.

But so many people seem to need to go beyond this position to claim that there can be no differences between racial groups, that IQ cannot have any heritability under any circumstances, that IQ measures nothing at all, that it has no connection at all with anything we might call 'intelligence', and that there can be no genetically identifiable racial groups. All these latter claims are profoundly false, and it never ceases to amaze me that so many liberal people feel compelled to believe them in order to shut out the spectre of racism. [if you want to see the excesses of the other side of the coin try the people at gene expression].

The Crooked Timber comments also include this gem:

"...the evidence that Down syndrome and similar conditions are linked to unremediable IQ deficits is just about as weak as the race-linked evidence, for many of the same reasons; see my article in Disability and Society, here – http://home.vicnet.net.au/~borth/DOWN1.HTM"

* I think this is because people are unable to understand that high heritability estimates for IQ do not mean that racial differences in IQ must be due to genetic differences. My favourite example of this is schizophrenia. We know that schizophrenia is heritable, with much greater chance of developing it if close family members have it, and monozygtic twin concordance of around 50%. There have also been a number of genes identified that confer a risk for developing schizophrenia. Now black people in the UK and the US (African Caribbean/African American ethnicity) have much higher rates of schizophrenia than the rest of the population. And this doesn't seem to be due to racist or culturally insensitive doctors overdiagnosing it (doctors from the Caribbean confirm that these people really do have schizophrenia). So there you go, must be due to black people being genetically predisposed to schizophrenia? Nope, because black people in Africa and the Caribbean don't have this elevated rate of schizophrenia. We don't know quite what causes this elevated rate, it doesn't seem to be due to poverty or migration, and many people suspect it is due to the neuropsychological impact of racism or being in a ethnic minority within a wider society.

Badscience blogs

The badscience blog feed is up and running at http://badscienceblogs.net/blogindex.php.

Here are the blogs it currently aggregates (via coracle):

A big side order of Why…
A canna’ change the laws of physics
Action For Autism
Ambri-guous
Apathy Sketchpad » Science And Religion
Bad Science
Beyond The Second Law
consider, evaluate, act
DC's IMPROBABLE SCIENCE
Dr Aust's Spleen
Education Watch
Evidence-based everything
extraordinary claims
Flexuosa
gimpy's blog
Hawk/Handsaw
Holford Watch: Patrick Holford, nutritionism and bad science
jdc325's Weblog
Junkfood Science
Left Brain/Right Brain
Letting Off Steam
Modne Bzdury
Mugs and money
Poor Pothecary
Pyjamas in Bananas
Science and Progress
SkeptoBot
The Broken Hut
the quackometer blog
Thinking Is Dangerous
We sell dreams in a bottle
Wellington Grey
What the hell is this?

That's a lot of blogs - many are well established blogs that have been around for a while, but quite a few have been got up just for the purpose of creating a big badscience blogging community in the last week or so - I'll have to decide whether to stick 'em all in my blog roll, slim the roll down and just include the aggregated feed, or stick to a hybrid model.

Atheists bad as gays and Jews

Theo Hobson has a very irritating little piece on Comment is Free. I'd like to share a bit with you:

"The comparison of American atheists to both homosexuals and Jews is very interesting. It is tantamount to crying: "Let's seek influence through posing as a victimised minority!" How Nietzsche would smile at the sight of a man so blatantly trying to foster a sense of resentment."

Now he's right that Dawkins talks about atheists being a minority that is discriminated against in the US - Hobson doesn't seem to have anything to say as to whether this discrimination is a bad thing or not - but I'm not convinced that Dawkins is seeking for others to give influence to atheists because atheists are discriminated against, rather he wants atheists themselves to claim some influence in order to counteract the discrimination they face.

It is a very odd position to hold that comparing your group to Jewish and gay people, who were (and are) discriminated against, because your group is discriminated against, is "tantamount to crying: "Let's seek influence through posing as a victimised minority!"" - and I'm not sure I'd like to think too hard about what these comments might reveal about his attitude to Jewish and gay people.

No mention of the American religious right either, curious omission, maybe he doesn't think they're as bad as those pesky gays and Jews?

Free will

I've never really 'got' free will - why it is so mystical and important and controversial. Maybe it is just that I don't see what the problems with determinism are supposed to be. As far as I can fathom free will is supposed to be the sense that we make our own decisions free of external causes, that we are the agents of our own actions. Sounds fair enough - but the problem is supposed to come when you add in determinism - apparently our thoughts and actions being causally determined by, e.g., our brains, is incompatible with our free will, with us being these free agents.


This leads some people to reject determinism in the favour of absolute randomness (something that is patently absurd), or statistical probability (e.g. quantum mechanics). Dan Dennett devotes a whole book (Freedom Evolves) to this question, I've only made it halfway through (busy man me), but I've heard him talk on the topic before. Dennett argues that in the random probability model the undetermined bits are precisely the types of freedom that are not worth having (Descartes has a similar point about the poverty of real freedom in choices made in the abscence of evidence or impulsion to one side or the other).


I have to agree - but I think that the impulse to embrace randomness to salvage free will from determinism highlights the fundamental misunderstanding that lies at the heart of the free will problem. Many of those that reject physical determinism - the idea that the brain gives rise to the mind - accept non-physicalism instead, they believe that the mind being something other than physical somehow frees them from the problem of determinism. But it is far from apparent that it does any such thing if there are causal factors operating in this mental world (and we have every reason to think that there are - from the physical input via the senses to the interaction of mental properties). It is hard to see how, if the mind is made of causal 'stuff' at all, how it can escape from determinism.


It reminds me of Nagel's famous question, "What is it like to be a bat?" - which assumes, for an answer, that it is even meaningful to ask how one mind-thing might gain access to being another, different mind-thing - the underlying assumption that you could somehow constitutively 'be' another thing, whilst retaining something of what you were before - the assumption, in other words, of a animating spirit or homunculus piloting the show (Nagel is actually using the argument to try and show that subjective experience cannot be reduced to a functionalist explanation).


At some point, one would think, there can be no more little men behind the scenes pulling the levers - something must be animating him - at some point the causal explanations must be grounded. Rejection of determinism just seems to be a refusal to begin this endeavour, a belief that if anything causal underlies the actions of a mind they somehow become unfree, because they are caused by something other than that mind. But, of course, they are not determined by something 'other' in a meaningful sense - the mistake is to confuse layers of explanation - when my arm lifts a glass - that the action is caused by the contraction of muscles, or, deeper still, by myosin sliding over actin, does not make it any less my arm that is doing the lifting.

Single jabs

These are images that we just can't see enough of in my opinion. They are from the Health Protection Agency's Centre for Infections, and show the uptake of measles and MMR vaccines against the incidence of measles infections and deaths.

Measles is a serious infection (mortality 1:5,000), is very contagious and it is unpleasant with fever, a rash, conjunctivitis, cough and cold symptoms, but there are a number of potential complications. Poor nutrition in the developing world, and immunocompromise in the West make these even more likely and thus infection more dangerous. Children in the UK with cancer who come into contact with measles are at a very high risk of complications.

Complications include ear infections (10%), pneumonia (5%), febrile convulsions (seizures which can be caused by any infection, and usually do not lead to epilepsy; 1:200) and myocarditis. About 1:1,000 of measles cases result in encephalitis with 15% mortality and serious long term complications in 40% of survivors such as seizures, deafness, paralysis, and learning disability

Subacute sclerosing panencephalitis is a rare illness that develops many years after infection by measles when very young (under 2yrs; 1:8,000) where persistent virus in the nervous tissue causes progressive brain damage, dementia, and death

Fortunately we can see that the rate of measles infection is now very low, and the number of deaths thus very small due to a concerted vaccination campaign using first single measles vaccine, and then MMR. Unfortunately it looks like people have forgotten how bad measles can be - the steadily climbing rate of vaccination has been compromised by the MMR-autism scare and measles is back.

This has lead some to argue that single vaccines should be provided. Leaving aside the obvious point that the MMR doesn't cause autism or gut problems, and that the vaccine was introduced to replace a single measles vaccine (Urabe) with undesirable side effects (meningitis), there are real problems with this idea. Separate vaccines must be administered many weeks apart (the minimum necessary period is unknown) to avoid interactions that might reduce the efficacy of the vaccines (the MMR components have been tested and shown not to have a problem if they are administered all at the same time), but they must also be given twice - to ensure coverage when very young (the first dose at 13 months), but also boosted to last for longer when older (the second dose before 5yrs of age). This gives 6 injections rather than two, and evidence suggests that parents are just much poorer at ensuring their children receive all the vaccinations. There is also a much longer period where children are not covered for those diseases they have not yet been vaccinated against. Note the increase in vaccine coverage following introduction of the MMR.

Side effects of the MMR are rare, and usually only after the first dose. These are milder versions of the results of infection, and thus much less common than with full infection, and due to the vaccine comprising attenuated viruses that replicate in the body. The most common side effect is a mild malaise, fever or rash after about a week, which resolves in a few days. Parotid swelling can occur in about 1% of children. Febrile convulsions can occur in 1:1,000 children (these do not lead to any long-term consequences such as epilepsy). Encephalitis is a theoretical risk but research suggests that MMR does not lead to any increased incidence. Very rarely clotting problems can occur in less than 1:20,000 children, and this resolves spontaneously.

Some people argue that only the measles vaccine should be given, but this underestimates the seriousness of mumps and rubella.

We can see from this graph that mumps is also massively on the rise, although this is presently in older children who have never been vaccinated. Mumps causes a fever and malaise with swelling of the parotid glands. Hearing loss is usually transient following infection, with deafness in only 1:20,000, but signs of meningitis are present in about 10% and encephalitis is found in 1:1,000. Pancreatitis is a potentially serious complication found in less than 10% of children. Orchitis (inflammation of the testicle) is very rare in children (but not adults), and almost never results in infertility because it is usually unilateral.

Rubella (german measles) is usually mild, with a low fever and rash for a few days. Complications such as arthritis, encephalitis or myocarditis are rare. However, maternal rubella infection can lead to severe damage to the foetus. Before 8wks gestation most children will be born with deafness, congenital heart disease, and cataracts. Infection at 13-16wks and infection will lead to impaired hearing in around a third of children (past 18wks damage is minimal).

Acupuncture for back pain

A new study into the efficacy of acupuncture versus 'conventional' therapy has received some coverage today.

The paper found that at 6 months the response rate (33% improvement or better on 3 pain-related items on the Von Korff Chronic Pain Grade Scale or 12% improvement or better on back-specific functional status measured by the Hanover Functional Ability Questionnaire) was 47.6% in the verum acupuncture group, 44.2% in the sham acupuncture group, and 27.4% in the conventional* therapy group. The acupuncture was better than the conventional group, but real Chinese acupuncture (verum) was no better than 'sham' needling (just sticking in needles superficially).

Now this obviously suggests that (a) acupuncture might work better than conventional treatments in chronic back pain, and (b) that this is a general effect of sticking in needles and not something magic to do with 'Qi' (cf. the gate control theory of pain).

However, there are some oddities about this study. Obviously there is a real problem with blinding patients, and they were all aware that the study was into acupuncture whatever group they were assigned to, plus the physicians conducting the study were unblinded when they provided the conventional therapy (perhaps explaining why there were such low treatment rates for physio or painkillers). But the study also had some interesting criteria for responders and non-responders.

I haven't been able to figure out just why the primary analysis was 33% improvement on 3 pain-related items on the Von Korff Chronic Pain Grade Scale or 12% improvement on Hanover Functional Ability Questionnaire measues of back-specific functional status, and why these were primary outcomes, while Short Form Health Survey, or Patient Global Assessment scores were secondary, and the supplied references didn't help. But more intriguing is the requirement that no proscribed therapy be used, or the patient is then assigned to the unresponsive category.

The initial figures are 58%, 68%, and 71% responders for conventional, sham, and verum acupuncture respectively. Yet, once those who took proscribed treatments (we are not told what these might be for conventional therapy, for acupuncture it is anything other than rescue treatment for acute episodes of pain with nonsteroidal anti-inflammatory drugs to be taken on no more than 2 days per week up to the maximum daily dose during the therapy period and only 1 day per week during follow-up) are classed as non-responders, and those who missed the 6 month assessment, these figures were 27%, 44%, and 47%.

Since failure to attend follow-up was 6%, 3%, 3%, this suggests a whopping quarter of all patients were classified as non-responders for using proscribed therapies. Now given the generous allowance of painkillers allowed to the acupuncture groups we might think this is just fine since their acupuncture clearly wasn't working for them, but what were the conventional therapy subjects being excluded for? I can't read the German therapy guidelines, and the paper doesn't specify, so we can but speculate what terrible therapy was being used by these people, acupuncture perhaps? I hope not, the study does say that:

"Patients in all 3 groups were informed before randomization that
acupuncture would be offered after completion of the trial."

But I'm sure no scientist would be stupid enough to give treatment to participants within 6 months thus getting the patient classified as a non-responder (would they?) - but who knows how many patients, having got the idea of acupuncture into their heads, then went out and had some? This is especially worrying as these were chronic back pain patients who had presumably tried (and failed to respond to) conventional therapies, but were explicitly acupuncture naive, and who had signed up to a trial of acupuncture in chronic back pain.

So what we have here is a study comparing sticking needles into patients versus conventional therapy (presumably delivered by the same doctors) where only the interviewers (assessing outcome) were blinded, and where somehow, only half of patients were given analgesics in the conventional therapy group, where the acupuncture therapy group were allowed analgesics 2 days a week, and where half of conventional therapy responders were excluded for having 'proscribed' treatment that is never defined or quantified. I think I'll stick to the NSAIDs for now.

*According to German guidelines - out of 387 patients in this group: physiotherapy in 197; massage in 180, heat therapy in 157, ; electrotherapy in 65; 'back school' in 36; injections in 48; guidance in 56; infusions, yoga, hydrojet treatment, and swimming in a few, pharmacologic treatment (95% analgesia) in 183).

UPDATE
Having thought about this study for a bit - I can only assume that the study was excluding people for using additional therapy in the follow-up period. For acupuncture there were a set number of interventions (you could get more if you responded) - and for the conventional therapy this was also true:

"All interventions comprised ten 30-minute sessions, generally 2 sessions per week, and 5 additional sessions if, after the tenth session (Figure 2), patients experienced a 10% to 50% reduction in pain intensity (Von Korff Chronic Pain Grade Scale)."

But whilst things like physiotherapy interventions could be considered comparable, a consultation leading to a course of pain killers seems somewhat different since it is hard to know how long the drug therapy was allowed to continue in the conventional therapy group outside the month or so of treatment sessions. If the study is excluding people for having therapy after the study interventions (and it is not clear whether this is the case) that might explain why so many people got excluded as non-responders. The declared permitted medication for acupuncture patients was:

"For acute episodes of pain, only rescue medication was permitted in both acupuncture groups. This was strictly defined as nonsteroidal anti-inflammatory drugs to be taken on no more than 2 days per week up to the maximum daily dose during the therapy period and only 1 day per week during follow-up. Use of any additional therapies for pain during the entire study period was prohibited"

And for conventional patients:

"Patients in the conventional therapy group received a multimodal treatment program according to German guidelines. The guidelines provide the treating physician with recommendations about the treatment algorithm and assess the various therapy forms according to the degree of evidence based on a literature search and recommendations of the specialist associations. Conventional therapy included 10 sessions with personal contact with a physician or physiotherapist who administered physiotherapy, exercise, and such.

Physiotherapies were supported by nonsteroidal anti-inflammatory drugs or pain medication up to the maximum daily dose during the therapy period. Rescue medication was identical to that for the acupuncture groups."

What I worry about here is that the use of further NSAIDs after the initial treatment period but in the follow-up period of six months might have been classed as 'proscribed' in the conventional therapy group as well. In that case we are comparing an intensive acupuncture intervention with intensive physician/physiotherapy interventions, but where the available pain and anti-inflammatory medication for the conventional group is restricted to the short (1 month or so) intervention period (a period in which acupuncture patients are permitted 2/7 days per week of full NSAID therapy).

An interesting line from the study says:

"Patients in both acupuncture groups also had clinically meaningful better results for all secondary outcome measures, including medication use (Table 6)."

But Table 6 doesn't provide any figures about medication use unfortunately. You'd really hope that the acupuncture group was using less medication than the conventional therapy group though, wouldn't you?

Table 6 does, however, provide you with information on initial treatment response - that is response at 6-weeks - which, given the limitations of the unclear exclusion criteria for 'proscribed rescue medication', might provide us with the most reliable estimate of relative efficacy. They found treatment response of 56%, 59%, and 61% for conventional, sham, and verum acupuncture respectively. Given what we know about the poor efficacy of both NSAIDs and acupuncture against placebo (the Bandolier site is a good resource for information on therapy for chronic back pain) the most conservative conclusion would be that very little works for chronic back pain - probably due at least partly to its complex psychosocial nature as Ben Goldacre points out.