Lunch at the Labs

Various web links I found to be of interest recently.

• A new study shows American democracy is getting weaker. And not because of Trump.

  Every year, the Economist Intelligence Unit (EIU), the research arm of the company that publishes the Economist magazine, issues a report assessing the state of democracy in countries around the world. This year's report, released on Wednesday morning, has a striking finding: The United States has, for the first time, been rated as a "flawed" rather than "full" democracy.

  You'd think, given the timing, that the election of Donald Trump is the reason why. But that's not it. The report is based on a quantitative metric, linked to survey data and policy, that doesn't incorporate the election results.

  "The decline in the US democracy score reflects an erosion of confidence in government and public institutions over many years," the report states. '[Trump's] candidacy was not the cause of the deterioration in trust but rather a consequence of it."

• Why Trump's Staff Is Lying

  By requiring subordinates to speak untruths, a leader can undercut their independent standing, including their standing with the public, with the media and with other members of the administration. That makes those individuals grow more dependent on the leader and less likely to mount independent rebellions against the structure of command. Promoting such chains of lies is a classic tactic when a leader distrusts his subordinates and expects to continue to distrust them in the future.

  Another reason for promoting lying is what economists sometimes call loyalty filters. If you want to ascertain if someone is truly loyal to you, ask them to do something outrageous or stupid. If they balk, then you know right away they aren't fully with you. That too is a sign of incipient mistrust within the ruling clique, and it is part of the same worldview that leads Trump to rely so heavily on family members.

• The Heroism of Incremental Care

  We devote vast resources to intensive, one-off procedures, while starving the kind of steady, intimate care that often helps people more.

  Observing the care, I began to grasp how the commitment to seeing people over time leads primary-care clinicians to take an approach to problem-solving that is very different from that of doctors, like me, who provide mainly episodic care.
  ...
  Rose told me, "I think the hardest transition from residency, where we are essentially trained in inpatient medicine, to my practice as a primary-care physician was feeling comfortable with waiting. As an outpatient doctor, you don't have constant data or the security of in-house surveillance. But most of the time people will get better on their own, without intervention or extensive workup. And, if they don't get better, then usually more clues to the diagnosis will emerge, and the steps will be clearer. For me, as a relatively new primary-care physician, the biggest struggle is trusting that patients will call if they are getting worse." And they do, she said, because they know her and they know the clinic. "Being able to tolerate the anxiety that accompanies taking care of people who are sick but not dangerously ill is not a skill I was expecting to need when I decided to become a doctor, but it is one of the ones I have worked hardest to develop."

• Fewer people are dying of cancer than ever before

  The number of deaths peaked in 1991.

  The number of Americans dying of cancer has dropped to a 25-year low, equaling an estimated 2,143,200 fewer deaths in that period, says the new annual report from the American Cancer Society. In that time, the racial and gender disparities that exist in cancer rates have also narrowed somewhat, but they remain wide in many places.
  ...
  The decline in deaths from cancer is attributed largely to the fact that fewer people smoke -- from about 42 percent in 1965 to 17 percent in 2013 -- as well as earlier detection for certain types of cancer.

• Economic Crises and the Crisis of Economics

  Despite its aspiration to the certainty of the natural sciences, economics is, and will remain, a social science. Economists systematically study objects that are embedded in wider social and political structures. Their method is based on observations, from which they discern patterns and infer other patterns and behaviors; but they can never attain the predictive success of, say, chemistry or physics.

  Human beings respond to new information in different ways, and adjust their behavior accordingly. Thus, economics cannot provide -- nor should it claim to provide -- definite insights into future trends and patterns. Economists can glimpse the future only by looking backwards, so their predictive power is limited to deducing probabilities on the basis of past events, not timeless laws.

• Derek Parfit Obituary

  Endearingly eccentric moral philosopher who was spoken of in the same breath as John Stuart Mill

  I don't know about his philosophy but a while ago I read this article about him Reason and romance: The world's most cerebral marriage and I could relate to the last three sentences:

  Here was obviously an extremely close and affectionate relationship between two people who were intellectually, morally and aesthetically compatible. Yet, at some level, Derek seemed strangely unaware that Janet was 60 miles away. "It matters to him that I exist," she says, "but it matters much less that I'm around."

  I also found the following excerpts to be pertinent:

  • Janet says she was initially "utterly baffled" by Derek. He lacks certain common traits and doesn't pick up on many normal social messages. In 2011, the night before they were due to get married in a register office, Derek and Janet were walking down Little Clarendon Street in Oxford on the way to a low-key celebration at an Indian restaurant. They had been together for 29 years, and had taken the decision to marry largely on pragmatic grounds. They felt they were getting old, and formalising their relationship made it easier to settle issues such as inheritance and next-of-kin. There were to be only four witnesses at the ceremony: Janet's sister and brother-in-law, her niece and her niece's partner.
  • "I may be somewhat unusual," he told the New Yorker, "in the fact that I never get tired or sated with what I love most, so that I don't need or want variety."
  • One of the reasons he dresses in the same outfit every day--black trousers, white shirt--is so he doesn't waste time selecting clothes.
  • Several of Derek's friends mention "Asperger's" when I ask them about him. What does he himself think? Might it explain the quality of some of his social interactions and his unusual lifestyle? "There may be something in this suggestion," he says, though he also attributes it to a boarding school education. The same friends also comment that his remarkable nature has required a huge amount of adjustment on Janet's part. She agrees. "But the adjustment was relatively straightforward once I had figured him out and stopped looking for what was not there. His way of life gives me enormous independence."

• The U.S. spends more on health care than any other country

  Here's what we're buying.

  A new study published in the Journal of the American Medical Association reveals what patients and their insurers are spending that money on, breaking it down by 155 diseases, patient age and category -- such as pharmaceuticals or hospitalizations. Among its findings:

  • Chronic -- and often preventable -- diseases are a huge driver of personal health spending. The three most expensive diseases in 2013: diabetes ($101 billion), the most common form of heart disease ($88 billion) and back and neck pain ($88 billion).
  • Yearly spending increases aren't uniform: Over a nearly two-decade period, diabetes and low back and neck pain grew at more than 6 percent per year -- much faster than overall spending. Meanwhile, heart disease spending grew at 0.2 percent.
  • Medical spending increases with age -- with the exception of newborns. About 38 percent of personal health spending in 2013 was for people over age 65. Annual spending for girls between 1 and 4 years old averaged $2,000 per person; older women 70 to 74 years old averaged $16,000.

• What's Pushing Down U.S. Life Expectancy?

  Drug overdoses and flu may have been key drivers behind the latest death toll numbers

  For the first time in a decade our death rate increased from the year before; 2015 saw roughly 86,000 more deaths than 2014, according to the new report. The National Center for Health Statistics (NCHS), which released the numbers this week, found that in 2015 the death rate jumped 1.2 percent from 724.6 deaths per 100,000 people in 2014 to 733.1. The agency calculated that this spike pushed life expectancy down, too. Standard life expectancy at birth dropped to 78.8 years from 78.9 just a year earlier. Preliminary analysis suggests the increase in deaths may have been driven by drug overdoses and an unusually severe flu season in early 2015, which may have exacerbated potentially fatal conditions such as heart disease.
  ...
  Cancer mortality continued to decline, which is good.

• Study Tied to Food Industry Tries to Discredit Sugar Guidelines

  The review was paid for by the International Life Sciences Institute, a scientific group that is based in Washington, D.C., and is funded by multinational food and agrochemical companies including Coca-Cola, General Mills, Hershey's, Kellogg's, Kraft Foods and Monsanto. One of the authors is a member of the scientific advisory board of Tate & Lyle, one of the world's largest suppliers of high-fructose corn syrup.
  ...
  Dr. Johnston said he recognized that his paper would be criticized because of its ties to industry funding. But he said he hoped people would not "throw the baby out with the bathwater" by dismissing the conclusion that sugar guidelines should be developed with greater rigor. He also emphasized that he was not suggesting that people eat more sugar. The review article, he said, questions specific recommendations about sugar but "should not be used to justify higher intake of sugary foods and beverages."
  ...
  But Barry Popkin, a professor of nutrition at the University of North Carolina at Chapel Hill, said he was stunned that the paper was even published at all because its authors "ignored the hundreds of randomized controlled trials" that have documented the harms of sugar.

• Gestational vitamin D deficiency and autism-related traits: the Generation R Study

  There is a growing body of evidence linking gestational vitamin D deficiency with neurodevelopmental disorders such as schizophrenia and ASD (Autism-spectrum disorder). Birth cohort studies have provided evidence that gestational vitamin D deficiency (based on prenatal maternal sera) is associated with impairment on a range of cognitive outcomes related to language, motor development and general intelligence.

• Chickenizing Farms and Food

  C-Span Video Interview After Words with Ellen Silbergeld

  Professor Ellen Silbergeld talked about her book Chickenizing Farms and Food: How Industrial Meat Production Endangers Workers, Animals, and Consumers, in which she looks at new farming methods and technology and their impact on consumers, the environment, and workers.

  Seems to me to be a fairly balanced overview of the good and bad of current farming methods.