Ramblemuse Touch Points

I’ve been reading the comments Elise Hancock makes on scientific opinion and consensus (pages 14-18) in her book on Science Writing, Ideas into Words. Hancock characterizes, correctly I believe, that scientific consensus is not like the precedence of law. In law, there are conflicting opinions and the precedence of former court cases, but there is no ultimate source of reality. Thus, at least at some point, all opinions start on an equal footing in that law is an entirely human creation. In science, consensus is developed by the accumulation of observations of the external world, analysis, and peer-review of the process to insure, as best as is humanly possible, the rigor of the conclusion. Hancock also stresses that scientific “mavericks” are generally to be avoided.

In a profession that makes a fetish of evidence and preserving an open mind, the true scientific outsider, fighting the same lonely battle year after year and claiming that no one will let him publish, is unlikely to have a case. Reasearch opposing the current model can and does get published.

In a Caltech commencement address given in 1974, the late physicist Richard Feynmann gave a succinct summary of the scientific process.

Now it behooves me, of course, to tell you what they’re missing. But it would be just about as difficult to explain to the South Sea islanders how they have to arrange things so that they get some wealth in their system. It is not something simple like telling them how to improve the shapes of the earphones. But there is one feature I notice that is generally missing in cargo cult science. That is the idea that we all hope you have learned in studying science in school–we never say explicitly what this is, but just hope that you catch on by all the examples of scientific investigation. It is interesting, therefore, to bring it out now and speak of it explicitly. It’s a kind of scientific integrity, a principle of scientific thought that corresponds to a kind of utter honesty–a kind of leaning over backwards. For example, if you’re doing an experiment, you should report everything that you think might make it invalid–not only what you think is right about it: other causes that could possibly explain your results; and things you thought of that you’ve eliminated by some other experiment, and how they worked–to make sure the other fellow can tell they have been eliminated.

Details that could throw doubt on your interpretation must be given, if you know them. You must do the best you can–if you know anything at all wrong, or possibly wrong–to explain it. If you make a theory, for example, and advertise it, or put it out, then you must also put down all the facts that disagree with it, as well as those that agree with it. There is also a more subtle problem. When you have put a lot of ideas together to make an elaborate theory, you want to make sure, when explaining what it fits, that those things it fits are not just the things that gave you the idea for the theory; but that the finished theory makes something else come out right, in addition.

In summary, the idea is to give all of the information to help others to judge the value of your contribution; not just the information that leads to judgement in one particular direction or another.

In research, we see the opportunity to do the research, publish it, and at times to shift the scientific consensus. Hancock provides a few examples of this, including the identification of Helicobactor pylori as a major cause of stomache ulcers. A similar occurrence that I’ve noted in the recent medical news is the identification of a fungi-triggered immune response as a major cause of chronic sinusitis.

Research and the research literature is thus the place to question the current paradigm of consensus and to defend new hypotheses. It is the area in which a general consensus emerges that defines the scientific viewpoint. There may well be continuing discussion and debate on specific issues within such a consensus, but this should not be construed by the press or public as absence of an overall consensus. This is as true in the areas of human-induced climate change (aka global warming) and in evolution of species as in any other area of science. The consensus supports both of these conclusions while questions of details remain. Those who believe they have research challenging or modifying one consensus or the other have every opportunity to contribute at the level of research and peer-reviewed publication.

In contrast to academic science, most professions have a distinction between research and professional application. This distinction has likely not been as strongly developed in much of science because, until recently, scientifc issues lacked immediate negative consequences to society and were not highly politicized. These times have obviously changed. In contrast to research, application operates within the current envelope of consensus. This is most obvious in civil engineering and medical practice, where straying far from consensus practice opens the door to malpractice and other liability lawsuits. Innovations happen, but they require substantial vetting by testing and peer-review (i.e. research documentation) before they become the basis for treating patients or supporting a building structure. Unlike what has been happening in discussions in climate change or evolution, there is not a concerted effort to circumvent the protocols by taking it to the media. One existing example in which scientific application has already been separated from scientific research is in the certification of broadcast meteorologists by the American Meteorological Society. You don’t have to be a researcher to qualify, but you do have to be practicing within the current consensus of meteorology.

Those who are practicing as experts in climate change or development of species, yet are publicly proclaiming themselves to be outside of the developed scientific consensus, place themselves in the paradoxical position of Epimenides the Cretan, famous for the statement that, “All Cretans are liars“. If they are practicing within a profession in an applied sense yet outside of the consensus of practice, then they are committing malpractice. If they are not part of the profession, then they have no claim to be experts within it and are simply offering up a lay opinion, a fact of which the public should be advised. It’s simply high time that we differentiate between the advancement of discussion within research and the professional application of scientific expertise within society.

As to climate change, the definitive international scientific consensus is captured in the reports issued by the Intergovernmental Panel on Climate Change (IPCC). There’s a blog put out by climate scientists operating within this consensus at Real Climate. On broader issues, The American Psychological Association has a page on issues of scientific integrity. The Union of Concerned Scientists also addresses issues of misuse and misrepresentation of science.

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The November/December issue of the journal Health Affairs covers the topic of Will Employer Coverage Endure? There’s further discussion that health coverage isn’t the same as the traditional concept of insurance in the Health Affairs Blog. The California Healthcare Foundation has also provided free access links to several of the articles from their page on the journal issue.

Apart from the Health Affairs issue, in an interview for Catallarchy, economist Arnold Kling provides a provocative discussion in which he notes that healthcare “insurance” is more insulation than insurance. Kling also notes the adverse effects gatekeepers can produce in furthering their own interests. Writing for Harvard Business Schools’ newsletter Working Knowledge, Michael Porter advocates that improving the healthcare system requires changing to a finer-grained level of competition for specific services rather than all-inclusive packages. Writing for the New Yorker, Malcolm Gladwell writes about the Moral-Hazard Myth and those not covered. Also for the New Yorker, Atul Gawande writes about funding medical care as Piecework.

Related to healthcare costs and consumer choice, I’ve been blogging about turf wars and professional association ethics on The Massage Politics Sheet. Much of this has been motivated for me by extensive lobbying by the California Chiropractice Association (CCA) to eliminate passive stretching from the massage profession’s scope of practice. Such a move would virtually eliminate Thai Massage and decimate a lot of other massage work. There’s a lot more discussion and background on this in posts just below the one linked above.

In general, it’s going to take public pressure to educate such associations that they don’t own particular sections of healthcare turf—that the turf they keep trying to claim is, instead, publicly owned. Public awareness is needed to create clarity that the various professions have simply been given a nonexclusive right of practice. Both British Columbia and Ontario reorganized their healthcare systems in the 1990’s to make the nonexclusive right of practice principle very explicit. Part of this process was in defining the concept of shared scopes of practice and in moving restricted/controlled acts from individual profession laws into relatively short centrailized lists. Even without a complete reorganization in the U.S., public awareness and pressure can “help” state legislatures to recognize implicit public ownership of scopes of practice and put an end to the restricted choices and increased costs resulting from turf battles.

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I recently subscribed to a couple of Time.com RSS feeds on science and health. On the health side, In Perils of the Lonely Brain, Jeffrey Kluger writes about research on how feelings of isolation negatively effect executive function. In What We’ll be Dying From, Michael Lemonick notes a World Health Organization report on the top expected causes of death. Third in the list is depression. Both alleviating isolation and helping with depression are areas in which massage, as a form of human connection and sensory input, is effective. The impacts of massage on trait anxiety and depression are discussed in A Meta-Analysis of Massage Therapy Research.

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My wife is a fabric “junkie” who has increasingly been using the Internet to shop on the long-tail of the distribution of what’s available. According to a recent press release the HAPTEX project at the University of Geneva is working to make such remote purchases even more satisfying by providing a virtual feel of the fabric.

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A recent press release by the Karolinska Institutet, a medical university in Sweden, notes a study revealing that stress in early life can be a major factor in later development of chronic fatigue syndrome. The study looked at 20,000 Swedish twins surveyed in 1973 and again in 1998. The scientists also noted a correlation between emotional instability and chronic fatigue. The research by Kenji Kato et al. was published in the November 2006 Issue of the Archives of General Psychiatry. Another article by Christine Heim et al. on early adverse experiences and chronic fatigue is in the same issue of AGP.

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This Sunday, being the 3rd Sunday in November, is the World Day of Remembrance for road traffic victims, according to the World Health Organization (WMO).

“In a split second, a traffic crash transforms forever the life of a family. Behind each statistic, there are fathers and mothers, sons and daughters, brothers and sisters, grandchildren, colleagues, classmates and friends,” notes Dr Etienne Krug, Director of the WHO Department of Injuries and Violence Prevention. “For every death or injury, there are scores of people who must cope with the physical, psychological or economic aftermath.

I don’t think such traffic accidents leave anyone unaffected who has lived a few decades. Over the years, I’ve lost colleagues and had colleagues who have lost parts of their families; several times in California central valley winter fog. It’s worth a thought or two to prevent what each of us can prevent by a bit of care as we approach this year’s Thanksgiving holiday.

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At a recent Earth Systems Science Partnership (ESSP) conference in Bejing, one of the plenary sessions was on the Importance of an Interdisciplinary Approach to Earth System Science. The description of the session noted the importance of continued research and mitigation strategies to offset negative impacts of global environmental change.

There is no doubt that humans have now become a global geophysical force, affecting the functioning of the Earth System in many ways and causing planetary-scale environmental changes. But humans are also the victims of these changes, suffering increasingly from the impacts of a changing climate and the loss or degradation of ecosystem services. How can food and energy supply be ensured in a sustainable manner? These are complex research questions that call for the highly interdisciplinary approach followed by the four projects of the Earth System Science Partnership on carbon, food, water, and health. The links between sustainability and Earth System Science are becoming stronger, and this Plenary Session will highlight how the four ESSP projects directly tackle the Earth System Science – sustainability connection.

A new joint project between the ESSP and the World Health Organization (WHO) on Global Environmental Change and Human Health (GECHH) was also announced.

The project aims to create an international network of researchers who can identify and quantify health risks posed by global environmental change, and develop adaptation strategies that are cost effective for reducing health risks.

It’s called Earth System Science, by the way, because you can’t understand what happens just by looking at individual parts. Changing one thing affects something else that effects something else, … Often the cycles close, which may decrease the original change (negative feedback) or increase it (positive feedback). In some cases, a small initial change in a sensitive system can shift a lot of things. This is the real world application of the metaphor of the single straw that broke the camel’s back. Here’s an introductory book on systems thinking by Virginia Anderson.

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With a few days more than a month to go until Winter solstice in the northern hemisphere, the days are getting short. Even at noon, the sun is a lot closer to the horizon than it was a month or two ago. For many, the lack of light also triggers a set of depressive symptoms called Seasonal Affective Disorder (SAD). Various light supplementation treatments have been found to be effective in treating SAD, but technology is adding something new to the devices. I’ve been running with a light emitting diode (LED) headlamp for several years and even have an LED for my laptop that draws power from the USB port. Now, LEDs are starting to make the jump into SAD light devices. Glickman et al. (2006) have a paper in Biological Psychiatry. There’s also a clinical trial on SAD and LED treatment.

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Creating a government that works means having the ability to listen to different viewpoints and negotiate workable compromises.

Creating trust in government comes from actively promoting an open flow of information and discussion. The essential words here are transparency and truth, as used by Stever Robbins in his articles for Working Knowledge on Building Trust and Truth and Trust.

Creating a sustainable future for our children and their children involves being a steward of our land and resources.

Many of us here in California’s U.S. Congressional District 11 feel strongly that Pombo and his ilk fly straight in the face of these values and that they are far better embodied with Jerry McNerney.

Tuesday is the time to be adamant that we deserve better and can create better.

On the massage politics front, I’ve been blogging about how the California Chiropractic Association (CCA) demonstrated that it’s time to pass Proposition 89. Bill Moyers has more to say on the need for public financing of elections — if we want to preserve a democracy.

In another article called In the Kingdom of the Half-Blind, Moyers also notes that the present administration has gone much further in restricting the flow of information than any prior administration.

It has to be said: there has been nothing in our time like the Bush Administration’s obsession with secrecy. This may seem self-serving coming from someone who worked for two previous presidents who were no paragons of openness. But I am only one of legions who have reached this conclusion. See the recent pair of articles by the independent journalist, Michael Massing, in The New York Review of Books. He concludes, “The Bush Administration has restricted access to public documents as no other before it.”

Today’s administration and legislature is not run by the Republican Party of Lincoln, Eisenhower, or Barry Goldwater. Fiscal conservatism has been replaced not by tax and spend Democrats but by cut-tax and still spend Republicans. It is not the party of responsibility and small government but the one of hiding information and dodging the tough questions — or, if you can’t dodge them, of silencing the questioner. As Susan Bottcher put it in the Gainsville Sun, This is not my Father’s Republican Party. Bottcher is not the only offspring of a Republican to wonder at the decline of Republican values. Pete McCloskey, a Republican from an earlier age of statemanship, offers a few words on the costs of apathy.
As I noted earlier,

Tuesday is the time to be adamant that we deserve better and can create better. Don’t kid yourself that it isn’t worth the effort to get out and vote.

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I’ve been absorbed lately bringing up a rebirth of the Annotated Bibliography for Massage Practitioners. A lot of the books come from my own library. Others occur because I’m familar with the author or publisher. I’ve attempted to capture a perspective that extends far beyond technique to include the interpersonal, sociological, and psychological implications of touch and massage. I’ve also tried to include material that has the viewpoint of massage as a life practice, rather than simply another way to take a bit of training and make a buck.

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