Sunday, June 10, 2018

Must protest be disruptive?


'Must protest be disruptive?'

Yes, protest needs must be disruptive. An act goes hand in hand with whatever motivates it so protest cannot be analyzed separate from its motivation. Protest is an act that calls for change from something the protestor considers unacceptable. Inertia, going with the flow, is easier and definitely doesn't require courage.

Usually, at any given time, those better served by change far outnumber those well-served by a status quo. Yet, for the most part, the vast majority of the former lumber on quietly, tolerating what comes from getting a bad deal, poverty, injustice, lack of dignity, exploitation, peril to life and limb, denial of rights or various other hardships.

In short, protest takes courage. It requires going against the grain. Courage typically the purview of only a handful, the masses ill-served by existing circumstance attach themselves to protest only in the face of simply unbearable provocation and inhumanity.

'Please, sir', said the famous little starving orphan boy of literature, 'I want some more', only after he drew the short straw in a game of chance. 'Of course, take more to your heart or rather your belly's content', replied no one ever. Why? 'Cos those with the privileges and entitlements, some endowed as part and parcel of birth, like to keep them, thank you very much, and won't give them up willingly. The have-nots are just plumb out of luck.

Societies haven't yet achieved Rosa Luxemburg's quest for a 'land of boundless possibilities' that requires active and immersive democratic participation by the majority. Instead as Walter Benjamin said,
'Every document of civilization is also a document of barbarism.'
No matter the country or culture, some type of power asymmetry is thus a fact of life. Only their degree and types differ. Plutocrats in some countries and kleptocrats in others are ubiquitous examples of extreme economic power asymmetries. Women and LGBTQ everywhere have to navigate their life around different degrees of patriarchy and chauvinism that seek to circumscribe their choices and roles. Meantime, we remain all too ready to perpetuate cultural privileges and entitlements based on caste, class, race, religion, which create and sustain other types of power asymmetries. Further, information asymmetry helps strengthen the roots of prevailing power asymmetries. Will Durant said,
'The political machine triumphs because it is a united minority acting against a divided majority.'
While dividing helps conquer, looking beyond ingrained tribal impulses requires manifestly strenuous effort. To quote Kipling,
'All good people agree
And all good people say,
All nice people, like Us, are We,
And everyone else is They:
But if you cross over the sea,
Instead of over the way,
You may end by (think of it) looking on We
As only a sort of They!'
The social (cultural, legal and political) systems we have concocted over the past few centuries have attempted to impose parity on a gamut of human practices. The problem is money, power, and the perks that come with them run screaming in the other direction. The mundane rules apply to the hoi polloi. The higher up the food chain, fewer those pesky rules apply or so the consensus goes. This is a generalizable status quo. Why? As Mark Twain pointed out,
'Man will do many things to get himself loved.
He will do all things to get himself envied.'
How then could protest be other than disruptive when heeding the voices of the better angels of our nature requires going against our own base impulses?


https://www.quora.com/Must-protest-be-disruptive/answer/Tirumalai-Kamala


Sunday, June 3, 2018

What are some examples of unethical behavior in the workplace?


Be it the government or private sector, the unethical behaviors I've seen most consistently are,

Petty thievery. Taking office supplies home. Paper, notebooks, pens, sharpies, you name it, I've seen people swiping them.

Gossiping about colleagues behind their back, usually badmouthing them.

Taking time off by lying about sickness (oops, well enough to walk around in the neighborhood while out sick).

Work hours/Time-sheet manipulation.
  • Taking care of personal business on work time.
  • Pretend to work on the computer. Instead browse the internet for non-work related stuff, especially online shopping, but log in time-sheet as work hours. Obviously this workplace didn't track internet usage.
  • An unusual one in a basic research lab, show up to work only late in the day, say by 7 or 8pm. Boss thinks person is a night owl but in actuality this crafty post-doc would usually leave by 11pm or 12am, rarely staying until 2am.
  • Take numerous coffee breaks throughout the day, ostensibly to discuss work-related matters but more often it would be just shooting the breeze.
Currying favor and its usually predictable corollary, blatant favoritism. Like a weed, seems to flourish in all kinds of workplaces of all sizes. Damages morale yet vanity being an inextricable part of human nature, this one will stay par for the course.
  • In a basic research lab, this took the form of the favorite(s) canceling or swapping their data presentation or journal club duties routinely, typically at the last minute, without incurring any penalties while non-favorites experienced an uncompromising feet-held-to-the-fire pressure to comply with 'mandated' policies.
Currying favor and attendant favoritism are unethical because they disadvantage employees who don’t engage in such shameful behavior.


https://www.quora.com/What-are-some-examples-of-unethical-behavior-in-the-workplace/answer/Tirumalai-Kamala


Sunday, May 27, 2018

Is there any relationship between the opioid addiction epidemic among working/middle class Americans, and the uneven gains from the economic recovery following the 2008-09 financial crisis?


'Is there any relationship between the opioid addiction epidemic among working/middle class Americans, and the uneven gains from the economic recovery following the 2008-09 financial crisis?'.

If the 2008-2009 financial crisis and its continuing fallout triggered and/or exacerbated the ongoing US opioid addiction crisis, a striking increase in opioid overdose deaths post-2008 would be expected. However, epidemiological data does not support such a premise. This answers summarizes
  • Data showing steady year-on-year increase in opioid overdose deaths from 1999 till date, overdose death rates varying widely from state to state, disproportionately affecting whites, and increasing in tandem as opioid prescribing rates rose from 1999-2010, deaths that the CDC already noted with alarm in 2006-07.
  • How starting in the 1990s aggressive opioid marketing and lobbying gestated the roots of the ongoing opioid epidemic by changing how the US medical system treats pain.
Steady Year-on-Year Increase In Opioid Overdose Deaths From 1999 Till Date
  • Opioids prescribed in the US peaked in 2010, decreasing steadily since then (see below from 1) though they're still much higher than in the rest of the world.
'CDC analyzed retail prescription data from QuintilesIMS to assess opioid prescribing in the United States from 2006 to 2015, including rates, amounts, dosages, and durations prescribed. CDC examined county-level prescribing patterns in 2010 and 2015. ..The amount of opioids prescribed in the United States peaked at 782 morphine milligram equivalents (MME) per capita in 2010 and then decreased to 640 MME per capita in 2015.’
  • Drug overdose deaths have steadily increased since 1999, doubling already by 2006 in 45 to 54 year olds (see second figure below from 2).
  • Drug overdose deaths vary widely from state to state, with states with rather different economic profiles such as West Virginia, New Hampshire, Ohio, Rhode Island, Pennsylvania, Massachusetts, Connecticut, Maine and Maryland experiencing substantial increases from 2010 to 2015 (see below from 3).
  • Overdose deaths disproportionately affect whites (see below from 2) though overall, black males continue to have the lowest life expectancy (see below from 4).
  • Opioid prescribing rates steadily increased 1999-2010 with overdose deaths rising in tandem (see below from 5).
  • Already in 2006-7, CDC reported alarming increases in opioid-induced overdose deaths (see below from 6).

Aggressive Opioid Marketing in the 1990s Changed How The US Medical System Treats Pain
A little known drugmaker best known in the 1980s for the painkiller MS Contin, Purdue Pharma morphed into a multi-billion dollar behemoth on the back of OxyContin, its 1990s upgrade, whose unprecedented marketing vaulted the Sackler family, owners of Purdue Pharma, into the ranks of the wealthiest Americans today.

Well worth the reading, Mike Mariani at the Pacific Standard (7) and Patrick Radden Keefe at the New Yorker (8) methodically and comprehensively unravel the process Purdue Pharma used to relentlessly lobby all manner of doctors from general practitioners to pain physicians alike to expand opioid prescription to those with all manner of chronic pain. US doctors in the incalculably innocent pre-OxyContin era tended to view opioids as 'dangerously addictive', limiting their use to those terminally ill, usually terminal cancer patients.

Mariani and Keefe recount how sheer money muscle was used to overturn this restriction in use of prescription opioids to instead render them acceptable to treat an expanding list of pain-related conditions.

In practical terms, this meant serious boots on the ground in the form of intense lobbying by the likes of the now-defunct American Pain Foundation (9), and thousands of highly paid and hence extremely motivated sales reps to relentlessly push all manner of doctors to start applying the fifth Vital signs - Wikipedia during their routine examination of patients to elicit information about their pain levels and then palliatively treat them with powerful prescription opioids (10, 11), all while repeatedly assuring them opioids weren't addictive (see below from 12, emphasis mine).
'Abbott’s relationship with Purdue and its part in building the OxyContin brand are detailed in previously secret court filings unsealed by a Welch, http://W.Va., state court judge at the request of STAT. The records were part of a case brought by the state of West Virginia against Purdue and Abbott that alleged they inappropriately marketed the drug, causing users to become addicted to the opioid. The case was settled in 2004 when Purdue agreed to pay $10 million to the state. Neither company admitted any wrongdoing.
The documents include internal Abbott and Purdue memos, as well as sales documents and marketing materials. They show that Abbott sales reps were instructed to downplay the threat of addiction with OxyContin and make other claims to doctors that had no scientific basis. The sales reps from the two companies closely coordinated their efforts, met regularly to strategize, and shared marketing materials.'
Opioid prescribing inducements included direct payments to doctors as well. One 2017 study estimated as many as 1 in 12 US physicians and ~1 in 5 family doctors accepted payments related to opioids during the course of the 29-month study (August 2013-December 2015) (13).
Such change in prescribing was based not on carefully conducted scientific studies but one mediated by relentless lobbying and marketing, and came into place within the span of a decade from the mid-1990s to the mid-2000s so much so that in 2012, 13 states had more opioid prescriptions than even people (see below from 14, 15). Clearly, change in prescribing (demand) went hand in glove with carpeting of the entire country with a surfeit of opioids (supply).


Investigative reporting suggests regulator-opioid maker revolving door also helped grease the wheels.
  • A Los Angeles Times report by Harriet Ryan, Lisa Girion, Scott Glover (16) uncovers how Dr. Curtis Wright, the FDA bureaucrat who led its medical review of Purdue Pharma's OxyContin application in 1995 left the FDA shortly after it approved it and within 2 years began working for Purdue.
  • A piece in the Milwaukee Journal Sentinel by John Fauber suggests (see below from 17, emphasis mine) beefing up pain advisory councils with opioid maker-friendly voices also helped smooth the way in expanding usage of opioids in pain treatment,
'Federal health industry regulators and executives of companies that make pain drugs have held private meetings at expensive hotels at least once a year since 2002 through an organization funded by the drug companies, according to emails obtained through public records requests and provided to the Journal Sentinel/MedPage Today.
Each year a handful of drug companies have paid up to $35,000 each to send a representative to meetings of IMMPACT, where they could discuss clinical trial testing procedures with officials from the U.S. Food and Drug Administration and other government agencies. IMMPACT's stated goal is to improve the design of clinical trials conducted to develop new pain treatments.’
  • Such meetings appear to have favored opioid makers even as recently as 2013 (see below from 18, emphasis mine).
'The Food and Drug Administration is under enormous pressure to change its mind about a powerful new prescription painkiller. Forty-two public health groups are urging the FDA to withdraw its support of Zohydro. The drug is similar to Oxycontin, except it comes in significantly higher doses. The FDA approved Zohydro last year, despite its own advisory panel voting against it. And critics are, among other things, raising questions about that approval process.’
  • As late in the US opioid crisis as January 2016, a federal government pain advisory panel of 18 had at least 5 with financial ties to opioid makers, connections that came to light (see below from 19),
'...after the committee last month bashed a federal plan to recommend doctors scale back on prescribing painkillers for chronic pain. The guidelines by the Centers for Disease Control and Prevention are intended to curb deadly overdoses tied to powerful but highly-addictive opioid drugs, including Percocet and Vicodin.'
The Center for Public Integrity - Wikipedia also uncovered evidence of opioid maker lobbying of Congress and state legislatures (20), efforts estimated by Mother Jones to be 8X that of the gun lobby and 200X that of those advocating stricter opioid prescription rules (21).

Raw numbers reflect the spectacular success of such unprecedented marketing and lobbying. In 1996, annual OxyContin sales were $48 million. For OxyContin's inaugural marketing alone, Purdue doubled its sales force to 600 and spent $207 million, so much so that already by 2000, OxyContin sales grew 23-fold to ~$1.1 billion (22).

Already by 2001, OxyContin had become the most frequently prescribed brand name opioid for treating moderate to severe pain in the US, with so much overprescribing that the US GAO issued a 58-page report warning about it all the way back in December 2003 (23).

In recent years, other opioid makers such as Insys Therapeutics Inc. (24) and Mallinckrodt Pharmaceuticals (25) have also come under the public spotlight for their aggressive sales practices, tactics that also applied to antidote makers such as Reckitt Benckiser (26).

Like a burst dam, such intense marketing and lobbying ended up transforming how US doctors treat pain, replacing wholesale old true and tried methods that erred on the side of caution to an approach where it suddenly became acceptable to treat any and all pain with extremely powerful opioids (1, 5, 27, 28), a change that a 2016 study (29) suggests had US family doctors and general practitioners at the forefront.

Could one seriously argue that from the years 1996 onwards, physical pain and/or existential angst increased so much among the US population as to justify such an increase in opioid sales and consumption? Obviously not. Instead, the US opioid epidemic is inextricably linked to an unprecedented medical culture change in how US doctors were carefully and relentlessly persuaded by opioid makers, their lobbyists and sales reps to treat all manner of pain, not just terminal, late stage cancer pain, with highly powerful opioids.

Problem is so far opioid makers haven't been held accountable for their willful recklessness (slaps on the wrist in the form of relatively piddling monetary fines obviously don't count) even as they've saturated the US market. Rather, a report in the Los Angeles Times by by Harriet Ryan, Lisa Girion, Scott Glover suggests that as their profits in the US market start to dry up, their ongoing intense lobbying around the world may end up replicating the US opioid crisis in other countries as well (30). For governments, policy makers and regulators the world over, how to avoid 'globalization of the prescription opioid epidemic' (31) thus becomes a matter of urgency.

Bibliography
1. Guy, Gery P. "Vital signs: changes in opioid prescribing in the United States, 2006–2015." MMWR. Morbidity and mortality weekly report 66 (2017). https://www.cdc.gov/mmwr/volumes...
2. Hedegaard, Holly, Margaret Warner, and Arialdi M. MiniƱo. "Drug overdose deaths in the United States, 1999-2015." NCHS data brief 273 (2017): 1-8. Welcome to CDC stacks
3. Rudd, Rose A. "Increases in drug and opioid-involved overdose deaths—United States, 2010–2015." MMWR. Morbidity and mortality weekly report 65 (2016). https://www.cdc.gov/mmwr/volumes...
5. Centers for Disease Control and Prevention (CDC. "Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008." MMWR. Morbidity and mortality weekly report 60.43 (2011): 1487. https://www.cdc.gov/mmwr/pdf/wk/...
7. Mike Mariani, February 23, 2015. Poison Pill
8. New Yorker, Patrick Radden Keefe, October 30, 2017. The Family That Built an Empire of Pain
9. Propublica, Charles Ornstein, Tracy Weber, December 23, 2011. The Champion of Painkillers — ProPublica
10. Tompkins, D. Andrew, J. Greg Hobelmann, and Peggy Compton. "Providing chronic pain management in the “Fifth Vital Sign” Era: Historical and treatment perspectives on a modern-day medical dilemma." Drug and Alcohol Dependence 173 (2017): S11-S21. http://www.sciencedirect.com/sci...
11. Harris, Matthew C., et al. "Prescription Opioids and Labor Market Pains." (2017). http://cber.haslam.utk.edu/staff...
12. Stat News, David Armstrong, September 22, 2016. Secret trove reveals Abbott's bold 'crusade' to sell OxyContin
13. Hadland, Scott E., Maxwell S. Krieger, and Brandon DL Marshall. "Industry Payments to Physicians for Opioid Products, 2013–2015." American journal of public health 107.9 (2017): 1493-1495. https://www.researchgate.net/pro...
16. The Los Angeles Times, Harriet Ryan, Lisa Girion, Scott Glover, May 5, 2016. http://www.latimes.com/projects/...
17. Milwaukee Journal Sentinel, John Fauber, October 6, 2013. Emails point to relationship between drug firms, regulators
19. Associated Press, Matthew Perrone, January 27, 2016. Federal pain panel rife with links to pharma companies
20. Public Integrity, Liz Essley Whyte, Geoff Mulvhill, Ben Wieder, September 18, 2016. Politics of pain: Drugmakers fought state opioid limits amid crisis
22. Van Zee, Art. "The promotion and marketing of oxycontin: commercial triumph, public health tragedy." American Journal of Public Health 99.2 (2009): 221-227. https://www.ncbi.nlm.nih.gov/pmc...
27. Boudreau, Denise, et al. "Trends in long‐term opioid therapy for chronic non‐cancer pain." Pharmacoepidemiology and drug safety 18.12 (2009): 1166-1175. 6 (2017). https://www.cdc.gov/mmwr/volumes...
28. Schuchat, Anne, Debra Houry, and Gery P. Guy. "New data on opioid use and prescribing in the United States." Jama 318.5 (2017): 425-426. https://www.issup.net/files/2017...
29. Chen, Jonathan H., et al. "Distribution of opioids by different types of medicare prescribers." JAMA internal medicine 176.2 (2016): 259-261. https://jamanetwork.com/journals...
30. Los Angeles Times, Harriet Ryan, Lisa Girion, Scott Glover, December 16, 2016. http://www.latimes.com/projects/...
31. Humphreys, Keith. "Avoiding globalisation of the prescription opioid epidemic." The Lancet 390.10093 (2017): 437-439.


https://www.quora.com/Is-there-any-relationship-between-the-opioid-addiction-epidemic-among-working-middle-class-Americans-and-the-uneven-gains-from-the-economic-recovery-following-the-2008-09-financial-crisis/answer/Tirumalai-Kamala


Sunday, May 20, 2018

What are some things everyone "knows" that are no longer true?


A few examples of things everyone “knows” that are no longer true.

Don't crack your knuckles. You'll develop arthritis” (Cracking joints - Wikipedia). Scientific evidence doesn't support the idea.
  • A 1990 study confirmed this in a controlled study of 300 knuckle crackers and 226 non-knuckle crackers (1), though it did conclude knuckle crackers ended up with swollen hands and lower grip strength.
  • A prior 1975 study on 28 elderly residents in a home for the aged had also found no correlation between knuckle cracking and osteoarthritis (2).
  • A quirky case study with an n of 1 consisted of the author, a rheumatologist, who for 50 years consistently and daily cracked twice a day the knuckles of only his left hand, leaving uncracked those on the right as controls. Fifty years later and left hand knuckles cracked some 36500 times, no arthritis in either hand and no apparent differences between the two hands (3).
  • Subsequent reviews and studies only concluded more of the same, no arthritis from knuckle cracking (4, 5, 6).
  • Use of better methodology and more sensitive technology found no evidence either that knuckle cracking led to hand swelling or lowered grip strength (7).
  • Losing the ability to crack knuckles might even be emotionally distressing for some, according to a study on patients with end-stage renal disease (8). It appeared habitual knuckle crackers in this group of patients had lost their ability to do so, apparently a result of hyperparathyroidism, a secondary feature of their kidney disease. Surgical removal, parathyroidectomy, restored this ability, bringing back “great satisfaction from the emotional relief from what appeared to be habitual knuckle cracking”.
Get cold, catch cold”. Hundreds of years old this superstition and yet controlled studies on volunteers repeatedly failed to prove exposure to cold led to increased risk of catching a 'cold' (9, 10, 11).

Five-second rule - Wikipedia, drop food or cutlery and they still remain safe enough to eat or use if picked up within five seconds. Several scientific studies have by now thoroughly debunked this myth.

Shaving hair makes it come back thicker and faster”. Hmm, sounds like a surefire cure for baldness so bald people remain so by choice, eh?

Bibliography
1. Castellanos, Jorge, and David Axelrod. "Effect of habitual knuckle cracking on hand function." Annals of the rheumatic diseases 49.5 (1990): 308-309. http://ard.bmj.com/content/annrh...
2. Swezey, Robert L., and Stuart E. Swezey. "The consequences of habitual knuckle cracking." Western Journal of Medicine 122.5 (1975): 377. https://www.ncbi.nlm.nih.gov/pmc...
3. Unger, Donald L. "Does knuckle cracking lead to arthritis of the fingers?." Arthritis & Rheumatology 41.5 (1998): 949-950. Does knuckle cracking lead to arthritis of the fingers?
4. Gaetano, John. "Cracking the Cracked Knuckle: A Medical Student’s Take." The Journal of rheumatology 36.11 (2009): 2624-2624. http://citeseerx.ist.psu.edu/vie...;
5. Olszewski, Mariusz, and Rebecca Ortolano. "Knuckle cracking and hand osteoarthritis." The Journal of the American Board of Family Medicine 24.2 (2011): 169-174. Knuckle Cracking and Hand Osteoarthritis
6. Powers, Tye, Gary Kelsberg, and Sarah Safranek. "Does knuckle popping lead to arthritis?." (2016). https://mospace.umsystem.edu/xml...
7. Yildizgƶren, M. T., et al. "Effects of habitual knuckle cracking on metacarpal cartilage thickness and grip strength." Hand Surgery and Rehabilitation 36.1 (2017): 41-43. https://ac.els-cdn.com/S24681229...
8. Ross, Edward A., Jennifer L. Paugh-Miller, and Robert W. Nappo. "Knuckle cracking: secondary hyperparathyroidism and what your mother did not tell you." Clinical kidney journal 6.6 (2013): 671-673. https://pdfs.semanticscholar.org...
9. Andrewes, Christopher Howard. "Adventures Among Viruses. III. The Puzzle of the Common Cold." Reviews of infectious diseases 11.6 (1989): 1022-1028.
10. Dowling, Harry F., et al. "Transmission of the common cold to volunteers under controlled conditions. III. The effect of chilling of the subjects upon susceptibility." American journal of hygiene 68.1 (1958): 59-65.
11. Douglas Jr, R. Gordon, Keith M. Lindgren, and Robert B. Couch. "Exposure to cold environment and rhinovirus common cold: failure to demonstrate effect." New England Journal of Medicine 279.14 (1968): 742-747.


https://www.quora.com/What-are-some-things-everyone-knows-that-are-no-longer-true/answer/Tirumalai-Kamala


Sunday, May 13, 2018

What are some examples of cultural variance in the results of behavioral economics research?


Plenty of behavioral science studies in recent decades and yet lack of data is a major problem in understanding how cultural differences impact behavior. That should have caused a double take. How could there be both abundance and scarcity of data on the same research topic? Easy. Subjects in most of the published studies are undergraduate university students, usually psychology students, all too often American undergraduate psychology students (see below from 1, emphasis mine).
'...the Western, and more specifically American, undergraduates who form the bulk of the database in the experimental branches of psychology, cognitive science, and economics, as well as allied fields (hereafter collectively labeled the “behavioral sciences”).
Talk about navel-gazing in a self-selecting group that chooses to study among other things navel-gazing!

While there was some kind of underground mumbling and grumbling about this issue for years, the true extent of this problem came into sharp relief with WEIRD. No, not the word, the acronym. This highly cited 2010 paper (1) authored by Joseph Henrich - Wikipedia, Steven Heine - Wikipedia and Ara Norenzayan coined Western, Educated, Industrialized, Rich, and Democratic (WEIRD) to describe the most commonly studied subject in behavioral science studies (2, 3). The paper reviewed the comparative database across behavioral sciences including in economics and concluded
  • Most choose to examine the same thin sliver of humanity, WEIRD.
  • However, the few experimental results that do exist across populations, many conducted by Henrich himself, suggest substantial variation in basic attributes such as visual perception, fairness, cooperation, various types of reasoning, etc.
  • Authors thus conclude results from behavioral science studies are not representative and therefore, rarely, if ever, generalizable.
See below from 1, emphasis mine.
'Abstract: Behavioral scientists routinely publish broad claims about human psychology and behavior in the world’s top journals based on samples drawn entirely from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies. Researchers – often implicitly – assume that either there is little variation across human populations, or that these “standard subjects” are as representative of the species as any other population. Are these assumptions justified? Here, our review of the comparative database from across the behavioral sciences suggests both that there is substantial variability in experimental results across populations and that WEIRD subjects are particularly unusual compared with the rest of the species – frequent outliers. The domains reviewed include visual perception, fairness, cooperation, spatial reasoning, categorization and inferential induction, moral reasoning, reasoning styles, self-concepts and related motivations, and the heritability of IQ. The findings suggest that members of WEIRD societies, including young children, are among the least representative populations one could find for generalizing about humans. Many of these findings involve domains that are associated with fundamental aspects of psychology, motivation, and behavior – hence, there are no obvious a priori grounds for claiming that a particular behavioral phenomenon is universal based on sampling from a single subpopulation. Overall, these empirical patterns suggests that we need to be less cavalier in addressing questions of human nature on the basis of data drawn from this particularly thin, and rather unusual, slice of humanity. We close by proposing ways to structurally re-organize the behavioral sciences to best tackle these challenges.'
Gizmodo's helpful infographic (see below from 4) digests this article whose gist is,
  • Population sampling is blatantly skewed in much behavioral science research.
  • Most WEIRDs are undergraduate psychology students.
  • Results of economic experiments such as the Ultimatum game - Wikipedia are not generalizable across cultures. Indeed, they aren't generalizable even among Americans.
  • Cross-cultural assessment of tests such as Rod and frame test - Wikipedia and Müller-Lyer illusion - Wikipedia show culture shapes perception to a previously unappreciated extent.

It would be careless to move on from this review without referring to one of its other important conclusions (1, emphasis mine),
'There are few research programs that have explicitly sought to contrast Americans with other Westerners on psychological or behavioral measures. However, those phenomena for which sufficient data are available to make cross-population comparisons reveal that American participants are exceptional even within the unusual population of Westerners – outliers among outliers.'
The review (1) found 'highly educated Americans differ from other Americans in many important respects
  • Tend to rationalize their choices more.
  • Are more individualistic.
  • Less conforming.
  • Embedded in less tightly structured social networks.
  • Less interdependent and holistic.
  • Moralize within the ethic of autonomy compared to the ethic of community and divinity used by the non-college-educated.
  • More favorable to diversity.
This much-needed jolt of reality brings to mind the almost century-old words of noted anthropologist, linguist, Edward Sapir - Wikipedia (5),
'The worlds in which different societies live are distinct worlds, not merely the same world with different words attached.'
Obviously Homo weirdus is unlikely to improve upon the by-now increasingly discredited Homo economicus. A rather embarrassing state of affairs considering the Nobels bestowed to date for Behavioral Economics research.

Unfortunately, even seven years on from the coining of WEIRD, apparently nothing much has changed with regard to sampling in behavioral science studies.

Bibliography
1. Henrich, J., S. J. Heine, and A. Norenzayan. "The weirdest people in the world?." The Behavioral and brain sciences 33.2-3 (2010): 61-83. http://hci.ucsd.edu/102b/reading...
2. Henrich, Joseph, Steven J. Heine, and Ara Norenzayan. "Most people are not WEIRD." Nature 466.7302 (2010): 29-29. http://www2.psych.ubc.ca/~heine/...
5. Sapir, Edward. "The status of linguistics as a science." Language (1929): 207-214. http://pubman.mpdl.mpg.de/pubman...


https://www.quora.com/What-are-some-examples-of-cultural-variance-in-the-results-of-behavioral-economics-research/answer/Tirumalai-Kamala


Sunday, May 6, 2018

What are your thoughts on the term ‘empty barrel’ to describe a person? What does it mean and what’s the origin?


'An empty barrel makes the most noise' may be a more modern derivation of older sayings about 'empty vessels'.

The 1908 book, A Dictionary of Thoughts by Tryon Edwards, features not one but two 'empty vessels' quotes, one from Plato and the other from Shakespeare. Book itself is available for free download here: https://ia800302.us.archive.org/...
A Dictionary Of Thoughts, page 560, Plato.
As empty vessels make the loudest sound, so they that have least wit are the greatest babblers.
A Dictionary Of Thoughts, page 46, Shakespeare.
The empty vessel makes the greatest sound.
Comments in a discussion thread from Did Plato say this? (see below, quotes in italics) offer several examples of 'empty vessels' usage in English over the centuries. Gist is 'all talk, no action' or 'ones who act, don't talk, those who talk, don't act'.
"I have always observed that your empty vessels sound loudest"
Jonathan Swift in "A tritical essay upon the faculties of the mind"
Published in "The Works" in 1803 by J. Johnson. (See page 270).
15 years later comes this:
"Empty vessels make the greatest sound.
The Scripture saith, A fool's voice is known by multitude of words. None more apt to boast than those who have least real worth ; least whereof justly to boast. The deepest streams flow with least noise."
 Page 71 of "A compleat collection of English proverbs of the Scotch, Italian, French, Spanish and other languages" by John Ray, published in 1818
Consider the following passage:
" Empty vessels make always the loudest sound; the less virtue, the greater report. Deep rivers pass away in silence ; profound knowledge says little ; but what a murmur and bubbling, yea, sometimes what a roaring, do they make in the shallows ! The full vessel gives you a soft answer, but sound liquor. Samson slew a lion, but he made no words of it: the greatest talkers are the least doers. As when a rabbi, little learned, and less modest, usurped all the discourse at table; one much admiring him, asked his friend in private, whether he did not take such a man for a great scholar: to whom he plainly answered, Fог aught I know he may be learned, but I never heard learning make such a noise. Religion is much heard of in our words, but it is little seen in our works. We have busy tongues, but lazy hands; and this argues but vain hearts ; we may be still empty vessels. By their unseasonable noise, men are known for empty vessels."
 Page 843 of "An Exposition Upon the Second Epistle General of St. Peter" by Thomas Adams and James Sherman, published by Henry G. Bohn in 1848.
In Shakespeare's Henry V, the character called "Boy" ends a scene with an aside about Pistol (a pompous and bombastic character) which begins as follows:
"I did never know so full a voice issue from so empty a heart: but the saying is true 'The empty vessel makes the greatest sound.' "
Shakespeare Henry V, Act IV, scene 4, line 72 (c. 1599)
pre-1430
 John Lydgate 
Pilgrimage of Man l. 15933
 A voyde vessel‥maketh outward a gret soun, Mor than‥what yt was ful.
1547
 William Baldwin
 Treatise of Moral Philosophy iv. Q4
 As emptye vesselles make the lowdest sounde: so they that haue least wyt, are the greatest babblers.
1599
 [Shakespeare, Henry V, already quoted above]
1707 
Swift Essay on Faculties of Mind I. 249 
"Empty Vessels sound loudest." [more fully quoted above]


https://www.quora.com/What-are-your-thoughts-on-the-term-%E2%80%98empty-barrel%E2%80%99-to-describe-a-person-What-does-it-mean-and-what%E2%80%99s-the-origin/answer/Tirumalai-Kamala


Sunday, April 29, 2018

Is “cultural appropriation” as a negative a purely American concept? Does it exist in other cultures?


Cultures have borrowed from each other since time immemorial. Cultures with political and economic power over others have also taken from them without permission (1). Naming and shaming of the latter practice as cultural appropriation is of recent vintage and of Canadian, not American origin, apparently having started from an impassioned debate about cultural appropriation from the First Nations during a 1989 resolution of the Writers' Union of Canada (see below from 2).
'In 1989, Lenore Keeshig-Tobias, an Anishnabe writer and Union member, effectively launched the Appropriation of Voice controversy at a Writers’ Union AGM in Kitchener, Ontario with her argument that the stories and cultures of the First Nations (and, by extension, other minorities) should not be appropriated by non-native writers. The debate about writers’ identities and writers’ responsibilities went far beyond the Union itself and generated extensive media comment, particularly over the Union-facilitated Writing Thru Race conference in Vancouver in 1994. The Union found itself attacked simultaneously for excessive political correctness and for representing only the white liberal mainstream of Canadian writing.'
During the heated discussions that followed on its heels, cultural appropriation came to be defined as (3)
'taking – from a culture that is not one's own – of intellectual property, cultural expressions or artifacts, history and ways of knowledge and profiting at the expense of the people of that culture'
Though named and defined fairly recently, the practice itself is likely as old as history. Today the broad waist-sash or Cummerbund is indelibly yoked to elite galas but was originally part of work attire for Indian soldiers. Obviously its appeal to the modern-day, typically Western cummerbund wearer lies in its aesthetics and more recent union with pomp courtesy the British Raj, and not in its subaltern origins.

Some might question, 'What's the harm in adopting someone else's cultural practices? Isn't it a sign of appreciation and respect?'. Akin to picking and choosing dishes from a free buffet table, cultural appropriation is scorned as painless gain when those from dominant cultures demonstrate their relative luxury of choice by exercising it to appropriate cultural attributes at their convenience from more marginalized cultures for whom such opportunities simply don't exist.
  • A black's dreadlocks are appropriated all the more easily by a non-black given they don't come wedded to a black's much higher propensity to be pulled over by a cop.
  • Hipsters wearing Keffiyeh in New York or London might do it to look cool or quirky, indisputably an entitlement since a middle eastern man wearing the same on those streets would likely be automatically labeled a terrorist or towelhead by some or even many, who knows.
  • Consider the Bindi -sporting Madonna, Katy Perry, Miley Cyrus, Selena Gomez, Gwen Stefani and other pop stars who can luxuriate in bindi-wearing
    • Utterly dissociated from its traditionally sacred meaning in its original culture.
    • Shorn of the many other, usually terrible fates and realities attendant to being a typical bindi-wearing Hindu woman in India. Fates such as dowry deaths, wife-beating, realities such as experiencing Eve teasing, a laughably imprecise term to describe men falling over and grinding themselves against hapless women traveling in India's notoriously over-crowded public transport system, to name just a few among the many inequities that are part and parcel of such women's lives.
    • To look cool while a bindi-wearing Hindu immigrant in their countries would be assailed for failing to assimilate.
Writers like Lionel Shriver, who created a furore in 2016 by decrying cultural appropriation as something that hobbled fiction writers, show at best a glib obtuseness and at worst terrible want of imagination when they choose to gloss over such painful realities as so much piffle and instead seek to assert their right to talk in the voice of cultural minorities no matter what (4).

Constituting at least 16 to 18% of India's population, Scheduled Castes and Scheduled Tribes or Dalit have suffered generational privations and discrimination. While doubtless born into a privileged background and definitely not a tribal herself, in her short stories, novels and essays, Mahasweta Devi, a colossus of Bengali language literature, wrote sincerely and untiringly about the struggles and hardships of specific tribes in central and eastern India. Yet Devi can't be labeled a cultural appropriator because her well-deserved literary acclaim wasn't a painless gain at the expense of those she wrote about.

Rather than use stories about tribals as vehicles to further her own literary ambitions, Devi chose to live their struggles and that experience is the source of the authentic-sounding tribal voice in her work while her sincerity fuels her artistic power to speak credibly on behalf of those whom an indifferent state brutally renders voiceless. In contrast, at least by the tone and type of arguments she makes, Shriver comes across as a petulant child peeved at being denied a specific treat in a candy shop (4).
Though it can sometimes be damnably hard to discern, intent determines the difference.
  • Seeking to write while recognizing an inherent comradeship and common humanity in another's struggle as Devi did prioritizes we, not I, and makes for powerful, unforgettable literature.
  • Seeking to use or exploit 'others' as props for one's own aggrandizement or pleasure or to 'escape the confines of' of one's own head (4) prioritizes I, not we, and makes for tawdry cultural appropriation.
And so we're back to where we started. No matter America or anywhere else, if both parties gain, a win-win, it's probably more accurately characterized as cultural exchange. If the parties are inherently unequal and the dominant one gains at the expense of the weaker, a win-lose or a punch down, it's more likely cultural appropriation.

Bibliography
1. LU12, H. A. R. T. M. U. T. "Cultural appropriation as a process of displacing peoples and history." The Canadian Journal of Native Studies 10.2 (1990): 167-182. http://www.learningandviolence.n...
3. Ziff, Bruce H., and Pratima V. Rao, eds. Borrowed power: Essays on cultural appropriation. Rutgers University Press, 1997.


https://www.quora.com/Is-%E2%80%9Ccultural-appropriation%E2%80%9D-as-a-negative-a-purely-American-concept-Does-it-exist-in-other-cultures/answer/Tirumalai-Kamala


Sunday, April 22, 2018

Why have fentanyl deaths and seizures climbed so steeply (540%) in the last three years? Fentanyl is now the number one cause of drug overdoses in the US.


What are Fentanyls
~100 times a more potent analgesic than morphine (1) and ~40 times more so than heroin, Fentanyl is a powerful opioid used for pain treatment, first in the 1990s as a patch and now as a spray. An example of its potency, David Juurlink an opioid researcher at the University of Toronto says he'd give a hospital patient 10mg of morphine but only 0.1mg of fentanyl (2).

Widely considered too dangerous for humans, carefentanil is fentanyl's much more potent analog (similar chemical structure) and used as an elephant tranquilizer. So potent is carfentanil some countries including the US have even considered its use as a chemical weapon in war (3).

Fentanyls are so dangerous in overdoses because they can even negate Naloxone - Wikipedia, which is usually used to reverse heroin overdoses.

For example, where typically just one naloxone dose can reverse painkiller or heroin overdose, fentanyl overdose requires several naloxone doses. This is because of fentanyl's much higher affinity for the mu opioid receptor in the brain, which it accesses much more easily than morphine or heroin, given its much higher fat solubility (4).

Fentanyls can be so deadly (see photo below from 4), first responders need to be trained to protect themselves from accidental overdoses themselves (5).


Why Fentanyls have become a new front in the current US opioid crisis

Recent steep climbs in US fentanyl overdose deaths and seizures personify the Balloon effect - Wikipedia (2). How to optimally deal with drug abuse? Need strategies to deal with both supply and demand.

US history shows it tends to crack down hard on the supply side while doing little to tamp down demand. Arguably, tamping down hard on the supply side would reduce future demand but what happens to current demand if it isn't a priority of drug control policy? Just as air in a half-inflated balloon moves to another part of the balloon when it's pressed, when supply's squeezed without equivalent effort to reduce demand, users and traffickers figure out other means for getting high (2).

How opioid demand was created. Starting in the late 1990s, US doctors began handing out opioids like candy. Apparently both they and the FDA were taken in by opioid manufacturers' false claims these opioids weren't addictive. This practice both created and nurtured the growth for opioid demand. Supply wasn't a problem either for many years. However, starting in the early 2010s, people started dying in unprecedented numbers from opioid abuse overdose. Law enforcement started cracking down on prescribing doctors and pill mills, though interestingly not the pharmas making these opioids. As supply started drying up, users and traffickers diversified, first to heroin then to heroin laced with fentanyls.

Rationale for fentanyls. Given its easy access, drug traffickers started adding fentanyl to heroin to juice it up. Economic argument for fentanyl made itself. Fentanyl and carfentanil are just two of many fentanyls, all relatively easy to make in a lab, a far more simpler and cheaper approach than growing the opium poppy plant, extracting from it morphine and converting that to heroin. They also give a better and cheaper high than even heroin. Dealers can make more money from fentanyl-laced heroin (2). Dealers add fentanyl of questionable purity to the heroin they sell using scales and balances of questionable accuracy (3). Problem is users are unaware when their heroin is laced with fentanyl so injecting a usual heroin dose can lead to fentanyl overdose. The ensuing tragedy writes itself.

How opioid supply keeps creating new products to stay ahead of crackdowns. US law enforcement believes most fentanyl comes from labs in China (3), easily made there in bulk quantities without US regulatory or law enforcement supervision and then shipped into US via Latin America. On March 1, 2017, China banned manufacture and sale of fentanyl and some of its analogs including carfentanil (6), adding more analogs to the ban a couple of months later (7), making restrictions on a total of 138 compounds. However, chemists keep coming up with newer fentanyl analogs (see below from 6), making their control by regulators and law enforcement a case of Whac-A-Mole - Wikipedia.


Bibliography
3. Associated Press, Erika Kinetz, Desmond Butler, October 1, 2016. Chemical weapon for sale: China's unregulated narcotic
4. STAT news, Allison Bond, September 29, 2016. Why fentanyl is deadlier than heroin, in a single photo


https://www.quora.com/Why-have-fentanyl-deaths-and-seizures-climbed-so-steeply-540-in-the-last-three-years-Fentanyl-is-now-the-number-one-cause-of-drug-overdoses-in-the-US/answer/Tirumalai-Kamala


Sunday, April 15, 2018

Is India's perception of the caste system similar to America's perception of racism?


Dissimilarities between perceptions of caste system among Indians & of racism among Americans

My experience suggests perceptions of the caste system among Indians and of racism among Americans have two key differences, one of degree and the other of kind.

The one of degree is longevity. Thousands of years older, India's caste system has had that much more time to get thoroughly marinated in people's psyche. Inequities that should rightfully horrify any decent mind have thus become part of daily life, meaning people display a shocking degree of acceptance about the whole kit and caboodle of caste. Such wholesale acceptance of structural inequities is somewhat less visible except to discerning eyes in the frantic churn of huge, bustling metros, but much more so going down to smaller towns, becoming especially visible in the hamlets and villages of rural India.

The one of kind is the diabolically clever manner by which the Indian caste system was kept in place through history, by ascribing actions of the past life, one's past life's karmas, as the arbiter for present life caste.

‘Born low caste or worse yet, casteless Dalit in this life? Too bad, only means you committed awful sins in your past life so you're fated in this one to beg, be a cobbler, dispose of dead bodies or clean other people's toilets.

Born a high caste in this life? Excellent, earning it by your past life good deeds, you merit all the advantages bestowed upon you in this life by the mere accident of birth.’

The Indian caste system evolved to maintain social order by distributing power hierarchically and hereditarily. Its in-built advantage was a permanent and permanently oppressed under-class of casteless Dalits serving as the pressure release valve to mitigate inherent power distribution differences among caste Hindus. As for the Dalits? Conveniently self-serving answer in the form of 'Too bad, they're fated to carry in this life the burden of their past life karma'. Maintaining such a spurious charade for so long took a seriously devious level of con-artistry. After all, one can't petition for better equity in this life by summoning one's past life in court to provide evidence under oath of past life virtues, can one?

Similarities between perceptions of caste system among Indians & of racism among Americans

Segregation. Both American racism and Indian casteism malevolently twist the notions of purity and pollution to foster and maintain untenable levels of structural social and cultural inequity. Forceful black segregation followed by white self-segregation to affluent neighborhoods and better endowed school systems are eerily similar to how Dalits were kept segregated in India.

‘No, not among us, your community needs to live leeward down where the effluents flow out to from our pure caste habitations and no, you aren't welcome in our temples either. Stay away from us, you dushtas! Even your shadow must not cross us.’

What could breed more easily than suspicion and mistrust when population segments are kept or keep themselves separate? That makes it easier to filter and dole out privileges based on caste or race. After all, there's no law that a black man caught with marijuana should spend years in jail while a similarly culpable white man either pays a small fine or goes free. One can have any number of laws on the books but selective interpretation and application, which can be sub-conscious and therefore that much harder to pin down, thus end up actively shaping common perceptions, the easiest among them making a self-fulfilling prophecy out of the demonizing trope of excessive criminality among blacks.

Denial. American racism and Indian casteism also have in my opinion similar degree and vehemence in hand-waving away benefits one accrues from accident of birth. Both have instituted various forms of welfare subsidies and affirmative action programs as attempts to expiate past inequities, eliciting immediate incessant howls of 'foul, foul, unfair' from some of the generationally privileged. Why? Apparently life is zero-sum. Government attempts to tilt the scale away from generational inequity to benefit one apparently do so at the expense of another, who as a result is directly deprived.

As these efforts visibly benefit their poorest, Dalits in India and blacks in America, recriminations against them are usually barely restrained and easily provoked into full bloom. For example in America, Ronald Reagan needed but one example, that of career grifter Linda Taylor - Wikipedia, to excoriate legions of welfare recipients as Cadillac-driving welfare cheats and use as an excuse to start gutting the American social welfare system, a process that each successive administration has only added to to different degrees but not reversed, at least not substantially until the ACA Medicaid expansions.

Growing up in India, the arguments against affirmative action were variations of, 'What do you mean? I was born dirt poor and look how successful I've been. I'm a self-made person. I didn't depend on government hand-outs.'. At least materially, those who spoke thus were indeed born relatively poor and ended up firmly within the ranks of the relatively affluent middle-class. So what benefits were they hand-waving away?

How about a long lineage of literacy? Literacy is a priceless advantage, a generational privilege so easily taken for granted, it can be and indeed is entirely glossed over. Everyone in my family could read and write, even my great grandmother. Even today how many middle-aged Indians could claim even their great grandparents were literate? When I started to learn to read and write, I had not just access to all the necessary materials but indeed birth advantage meant just about everyone in my formative environment was able to help me along every step of the way.

Mind you, even those within my circle who grew up poor and claimed to be self-made somehow managed to attain multi-lingual fluency, being fluent in not just several Indian languages but also English, clear evidence if such were even necessary that even the so-called dirt poor aren't homogenous, with some endowed by caste (or race in America) with structural advantages of support networks and connections that rote political discourses choose to conveniently overlook.

Resentment. Another standard trope common to Indian casteism and American racism is the lowering of so-called standards and norms. Well, maybe the first few generations of literates among the generationally fettered would fluently deploy better vocabulary, syntax, grammar and spelling if they'd also been so lucky as to have their formative environment be staffed and stuffed with those capable of helping them every step of the way day in, day out but they just didn't.

For the most part, in both India and America they've merely had difficult and unstable access to poor schools in poor neighborhoods, staffed by poorly paid, poorly trained and likely poorly motivated teachers, access to few or none after-school resources, and certainly little access to knowledge and learning within their own families, communities and neighborhoods, not from any lack of moral fiber but simply as the reality of how structural social and cultural inequity plays out.

Rather than individual merit alone, intergenerational wealth and resource transfer greatly influence one's own success in life. Disproportionate numbers among Indian Dalits and American Blacks lack the resources to help finance their children's college education, help them make down payments on their houses or leave behind a bequest or inheritance, advantages the rest take for granted, and which help them both build and retain wealth across generations.

However, admitting such essential truths means letting the proverbial cat out of the bag, that such inequities exist not by accident but on purpose, to keep a permanent underclass of cheap and desperate labor available at the ready to do the bidding of the rest of society comprised of relative winners by birth. In that respect, not just perception but also purpose of caste in India and of racism in America are entirely yoked.


https://www.quora.com/Is-Indias-perception-of-the-caste-system-similar-to-Americas-perception-of-racism/answer/Tirumalai-Kamala