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Lawrence Hrubes

How Measurement Fails Doctors and Teachers - The New York Times - 1 views

  • TWO of our most vital industries, health care and education, have become increasingly subjected to metrics and measurements. Of course, we need to hold professionals accountable. But the focus on numbers has gone too far. We’re hitting the targets, but missing the point.
  • We also need more research on quality measurement and comparing different patient populations. The only way to understand whether a high mortality rate, or dropout rate, represents poor performance is to adequately appreciate all of the factors that contribute to these outcomes — physical and mental, social and environmental — and adjust for them.
  • He developed what is known as Donabedian’s triad, which states that quality can be measured by looking at outcomes (how the subjects fared), processes (what was done) and structures (how the work was organized).
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  • “The secret of quality is love,” he said.
Lawrence Hrubes

Meet the woman who can't feel fear - The Washington Post - 1 views

  • "Tell me what fear is," Tranel began. "Well, that's what I'm trying to -- to be honest, I truly have no clue," SM said, her voice raspy. That's actually a symptom of the condition that stole fear from her. Urbach-Wieth disease
  • Even though she's a talented artist, she always has trouble drawing (or reading) a fearful facial expression. "I wonder what it's like, you know, to actually be afraid of something," she told Tranel.
  • That's actually just one of two times that SM has been held at knife point. She's also been held at gunpoint twice. And after the above incident, she didn't feel like she should call the police. The threat had passed. She didn't have any lasting trauma, because the event had failed to faze her. SM isn't stupid. She understands what can and can't kill her. But she lacks the quick, subconscious, visceral response that the rest of us feel when we're exposed to danger.
Lawrence Hrubes

Karolinska Institute to cut ties with controversial surgeon : Nature News & Comment - 0 views

  • The Karolinska Institute (KI) in Stockholm is ending its association with acclaimed but controversial surgeon Paolo Macchiarini, who pioneered transplants of artificial windpipes but has been accused of ethical breaches in his work. 
  • Ethical questions The surgeon’s work was hailed as a game-changer in regenerative medicine when, in 2011, he implanted a plastic artificial trachea, using bioengineered stem cells, into a patient whose own windpipe had been damaged. Over the next three years, he carried out seven more synthetic trachea implantations — two more at the Karolinska, one in Illinois and four in Russia, where he heads a tissue engineering project. Six of the eight patients have died (from causes unrelated to the transplants, Macchiarini says), and one has been in intensive care since the procedure.
Lawrence Hrubes

A mouse's house may ruin experiments : Nature News & Comment - 0 views

  • It’s no secret that therapies that look promising in mice rarely work in people. But too often, experimental treatments that succeed in one mouse population do not even work in other mice, suggesting that many rodent studies may be flawed from the start.
markfrankel18

'Son of Saul,' Kierkegaard and the Holocaust - NYTimes.com - 0 views

  • There are generally two, radically different ways to relate to the world: objective and subjective. Objectivity is an orientation towards reality based on abstracting away, in various degrees, from subjective experience, and from individual points of view. A subjective orientation, on the other hand, is based on an attunement to the inner experience of feeling, sensing, thinking and valuing that unfolds in our day-to-day living. This distinction has been brought into contemporary philosophical discourse most notably by Thomas Nagel, in a number of his essays, most famously in “What Is It Like to Be a Bat?”The spectacular success of science in the past 300 years has raised hopes that it also holds the key to guiding human beings towards a good life. Psychology and neuroscience has become a main source of life advice in the popular media. But philosophers have long held reservations about this scientific orientation to how to live life. The 18th century Scottish philosopher David Hume, for instance, famously pointed out, no amount of fact can legislate value, moral or otherwise. You cannot derive ought from is. But there is another, in some way more radical concern, expressed in Western philosophy most forcefully by Kierkegaard, and in literature by Dostoyevsky — two religiously inspired thinkers — namely that our experience of life matters in ineffable ways that no objective understanding of the world can capture.
Lawrence Hrubes

Up All Night - The New Yorker - 0 views

  • In the nineteen-eighties, Allan Rechtschaffen and Bernard Bergmann, both, like Kleitman, sleep researchers at the University of Chicago, performed what is now considered to be one of the classic experiments in the field. It showed that rats, when totally deprived of sleep, would, after two or three weeks, drop dead. But Rechtschaffen and Bergmann could never figure out the precise cause of the rats’ deaths, and so, they wrote in a follow-up paper in 2002, even “that dramatic symptom did not tell us much about why sleep was necessary.” Rechtschaffen has observed that “if sleep doesn’t serve an absolutely vital function, it is the greatest mistake evolution ever made.”
Lawrence Hrubes

The Excrement Experiment - The New Yorker - 0 views

  • Crohn’s disease affects as many as seven hundred thousand Americans, but, like other autoimmune disorders, it remains poorly understood and is considered incurable. (Autoimmune disorders are thought to arise when the immune system attacks healthy tissue, mistaking it for a threat.) The standard treatments for Crohn’s often don’t work, or work only temporarily, and many have serious side effects.
  • His mother showed him an article from the Times about a man who had been nearly bedridden by ulcerative colitis—a condition related to Crohn’s—and who had largely recovered after a month or so of fecal transplants. Gravel found a how-to book on Amazon and bought the recommended equipment: a blender, a rectal syringe, saline solution, surgical gloves, Tupperware containers. His wife agreed to be his donor.
  • New research suggests that the microbes in our guts—and, consequently, in our stool—may play a role in conditions ranging from autoimmune disorders to allergies and obesity, and reports of recoveries by patients who, with or without the help of doctors, have received these bacteria-rich infusions have spurred demand for the procedure. A year and a half ago, a few dozen physicians in the United States offered FMT. Today, hundreds do, and OpenBiome, a nonprofit stool bank founded last year by graduate students at M.I.T., ships more than fifty specimens each week to hospitals in thirty-six states. The Cleveland Clinic named fecal transplantation one of the top ten medical innovations for 2014, and biotech companies are competing to put stool-based therapies through clinical trials and onto the market. In medicine, at any rate, human excrement has become a precious commodity.
Lawrence Hrubes

What Google Learned From Its Quest to Build the Perfect Team - The New York Times - 1 views

  • Five years ago, Google — one of the most public proselytizers of how studying workers can transform productivity — became focused on building the perfect team. In the last decade, the tech giant has spent untold millions of dollars measuring nearly every aspect of its employees’ lives. Google’s People Operations department has scrutinized everything from how frequently particular people eat together (the most productive employees tend to build larger networks by rotating dining companions) to which traits the best managers share (unsurprisingly, good communication and avoiding micromanaging is critical; more shocking, this was news to many Google managers).The company’s top executives long believed that building the best teams meant combining the best people. They embraced other bits of conventional wisdom as well, like ‘‘It’s better to put introverts together,’’ said Abeer Dubey, a manager in Google’s People Analytics division, or ‘‘Teams are more effective when everyone is friends away from work.’’ But, Dubey went on, ‘‘it turned out no one had really studied which of those were true.’’In 2012, the company embarked on an initiative — code-named Project Aristotle — to study hundreds of Google’s teams and figure out why some stumbled while others soared.
  • As they struggled to figure out what made a team successful, Rozovsky and her colleagues kept coming across research by psychologists and sociologists that focused on what are known as ‘‘group norms.’’
  • As the researchers studied the groups, however, they noticed two behaviors that all the good teams generally shared. First, on the good teams, members spoke in roughly the same proportion, a phenomenon the researchers referred to as ‘‘equality in distribution of conversational turn-taking.’’ On some teams, everyone spoke during each task; on others, leadership shifted among teammates from assignment to assignment. But in each case, by the end of the day, everyone had spoken roughly the same amount. ‘‘As long as everyone got a chance to talk, the team did well,’’ Woolley said. ‘‘But if only one person or a small group spoke all the time, the collective intelligence declined.’’Second, the good teams all had high ‘‘average social sensitivity’’ — a fancy way of saying they were skilled at intuiting how others felt based on their tone of voice, their expressions and other nonverbal cues. One of the easiest ways to gauge social sensitivity is to show someone photos of people’s eyes and ask him or her to describe what the people are thinking or feeling — an exam known as the Reading the Mind in the Eyes test. People on the more successful teams in Woolley’s experiment scored above average on the Reading the Mind in the Eyes test. They seemed to know when someone was feeling upset or left out. People on the ineffective teams, in contrast, scored below average. They seemed, as a group, to have less sensitivity toward their colleagues.
Lawrence Hrubes

Elizabeth Kolbert: When Grownups Take the SAT : The New Yorker - 1 views

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    "Whatever is at the center of the SAT-call it aptitude or assessment or assiduousness or ambition-the exam at this point represents an accident. It was conceived for one purpose, adapted for another, and somewhere along the line it acquired a hold on American life that nobody ever intended."
markfrankel18

Does This Ad Make Me Fat? - NYTimes.com - 1 views

  • A team of researchers walked every street in 228 census tracts around Los Angeles and New Orleans and recorded every outdoor ad they saw. Another group surveyed 2,881 residents of the same census tracts by telephone, paying them to report their height, weight and other information. After analyzing this hard-won data, the authors conclude: “For every 10 percent increase in food advertisements, the odds of being obese increased by 5 percent.” That is, areas with more outdoor food ads have a higher proportion of obese people than ones with fewer ads.
  • The problem is that their policy recommendations rest on a crucial but unjustified assumption: that any link between obesity and advertising occurs because more advertising causes higher rates of obesity. But the study at hand showed only an association: people living in areas with more food ads were more likely to be obese than people living in areas with fewer food ads. To be fair, the researchers correctly note that additional steps would be needed to prove that food ads cause obesity. But until those steps are taken, talk of restricting ads is premature. In fact, it is easy to imagine how the causation could run the opposite way (something the article did not mention): If food vendors believe obese people are more likely than non-obese people to buy their products, they will place more ads in areas where obese people already live. Suppose we counted ads for fitness-oriented products like bicycles and bottled water, and found more of those ads in places with less obesity. Would it then be wise anti-obesity policy to subsidize such ads? Or would the smarter conclusion be that the fitness companies suspect that the obese are less likely than the fit to buy their products?
  • When we seek to base policy on evidence, we must remember that not all “evidence” is created equal. Taken at face value, the study on ads and obesity provides some indication that the two are linked, but no evidence that food ads cause obesity. The fact that the causal conclusion may coincide with a moral belief — that it is wrong to tempt people who overeat by showing them ads for food — does not make it valid.
markfrankel18

Facebook math problem: Why PEMDAS doesn't always give a clear answer. - 0 views

  • You might expect 10 ÷ 5 is the same as 10/5 is the same as 10 over a 5 with a vinculum between them, but each has its own eccentricities. We’ve already noted that ÷ can mean “divide the number on the left by the number on the right” or “divide the expression on the left by the expression on the right.” But it gets really tricky when people assume that a slash replaces a vinculum. Does ab/cd = (ab)÷(cd) or ((ab)÷c)÷d? Does a/b/c mean (a)÷(b)÷(c) or a÷(b/c) or (a/b)÷c? (Answer: Use some parentheses!)
  • The bottom line is that “order of operations” conventions are not universal truths in the same way that the sum of 2 and 2 is always 4. Conventions evolve throughout history in response to cultural and technological shifts.
Cisco Walker

What if the Universe is a Computer Simulation? - Computerphile - YouTube - 1 views

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    Thoughts and reflections on possible realities like The Matrix (among others) using the model of Conway's Game of Life... simple rules breeding complex outcomes.
Lawrence Hrubes

Guns are now killing as many people as cars in the U.S. - The Washington Post - 0 views

  • Medical ailments, such as cancer and heart attacks, kill considerably more people each year than either guns or automobiles, according to the CDC. But firearms and motor vehicles are among the leading non-medical causes of mortality in the United States. They kill more people than falls do each year, and considerably more people than alcohol.
Lawrence Hrubes

BBC News - Should drug firms make payments to doctors? - 1 views

  • Using data from more than 330,000 doctors and 12 pharmaceutical firms, it identified 58% as having received payments. It found that payments were unlikely to represent significant opportunities to educate doctors about new drugs, and that financial gain appears to be an important motive for doctors. Daniel Carlat, director of the prescription project at the non-profit group Pew Trusts, says research to date shows that doctors who have dealings with drugs reps "tend to prescribe differently". "They prescribe more drugs, more expensive drugs, more brand-name drugs, and they're less likely to follow evidence-based practice guidelines in prescribing drugs.
Lawrence Hrubes

Remembering a Crime That You Didn't Commit - The New Yorker - 1 views

  • Earlier this year, two forensic psychologists—Julia Shaw, of the University of Bedfordshire, and Stephen Porter, of the University of British Columbia—upped the ante. Writing in the January issue of the journal Psychological Science, they described a method for implanting false memories, not of getting lost in childhood but of committing a crime in adolescence. They modelled their work on Loftus’s, sending questionnaires to each of their participant’s parents to gather background information. (Any past run-ins with the law would eliminate a student from the study.) Then they divided the students into two groups and told each a different kind of false story. One group was prompted to remember an emotional event, such as getting attacked by a dog. The other was prompted to remember a crime—an assault, for example—that led to an encounter with the police. At no time during the experiments were the participants allowed to communicate with their parents.
  • What Shaw and Porter found astonished them. “We thought we’d have something like a thirty-per-cent success rate, and we ended up having over seventy,” Shaw told me. “We only had a handful of people who didn’t believe us.” After three debriefing sessions, seventy-six per cent of the students claimed to remember the false emotional event; nearly the same amount—seventy per cent—remembered the fictional crime. Shaw and Porter hadn’t put undue stress on the students; in fact, they had treated them in a friendly way. All it took was a suggestion from an authoritative source, and the subjects’ imaginations did the rest. As Münsterberg observed of the farmer’s son, the students seemed almost eager to self-incriminate.
  • Kassin cited the example of Martin Tankleff, a high-school senior from Long Island who, in 1988, awoke to find his parents bleeding on the floor. Both had been repeatedly stabbed; his mother was dead and his father was dying. He called the police. Later, at the station, he was harshly interrogated. For five hours, Tankleff resisted. Finally, an officer told him that his father had regained consciousness at the hospital and named him as the killer. (In truth, the father died without ever waking.) Overwhelmed by the news, Tankleff took responsibility, saying that he must have blacked out and killed his parents unwittingly. A jury convicted him of murder. He spent seventeen years in prison before the real murderers were found. Kassin condemns the practice of lying to suspects, which is illegal in many countries but not here. The American court system, he said, should address it. “Lying puts innocent people at risk, and there’s a hundred years of psychology to show it,” he said.
xinniguo

The Clothes Make the Doctor - The Atlantic - 3 views

  • stilettos and a tailored expensive-looking suit. This wasn’t a case of a low-cut blouse or a thigh-revealing skirt
    • xinniguo
       
      Prejudice - caused by induction. women who wear stilettos and expensive suits tend to be not as professional as male doctors in uniforms
    • xinniguo
       
      uniforms - fulfilment of a schema in our head -> all great doctors are in long white coats with formal suits underneath.. -> stereotype
  • uniform
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  • But forcing all clothing-description categories into one or the other of those two somewhat vague terms is misleading.
    • xinniguo
       
      our perception or ideas are very different. conservative x modern
Lawrence Hrubes

Will You Ever Be Able to Upload Your Brain? - The New York Times - 1 views

  • I am a theoretical neuroscientist. I study models of brain circuits, precisely the sort of models that would be needed to try to reconstruct or emulate a functioning brain from a detailed knowledge of its structure. I don’t in principle see any reason that what I’ve described could not someday, in the very far future, be achieved (though it’s an active field of philosophical debate). But to accomplish this, these future scientists would need to know details of staggering complexity about the brain’s structure, details quite likely far beyond what any method today could preserve in a dead brain.
Lawrence Hrubes

BBC - Earth - Black holes made simple with Stephen Hawking - 1 views

  • Fact can be stranger than fiction. This is especially true of black holes, as Prof Stephen Hawking explains.For instance as soon as you entered the black hole, reality would split in two. "In one, you would be instantly incinerated, and in the other you would plunge on into the black hole utterly unharmed," as we have previously explored.In the 2016 Reith lectures broadcast on BBC Radio 4, Prof Hawking further examines and challenges the latest scientific thinking about black holes.
markfrankel18

Malcolm Gladwell got us wrong: Our research was key to the 10,000-hour rule, but here's... - 0 views

  • First, there is nothing special or magical about ten thousand hours. Gladwell could just as easily have mentioned the average amount of time the best violin students had practiced by the time they were eighteen — approximately seventy-four hundred hours — but he chose to refer to the total practice time they had accumulated by the time they were twenty, because it was a nice round number.
  • And the number varies from field to field.
  • Third, Gladwell didn’t distinguish between the type of practice that the musicians in our study did — a very specific sort of practice referred to as “deliberate practice” which involves constantly pushing oneself beyond one’s comfort zone, following training activities designed by an expert to develop specific abilities, and using feedback to identify weaknesses and work on them — and any sort of activity that might be labeled “practice.”
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  • The final problem with the ten-thousand-hour rule is that, although Gladwell himself didn’t say this, many people have interpreted it as a promise that almost anyone can become an expert in a given field by putting in ten thousand hours of practice. But nothing in the study of the Berlin violinists implied this. To show a result like this, it would have been necessary to put a collection of randomly chosen people through ten thousand hours of deliberate practice on the violin and then see how they turned out. All that the Berlin study had shown was that among the students who had become good enough to be admitted to the Berlin music academy, the best students had put in, on average, significantly more hours of solitary practice than the better students, and the better and best students had put in more solitary practice than the music-education students.
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