Thai Brides
Paying for sex
John Humphrys (BBC Radio 4, Today Programme) tried to work himself into a lather this morning about thousands of immigration requests apparently lost by the UK Border Agency. Having been refused entry, the applicants had grumbled rather than filing a formal appeal, and the agency hadn’t made it clear that they had dropped into bureaucratic oblivion. Not much of a scandal, especially when the BBC’s researchers could only rustle up a fellow from Rotherham whose Thai bride had been refused entry!
Here’s a prediction. The BBC will soon campaign against old guys paying women from poor countries for sex and household services, and avoiding the accusation of prostitution by getting a marriage certificate. Only yesterday Humphrys was winding himself up about people-trafficking from Eastern Europe. His successor will soon be tut-tutting at how Thai brides are happy to seal the deal for a low price if you throw in UK citizenship.
Don’t misunderstand me; I’ve no problem with immigration, or paying adults for housework or even for sex. I just don’t think it’ll be long before Aunty asks how we could have tolerated such things as recently as 2013?
I doubt it’ll take ten years.
Jim Thornton
The Golden Peace
Dining with the Swedish Academy
Dinner last night at Den Gyldene Freden, the Stockholm restaurant where the eighteen members of the Swedish Academy meet every Thursday to discuss, and once a year to pick the next Nobel prizewinner for literature. The restaurant, in the old town, goes back well before the prize was instituted, or even the Academy founded.
It was a favourite drinking houses of Carl Michael Bellman, the 18th century poet and composer, who is so loved in Sweden that children tell unfunny “Bellman” jokes. Here’s one.
A Norwegian, a Dane and Bellman decided to swim the Atlantic. The Norwegian swam a mile and drowned. The Dane swam ten miles and drowned. Bellman got almost to America but turned back because he was tired.
And here’s his song to Den Gyldene Freden
To the Golden Peace,
hold the lines,
the patrol is off!
Ale in the head,
now at the Star,
The Commander cheers.
The peril we see, but fear her not,
Hither now to the left at the Dutch Moor,
First platoon of the Battalion
drink your cups!
Carl Michael Bellman from Fredman’s Song No. 3
Larkin and Housman on sex
Dry-Point and “The Nettle Poem”
Dry-Point is not about the dry-point technique of etching with a sharp needle, but about sex. Larkin originally paired it with another poem on the same topic, nominally about a different way to make pictures, but he never bothered to publish Oils, and most experts agree it was not much good. But everyone thinks Dry-Point is a masterpiece.
I disagree. It doesn’t rhyme, and the grammar’s all wrong. Repeated exclamation marks! Readers shouldn’t have to look up that Birmingham refers to the allegedly tawdry jewellery made in that city. Annus Mirabilis and High Windows said so much more, and said it better. We don’t read poetry to learn that sex often disappoints, and we don’t read Larkin for poems that need explaining.
Dry-Point
Endlessly, time-honoured irritant,
A bubble is restively forming at your tip.
Burst it as fast as we can –
It will grow again until we begin dying.
Silently it inflates, till we’re enclosed
And forced to start the struggle to get out:
Bestial, intent, real.
The wet spark comes, the bright blown walls collapse,
But what sad scapes we cannot turn from then:
What ashen hills! what salted, shrunken lakes!
How leaden the ring looks,
Birmingham magic all discredited,
And how remote that bare and sunscrubbed room,
Intensely far, that padlocked cube of light
We neither define nor prove,
Where you, we dream, obtain no right of entry.
It nods and curtseys and recovers
It nods and curtseys and recovers
When the wind blows above,
The nettle on the graves of lovers
That hanged themselves for love.
The nettle nods, the wind blows over,
The man, he does not move,
The lover of the grave, the lover
That hanged himself for love.
A E Housman
Hormone coil for heavy periods
The ECLIPSE trial
Wonderful when years of work come to fruition. My colleague Janesh Gupta and his team from Birmingham and Nottingham had their ECLIPSE trial published in the New Engl J Med this week. Click here.
The results are clear. Popping in a progesterone hormone releasing coil (tradename Mirena) is much more effective than old fashioned oral treatments for women with heavy periods.
I’m thrilled, not just because it’s good to get a clear answer that helps women, but because I’ve been peripherally involved, as chair of the independent trial steering comittee. It was my job to hassle the triallists when recruitment was slow, to threaten to withdraw their funding if they didn’t buck their ideas up, and to pester them when they failed to find out exactly what had happened to every patient. For years Janesh had nightmares about me.
But it’s all worthwhile now. Well done ECLIPSE team.
Jim Thornton
Mild overweight is good for you
BMI 25-30 live longer
A review of 98 studies, including 2.9 million people has concluded that being very obese (Body Mass Index >35) is associated with increased all cause mortality (hazard ratio 1.3;’ 95% confidence interval 1.2-1.4). But a BMI of 30-35, mild obesity, was associated with no increased risk, and a BMI of 25-30, which is classed as overweight, is associated with a lower mortality (HR 0.94; 95% CI 0.91-0.96), compared with “normal”. Here‘s the paper in JAMA.
I usually ignore observational studies. But with a personal BMI of 26, I’ll believe this one, and ignore the BMJ health police (click here), who say it’s probably an artefact.
Jim Thornton
Apostel-2
Maintenance tocolysis
Superb trial in this week’s JAMA (click here). The Dutch Apostel-2 group tested the effect of a popular but unlicensed drug (nifedipine), used to suppress uterine contractions after the first 48 hours of treatment for suspected pre-term labour. Experts believe 48 hours treatment is effective, but after that, there is uncertainty whether drugs even prolong pregnancy, let alone reduce important adverse outcomes. The trial was registered, double-blind, hit its planned sample size, and reported its pre-specified primary endpoint. Perfect.
But the drug didn’t work. Here’s the graph of the proportions undelivered over time in each group. Hardly surprising that there was no difference in baby outcomes.
Apostel-2 has protected women from an ineffective drug.
The authors also state that all other drugs are equally ineffective because no maintenance tocolysis trial has shown a reduction in adverse fetal outcomes. But they don’t mention the only trial of maintenance tocolysis with the safest licensed drug used for this purpose, atosiban. It’s not easy to access, so here’s a copy (Valenzuela 2000). And here’s the main trial figure, upper line atosiban continued after 48 hours, lower line placebo after 48 hours. The figure is censored at 36 weeks.
Note 1 – these figures don’t show the same things. The upper (Apostel-2 trial of nifedipine) shows the proportion undelivered at each time point – no difference. The lower (Valenzuela trial of atosiban) shows the proportion undelivered and not given an alternative tocolytic – atosiban has a modest beneficial effect. Neither drug reduced adverse fetal outcomes. Nevertheless both trials were double blind and placebo controlled, so the lower graph is measuring a real effect of the drug.
In the absence of fetal compromise, ruptured membranes, infection or bleeding, maintenance tocolysis with atosiban remains a reasonable treatment for extremely pre-term labour.
Note 2 – I have received lecture fees from Ferring, the manufacturer of atosiban, and served on their advisory board. I oppose using unlicensed drugs when a licensed alternative exists, and have criticised the poor quality of many trials of nifedipine.
Jim Thornton
An April Sunday brings the snow
To the other Pop Larkin
The quality of the stuff Larkin left unpublished is incredible. This was occasioned by his father’s death in 1948. Sydney Larkin was a fascist-loving bureaucrat who bullied his wife. But his jam-making gave his son this wonderful metaphor for what we lose in death – sweet and meaningless and not to come again.
An April Sunday brings the snow
Making the blossom on the plum trees green,
Not white. An hour or two, and it will go.
Strange that I spend that hour moving between
Cupboard and cupboard, shifting the store
Of jam you made of fruit from these same trees:
Five loads – a hundred pounds or more –
More than enough for all next summer’s teas.
Which now you will not sit and eat.
Behind the glass, underneath the cellophane,
remains your final summer – sweet
And meaningless, and not to come again.
Philip Larkin
Lyndon Johnson
Great biography, dreadful man
Means of Ascent, Vol 2 of Robert Caro’s biography is superb. Skip the childhood stuff – Caro summarises Vol 1. Jump in with Lyndon in 1942, a 3rd term US representative, who had risen to influence on FDR’s coat-tails, and through control of the Democrat’s donations from Texan oil. Now with better audited accounts, and having just lost his first Senate race, he returns to Washington a frustrated man. He had promised voters he would rush to the front line when the US entered the war, but delays – getting in a bit of adultery on the way – until his apparent cowardice threatens his future electoral chances. He wrangles a congressional investigatory trip, joins one bombing raid as an observer, and for the rest of his life portrays this single action as a brave fighting campaign in the Pacific.
After the war he makes a fortune peddling political influence into broadcasting licences held in his wife’s name. And then the meat of the book – “the 87 votes that made history”. How he stole the 1948 senatorial primary from Coke Stevenson, the most honest politician in Texas. He did it by flying around in a helicopter, by portraying his opponent, a genuine friend of poor farmers, as in the pockets of business, the place where Johnson himself really lay, and finally by buying votes. Texan politicians had been doing the latter for years, but Johnson stole more, and more brazenly than anyone before. Despite all this, and Johnson’s shocking treatment of his wife and underlings, Caro somehow makes us care about the outcome, as he leads us through the dramatic post-election intrigues, all the way to the US Supreme court ruling, that finally installed Johnson as senator.
How could such a man have gone so far? Caro credits energy, charisma and ruthlessness. Although Johnson hid his villainy from electors, behind closed doors he boasted openly of doing whatever it took. He had power, and he made sure people knew it.
Jim Thornton
Objective sociology?
Nice test coming up
A recent retraction in Society & Natural Resources should test the researchers’ objectivity. Story here.
The original paper claimed that the U.S. Environmental Protection Agency (EPA) was racist, in that it was less likely to fine companies who polluted in areas where poor or ethnic minorities lived. It was retracted on 19 Dec 2012, because a coding error – transposed zeroes and ones – had reversed some, possibly all, of the results. These things happen. Full marks to the authors for retracting, but a revised paper should appear, once the error has been corrected. It would be unscientific to only publish if A increased B but not if A decreased B.
But this is sociology. The lead author is co-director of the Center for the Study of Social Justice at the university of Tennessee. Here‘s the abstract of the original “retracted” paper. It’s difficult to read over the “retracted” watermark, so here is a clean version.
Despite its responsibility to handle compliance and enforcement concerns, the U.S. Environmental Protection Agency (EPA) has become more concerned with protecting the interests of those it is supposed to be regulating than with the communities affected by environmental hazards. This research adds to the debate over environmental justice and injustice by examining U.S. EPA enforcement activity in Tennessee and the relationship between a Census place’s race and income structure and the monetary fine (if any) assessed to a violating facility in that census place. Data were taken from the U.S. EPA Enforcement and Compliance History Online Database and the U.S. Census, and both logistic and truncated regression techniques were utilized to model outcomes. The results provide evidence for environmental racism with regard to whether or not a fine was assessed; however, the amount of fine assessed appears unrelated to the racial and economic structure of the places where violations occurred.”
The opening sentence suggests that the authors knew what they were going to find before they looked at the data. But maybe I’m overly sceptical. The full text of the original (retracted) paper would provide a great test of the researchers’ objectivity. It would serve the same function as an analysis plan for a randomised trial, published before the treatment codes were broken. All the endpoints, covariates and statistical tests would be pre-specified.
If these authors really are disinterested seekers after truth we might expect the new abstract to end something like this.
“Fines were imposed in a racially discriminatory way, but in the direction of positive discrimination. Polluters in poor and minority regions were more likely to suffer fines from violations. However, the size of fine was unrelated to the racial and economic structure of the place where violations occurred. These results refute the assumption of environmental racism by the EPA against poor and minority ethnic groups.”
We’ll see.
Jim Thornton
Patrick Mooore
4 March 1923 – 9 December 2012
From AO deadpool. In 1957, when the BBC picked a little known amateur to front their new astronomy programme, they could hardly have expected him to be quite so popular, or to last so long. People loved his enthusiasm, rapid-fire delivery, and monocle, and he soon embodied astronomy in the UK. The Sky at Night became the world’s longest running TV series to have retained its founding presenter.
But I bet they didn’t expect him to turn out quite so reactionary. He chaired an anti-immigration political party, United Country, defended motorists from overzealous speed cops, blamed gays for the spread of AIDS, women presenters for the decline of the BBC, and the French and Germans for just about everything else. The latter may have had something to do with his fiancée being killed by a German bomb in the war. He never married.
He tested the BBC’s patience, but it took death to get him off the air.
With his rapid speech and old-fashioned monocle,
For fifty-five years he was on TV.
Old Patrick Moore was quite unstoppable
On Sky at Night on the BBC.
He wanted girls in the kitchen, and gays in the closets,
But people forgave him such an old-fashioned view,
Because he spoke about stars, and planets, and comets,
And perhaps some quietly, agreed with him too.
Jim Thornton
Ripe-tomato.org 