Maternal Mortality

Tuesday, May 19th, 2015

Between 1990 and 2013, the US’s maternal mortality rate surged 136%:

Even with that increase, the US’s current rate maternal mortality rate is still much smaller than that of many poorer countries — but by no means not all of them. Mothers in Uruguay, Lebanon, Libya, Kazakhstan, Chile, Albania, Azerbaijan, Russia, and Thailand die at lower rates. The average for developed countries, excluding the US, is just shy of 11 maternal deaths per 100,000 live births.

maternal_deaths_per_100000_live_births_us_chile_uruguay_russia_chartbuilder

It’s not just the deaths. On top of the 1,200 American women who die every year of pregnancy-related causes, there are 60,000 “near misses,” or women who were really close to dying but survived. The combination of deaths and near-misses makes American women over 10 times more likely than their peers in, say, Austria or Poland to die of pregnancy-related causes — this despite the fact that the US’s per capita spending on maternal care is higher than any other country.

What’s behind this alarming spike in US maternal mortality?

Priya Agrawal, obstetrician and director of Merck for Mothers, identifies three leading causes of maternal death in the US: postpartum hemorrhage (heavy bleeding after giving birth), preeclampsia (high blood pressure during pregnancy), and complications arising from pre-existing health conditions. Women getting pregnant are increasingly less healthy, she says. “This year, one in five women [in the US] who become pregnant are obese,” said Agrawal at the Women in the World conference. “Then there’s diabetes and hypertension.”

So, American women are fat and out of shape? Well…

Good health care isn’t always available to mothers before and after giving birth, says Monica Raye Simpson of Sister’s Song, a non-profit group promoting reproductive rights for women of color.“The first barrier is access,” Raye Simpson told Forbes. “The second barrier is racial discrimination.” The black community is particularly affected by maternal mortality, with black American women being over four times more likely to die of pregnancy-related causes than white peers.

Pre-Modern Life Expectancy

Sunday, May 17th, 2015

Basing quality-of-life estimates on average life expectancy at birth warps our view of pre-modern life:

For Neanderthals and other pre-modern humans life was short and brutal primarily because they had to kill animals with handheld weapons at close range. Neanderthals who survived into their thirties looked like they had been pulled out of a Humvee that was hit by an IED. One fellow was missing an eye, an arm, a thumb and a foot! These guys suffered from no known diseases. However, their main food [according to chemical analysis of their bones] was the auroch — basically a rodeo bull — which they had to kill be wrestling with it, stabbing it, and smashing it with rocks!

For a Neanderthal 35 years old was as old as it is for an NFL running back or a lightweight boxer. If one imagines a world where such athletes were executed at retirement, and that all men were such athletes, you get a good idea of the climate for thirty-something folks in the Old Stone Age.

Mature Stone Age hunting and gathering societies, which had not yet invented alcohol, and which did not live with disease bearing domesticate animals, and did not engage in repetitive chores that wear away their connective tissue, produced healthier warriors and women than more technologically advanced societies until the 20th Century. Although few men survived to old age due to constant small scale warfare, male leaders and women living into their 70s was common. As with other apex predators, like lions, most of a primitive’s day consisted of leisure activities.

Agriculture caused people to live in one place, which encouraged disease. With the addition of domestic animals living in close proximity, humanity acquired the measles, all the pox diseases, and venereal disease [don’t ask how]. The result was that few children lived to age five. This is reflected in the fact that many societies did not name children at birth, and that children were seen as a burden until they were able to engage in the horrid economy which the adults were shackled to.

An agrarian man typically worked from sunrise to sundown doing a small cluster of repetitive motions, resulting in a terribly worn body by about age 30. The woman had it no better, on her knees grinding grain all day long, and becoming arthritic before age 30.

This was a nasty way to live, so conquerors lived according to the more ancient primitive tradition. The apex of the population — the nobility and royalty, being the top 5% — continued to live as primitives, hunting and fighting and enjoying leisure time, and making all of those great scientific, literary, artistic, and military advances.

The common agrarian person was a machine, a brute who ate, worked, shat and died in misery, and was regarded as subhuman by his masters, who lived, essentially, as a primitive warrior class.

Note that the age of majority has always been based on man’s prime as an athlete or war fighter. Ancient Greek warrior-athletes, Roman soldiers and medieval knights were not considered fit for combat until age 21, and were regarded as pretty well shot by 40. This has not changed, with modern boxers and football players considered subpar until age 22 and over the hill by age 35. Likewise, various social rights, such as firearms licenses, drinking privileges, voting rights, and military service, have typically not been granted until the 18–22 year age range. It has also remained nigh unthinkable for a head of state to be younger than 35 years of age. This athletic life span corresponds with the hunting life span of the Neanderthal auroch hunter.

Crash course diet reverses Type 2 diabetes in a week

Thursday, May 7th, 2015

Until recently, received medical wisdom was that Type 2 diabetes was largely irreversible, but a new study shows that a crash-course diet can reverse Type 2 diabetes in a week:

Prof Taylor asked 11 volunteers, all recently diagnosed, to go on what he admitted was an “extreme diet” of specially formulated drinks and non-starchy vegetables, for eight weeks.

After just a week, pre-breakfast (‘fasting’) blood sugar levels had returned to normal, suggesting a resumption of correct pancreas function.

After eight weeks, all had managed to reverse their diabetes. Three months on, seven remained free of it.

Prof Taylor explained that too much fat “clogged up” the operation of the pancreas at a cellular level, preventing normal secretion of insulin which regulates blood sugar.

When this fat was removed — by way of the diet — normal function resumed.

[...]

The idea of the crash diet came from the observation that gastric bypass patients often quickly stopped being Type 2 diabetics.

Many thought this was because surgery affected gut hormones which had a knock-on impact on the pancreas.

But Prof Taylor thought it might really be because the surgery severely constrained what patients could eat. He set up the diet experiment to test his ‘fat’ hypothesis.

He said special MRI scans showed the proportion of fat in volunteers’ pancreases dropped during the eight weeks, from eight to six per cent.
“This study does not just show proof of principal, it shows proof of mechanism,” he concluded.

[...]

Despite the diet’s potential, Prof Taylor was a little pessimistic about how many would stick to it.

“Maybe five per cent,” he said. “However, if they did, it would save the NHS many millions of pounds.”

Almost a tenth of the entire NHS budget, or about £9 billion a year, is spent managing diabetes and its complications. Most of that is spent on type 2 diabetics, who outnumber type 1 diabetics by about nine to one.

(Hat tip to P.D. Mangan.)

Scrabble Expertise

Monday, May 4th, 2015

Scrabble expertise follows the usual pattern — it depends on both practice and talent:

In one study, using official Scrabble rating as an objective measure of skill, researchers found that groups of “elite” and “average” Scrabble players differed in the amount of time they had devoted to things like studying word lists, analyzing previous Scrabble games, and anagramming—and not by a little. Overall, the elite group had spent an average of over 5,000 hours on Scrabble study, compared to only about 1,300 hours for the average group. Another study found that competitive Scrabble players devoted an average of nearly 5 hours a week to memorizing words from the Scrabble dictionary.

Clearly, expert Scrabble players are to some degree “made.” But there is evidence that basic cognitive abilities play a role, too. In a study recently published in Applied Cognitive Psychology, Michael Toma and his colleagues found that elite Scrabble players outperformed college students from a highly selective university on tests of two cognitive abilities: working memory and visuospatial reasoning. Working memory is the ability to hold in mind information while using it to solve a problem, as when iterating through possible moves in a Scrabble game. Visuospatial reasoning is the ability to visualize things and to detect patterns, as when imagining how tiles on a Scrabble board would intersect after a certain play. Both abilities are influenced by genetic factors.

Further evidence pointing to a role of these abilities in Scrabble expertise comes from a recent brain imaging study by Andrea Protzner and her colleagues at the University of Calgary. Using functional magnetic resonance imaging (fMRI), these researchers recorded the brain activity of Scrabble players and control subjects as they performed a task in which they were shown groups of letters and judged whether they formed words. (fMRI measures brain activity by detecting changes in blood flow within different regions of the brain.) The major finding of this study was that competitive Scrabble players recruited brain regions associated with working memory and visual perception to perform this task to a greater degree than the control subjects did.

What might explain Scrabble experts’ superiority in working memory and visuospatial reasoning? One possibility is that playing Scrabble improves these cognitive abilities, like a work-out at the gym makes you stronger. However, this seems unlikely based on over a century of research on the issue of “transfer” of training. When people train on a task, they sometimes get better on similar tasks, but they usually do not get better on other tasks. They show “near” transfer, but not “far” transfer. (Practice Scrabble and you’ll get better at Scrabble, and maybe Boggle, but don’t count on it making you smarter.) For the same basic reason that basketball players tend to be tall, a more likely explanation is that people high in working memory and visuospatial reasoning abilities are people who tend to get into, and persist at, playing Scrabble: because it gives them an advantage in the game. This explanation fits with what behavioral geneticists call gene-environment correlation, which is the idea that our genetic makeup influences our experiences.

New Paltz Neanderthal Project

Friday, May 1st, 2015

According to the New Paltz Neanderthal Project’s findings, people with high levels of Neanderthal shared personality traits:

  • They were introverted.
  • They were more neurotic than an average person.
  • They liked reading non-fiction more than fiction.
  • They were more promiscuous.
  • They had a poor relationship with their biological fathers.
  • They felt that others did not support them socially or emotionally.
  • They had bipolar tendencies and were more likely to be on the autism spectrum.

The picture that this paints of Neanderthals — and why they suddenly died out around 40,000 years ago — seems clear. They weren’t as adept at forming large social groups as humans.

Sunshine and Atropine

Wednesday, April 29th, 2015

East Asia is growing increasingly myopicliterally — but ophthalmologists there have a solution:

Jason Yam, an ophthalmologist and professor at the Chinese University of Hong Kong, says it’s the first piece of advice he gives parents who bring in their nearsighted children. “The parents say yes, but they don’t do it,” he says.

Usually they come back and say their children didn’t have time to go outside because of homework. However, when he brings up another prevention strategy — using daily atropine eye drops — parents are very committed, Dr. Yam says.

Atropine, a drug used for decades to dilate the pupils, appears to slow the progression of myopia once it has started, according to several randomized, controlled trials. But used daily at the typical concentration of 1%, there are side effects, most notably sensitivity to light, as well as difficulty focusing on up-close images.

In recent years, studies in Singapore and Taiwan found that a lower dose of atropine reduces myopia progression by 50% to 60% in children without those side effects, says Donald Tan, professor of ophthalmology at the Singapore National Eye Centre. He has spearheaded many of the studies. Large-scale trials on low-dose atropine are expected to start soon in Japan and in Europe, he says.

Researchers are unsure how long children should use the eye drops for maximum effect. So far, the longest study has followed children for five years. In Singapore, children typically receive drops for three to six months at the first sign they’re becoming nearsighted. If their myopia continues to progress, they typically continue the drops for up to a year, Dr. Tan says.

The Only Relevant Thing

Monday, April 27th, 2015

Instead of learning science, British pupils will learn about the way science and scientists work within society, because their education must be relevant to the 21st century — which reminds David Foster of this passage from C.S. Lewis’s A Preface to Paradise Lost, contrasting Milton’s takes on Adam and Satan:

Adam talks about God, the Forbidden tree, sleep, the difference between beast and man, his plans for the morrow, the stars and the angels. He discusses dreams and clouds, the sun, the moon, and the planets, the winds and the birds. He relates his own creation and celebrates the beauty and majesty of Eve…Adam, though locally confined to a small park on a small planet, has interests that embrace ‘all the choir of heaven and all the furniture of earth.’ Satan has been in the heaven of Heavens and in the abyss of Hell, and surveyed all that lies between them, and in that whole immensity has found only one thing that interests Satan.

The only thing relevant to Satan is Satan himself:

One need not believe in a literal Satan, or for that matter be religious at all, to see the force of this. There is indeed something Satanic about a person who has no interests other than themselves. And by insisting that everything be “relevant” and discouraging the development of broader interests, the educational authorities in Britain are doing great harm to the children put in their charge.

The new lite-yet-relevant curriculum leads to questions on the national exam like this:

In a multiple choice question, teenagers were asked why electric wires are made from copper. The four possible answers were that copper was brown, was not magnetic, conducted electricity, or that it conducted heat.

Parents Can Help Preemies

Monday, April 27th, 2015

A new study is testing the crazy idea that parents might help care for their own babies who are born prematurely:

The idea is to put parents in charge for at least eight hours a day of taking care of their babies in the neonatal intensive care unit, or NICU. Typically, babies born prematurely, who might weigh little more than a pound, are considered too fragile for anyone but highly trained doctors and nurses to care for.

“Yes, they are fragile. But parents aren’t the source of bad things that can happen, they’re the source of good things that can happen,” says Dr. Douglas McMillan, a neonatologist at IWK Health Centre in Halifax, Nova Scotia, one of the study sites.

The study, being conducted at 20 hospitals in Canada and 10 in Australia and New Zealand, follows a pilot program at Toronto’s Mount Sinai Hospital that involved 42 premature newborns. The outcome: Preemies cared for by their parents gained 25% more weight and were nearly twice as likely to be breastfeeding when they went home as those taken care of primarily by nurses. Infections, 11% in the nurse group, fell to zero in the parent group.

Microbiomes and Temperament

Sunday, April 26th, 2015

Gut microbiomes help explain temperament in young children:

From 2011 to 2012, researchers at Ohio State University in Columbus recruited 77 pairs of mothers and toddlers, age 18 to 27 months. Mothers rated their children’s temperament on questionnaires and provided information about breast-feeding and timing of solid foods. Gut bacteria were analyzed from stool samples on diapers.

Boys were more active and extroverted, and had less self-control compared with girls. More physical movement and higher sociability were significantly associated with a particular composition of gut bacteria in boys. In girls, higher self-control and fear of potentially unpleasant or threatening situations were associated with specific clusters of gut bacteria.

No association was found between diet, gut bacteria and temperament differences in boys or girls, though consuming less meat and vegetables was linked to a greater need for stimulation in boys. It isn’t clear if the findings reflect the effects of temperament on the gut or the effects of the gut on temperament, or a combination of the two, researchers said.

Psychopathic violent offenders’ brains can’t understand punishment

Friday, April 24th, 2015

Psychopathic offenders are different from regular criminals in many ways:

“Regular criminals are hyper-responsive to threat, quick-tempered and aggressive, while psychopaths have a very low response to threats, are cold, and their [aggression] is premeditated,” added Dr. Nigel Blackwood, who is affiliated with King’s College London. “Evidence is now accumulating to show that both types of offenders present abnormal, but distinctive, brain development from a young age.”

[...]

While inside the brain scanner, the violent offenders and non-offenders completed a task that assessed their ability to adjust their behaviour when the consequences of their responses changed from positive to negative. The task was an image matching game — sometimes points were awarded for correctly pairing images, sometimes they weren’t. “When these violent offenders completed neuropsychological tasks, they failed to learn from punishment cues, to change their behaviour in the face of changing contingencies, and made poorer quality decisions despite longer periods of deliberation,” Blackwood explained.

The researchers also examined activity across the brain during the completion of the task. “We found that the violent offenders with psychopathy, as compared to both the violent offenders without psychopathy and the non-offenders, displayed abnormal responding to punishment within the posterior cingulate and insula when a previously rewarded response was punished. Our previous research had shown abnormalities in the white matter tract connecting these two regions. In contrast, the violent offenders without psychopathy showed brain functioning similar to that of the non-offenders,” Blackwood explained. “These results suggest the violent offenders with psychopathy are characterized by a distinctive organization of the brain network that is used to learn from punishment and from rewards.”

Deciding on what to do involves generating a list of possible actions, weighing the negative and positive consequences of each, and hopefully choosing the behaviour most likely to lead to a positive outcome. “Offenders with psychopathy may only consider the possible positive consequences and fail to take account of the likely negative consequences. Consequently, their behavior often leads to punishment rather than reward as they had expected,” Hodgins said. “Punishment signals the necessity to change behaviour. Clearly, in certain situations, offenders have difficulty learning from punishment to change their behaviour.”

(Hat tip to Peter Turchin.)

Individual Differences in Executive Functions Are Almost Entirely Genetic in Origin

Thursday, April 23rd, 2015

Individual differences in executive functions are almost entirely genetic in origin:

Recent psychological and neuropsychological research suggests that executive functions — the cognitive control processes that regulate thought and action — are multifaceted and that different types of executive functions are correlated but separable.

The present multivariate twin study of three executive functions (inhibiting dominant responses, updating working memory representations, and shifting between task sets), measured as latent variables, examined why people vary in these executive control abilities and why these abilities are correlated but separable from a behavioral genetic perspective.

Results indicated that executive functions are correlated because they are influenced by a highly heritable (99%) common factor that goes beyond general intelligence or perceptual speed, and they are separable because of additional genetic influences unique to particular executive functions. This combination of general and specific genetic influences places executive functions among the most heritable psychological traits. These results highlight the potential of genetic approaches for uncovering the biological underpinnings of executive functions and suggest a need for examining multiple types of executive functions to distinguish different levels of genetic influences.

Enlisting in the Military

Wednesday, April 22nd, 2015

Why do people enlist in the U.S. military? It’s genetic:

Analysis of twin pairs drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health) revealed that 82% of the variance was the result of genetic factors, 18% of the variance was the result of nonshared environmental factors, and none of the variance was accounted for by shared environmental factors.

Elite Anti-Elitists

Monday, April 20th, 2015

A modern textbook tries to “sell” students on physics as a source of “new technologies for leisure” and tries to humanize physicists as regular people, but, Matthew B. Crawford laments, it makes no effort to resuscitate the ideal of ancient science, learning for its own sake:

The pose of anti-elitism seems to be a cover for something far more disturbing, something that is perhaps typical of elite anti-elitists. The author writes, “Sometimes the results of the work of physicists are of interest only to other physicists. Other times, their work leads to devices…. that change everyone’s life.” Are these the only two possibilities? Physicists on their mountaintop, speaking only to one another, and the rest of us in the plains, waiting for them to descend bearing magical devices? Nothing in-between? Aren’t there intelligent, curious people who are not professional physicists, but who have the patience and desire to learn? I believe it is this dichotomization of humanity into two ideal types, professional scientists and ignorant consumers, that is responsible for this book’s cynicism. The author doesn’t seem to think his readers are really capable of being educated. This is the worst sort of elitism. Paradoxically, we have here the worst of both worlds: an anti-elitist rhetoric that discredits the higher human possibilities, the very possibilities by which the author orients his own life as a scientist, together with a more substantive elitism that views students from so far above that it can’t be bothered to cultivate in them those same human possibilities.

The author’s cynicism is ultimately rooted in a common confusion, a false conflict between democracy and elitism, one that forgets the ways in which these two human ideals actually depend on one another. Thomas Jefferson envisioned a “natural aristocracy,” made possible by the liberation of talents that comes with equality of opportunity. He suggests that democracy not only makes such a natural aristocracy possible, it is also peculiarly in need of cultivated human beings who can exert a leavening effect on society, giving our common freedom the character of liberty rather than license. That distinction seems to turn on the objects toward which freedom is directed. It is a distinction that allows us to speak of liberal pursuits, such as music, science, literature, mathematics, and so forth. If liberal democracy requires a critical mass of liberally educated citizens, it would seem to require a regime of education guided not only by the love of equality but also by the love of thinking. Happily, such a love is requited by those beautiful things that unveil themselves before a powerful and disciplined mind working at full song. Here is a logic that reconciles the private good of the student with public felicity. It is the logic of liberal education, classically understood.

A great teacher once said that precisely because we are friends of liberal democracy, we are not permitted to be its flatterers. With its confused anti-elitism, this book flatters the lowest elements of the democratic spirit. This is unfortunate because it is precisely the democratic spirit that, at its best, provides the most fertile home for the spirit of scientific inquiry. Glencoe Physics takes a very dim view of the educability of students, never venturing to lead them beyond the narrow concerns of comfort and entertainment. This is not so much meeting the students on their own terms as capitulating to the terms offered to students by mass commercial culture. Cowed by the times, our author lacks political courage on behalf of thinking, something that is incumbent on all teachers.

The Right Dose of Exercise for a Longer Life

Saturday, April 18th, 2015

The right dose of exercise for a longer life is about an hour of walking per day:

They found that, unsurprisingly, the people who did not exercise at all were at the highest risk of early death.

But those who exercised a little, not meeting the recommendations but doing something, lowered their risk of premature death by 20 percent.

Those who met the guidelines precisely, completing 150 minutes per week of moderate exercise, enjoyed greater longevity benefits and 31 percent less risk of dying during the 14-year period compared with those who never exercised.

The sweet spot for exercise benefits, however, came among those who tripled the recommended level of exercise, working out moderately, mostly by walking, for 450 minutes per week, or a little more than an hour per day. Those people were 39 percent less likely to die prematurely than people who never exercised.

At that point, the benefits plateaued, the researchers found, but they never significantly declined.

Poor kids have smaller brains

Thursday, April 16th, 2015

A recent Nature Neuroscience paper demonstrated that poor children have smaller brains than affluent children:

Neuroscientists who studied the brain scans of nearly 1,100 children and young adults nationwide from ages 3 to 20 found that the surface area of the cerebral cortex was linked to family income. They discovered that the brains of children in families that earned less than $25,000 a year had surface areas 6 percent smaller than those whose families earned $150,000 or more. The poor children also scored lower on average on a battery of cognitive tests.

The region of the brain in question handles language, memory, spatial skills and reasoning, all important to success in school and beyond.

So, what did the study’s authors conclude?

“We’ve known for so long that poverty and lack of access to resources to enrich the developmental environment are related to poor school performance, poor test scores and fewer educational opportunities,” Sowell said. “But now we can really tie it to a physical thing in the brain. We realized that this is a big deal.”

Really? Yes, these are their two hypotheses for why:

One is that poor families lack access to material goods that aid healthy development, such as good nutrition and higher-quality health care. The other is that poor families tend to live more chaotic lives, and that stress could inhibit healthy brain development.

Amazingly, journalist Lyndsey Layton interviewed James Thompson and accurately shared his thoughts — and Charles Murray’s:

“People who have less ability and marry people with less ability have children who, on balance, on average, have less ability,” he said. Thompson noted that there is a genetic component to intelligence that Noble and Sowell failed to consider.

“It makes my jaw drop that we’ve known for years intelligence is inheritable and scientists are beginning to track down exactly how it happens,” Thompson said. “The well-known genetic hypothesis has not even had a chance to enter the door in this discussion.”

[...]

“It is confidently known that brain size is correlated with IQ, IQ measured in childhood is correlated with income as an adult, and parental IQ is correlated with children’s IQ,” Murray wrote in an e-mail. “I would be astonished if children’s brain size were NOT correlated with parental income. How could it be otherwise?”