Odetta 1930-2008

On a completely off-topic post, a great music legend, Odetta, died this last week. I'm quite passionate about my music and Odetta, in my eyes, has to be one of the greatest vocalists of the last century. Such an incredibly powerful voice and a great use of some bizarre noises make her a giant of folk and music as a whole. Bob Dylan said of her: "The first thing that turned me on to folk singing was Odetta. I heard a record of hers in a record store... Right then and there, I went out and traded my electric guitar and amplifier for an acoustical guitar... [That album was] just something vital and personal."

She was also apparently the first person that other giant among female vocalists, Janis Joplin, imitated when she first started singing. Here are a couple of videos from youtube showing the great Odetta in concert. The first is a brief recording of her singing Waterboy on The Harry Belafonte Show in 1959 (listen to those crazy yelps) and the second is a sound recording of one of my favourites of hers "Another Man Don' Gone".



Unfortunately I can't embed the next one, but it is amazing so please listen!

Abortion & Contraception: Freedom for women.

First, I should begin with a little update on a recent post about a pants New Zealand paper claiming that having an abortion adversely affected women's psychological health. Well now an American Psychological Association (APA) task force has performed a review of the literature evaluating papers since 1989 analysing any link between abortion and a woman's mental health. They conclude: “among women who have a single, legal, first-trimester abortion of an unplanned pregnancy for nontherapeutic reasons, the relative risks of mental health problems are no greater than the risks among women who deliver an unplanned pregnancy.”

In related news, there seems to have been a lot of buzz recently in the British press about contraceptives. The British Pregnancy Advisory Service (BPAS) is going to be prescribing the morning-after-pill to women for free and in advance. I think this sounds like a fantastic idea. The BPAS point out that GPs' surgeries are often closed over christmas. Since the morning-after-pill needs to be taken within 72hrs, this could cause problems if a condom breaks or people get carried away without contraceptives. As Ann Furedi, chief executive of the BPAS, puts it: "You don't wait until you get a headache to buy your pain relief. Why wait until you've risked pregnancy to get the morning after pill?" Indeed!

In a similar vein, there have been two other stories this week about contraceptives. The first tells that from next year, the NHS are introducing some pilot schemes to sell the contraceptive pill without prescription. Fantastic. Give people as great an access to contraceptives as possible I say. The second story comes from an outraged article in the Manchester Evening News: "Schools Give Condoms to Kids Aged Just 13." It's worth pointing out that the colour change was not added by me and in fact was displayed that way in the headline.

Manchester has very high teenage pregnancy rates compared to the rest of the country, and it's rising. It seems very sensible to me to therefore increase teenagers' access to contraceptives to decrease these pregnancies. Apparently all 'non-faith' secondaries in the city have agreed to let their nurses hand out contraceptives and give advice about sex. This really should just provide another nail in the coffin of publicly-funded 'faith schools.' They're using their outdated superstitious ideology to prevent access to contraceptives to children and so I wouldn't be surprised if teen pregnancies in these schools continue to rise. What's more, in some of these schools, abortion will be very strongly discouraged for those teenagers who do become pregnant and so some children's lives will be more or less mapped out for them based on which school they go to. Shocking and at the taxpayers' expense.

"Parents are NOT told when their children ask for advice or contraception" Good! Children, just like everyone else, should not feel that there will be fallout from them asking legitimate and pertinent questions about sex or contraception. This would in effect stop condoms being totally accessible, especially to those children with ideological parents. An unnamed 'conservative campaign group' apparently thinks it's an 'incentive' to sexual activity. These people seem to be completely oblivious to the fact that these children clearly ARE sexually active.

In light of some more recent news, perhaps conservatives should be less concerned with contraceptives and sex and move onto that very dangerous arena that is kissing!

Demon Douchebag

So it's been a few days since I last posted. I've been pretty damn busy outside of work, so I've simply not had time to post. However, there are a number of relevant things that have either pissed me off or excited me in the last few days, so I wouldn't be surprised if I end up posting a ridiculous number of posts to make up for the lull.

So first off is a link I came to via the Skeptics' Guide to the Universe Forum. Demontest.com claims that it "may be the most important spiritual decision you have made." The test apparently determines your risk of being possessed or spiritually oppressed (whatever that means) by a daemon. It is run by the Rev. Bob Larson who handily seems to sell solutions to all your possession problems (no really that guy on the right is serious).

I know what you're thinking: "We see these crackpots every day thinking they're casting demons out and charging for the pleasure." What's particularly infuriating about this Rev. though is that he seems to be actively preying on the mentally ill, the depressed in particular:

3) Have you been sexually violated (raped, incested, molested)?
4) Do you sometimes manifest behavior not consistent with your normal personality?
5) Do you abuse alcohol or drugs to escape painful past experiences in life?
7) Have you ever attempted or contemplated suicide?
8) Are you sometimes overwhelmed with feelings of severe depression and hopelessness?
9) Do you indulge in self-abusive behavior such as anorexia, bulimia, cutting or self-mutilation?
10) Have you experienced life-changing trauma from which you haven't recovered?
12) Do voices tell you to commit illegal acts, blaspheme God, or indulge in immoral acts?
15) Have you experienced emotional or physical abuse from your biological parents?
16) Have you been emotionally or physically abandoned by either biological parent?
17) Have you felt repeated, disabling episodes of rejection or depression?
18) Have you failed repeatedly in significant relationships?
19) Have you failed to experience trust and lasting love from a significant other?

He might as well just write in big letters "FEELING VULNERABLE? SERIOUS PSYCHIATRIC PROBLEMS? THEN COME AND BE EXPLOITED!"

In the page following the questions, some explanations are given for these questions. Essentially it seems to be the same tactic as that of the cult of Scientology: "You are unhappy and there's only one way you could be unhappy - possession by a daemon/thetan. Don't listen to those psychiatrist guys, they're talking rubbish (or if you're a scientologist, they caused the holocaust). There is an excellent way to become happy again! Buy my books and DVDs/give money to my church!"

The good reverend does explain question 8 as follows: "The key to understanding depression is whether it incapacitates normal life for extended periods of time. Reactive depression, due to a difficult life-situation, should be viewed differently from biochemical depression, which a physician can identify when neurotransmitters, such as serotonin, are improperly imbalanced. If there is enough evidence to suggest that the depression has been spiritually triggered, then intervention by inner healing is appropriate."

I'm not quite sure how to take this. He seems to say that there are two kinds of depression, the chemical kind (lets just disregard the whole debate over a serotonin-based aetiology for depression for a moment) and the reactive kind. Is he then implying that the intervention is only required if the depression is reactive? The other obvious question is what evidence could there possibly be that depression has been "spiritually triggered"?

Oh and of course so as to not miss out on any financial hardship due to current economic situations, we also get this gem: "20) Do you consistently experience serious health or financial issues?" I suspect some of the people in financial hardship are there because they've spent $90 on the Rev's "The Complete Guide to Curse Breaking." Then, just to make sure he hasn't missed out anybody, he extends the boundaries of possible problems to "ancestors who committed murder, suicide, or sexual perversion". He's not clear here on what sexual perversion includes, but I'm gonna bet it's quite a wide term. Rev. Larson says "Satan attacks family bloodlines, knowing the principle that the sins of the fathers are perpetrated in perpetuity (Exodus 20:5; 34:6-7). This "right" to attack trans-generationally continues until there is appropriate spiritual intervention." Damn it! God's given Satan rights over my soul and the souls of my children! Curse you Yahweh!

Of course I'm probably saying all this because I'm possessed by a daemon. After all, I am "significantly hindered in prayer, worship, Bible reading and church attendance" (Q13) and there was that time I "asked Satan to take [my] life in exchange for something" (Q21).

What is Psychiatric Illness?

Scientific American just published an interview with the authors of a recent book "The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder." In this book, they, Horwitz and Wakefield, argue that, contrary to popular belief, there is no recent upsurge of depressive disorders (assumedly in the US or Western world) but that changes in diagnosis are causing the appearance of an increase. I'm not going to argue for or against this statement as I don't know enough about it. What really interested me about this article were sentences like the following:

"In fact, we think what has really changed is that since 1980 psychiatry and the other mental health professions have used a definition of depression that conflates genuine depressive disorder with intense, but normal, states of sadness."

This begs an incredibly important question for depressive disorders and psychiatric medicine as a whole. What I mean is who's to say that it's not the old definition of depression that's wrong and the new one that's right? In other words, how do you define what is within the normal variation of human emotions and what is mental illness. Where do you draw the line between sadness and depression.

According to Horwitz and Wakefield:

"Since the third version of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-III) was published in 1980 psychiatry has relied primarily on a list of symptoms for its definition of depressive disorder. So someone who has five symptoms out of a list that includes things like depressed mood, loss of interest in usual activities, insomnia, fatigue, lessened appetite, an inability to concentrate and similar symptoms for as brief a period as two weeks is considered to have a depressive disorder.

"Yet loss events such as a betrayal by a romantic partner, being passed over for a much-anticipated promotion, failing an important test, having a mortgage foreclosed, or discovering a serious illness in oneself or a loved one could naturally lead the same symptoms to arise and endure for a two-week period. When such criteria are applied to the general population, very large estimates of untreated depressive disorder emerge, because one is capturing intense normal reactions to losses as well as genuine depressive disorder."

So it seems that they draw the line at the causes of the emotions. If someone's intense sadness/depression is deemed simply to be a response to external stimuli, such as the death of a loved one, losing a job etc. then the authors think this should not be regarded as mental illness, or at least if the symptoms have not persisted too long. However, if someone displays the symptoms of intense sadness/depression in the absence of any event or cause, they suggest it is a mental disorder.

I think there is great merit to this idea since the presence of an external cause could suggest the possibility of an external cause of betterment. For example, if someone were to lose their job and become "depressed", one could see that perhaps getting a new job may alleviate these symptoms, or perhaps the support of friends and relatives could help people who are grieving. However, there are still problems. It could be argued that an external stimulus could trigger depression which becomes a mental illness in its severity. One still has to draw the line in such cases between what is a normal response to hardship and what is an excessive response and/or mental disorder.

Another way of looking at the problem could be through statistics. If someone's response is thought (if it could be worked out) to be outside a certain number of standard deviations of the mean, it could be deemed mental illness. However, wherever it is drawn, this line can only be arbitrary. Some people think that assessing the levels of neurotransmitters in the brain is the key to diagnosis of mental disorders. Nonetheless, a line must still be drawn between "normal" and "mentally ill" and the line must still be arbitrary, the only difference being that a different symptom is being measured. What is a "normal" level of neurotransmitters and what is a level signifying "illness."

This is not simply an academic argument. Deciding whether someone is simply outside of the mean of human experience or that they are mentally ill determines how medics should deal with them. It is not desirable that people be medicated for something that is simply natural variation between individuals. I don't pretend to know the answer to what should be, but I think it's a very important debate that needs to constantly take place within and without the psychiatric science community.

More Consequences of the Media's MMR Hoax

The BBC reports this week that measles cases in the UK have gone up past 1,000 cases for the first time since the current monitoring method was introduced in 1995. This just as UNICEF is about to announce a "remarkable reduction" in global measles deaths since 2000. The frankly shameful increase in measles cases in the UK has certainly been caused by what everyone's favourite British science journalist, Dr Ben Goldacre calls "The Media's MMR Hoax." Goldacre puts a pretty good case forward for utter irresponsibility by the media in the debaucle.

The graph to the right shows the actual toll such scientific-illiteracy can take on real people in the real world. The infamous Wakefield paper appeared in 1998, but the media campaign didn't really take off til 2001. Looking at the graph, we can see just how immediate the public's reaction was. Within 7 years, measles cases have risen nearly 10-fold! If evidence were ever needed that scientific literacy isn't just a matter for academic debate, this is it. The public's understanding of science and their ability to evaluate scientific stories and articles affects real people in the real world.

Just in case you thought the media might have learnt their lessons though, The Daily Telegraph just had to prove otherwise with an article from Cassandra Jardine arguing that separate individual vaccines as an alternative to the combined MMR should be made available to parents in Britain:

"Plenty of studies have shown MMR to be safe, but Jabs, the support group for parents of children whom they believe to be affected by vaccines, is still being contacted about new cases."

Here Jardine seems to place scientific evidence published in respected peer-reviewed journals on the same level as anecdotal reports from a considerably dubious organisation such as Jabs. Jardine goes on:

"With the illness on the rise, one comfort for parents in this country is that even if a child does contract measles, it is highly unlikely to be fatal."

Highly unlikely maybe, but as was proved in 2006 (sorry for repeating the link), well within the realms of possibility.

"But even though the risk of long-term complications is low, parents in Britain shouldn’t have to gamble with their children’s health."

This is just a ridiculous sentence. Parents in Britain DO NOT have to gamble with their children's health. The MMR vaccine ensures that the child's risks of measles, mumps or rubella infection are vastly reduced. It is only by not having the vaccine that the parents are gambling. I should also add that they are not just gambling with their own children's health, but also the health of any children with whom their children come into contact.

Jardine goes on to complain, backed by Patrick Holversen, that parents should be allowed to choose the separate single vaccines over the triple MMR. Well funnily enough, the NHS has time and time again revealed why it doesn't offer separate vaccines, wait for it, child safety:

"There is no evidence to suggest that separate vaccines are safer than the MMR vaccination, and having single vaccines could put your child at risk of catching the diseases in the gaps between vaccines. The MMR vaccination gives children the best protection against catching measles, mumps, and rubella which are serious, and potentially fatal, diseases."

'Nuff said.

I shan't go any further into vaccines and the anti-vaccinationist morons who seem to be growing in strength, especially in the US because Steve Novella's done a fine job this week in one of his blogs exposing the fallacies of a certain Dr Jay Gordon. Suffice it to say that no, vaccines aren't bad for you.

Britons keeping not just a stiff upper lip...

I've just finished watching Brian Cox on BBC2's excellent Horizon documentary about time. Prof. Cox was recently named by People Magazine (seen via Bad Astronomy) as one of the sexiest men in the world. This and a survey which appeared yesterday lead me to believe that perhaps Britain is getting just plain sexier.

Well in reality the survey doesn't really say a lot, but it is a bit of fun released by the AIDS charity, The Terrence Higgins Trust to coincide with World AIDS day. In response to the current credit crunch, when banks are pulling out of credit, the survey asked British people what their favourite free activity was. It turns out, drum roll please, it's sex! Holy fornication batman! Apparently it even scored ahead of "gossiping with friends, going to a museum or window shopping." Hmmm... I think I know which I'd rather be doing... but I'll let you guess on your own.

In reality, this survey's just silly and trying to bring using condoms to people's minds by pointing out how cheap they are (or even free if you go to family planning and sexual health clinics), but it's a good excuse for a bit of a giggle. I'll avoid any jokes about being low on money and splurging.

Anyways, in other recent sex news, it turns out that having competition increases sperm production in male mice and humans. To be honest, this human study sounds vaguely ridiculous. Subjects were shown 'explicit pictures' either of sperm competition or no sperm competition. What this means in reality is that half the subjects were shown three women (no sperm competition) while the other half were shown two men and a woman (sperm competition). Apparently, there was a significant difference between the two groups in terms of sperm motility.

I don't really see how you could stretch this to saying that competition led to this difference in sperm quality, especially considering the small sample group (~50). Who knows? Maybe if there is a significant effect it could lead to advice for couples trying to have children. Avoid lesbian porn? Perhaps have a threesome? That way you should get the cream of the crop (bedoom tish). Interesting ideas, but if I were you, I'd wait for more concrete studies.

Finally, in related news, patients in Bristol are trying to claim personal injury damages for sperm accidentally destroyed after a freezer broke down. Previously, a judge ruled that the sperm lost was equivalent to hair being cut off by a barber. I think I agree with him. I certainly don't think it can be equated with breaking a bone.

Abortion is BAD... but not as bad as bad science

On Sunday, the Daily Telegraph reported "Women who have an abortion are 30 per cent more likely to develop a mental illness." Television New Zealand went one further with the headline "Study shows abortion not the answer." Predictably, the 'conservative,' 'pro-life' and fundamentalist christians have pounced upon this study saying that a woman's mental state can no longer be used as justification for abortion (as if it were necessary).

So what does the study actually say? The researchers followed the mental health and pregnancy history of over 500 women in New Zealand. They compared women who had terminations to those who were never pregnant and found what they describe as a "small increase" in risk of mental disorders. However, they claim that the increase is 1.5-5.5%, a far cry from the 30% stated in the Telegraph. So maybe this is all just the fault of the overactive imaginations of the media?

I'm afraid not. Although the 30% number seems to have been plucked from nowhere, the researchers certainly have not helped the appropriate conclusions to be drawn by journalists. After thinking for a few seconds, even the most simple-minded of scientists can see that comparing women who've had terminations to women who've never been pregnant does not give you the difference between someone who chooses abortion and someone who chooses to keep the baby. So maybe it's the media just jumped to the wrong conclusion.

Wrong. Unfortunately, the first author of this paper made what I think is a rather irresponsible statement, saying "There is nothing in this study that would suggest that the termination of pregnancy was associated with lower risks of mental health problems than birth." Technically that is true, but that could be simply because women who terminated were not compared with women who went on to birth despite doubts. There is also nothing in the study that would suggest that termination of pregnancy was associated with higher risks of mental health problems than birth.

What's more, the study takes no account of the possible motivations for termination. Pregnancies are terminated for a large number of reasons. For some, one could immediately imagine possible psychological distresses as a result of such a decision. Perhaps if a termination was advisable because the child was likely to have congenital defects or if the mother's health was at risk, the risks of mental health problems might be higher than in a less complex case. I don't know, I haven't done a study, but neither have these people.

It seems to me that if these researchers had wanted to find the answers to the questions they seem to be asking retrospectively they should have: a) found a large number of women who were contemplating abortion for a variety of reasons; b) record those reasons; c) record whether the pregnancy was carried to term or terminated or miscarried or another I haven't thought of and d) record the mental health history of these women for a predetermined amount of time following pregnancy. It's really not that complicated a study to design. I'd be very interested to hear the results.