Why Scientists Often Have To Repeat Their Studies

Harvard sleep expert, Dr Charles Czeisler, has spent about $3 million over the years showing that doctors who don’t get enough sleep make mistakes on the job. Yet long shifts for interns and residents are a staple of hospital culture, and, as anyone’s welfare in hospital might be at stake, one might have thought it important to rectify excessive hours.

But it has taken Czeisler the best part of three decades getting the medical establishment to acknowledge it, and still the rules governing doctors’ working hours remain hard to change. When he gave evidence that workers on rotating shifts at a chemical plant suffered from disrupted sleep, the medical establishment said doctors were different. Czeisler’s data “was dismissed out of hand”. They kept using the same argument even when tests had refuted it. When he published results showing that physicians’ 24 hour plus shifts contributed to car accidents and attention lapses at work, some said it might be true—but not for them!

In 2008, the Institute of Medicine issued guidelines calling for limiting interns’ and residents’ shifts to 16 consecutive hours. Eventually, authorities did cut back to 16 hours, but only for interns. Czeisler had studied interns, so the establishment claimed they had seen no evidence for residents! Now Czeisler is having to research whether residents’ performance also is affected by lack of sleep. “I can’t believe we have to do this extra study.”

Science cannot accept a single study as definitive proof of its findings. Some error could have been made or some bias have been inadvertantly built in, and any such mistakes need independent repetition of the study to discount error. Repeating a previous study which confirms it multiplies the reliability of both studies. Moreover, this case on the working hours of hospital doctors shows another reason why some research has to be repeated—a refusal to act on well established scientific work for political or economic reasons, or simply reasons of will.

Daniele Fanelli, an expert on bias at the University of Edinburgh in Scotland, points this out. “People want to draw attention to problems” rather than aiming to find something new, especially when important policy decisions are being delayed by procrastination or lack of political will. Experts have to prove some things again and again to get decision makers to act. Some might object that it is not a scientist’s job to persuade decision makers, but it is the duty of all of us to do it, surely, especially when the proof is there that lack of action is costing lives.

“There are some subjects where it seems you can never publish enough”, says Ronald J Iannotti, a psychologist at the National Institutes of Health. “Think about the number of studies that had to be published for people to realize smoking is bad for you.” Almost 50 years after cancer and lung disease were first linked to smoking, work continues to be published because the extent of the problem is still challenged, not least by those who make money out of selling tobacco products. A detailed analysis in the Canadian Medical Association Journal has had painstakingly to lay out that secondhand smoke in cars is bad for children. Many people will say that is too obvious to merit funding, but cigarette vendors, and those still addicted to smoking evidently still need reminding that harming the health of kids is not excusable—it is wrong.

The Ig Nobel Prizes are spoof awards to mock improbable research. One winner was a study that found nose picking was common among teens. Some might consider the research is not only pointless but in bad taste(!), yet it can hardly be said to be obviously so, and finding that it is common has health consequences. Staphylococcus aureus is a bacterium that is getting highly dangerous through its growing resistance to antibiotics (MRSA).

Iannotti says, even if initial findings seem self evident “you still need to establish the facts. That’s how science moves forward—incrementally”. Plainly not every study is equally worthwhile, and some studies approved for funding might be bad decisions, but the danger is that an over zealous aim to cut back on wasteful research will succeed only in cutting out useful research.

It would be far more useful to cut back on the excessive rewards given to bankers for not doing much at all, and to stop giving them even bigger rewards for wrecking the national economy. It is far more costly and ridiculous to reward useless bankers than it is to hand out funds for occasionally poorly thought out scientific studies. Bankers reward themselves with millions of dollars each a year. Many useful studies cost buttons by comparison, but no one seems to object to us giving megabucks to greedy bankers for doing little of merit.

People of Color Will be the US Majority by 2042

America's Tomorrow from PolicyLink on Vimeo.

The faces of America’s children are changing and many believe that the still white majority population and the political leaders do not see themselves in these new faces. By 2042, most Americans will be people of color. Already, California, Texas, Hawaii, New Mexico, and DC have more people of color than whites. And today, nearly half of all children are kids of color. If they don't succeed, the nation won't succeed.

While policies are looking at slashing Medicaid and cutting education budgets, the future generations of Americans are paying the price. There was a time not that long ago when we listened to the voices of tomorrow and invested in our national future. The GI Bill, affirmative action, and strong unions all helped the “Greatest Generation” establish a potent and stable middle class—and gave their children tangible hope for the future. But we aren't doing that any more. Too many who have achieved success for themselves now want to pull up the ladder behind them.

People of color are disproportionately saddled with high poverty rates, failing schools, poor health, and under-invested communities. But white families that rely on the public education system struggle with these nationwide school budget squeezes. White college students are graduating with six figure debt. White workers who need public transit to get to their jobs are hurt by the lack of forward thinking investment. And white entrepreneurs are having to spend money giving new hires the job skills a strong public school system should offer. It's no way to run a country.

This study implies the need to promote equity—just and fair inclusion. The next generation of Americans needs to be supported and encouraged, regardless of their skin color. Economists and community leaders are now seeing this idea of equity is no longer a moral battle. It will become imperative in order for America to succeed on an economic level.

PolicyLink, an American research institute which works to advance social and economic equity within the United States has released their new report titled Prosperity 2050. The report shows how, over the next 30 years, the face of America will be changing.

PolicyLink’s CEO and founder, Angela Glover Blackwell, said that the success and the future of the United States will depend on the success of people of color. She believes that equitable policies, in light of this new information, will become an economic imperative more so than a moral one. The current discrepancies of social status and wealth between the different demographics could be harmful to the future of the United States.

As a nation, we can see our future and it is captured in the hopes and dreams of a 5-year-old Latina girl and a 7-year-old African American boy. Our success depends on theirs.

PolicyLink was founded in 1999 and works on the mission of Lifting Up What Works. They believe that those people that are facing the hardest challenges, mainly the low-income and colored communities, are the most important in finding and creating solutions. In areas such as jobs, public schools, and affordable housing, PolicyLink believes that equity must be behind all federal, state, and local policies.

Who Would Want to be a Teacher in Walker’s Wisconsin?

Craig A Olson, a University of Illinois professor of labor and employment relations, and an expert in employment relations and labor economics, shows the salaries of Wisconsin teachers have fallen behind changes in the cost of living as well as wage growth in the private sector over the last 16 years.

By comparing public data from 1995 to 2009 of the earnings of an average college graduate employed in the private sector in the US versus the earnings of an average college educated teacher in Wisconsin, after accounting for inflation, and not counting fringe benefits, Olsen found:

1. in Wisconsin, the average teacher’s salary declined by 10 percent,
2. the average private sector college graduate’s weekly earnings increased by 10 percent.

In 1995, the average college educated private sector worker in the US earned 17 percent more than a Wisconsin teacher, in 2009, this gap had increased to 36 percent. Olson commented:

Not only did Wisconsin teachers not keep up with inflation, their earning power also fell behind their private sector counterparts.

Many teachers accept that they have some security of employment compared with many in private industry, and have school holidays—though they seem a much better perk than they are because the have to spend more time preparing for the academic semester than many onlookers think. So they are content not to be paid the same salary as their fellow graduates in the sometimes riskier private sector, but this work shows that their wages are getting progressively worse, with no added benefits to compensate for the decline.

Governor Walker argued that Wisconsin public employees should be required to pay higher premium co-payments to match the higher co-payments paid by employees in the private sector. In Illinois, the average inflation adjusted premium for a family health insurance policy for Illinois teachers increased from $5,758 to $10,905 from 1993 to 2008. Health insurance premium costs for the private sector also have risen sharply during that time, increasing from $5,742 in 1999 to $13,770 in 2010, adjusted to 2009 prices.

But typically, when premiums have gone up the most, teachers, through their local unions, accepted lower salary increases or agreed to higher teacher health insurance premiums when compared to districts that faced smaller increases in premiums. And Wisconsin teachers did protect their health benefits when premiums were rising rapidly… by accepting lower wage increases.

Olson thinks that Walker’s budget bill will have ill considered consequences. While these changes will save Wisconsin school districts some money in the short term, he thinks it will have an adverse impact on the quality of the state’s teacher workforce:

My rough calculations of the changes in employee pension and health benefit contributions required under the proposal suggest the changes will cost the average Wisconsin teacher about $5,000 in total compensation. This reduction in total compensation is equal to about 10 percent of the salary for an average Wisconsin teacher. Since salary increases under the bill are limited without a voter referendum to changes in the cost of living, teachers will have great difficulty negotiating higher pay to offset these higher contributions. Obviously, it will make it more difficult for Wisconsin to attract high quality young adults into teaching. What parent in Wisconsin would encourage their child to become a teacher given the trends of the last 16 years and Governor Walker’s proposal?

The cause of the Walker attack is supposedly the deficit. And whose deficit is it? Clinton had a virtually balanced budget, but the aim of Republicans is to stiff the poor to give the rich more wealth. Theft from the poor is the source of the deficit, most obviously the manufacture and sale of junk bonds and the accompanying accumulation of banking bonuses in the so-called banking crisis. Banks now are back to their old tricks, and so Joe and Jane Public are forever coughing up their hard earned moolah for the benefit of the already sickeningly rich. Hillary Clinton tells us the US is losing the information war. Without proper education, the country will nosedive into the trough. The pigs at the top already have already had their nose in it for the last thirty years. If many Arabs, every American’s favorite bogeymen of the hour, can evict their corrupt leaders, maybe it is time smart Americans did.

Cooperation and Monitoring to Deter and Punish Free Loading Works Best

The default assumption of evolution is that each individual animal follows only its own interests, and so cooperation in more than small groups is impossible because free riders take advantage of the others to enjoy the benefits without contributing anything, or as much, to the joint venture. Yet, human beings do cooperate, and field studies show that many communities are able to manage their commons—woodland, pasture, fishing. They manage to do it by combining a degree of cooperation with monitoring free riders to deter them.

Researchers, Professor Michael Kosfeld, Devesh Rustagi and Professor Stefanie Engel, studied a forest commons management program of pastoralists in Ethiopia. They recorded the degree of conditional cooperation in a group—the proportion of members willing to cooperate provided that others cooperate too. They found that groups differ widely in their share of conditional cooperators, from 0 percent to 88 percent. When conditional cooperators were a small proportion, not surprisingly, many were free riders. Presumably, this amounted practically to free exploitation of the resources.

Statistical analysis showed that the groups with more conditional cooperators were more successful in managing their forests, as measured by the number of immature trees there were per hectare. Looking into this further, the researchers investigated what the groups actually did to guard against free riding. They measured the time spent in monitoring the forest.

Groups with more conditional cooperators not only cooperated more but also monitored more by patrolling the forest to detect and deter free riders. With 60 percent conditional cooperators, a group spent on average 14 hours more per month monitoring than a group without any conditional cooperators. It shows that conditional cooperators spend time not just helping each other but also trying to stop free riders. Professor Kosfeld said:

Our findings fill a long standing gap between field and laboratory studies on human cooperation.

A positive correlation between conditional cooperation and costly monitoring sheds light on the evolution of human cooperation. The theory of gene culture evolution predicts greater cooperation in groups which enforce cooperation by deterring or punishing free riders. Rustagi explained:

The results yield important policy implications for the governance of human collective action. Because humans differ in their motivation to cooperate, an effective solution to commons problems should not be based on incentives for purely self regarding individuals alone but needs to explicitly take into account the complex interplay of heterogeneous motivations and behavioral norms to cooperate voluntarily.

This circumlocution must mean that free riders ought to be deterred from having the benefits of the cooperation of others or somehow punished for it. What can that mean in our modern societies, however? Are the so called benefit scroungers to have their benefits withheld, as the UK Con-Dem government are threatening, so that they have to starve, beg or turn to thieving to live? Or do the cooperators accept that people who are willing or are only able to live at a sustenance level nevertheless have the right to life without being starved to death. Earlier human societies always let the poor, aged, and disabled use common heath land, and a commandment in the Jewish scriptures (the Old Testament of the Christians) was to leave a portion of a field to be picked by the poor. No decent society has ever let people starve in the midst of surplus.

Does it mean then that the very rich, who pay others to do their work and are able to do so by taking much more than their fair share of society’s output, should be punished for being greedy and selfish while others have to work for their share? These wealthy people surely are the latter day free riders of our society. Mostly, they have done nothing themselves to advance society. They are where they are because some relative, a father, grandfather or perhaps uncle, who did something useful and successful, have left them with money and possessions that they have never earned themselves, but yet that they insist is rightfully their own, or nowadays by voting themselves huge compensation packages and bonuses. They are the free riders of today, and they are the ones who should be rightfully punished by society.

By far the easiest way to punish them, and to allow the ones in society who do the work to benefit, is to tax the rich at a suitably punitive level, and to distribute the money in social wages, that is to say, better social services like health and education, services that everyone in a decent society should expect to get free when they need it. Everyone will be freely educated when they are young, will be freely treated when they are ill or injured, and will be freely cared for as old people.

That is a society in which cooperation works, in which the real scroungers, the free loading rich are benignly punished by removing some of their unearned wealth and giving it to the poor who at present cannot afford many of the basic things in life. It has the benefit for the wealthy too, the people who still own the factories and banks, of letting people consume, for it is out of consumption that the free riders take their surpluses. A proper civil society is called civilization, and harks back to the sort of societies we used to have albeit on a smaller scale. It is human and humane. Let’s do it.

Americans Favor Federal Research Funding on Science and Medicine

Research!America commissioned a national poll which found most Americans (58%) would vote for a candidate who wanted higher federal spending on job creation and federal health research funding. 91% of Americans think research and development (R&D) is important to their state's economy, and 71% said investing in health research is important for job creation and economic recovery.

Despite strong public support for research funding, the poll found that 53% are not well informed about the views of their senators and representatives on medical, health and scientific research. Mary Woolley, president and CEO of Research!America said:

Our poll findings show that Americans understand very clearly the connection between greater investment in research and economic growth and job creation, yet too few know their candidates' views on research. I urge all Americans to find out where their candidates stand on these important issues.

88% of Americans said it is important for Congress to work on a bipartisan basis to research to make health a top national priority. Research!America's chair, former Illinois Congressman John Edward Porter said:

Research investment is absolutely essential to America's future—for our health and our economy—and it's essential that candidates for Congress understand this. Each dollar invested in research produces more than double that amount in economic output. Americans deserve leaders in Congress who will work together to achieve sorely needed results for our nation's health and economic challenges today and in the future. Medical research, science and innovation are investments we simply cannot afford to postpone.

The poll also found:

• 87% think a good use of tax dollars is military investment improving health for service members and veterans
• 84% say the US should work to improve health globally through research and development
• 88% think basic scientific research should be supported by the federal government
• 87% say he US should adopt the aim of other countries to spend 3% of GDP on research and development
• 74% say US competitiveness and future economic prosperity depends on education and training in science, technology, engineering and math
• 84% say prevention and wellness reduce health care costs, and 77% say research helps solve these rising costs
• 70% favor federal funding for research using embryonic stem cells
• On balance, Americans favor speeding up the time it takes the US Food and Drug Administration to approve drugs: 42% say is too long, 12% say not long enough and 28% say it is about right.

The increasing commercialisation of science

The British Medical Journal reports that increasing commercialization of science is restricting access to vital scientific knowledge and delaying the progress of science. The scientific community is reacting to the increasing commercialization of science. Varuni de Silva and Raveen Hanwella, from the University of Colombo in Sri Lanka, argue that copyrighting or patenting medical scales, tests, techniques and genetic material, limits the level of public benefit from scientific discovery.

For example:

• Many commonly used rating scales are under copyright and researchers have to pay for their use.
• Extreme commercialization of science can also lead to patents on medical procedures and techniques. However, the American Medical Association recently concluded that it is unethical for physicians to seek, secure or enforce patents on medical procedures.
• Some genetic tests also carry patents, which prevent other laboratories from doing the test for a lesser cost. Earlier this year, a New York court ruled that patents held by Myriad Genetics for the diagnosis of mutations in the BRCA1 and BRCA2 genes—linked to breast and ovarian cancer—were unconstitutional and invalid.

The fundamental philosophy of Western science is sharing knowledge, which is why all genome sequences generated by the human genome project have been deposited into a public database freely accessible by anyone, while organizations such as the National Institute of Health and Wellcome Trust insist on open access to publication resulting from research funded by them.

While patenting is a useful tool for protecting investments in industry, the authors write:

We need to rethink its role in science. Although those who consider science as a commodity are willing to invest in research and development, much medical research is still carried out by non profit organizations using public money. It is only right that such knowledge is freely shared. This is possible because academic scientists still consider the prestige of discovery more important than monetary reward.

UM Studies Support National Health Programs

A University of Michigan (UM) study of workplace wellness programs, in a Midwest utility company, showed it pays to keep employees healthy—it saved $4.8 million over nine years—the program cost $7.3 million and it saved $12.1 million. Dee Edington, director of the UM Health Management Research Center and principal investigator, said the findings are good news for companies looking to implement wellness programs. Well, by the same token, isn't it good news that Obama has brought in the means for ensuring that the whole population stays healthier than it is?

The UM study showed wellness programs work long-term, even though the employees who participated aged during the study, and it showed that those who participated throughout benefited most. Companies are realizing that insurance plans to care for sick employees must include wellness plans to keep healthy workers healthy. Summing up the findings among employers, Edington said:

Employers want a benefit plan that will take care of sick people but also keep your healthy people healthy and working.

Another UM study found that the pressure to keep their jobs in times of high unemployment is stressing out hundreds of thousands of American workers. Workplace stress is estimated to cost US businesses about $300 billion a year through absenteeism, diminished productivity, employee turnover, and direct medical, legal and insurance fees. About 75 percent of Americans list work as a significant source of stress and more than half say their work productivity suffers due to stress.

But companies can benefit from alleviating workplace stress, and possible violence, among workers by providing complementary alternative benefits. Cindy Schipani, professor of business law at Michigan's Ross School of Business, said:

It would seem that a healthy, less stressed and collegial work force would be less prone to resolve conflicts by violence. Not only might stress reduction contribute to a more peaceful society, reduction of employee stress together with the promotion of good health may positively affect the bottom line.

Schipani and Ross School colleague Norm Bishara did a best practice study, looking at companies on the Forbes magazine list of the “best companies to work for” that offer complementary alternative benefits, above and beyond traditional benefits that create value in the workplace by implicating employee stress reduction and positively impacting health.

Complementary alternative benefits may include:

• flexible work hours and working from home
• employer-paid health care premiums
• subsidized health care classes and health club memberships
• onsite fitness centers and medical and dental clinics
• paid leave time and special services for new parent employees
• laundry and dry-cleaning services, valet parking and grocery delivery
• discounted tickets to after-hours social activities, such as movies, plays, museums, sporting events and amusement parks.

Companies on the Forbes list that offer generous complementary alternative benefits enjoy a significant reduction in employee turnover, compared to the industry average. The average cost savings for the firms examined as a group was about $275 million in 2007. Bishara, assistant professor of business law and business ethics noted:

From a pure business perspective, complementary alternative benefits are attractive because reducing stress and, therefore, reducing costs associated with things like absenteeism, sick time and premature turnover, can increase profits.

Benefits accruing to the employer were:

• lower employee turnover
• higher worker productivity
• reduced employee health care costs
• healthier and less stressful lifestyles for employees
• a sense of community among workers

Most of the actions and benefits here are specific to the employer, but if they work across large companies, it makes sense to allow them to work across society:

In addition to improving the lives of their employees and benefiting shareholders, providing employees ways to reduce stress and promote health may also have a positive impact on society.

Schipani

Someone healthy enough to work could still cost an employer more than $4,000 annually in unnecessary health care costs. It makes sense for employers to reduce their own costs by supporting health benefits provided by the federal government, and competing then on making their workplace attractive to the best workers.

The University of Michigan also looked at how metabolic syndrome (MetS) and associated chronic disease can cost employers up to $5,867 annually in health care, pharmacy and short term disability, compared to $1,600 for a healthy worker. MetS is a collection of health risks that includes body mass index, cholesterol, glucose, blood pressure and triglycerides. The study was designed to determine the relationship between MetS and disease among employed adults. Health risk assessments were given to 3,285 employees in a Midwestern manufacturing company in 2004, and again in 2006. They hoped to determine whether employees with MetS would develop one of five chronic conditions—heart disease, diabetes, chronic pain, heartburn, or arthritis—associated with MetS.

Workers with MetS were significantly more likely to report arthritis, chronic pain, diabetes, heartburn and heart disease. If someone had MetS in 2004, they were much more likely to develop one of the associated chronic conditions by the second test in 2006. Study author, Alyssa Schultz, says workers in the study were just as likely to develop heart disease and diabetes as the general population. People in the general population with MetS are known to be more likely to develop health problems such as heart disease and diabetes without health intervention, but this is the first time the link has been studied and shown in working populations.

This finding challenges the supposed “healthy worker” effect that working people are healthier and more insulated from disease than the unemployed. Schultz said:

People with MetS cost employers money, but people with MetS and disease cost a lot more. It shows disease is an issue for corporations and other organizations, and they need to take action to help employees stay healthy.

A prevention and intervention program for at risk workers can cost as little as $150 a year per employee, according to the paper.

The important thing is to catch employees who have the risk factors before it escalates to a disease state. Keeping people healthy is much wiser then treating the illness or disease after it occurs.

It leads to improved vitality and quality of life for individuals, and cost avoidance for corporations in the form of lower health care, pharmacy and short term disability costs. Surely it follows, for employers as well as the employed and unemployed people who will come into the workforce when there is work available, that it must be good news if the general health of the population is improved by a federal health scheme. With all this plain evidence garnered directly from industry, is there so much irrational opposition to health care in the US, from both sides, ordinary people, and captains of industry.