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Thursday, April 21, 2011

Science & Medicine Round-up

  • Nature has an editorial and a number of articles discussing the current state of and fixes to the PhD system. They're mostly concerned with PhDs in science, technology, and engineering but some of the issues discussed are also relevant for the social sciences and humanities. Trigger warning for grad students and recent PhDs: lots of doom and gloom.
  • In other news in the Depression section, Nature has a good summary of the impact of the current US budget on the different areas of science funding. Summary: bad, but could've been worse. doi:10.1038/472267a
  • The situation in Fukushima is still far from resolved but media attention is declining, as can be seen in the declining number of articles in the major journals. 
    • Nature features a fairly critical interview with the chairman of the World Association of Nuclear Operators, Laurent Stricker. Asked if another disaster could be the end of nuclear power, Sticker replies, "I fear so. As we have seen at Fukushima, an accident in one country has consequences for all nuclear operators elsewhere." doi:10.1038/472274a 
    • Science discusses the impact of Fukushima on marine life and those whose living depends on it. doi:10.1126/science.332.6027.292  
    • In a letter to the BMJ, a Japanese obstetrician reports on the psychological effects of uncertainty and fear about radiation risks for pregant women. doi:10.1136/bmj.d2434 
    • According to WHO officials, the raised severity rating of the Fukushima disaster does not necessitate new public health countermeasure, reports the BMJ. doi:10.1136/bmj.d2491 
  • Drug companies love advocacy groups. Today: anti-smoking campaigners and producers smoking-cessation products. doi:10.1136/bmj.d2430 
  • JAMA reprints an article from 1911, discussing the promises of using sociology for preventive medicine. "The problems of sociology are, in most instances, problems of preventive medicine, and many of the problems of preventive medicine resolve themselves into sociologic questions." Well worth a read. doi:10.1001/jama.2011.335
  • The problem of overdiagnosis in all fields of medicine is the topic of the book, "Overdiagnosed: Making People Sick in Pursuit of Health" by H. Gilbert Welch, Lisa M. Schwartz, and Steven Woloshin, reviewed in JAMA by Leonard Berlin. For STSers there are probably better books out there, but for a general audience and physicians Overdiagnosed might be a good read. doi:10.1001/jama.2011.391
  • Once again, we are "[a] step closer to personalized medicine," according to a JAMA editorial about whole-genome sequencing by Boris Pasche und Devin Absher. doi:10.1001/jama.2011.484
  • An interesting mix of expertise, medicine, politics, and the law is in play in the case of the death of Ian Tomlinson at the 2009 London G20 protests. The BMJ reports on the latest developments in determining if Tomlinson's death was caused by being hit and pushed to the ground by a police officer. doi:10.1136/bmj.d2459
  • Another case of the intersections of law and science is the issue of DNA fingerprinting. In Science Michael Goldman reviews a new book by Sheldon Krimsky and Tania Simoncelli, titled "Genetic Justice: DNA Data Banks, Criminal Investigations, and Civil Liberties." doi:10.1126/science.1204097
  • Vaccinations and their alleged risks continue to be a contested issue, as can be seen in a controversy about an anti-vaccination ad at New York's Times square.
  • Obtaining the lethal substances used in executions is becoming increasingly difficult for the US. The UK government, that has banned the export of these substances, now "[u]urges rest of Europe to also ban export of “execution drugs,” reports Clare Dyer in the BMJ. doi:10.1136/bmj.d2507
  • Germany has been traditionally very cautious about preimplantation diagnostics, implementing a ban in 1990. The BMJ reports that the German parliament will soon vote on limited changes to the ban. The outcome is far from certain. doi:10.1136/bmj.d2473
  • On my bike blog, I have already reported on new research about what keeps a bicycle upright. Now the actual article in Science has been published. doi:10.1126/science.1201959
  • Isabella Rossellini, producer of humorous animal movies, is interviewed in Nature. doi:doi:10.1038/472294a
  • Sleep deprivation leads to riskier decision-making and coffee doesn't help: "stimulants such as caffeine might make sleepy people more alert, they do not improve decision-making abilities." doi:10.1523/​JNEUROSCI.4407-10.2011

Monday, April 18, 2011

Meta-review: Schizophrenia and racism

The publication of Jonathan Metzl's The Protest Psychosis: How Schizophrenia Became a Black Disease has generated a number of reviews. While all reviewers have plenty of praise for his project, there is a discussion about his main argument that the becoming of schizophrenia as a black disease is basically a matter of misdiagnosis because of the psychiatric professions' racism. Some of these reviews rubbed me the wrong way, and this blog post is my attempt in explicating my unease.

Tanya Luhrmann, anthropologists and author of a great ethnography of psychiatric institutions, argues that this argument missing a crucial point: the different rates of prevalence of schizophrenia in different ethnic groups.

If one has a dark skin, one's risk of schizophrenia increases as one's neighborhood whitens, a disturbing finding known as the "ethnic density" effect. The risk of developing schizophrenia among African Caribbeans who have migrated from Jamaica to the United Kingdom is as much as 15 times higher than that among the local whites; the effect holds true for black-skinned Surinamese who have immigrated to the Netherlands.
There is, therefore, a mixture between "being schizophrenic" and "being classified as schizophrenic" in action: Not only are members of racially disadvantaged groups more likely to be diagnosed (Metzl's position; misdiagnosis model); but members of racially disadvantaged groups are more likely to have schizophrenia (Luhrmann's model; racism as risk factor model).

These two explanations are not completely incompatible--Luhrmann clearly acknowledges that misclassification is indeed going on-- but they also don't go together easily. First, if persons from racially disadvantaged groups are indeed at higher risk of having schizophrenia, then one could argue that a higher rate of diagnosis for them just reflects this reality and there is no problem. In this sense, the coming into existence of schizophrenia as a black disorder that Metzl describes could actually be seen as an improvement. Obviously, this is not where Luhrmann and Neely Myers, who reviewed the book on Somatosphere, want to go, but I think this issue has to be addressed.

The underlying ontological and epistemological issue that would help sorting this out is that of the reality of mental illness. Luhrmann's position is based on a position that assumes that schizophrenia exists "out there," without explicating what that schizophrenia is. Is schizophrenia sufficiently defined by its behavioral symptoms listed in the DSM? Is is it an experiential category? Is it a specific kind of "physiology of despair and resilience and [...] individually shaped both genetically and epigenetically," as Neely Myers argues? Aside from this problem, in principle, there is nothing wrong with insisting on the reality of mental disorders, and Luhrmann points out that members of African Caribbean communities in London themselves "attribute their high rates of schizophrenia to the experience of living in poverty with a history of racism and slavery." Dismissing Metzl's misdiagnosis argument as that of a detached liberal academic that doesn't want to acknowledge the devastating effects of poverty and racism appears misguided, though.

Why, for example, do the African Caribbeans mentioned above think of their condition as resulting in schizophrenia and not in terms of a different diagnosis or in non-psychiatric terms? The creation of categories and that of identities go hand in hand, as Ian Hacking has so convincingly argued. Metzl's historical account of the classification of schizophrenia helps us to unravel the creation of an "ecological niche" (Hacking) that not only has allowed psychiatrists to label and institutionalize "angry black men" as schizophrenic, but also allowed disadvantaged communities to think of their social situation in terms of mental disease.[1]

My objections notwithstanding, I think Luhrmann and Myers have pointed out something important when it comes to the conclusions to be drawn from Metzl's analysis. Racism is not merely a matter of the psychiatric profession misdiagnosing certain groups of people. Living in a racist and economically unjust society clearly does something to those affected by it, and dealing only with psychiatry won't make that something go away. To think of the effects of racism primarily in psychiatric terms, however, is no solution either. I hope this debate will continue in a productive manner.

[1] I wonder if those diagnosed with schizophrenia by psychiatrists and their community share the perspective of schizophrenia as a product of racism. Emily Martin's Bipolar Expeditions is very helpful in thinking about the experience of "living under the description" of a mental disorder. 

Thursday, April 14, 2011

Science & Medicine Round-up

  •  Nature has an editorial calling for preparedness for worst-case scenarios, natural and man-made doi:10.1038/472135b
  • Also in Nature, Bart Penders reviews Mark Wohlsen's book "Biopunk" about DIY biologists. doi:10.1038/472167a
  • Douglas Fox provides a comprehensive and comprehensible overview of the experiments with transcranial direct-current stimulation (tCDS) for cognitive enhancement. doi:10.1038/472156a
  • From the category of "unexpected side effects," Nature reports that the "Libyan uprising may boost bluefin tunadoi:10.1038/472169b 
  • The nuclear crisis in Japan continues to be covered in the major journals. 
    • Nature news reports on the political struggles about the future of energy generation in Japan. doi:10.1038/472143a
    • A Nature editorial discusses the information management and data publishing policies of the Japanese authorities, arguing for "better data, in more user-friendly forms, and more sophisticated analyses." doi:10.1038/472135a
    • Lack of data and data overload at the same time about radiation exposure in Japan is topic of an article about the Fukushima health risks in Nature news. doi:10.1038/472013a
    • Linking increased cancer incidence in the vicinity of (non-failing) power plants has been and continues to be a tricky and controversial issue, as can be seen in a debate about a US study by the Nuclear Regulatory Commission and the National Academy of Science. doi:10.1038/472015a  
  •  Historian of science and technology, David Kaiser, uses the history of MIT to discuss the role of private and government funding for research and education. His conclusion is that "[r]ather than focus on the source of cash — public or private — we must remember to scrutinize the inevitable strings attached." doi:10.1038/472030a
  • The ozone hole seems to be beginning its recovery, earlier than expected, says an article in Science. doi:10.1126/science.332.6026.160
  • Instead of increasing the number of Graduate Research Fellowships, the NSF is increasing the stipend for grant recipients in order to "keep the program competitive." doi:10.1126/science.332.6026.162-b
  • In Europe, last summer was hot, really hot. So hot actually that despite an increasing incidence of "mega-heatwaves ... the likelihood of an analog over the same region remains fairly low until the second half of the 21st century." doi:10.1126/science.1201224
  • Once again, there is a controversy about the potentially dangerous side-effects of two new anti-diabetes drug, known  as Byetta and Januvia. A paper has been published but withdrawn after complaints from the drugs' manufacturers. doi:10.1136/bmj.d2335 
  •  A UK government advisory body has argued for making preconception genetic testing more widely available. Critics, however,  argue that "[p]reconception screening is the most dangerously eugenic application of genetics: unlike prenatal genetic testing, where there is a severe cost (ie the termination of a wanted pregnancy), preconception screening offers apparently nothing more than information, which will only later severely affect the person’s life chances and the whole society." doi:10.1136/bmj.d2324
  • Fresh from the "Duh" department, BMJ reports that "Listening to patients' narratives can help improve quality of psychosis care." doi:10.1136/bmj.d2245 
  • Same department, different topic: "Use of bombs in populated areas is having a devastating effect on civilians, say reports." doi:10.1136/bmj.d2161  
  • "The art of remembering" and mnemotechnics was invented in Ancient Greece and is one topic of Joshua Foer's book "Moonwalking with Einstein: The Art and Science of Remembering Everything." Foer, himself being a former memory artist, interweaves information about the psychological research on memory with stories about contemporary "memory artists" and "mental athletes." doi:10.1038/472033a
  • Finally, PLoS one reports on the "rubber voice" (analogous to the rubber hand paradigm) phenomenon, "in which a stranger's voice, when presented as the auditory concomitant of a participant's own speech, is perceived as a modified version of their own voice."doi:10.1371/journal.pone.0018655

Tuesday, April 05, 2011

From the STS Journals

What's new in the STS journals?

  • Theory, Culture & Society  has a review of Giorgio Agamben's most current book, The Signature of All Things. Unfortunately, Cornell's subscription to the journal has a 1-year moving wall, so I can't say more. doi:10.1177/0263276411398277 
  • The current issue of Social Studies of Science has several interesting article.
    • Dimitris Papadopoulos, who was crucial in turning me from a psychology student into an STSer, writes about "Alter-ontologies: Towards a constituent politics in technoscience." After summarizing four approaches to the relation between science and politics -- formalist, participatory, assembly, grounded -- and discussing their problems and shortcomings, Papadopoulos develops the notion of "alter-ontologies" and "constituent politics" as an alternative. Using the case of AIDS activism in the 1980s, Papadopoulos how the creation of new materially grounded "forms of life" based around the notion of justice and emergent forms of everyday experience in the 1980s were a necessary antecedent to the forms of politics focused on expertise and inclusion that Steve Epstein has described. I highly recommend reading the whole article. doi:10.1177/0306312710385853
    • Daniel Nevon discusses "genomic designation," the definition of a medical category based on specific genetic variations that is not dependet on the prior existence of a phenotypically defined disease category. doi:10.1177/0306312710391923
    • Harry Collins explores the realm between language and practice and argues that "language is, and must be, more central than physical practice in individual acquisition of practical understanding. Only this makes it possible for there to be a sociology of scientific knowledge, for there to be scientific specialities, for there to be a division of labour in society and for there to be a society that is more than a set of narrow and isolated worlds." doi:10.1177/0306312711399665
    • Collins's work is also the focus of Park Doing's review essay on "Tacit knowledge: Discovery by or topic for science studies?" By discussing Collin's latest book on "Tacit and explicit knowledge" and the re-issue of Polanyi's "Tacit Dimension, Doing asks "what tacit knowledge means to the field of science studies." doi:10.1177/0306312710397690 
  • Social History of Medicine reviews a number of interesting books:
    • David Herzberg reviews Laura Hirshbein's contribution to the history of depression in the US in the 20th century, titled American Melancholy: Constructions of Depression in the Twentieth Century. Much has been written on this topic, but Herzberg points out two specific contributions of Hirshbein: the role of professional psychiatrists in pushing the disease and "new insight into how that expansion gendered depression such that it became a ‘women's disease’." doi:10.1093/shm/hkr015 
    • Christine Leuenberger concludes her review of Paul Stepansky's account of the rise and fall of psychoanalysis over the course of the 20th century as follows: "As an insider and yet an outsider, Stepansky has a unique, rare and valuable perspective on the social history of American psychoanalysis. But his message that psychoanalysis has yet to become a science will not always be welcome. However, if psychoanalysts do not heed this call for change, the profession is likely to end up like railway surgeons and psychological mediums—a footnote to the history of professions." doi:10.1093/shm/hkr016
    • Another work about psychiatry is Jonathan Metzl's The Protest Psychosis: How Schizophrenia Became a Black Disease, reviewed by Priscilla Wald. Metzl's put the psychiatric category of schizophrenia in the context of the Civil Rights Movement and racism and "how anxious responses to the dramatic transformations enacted by the Civil Rights Movement translated into a racist redefinition of schizophrenia as a disease of angry black men." doi:10.1093/shm/hkr027   
    • Gordon Shepherd, himself a prominent neuroscientist and insider to the history he is writing, has written an account of "Creating Modern Neuroscience: The Revolutionary 1950s", reviewed by Charles Gross. Despite some deficits in specific topics, Gross praises the book as "required reading for virtually everyone in the field." doi:10.1093/shm/hkr020
  • Not in the journals, but definitely worth reading is this interview with the anthropologist Marilyn Strathern.

    Saturday, April 02, 2011

    Science & Medicine Round-up

    Time for the second volume of what I've found notable in my RSS feeds:

    • Nature has several articles on nuclear energy and the events at Fukushima. Amongst them, Mark Peplow looks a "Chernobyl's legacy," asking if there lessons to be learned from the 25 years of clean-up efforts that can be applied once the immediate emergency in Fukushima has come under control. He also focuses on the research done on the long-term health effects of the Chernobyl disaster. doi:10.1038/471562a
    • A different research effort on radiation risks was the work done by the Radiation Effects Research Foundation in the aftermath of the nuclear attacks on Hiroshima and Nagasaki, portrayed by Jocelyn Kaiser for Science. doi:10.1126/science.331.6024.1504
    • Colin Macilwan questions the judgment of many scientific experts in the aftermath of Fukushima: "the collective impression has been unconvincing: defensive, selective, condescending towards public fears and, in my view, ultimately counterproductive. Their combined message seems to have been: don't worry, things are under control, and Fukushima is not Chernobyl." Macilwan points out three main factors that have contributed to the disaster in Japan, but that are also wide-spread in nuclear power plants around the world: the amassing of several reactors at one site; the inherent safety problems of pressurized-water reactors; and the practice of storing spent fuel rods on-site. doi:10.1038/471549a
    • Spent fuel rods are also the focus of an analysis in Science. Eli Klintisch is trying to figure out what exactly went on in the storage tanks at the #4 reactor at Fukushima and discusses "concerns about U.S. spent nuclear fuel pools, which are thought to be packed more tightly than those in Europe or Asia." doi:10.1126/science.332.6025.24 
    • Another article in Science gives a brief overview that the Fukushima disaster has had on nuclear policy in countries around the world. doi:10.1126/science.331.6024.1502 
    • The current president of Arizona State University, Michael M Crow, advocates a radical restructuring of the National Institutes of Health (NIH) in an article in Nature. He argues that spending 30 billion dollars per year on basic biomedical research is problematic when looking at the limited impact that research has on clinical outcomes and the health of society. Instead of focusing on translational research, Crow suggest that the NIH should be based on three pillars: a "fundamental biomedical systems research institute" that would include sociological, behavioral and environmental perspectives in addition to the typical biomedical sciences; an institute focused on health outcomes, again combining "behavioural sciences, economics, technology, communications and education as well as [...] fundamental biomedical research."; and finally "a 'health transformation' institute, should develop more sustainable cost models by integrating science, technology, clinical practice, economics and demographics." doi:10.1038/471569a
    •  Science has interesting material on and by Steve Wise, founder of the Nonhuman Rights Project. The projects goals is to "fil[e] lawsuits on behalf of intelligent animals such as chimpanzees and dolphins in an attempt to convince courts that at least some nonhuman animals meet the requirements of legal personhood and should be accorded certain basic rights." 10.1126/science.332.6025.30  (news focus article), doi:0.1126/science.332.6025.28  (Steve Wise on "The rise of animal law")
    • Saleem H. Ali favorably reviews sociologist and Max Weber scholar Toby Huff's book "Intellectual Curiosity and the Scientific Revolution A Global Perspective," an investigation into "Western scientific superiority." 10.1126/science.1204095
    • Science has a special issue, celebrating the 40th anniversary of the National Cancer Act. An introduction by Paula Kiberstis and Eliot Marshall provides an overview of the issue. doi:10.1126/science.331.6024.1539-a
    • The BMJ reports on the launch of a new European online register that will provide " information on every clinical trial taking place in 30 European countries." doi:10.1136/bmj.d1994

    Monday, March 21, 2011

    Science & Medicine Round-up

    [This is a new feature in this undead blog: I'll post quick notes about current articles that popped up in my Google Reader. I used to cover these articles on Twitter, but it has become increasingly annoying to limit my summary/comments to 140 characters. So we'll see if this is going to be the better.]

    • Nature strongly warns that a recent attempt of Congress to overturn the EPA's assessment that climate change is a "threat to public welfare" will lead "Into Ignorance." doi:10.1038/471265b
    • The BMJ reports that the human rights group "Physicians for Human Rights" accuses US psychiatrists in the case of Bradley Manning are "complicit in torture"  doi:10.1136/bmj.d1792
    • Brian Wynne sent a letter to Nature, criticizing the British chief scientist's false dichotomy between science and pseudoscience: "Scientific knowledge should inform public issues, not define them." doi:10.1038/471305b
    • Nature features a review of "Unnatural: The Heretical Idea of Making People" by Philip Ball. The reviewer, Chris Mason, considers myths and literature like Goethe's Faust or Shelley's Frankenstein as irrational impediments to the realities of contemporary biotechnology, but nonetheless asks scientists to take them seriously: "For scientists, clinicians and biotechnology business people, understanding deep-rooted ideas, however irrational, is vital for successful dialogue with the public." doi:10.1038/471297a