Monthly Archives: February 2017
Meet “Handle”, the kind of robot we only dreamed about as kids (well, if you’re as old as I). It’s just now been introduced to the world by Boston Dynamics, and the YouTube notes say this:
Handle is a research robot that combines the efficiency of wheels with the versatility of legs. It stands 6.5 ft tall, travels at 9 mph and jumps 4 feet vertically. It uses electric power to operate both electric and hydraulic actuators, with a range of about 15 miles on one battery charge. Handle uses many of the same dynamics, balance and mobile manipulation principles found in the quadruped and biped robots we build, but with only about 10 actuated joints, it is significantly less complex. Wheels work efficiently on flat surfaces while legs can go almost anywhere: by combining wheels and legs Handle can have the best of both worlds.
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Some time ago I related a frustrating conversation I had with one of my relatives, an intelligent and educated person, who however holds onto what I consider hardly rational views not just in politics (where there is usually ample room for disagreement), but also about conspiracy theories, and more broadly the nature of the world. Recently, I’ve done it again. This time spending days on and off having a conversation via social media with a person I’ve never met and will never likely meet. Let me tell you what I learned from it.
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Liberal MP David Coleman plans to introduce a private member’s bill to bring in fixed, four-year terms for the House of Representatives. Currently, our federal lower house is elected to serve up to three years. As Coleman notes:
Since Federation … the average term has been a little more than two-and-a-half years, as prime ministers have wide discretion to call an election at a time of their choosing.
The House of Representatives is the only lower house chamber in the Australian parliamentary system with non-fixed three-year terms.
In March 2016, Queenslanders voted in a referendum to adopt fixed, four-year terms for members in the state’s lower house. Although the result could hardly be described as a landslide endorsement (53% yes; 47% no) the victory is a salient message to those in the federal parliament. People are likely to vote for longer parliamentary terms. They want fewer elections and are dissatisfied with politics.
Pros and cons
In Queensland it was obvious proponents of longer parliamentary terms relied on voter dissatisfaction. They claimed, among other things, fewer elections would:
- “prevent summer holidays being interrupted by an election”
- remove uncertainty for “families who like to plan their travel”
- “for regional and north Queensland, it means the election period is taken out of the wet season”.
To be fair, arguments in support of longer parliamentary terms have merit. They include benefits such as:
- certainty about election dates
- removing the strategic and political advantage of snap elections
- cost savings due to fewer elections
- confidence in the business community
- improvement in public policy outcomes and government decision-making
- consistency with the states and territories.
The chairman of the Australian Institute of Company Directors and boss of the Australian Chamber of Commerce and Industry claim longer terms create stability for business.
Naturally, there are also arguments against extending parliamentary terms. These might include:
- fewer democratic opportunities and loss of voter control
- more complacent governments and politicians
- politicians’ job security ahead of voters’ rights
- no guarantee of better planning and policy.
Hurdles to overcome
Journalist Mike Steketee has described federal four-year parliamentary terms as being the “bridesmaid but never the bride”. This is because the idea of longer federal parliamentary terms never actually reaches the “political altar”.
Even though the “bridesmaid” is much closer to the altar these days, there are still several potential hurdles to overcome. One major hurdle relates to the constitutional difficulty associated with referenda.
Parliamentary terms for the Senate (six years) and the House of Representatives (three years) are established in the Australian Constitution (Chapter 1, Parts 2 and 3). Any alteration to these constitutionally entrenched arrangements must comply with section 128. This requires a referendum in which a majority of people in a majority of states and territories must vote for the change.
Referenda in Australia have traditionally not fared well. Only eight out of 44 have passed.
The next impediment relates to private member’s bills – what Coleman plans to introduce. Private member’s bills are notoriously difficult to pass without overwhelming support from other members.
Support for the bill might also be required from the crossbenchers. It would be difficult to know how the Greens or independents might cast their votes.
Since Federation in 1901, around 20 private member’s bills have become law – out of more than 450 that have been introduced. Support for the bill might be easy to attract this time, though, given politicians are being asked to vote on their own longevity.
This issue may not get too much traction federally due to differences between state and federal areas of responsibility. Voters might not tolerate a longer time to cast their vote as they would on certain state or territory issues.
For many, Indigenous constitutional recognition, same-sex marriage, taxation reform, asylum-seeker policy and the National Disability Insurance Scheme – to name a few – take precedence over certain state and territory issues.
The question now is whether federal politicians are prepared to force the Australian people to vote on whether they have an extra year in the job (or possibly two years in the Senate’s case).
A cynic might say the best way to secure longer federal parliamentary terms at a referendum is to follow Queensland’s approach: adopt complete bipartisanship, say very little in the media, and harness the discontent of the electorate.
Very early in my career, I was invited to afternoon tea with the head of the Commonwealth Institute of Health at Sydney University, where I worked. The best bone china was produced and pleasantries exchanged. The agenda soon became clear.
He laboured into a parable about the difference between young and old bulls when locked in a small yard. He told me young bulls run hard at the gate, exhausting and sometimes harming themselves.
But old bulls are generally patient and placid. They always know the farmer will open the gate and they’ll walk out and soon get among the pasture and the cows.
Young bulls should learn from old bulls, he told me.
I knew exactly why he’d called me. For some months, I’d been in the forefront of a small group of public health people who were confronting the advertising industry’s self-regulation body with data about the appeal of Paul Hogan, who fronted the massively successful Winfield cigarette advertising campaign. Hogan’s own TV program had huge appeal to children. The advertising campaign was, therefore, in flagrant breach of the industry’s own guidelines and so needed to be stopped.
After 18 months of trying to ignore us, we won. We quickly discovered while the advertising industry could ignore our letters, going public turned 10,000 watt arc lights on the self-regulation farce. Over that time the media often interviewed us. A headline after we won said our slingshot had cut down the advertising ogre. Hogan said he’d been sent from the field for kicking too many goals. That was in fact our argument.
My “young and old bulls” mentor later told me he’d been tapped by the Vice Chancellor to tighten the reins, after receiving complaints from connections with the tobacco industry.
Then, and even today, there still remain large remnants of the attitude in universities that scientists and researchers should avoid talking to the media. News media are frequently disdained by academics as trivialising and superficial, something from which those with ambitions of gravitas should keep well away.
A long history
The roots of this go way back. In 1905 Sir William Osler a foundation professor at Baltimore’s Johns Hopkins Hospital, warned against “dallying with the Delilah of the press”. More than 100 years later, a 2006 report by the UK Royal Society noted 20% of UK scientists believed colleagues who engage with the media are “less well regarded” by their peers.
Public engagement was something “done by those who were ‘not good enough’ for an academic career”. Those who did so were seen by some as “light” or “fluffy” and, wait for this, more likely to be women. While 60% of UK researchers wanted to engage with politicians about their research, far fewer (31%) wanted to engage with journalists.
The cocooned naivety of this position is quite staggering.
Knowing someone, but never meeting
Early in Nicola Roxon’s tenure as Australian health minister I approached her after a talk she gave at a conference. “I don’t think we’ve ever met,” I said. “No, but I feel I’ve known you all my adult life,” she replied.
This could have only meant she knew me through the media.
There is an abundance of research showing people get a huge amount of their information and understanding of health issues from the news media. Equally, most politicians and their advisors rarely read scholarly papers in research journals. They form their understandings of the issues in their portfolio in a variety of ways. But like us all, they are daily exposed to information and discussion about health and medicine through the media they consume voraciously every day.
I had an instinct about the importance of all this right from the beginning of my career and so quickly took to trying to get my research covered in the media; I gave high priority to making room in my day to provide commentary about the areas in which I worked.
Here, I quickly learned the constraints on time and space meant something richly nuanced and complex always needed to be condensed into just two or three sentences in print media reports, or 7.2 seconds in television news. When I started taking opportunities to write opinion page and feature articles, the access to my work and commentary on controversies in public health rapidly accelerated.
Visibility brings access
The visibility this brought opened many doors to senior policy advisors and politicians. I also frequently had the experience of dozens of people telling me across a day they had read and enjoyed a piece I’d written in a newspaper that morning, or a breakfast radio interview as they got ready for work. Most of these colleagues work in adjacent areas of public health and would have only occasionally read my research work in journals.
My own GP and other clinicians have often told me about patients who brought in one of my newspaper articles to ask about it. This was especially true about pieces I wrote on the risks and benefits of prostate cancer screening. This feedback inspired a 2010 book – Let Sleeping Dogs Lie?: what men should know before getting tested for prostate cancer. Colleagues and I published it as a free ebook and it’s been downloaded over 35,000 times.
My 85 articles in The Conversation have been read over two and a half million times. Just two of them have together been read over 1.8 million times. By contrast, the most read of over 500 papers I’ve published in peer reviewed journals has been read only 150,000 times. Many are lucky to get even 5000 readers. Being locked behind subscription paywalls doesn’t help.
Who are the ‘influencers’?
A few years ago, colleagues and I researched the characteristics associated with peer-voted “influential” researchers. We invited all Australian researchers who had published 10 or more papers in particular fields of public health to name five Australian researchers who were “most influential” in each of these fields. We then interviewed the top five from each field.
Overwhelmingly, nearly all said they believed researchers had a responsibility and even a duty to produce work that might help shape policy and practice. Most of these were very comfortable in actively pursuing media opportunities to bring understanding of their work to the public. Those who weren’t comfortable in the media were very happy for others to do this on their behalf.
This approach started with choosing research questions they hoped would provide strategically useful information to inform policy. Their approach then passed through the necessary steps of grant application craft to best ensure it was funded through the highly competitive National Health and Medical Research Council process that now sees only 17% of applications funded.
These two steps are meat and potatoes for all funded research.
But it was in post-publication behaviour where influential researchers differ. They actively promote their work – not just to other colleagues in seminars and conferences, but to the public and those who might act on it politically.
And after all, isn’t helping evidence-based policy and practice the whole point of wanting to do the research in the first place? Why else would you bother?
Don’t just ‘stick to the facts’
Some critics of researchers with media profiles argue researchers should just “stick to the facts” in media interviews. Our study participants saw this as naïve because “people always want to know what the policy implications are”.
A total of 94% of those we interviewed disagreed with the view it was inappropriate to express opinions in the media about public health policy. Journalists might begin with a research finding or an expert clarification of a new report. But they invariably then asked what needed to be “done” about the problem, typically by government.
Journalists and audiences would meet with incredulity any researcher who tried to end an interview when there were questions about policy reform “oughts”, or claimed to have no opinion on what should be done. We expect those who know most about health problems to have views about what should be done to solve them and the courage to put these forward, even if they imply criticism of governments or powerful interest groups.
Speak up, speak up
Trump’s recent gagging of all government environmental agency staff is surely the start of a process that will spread to government funded universities in the USA. There has never been a more important time for researchers all over the world to speak up about their work, it’s implications and how societies and governments should act on it.
I’ve just published a collection of 71 of my essays and op eds across a large variety of public health issues. Like this column, the book is called Smoke Signals, and is published by the Sydney University Press imprint, Darlington Press. It’s available in paperback or as an ebook.
This article will be the subject of ABC Radio National’s Ockham’s Razor on Sunday, February 26, 2017 at 7.45am.
From my CNN news feed:
“I will not be attending the White House Correspondents’ Association Dinner this year,” the President tweeted. “Please wish everyone well and have a great evening!”
Here’s the damn tweet:
There’s no more information than this. I can’t recall any other President skipping this dinner, which of course is a lighthearted but sarcastic affair, with comedians and others taking the podium to make fun of the President.
Trump, of course, is a narcissist, and narcissists can’t take criticism, especially when they’re sitting there having to listen to it. And this expresses further disdain for the press, which…
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Three types dominate extremist movements: crazies, cynics and creeps. The true crazies are always at the bottom of the heap. Cynical propagandists stoke their righteous fury, without which the extremist movement would collapse. Creeps rise to the top, in extremist movements as elsewhere. They are cynical, too, of course. They know how to manipulate their base. But they must show signs of authentic craziness as well or their grip on leadership would weaken and others would take their place.
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Today National Public Radio, on its “Morning Edition Show,” had a four-minute piece on the April 22 March for Science scheduled in Washington, D. C. You can hear the piece and read the transcript here (it was written by Nell Greenfield).
The piece was pretty even-handed, quoting both advocates and critics. I suppose I’m largely on the fence about the March for several reasons (see my post on the issue here).
First, I approve of scientists marching in defense of the truth, and there are many reasons to think that the Trump administration is going to denigrate truth and muzzle scientists. But I’d prefer to wait until that happens in a more obvious way. After all, the Obama administration certainly damaged science, but in another way: repeatedly cutting funding to federal granting agencies. Nobody demonstrated about that.
Second, I worry that the march will turn into a partisan, political march involving…
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Scientists are the unrecognized benefactors of humanity. How many laypeople will recognize the name of Fritz Haber or Karl Bosch? Togetether they’re estimated to have saved over a billion lives. What about Norman Borlaug? He saved over 259 million lives. Ann Holloway, Samuel Katz, Kevin McCarthy, Milan Milovanovic, Anna Mitus, and Thomas Peebles? Together—over 100 million lives. Andreas Gruetzig? 15,400,000 lives. These people invented synthetic fertilizers, new breeds of wheat, measles vaccines, angioplasty, and so on.
The average person might recognize the name of Edward Jenner, who popularized (but perhaps didn’t invent) smallpox vaccination, thereby saving an estimated 530,000,000 lives; and they’d probably recognize Jonas Salk and Albert Sabin, whose polio vaccines saved the lives of over a million people, but I bet you could stop a college student, give them those three names, and none would be recognized.
You can see their stories, and read about (or question) the numbers…
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New proposals from Australia’s drug regulator should give you a better idea if your complementary medicines do what they say on the packet.
One change proposed by the Therapeutic Goods Administration (TGA) is a “stamp of approval” on the packaging and promotional material of some vitamins, minerals, herbs and other supplements to tell you there is enough evidence to back health claims.
Other proposals include reducing the number of often unsubstantiated indications that manufacturers of complementary medicines currently make on their TGA application, which are then used as the basis for advertising claims.
The TGA also proposes incentives for companies to develop and market products with new active ingredients, or make new claims based on research.
The proposed changes, which are out for public consultation, follow the recent ABC Four Corners program, which highlighted long-standing problems with the way complementary medicines are currently regulated.
What’s the problem?
The TGA’s proposals are urgently needed to fix three major shortcomings of the current regulatory system.
First, consumer organisations and health professionals have lost confidence in the complementary medicines industry’s ability to regulate its own advertisements, and in the TGA’s ability to apply adequate sanctions when companies don’t follow the rules.
Second, there is little incentive for the manufacturers of complementary medicines to research new innovative products or prove existing ones work.
There are about 11,000 listed complementary medicines on the Australian Register of Therapeutic Goods (indicated by Aust L on packaging). Listed medicines are meant to contain pre-approved, relatively low-risk ingredients, produced with good manufacturing practice and only make “low-level” health claims for which evidence is held. However, the TGA does not check these requirements before the product is marketed; post-marketing surveillance and upheld complaints show high levels of regulatory non-compliance.
But there are only 35 registered complementary medicines (indicated by Aust R on packaging) the TGA says have been thoroughly assessed for safety, quality and efficacy (there is also debate about whether many of these older products should still be on this TGA list). There are fewer products on this list because research to meet registration requirements is expensive, the public doesn’t understand the subtleties between an Aust L and Aust R product and a better return on investment comes from promotional hype and celebrity endorsement of listed products.
Third, the TGA provides only limited transparency about companies and products that fail post-marketing evaluation or have complaints upheld. This information is currently regarded as commercial-in-confidence, fuelling the perception the TGA is more concerned with helping industry than protecting consumers.
How could the new measures help?
The proposal to restrict companies to only making pre-approved, “low-level” indications and claims for a product, such as, “may relieve the pain of mild osteoarthritis”, will minimise the risk of misleading consumers. But it is not yet clear how the list of allowed indications will be established nor how a specific product will be matched with an appropriate allowed indication.
The regulator also proposes manufacturers apply for “intermediate-level” health claims falling outside the permitted list (outlined above). An example might be, “our formulation of cranberry reduces the frequency of recurrent urinary infections in women”. For this, the TGA would have to assess the evidence substantiating the claim for a particular product. If the evidence stacks up (and there’s a debate about the type of evidence needed), the product could then carry a TGA “stamp of approval” on the label and any promotional material. But it is not clear what this “stamp of approval” will be. Is it text, a symbol or both?
In preliminary TGA stakeholder consultations, consumer representatives supported a prominent visual identifier (like a logo or symbol) because of the failure of the existing Aust L and Aust R labelling to inform consumers. But industry representatives were concerned a highly visible identifier for a small number of evidence-based complementary medicines might affect sales of the bulk of listed products without one.
The TGA’s proposals encourage innovation because they will stimulate companies to engage in research to qualify for a TGA “stamp of approval”. The proposal also suggests companies that develop a TGA approved evidence-based claim would be awarded a three-year period of data protection to stop others freeloading on their research.
But the proposed changes do not yet address the need for greater transparency in the regulatory process. For instance, it is not clear whether the TGA’s assessment of evidence to back higher-level health claims for complementary medicines will be publicly available, as they are for prescription medicines.
What happens next?
These proposed changes, which are out for public consultation until March 28, 2017, sit alongside other recommendations aimed at improving the advertising complaints system.
If the TGA implements this package of recommendations, Australia will be a world leader in how complementary medicines are regulated. Despite the substantial and increasing use of supplements, no other country has developed a system that helps consumers and health professionals separate the evidence-based wheat from the chaff, improves confidence in the industry, stimulates more evidence-based products and has the potential to boost exports.