Tuesday, July 15, 2014

SIDS statistics

Response to a misleading headline at http://www.thehoopsnews.com/2014/07/14/211/infant-death-syndrome-kills-babies-share-beds-parents/, since corrected:

"Infant death syndrome kills most babies that share beds with parents"? Wrong. Misleading. That would mean that out of 1,000 babies who share beds with their parents, more than 500 die of SIDS! This is not true.

Out of 100,000 babies, roughly 15000 share beds with their parents [see note 1 below], and 97 (per 100,000) die of SIDS or SIDS-related causes (hereinafter "SIDS"). [2]

What this article implies is not that there are more than 7500 SIDS deaths out of those 15000 bed-sharing babies(!), but that, of the 97 deaths (per 100,000 babies) from SIDS, about 71 [3] were in bed-sharing babies and about 26 [4] in babies who did not share a bed with their parents.

In other words, for babies who sleep on their own, the SIDS death rate is roughly 1 SIDS death per every 3300 babies [5], and for babies who sleep with their parents, the SIDS death rate is roughly 1 SIDS death out of every 210 babies [6].

According to the available data then, by having a baby sleep with its parents, its risk of death from SIDS does not just double, triple, or quadruple—it increases to about 15 times the risk of death from SIDS for babies who sleep on their own. [7]

Even at that the risk is still "small." Statistically, in a town of 10,000 bed-sharing babies, only about 47 will die of SIDS. But in a town of 10,000 babies sleeping on their own, only 3 will die of SIDS.

So it is wildly inaccurate to say "[SIDS] kills most [of] the babies [who] share beds with parents." I think most people would have noticed by now if over half the bed-sharing babies were dying!!!

It is, however, accurate to say "Most babies who die of [SIDS] share beds with parents," if you are describing a study (this one) that says that of every 3 SIDS deaths, 2 are in babies who share beds with their parents. [8]

The take home message, though, is that bed-sharing babies are about 15 times as likely to die from SIDS as are babies who sleep alone.

Notes
[1] A study found a rate of 14% in 2010, and that rate had increased from 7% in 1993, with bed sharing continuing to increase in popularity. http://www.cnn.com/2013/10/02/health/bed-sharing-infants-increases/

[2] SIDS/SUIDS, accidental strangulation/suffocation in bed, or unknown/undetermined cause, at rates of 55 per 100,000; 27 per 100,000; and 16 per 100,000 babies, respectively: http://mchb.hrsa.gov/chusa13/perinatal-health-status-indicators/p/SIDS-SUID.html; I chose 2009 data for the purposes of this analysis, as they were closest to the data used in the Pediatrics study: http://pediatrics.aappublications.org/content/early/2014/07/09/peds.2014-0401.full.pdf+html.

[3] 69.2 percent of 97 = 71.34

[4] 97 - 71 = 26

[5] 26/85,000 = 0.00030588 = 0.03%; 1/0.00030588 = 85,000/26 = 3269

[6] 71/15,000 = 0.004733333333 = 0.473%; 1/0.004733333333 = 15,000/71 = 211

[7] 3269/211 = 15.49

[8] 69.2%. Be careful not to misinterpret this statistic! The fact that only 15 percent of babies are bed sharing, versus 85 percent that are not, means that, given the overall SIDS death rate of 97 deaths per 100,000 babies, bed-sharing babies die from SIDS at a rate that is 15.5 times the rate of SIDS deaths for babies who do not share beds, as explained above. If you are reading this as bed-sharing babies having only twice the rate of SIDS death, you are either assuming that just as many babies are sharing a bed as are not [a bed-sharing to non-bed-sharing ratio of 50/50, rather than 15/85] or you may need to brush up on math.

Monday, July 7, 2014

"Race" is a racist concept

Race is an idea created to justify racism.

Studies based on race serve only to perpetuate racist ideas, while obscuring the true factors behind the observed variations in results. This is why studies which use race as a category produce ambiguous or conflicting results, while studies which use fine divisions of household wealth or income produce clear results.

Race is not a cause of anything; only a creation of racists.

Studying economic disparities and their effects is understandably unpopular in some circles--especially among the elites and upper classes, for some odd reason. Unfortunately these are the same people who have the most influence on what gets studied.

The danger in studies based on fine gradations of income (unlike, for example, the 50-50 division in studies of students on "free or reduced-priced lunch" compared, not with the richer half, but with students "overall") is that results showing a greater negative effect on families making $0-$4,999 per year versus families making $95,000-$99,999 per year, with the degree of negative results tied directly to the degree of poverty--the trouble with these clear results is that, once we learn them, there is something we can clearly do to fix the problem; namely, do whatever necessary to bring an end to poverty.

The "advantage" (for racists and for economic elites) of race-based studies is that once we draw the conclusion that the browner someone is, the worse off they are, there is nothing we can do about it, except congratulate our less brown selves for doing better (through "hard work," presumably), pity the other "races" for being "inferior" (as "proved" by yet another race-based [racist] study), and throw up our hands in futility, because we think that being "black" or "Hispanic" is what causes these problems, and there is nothing anyone can do about someone being a certain race!!

But the honest answer is we can do something about it. We can give up these few-centuries' old falsehoods about "race," we can stop treating other people as fundamentally different from ourselves (they are not), we can reject the continued use of this racist "race" concept in what should be scientific(!) studies, and we can instead scientifically study true causes (injustice, racism, power imbalances, corrupt economic and political systems, greed) of our problems in ways that will lead to real answers that we can take real actions to address and fix.

-----

Originally thumb-typed in response to the Medical News Today article at http://www.medicalnewstoday.com/articles/279260.php (Nutrition and health 'have greater influence on newborn's size than race').

Tuesday, June 24, 2014

Culture Shock Advice

Some advice about culture shock from a letter I was writing: ----- If you have not lived overseas before for an extended length of time, you might find it helpful to have read this book before going over there:

http://www.amazon.com/Survival-Kit-Overseas-Living-4th/dp/185788292X/ (Survival Kit for Overseas Living: For Americans Planning to Live and Work Abroad)

It's a good introduction to being an American and living overseas, dealing with stereotypes and culture shock, and knowing about them ahead of time, so that you are more prepared to understand them and deal with them more positively.

If you are unlikely to read a 200 page book (even though it is a great one), the main point to know is that there are usually a couple low points emotionally for anyone living overseas. The first one, which is relatively minor, comes around the end of the first month, after the newness and excitement has worn off. The second one, comes close to halfway through one's time overseas, which is funny in a way because, if you are going for two years, it tends to hit close to the one year mark, but if you are going for six months, it will hit close to the three month mark. If you know it's coming, and know that most people do get through it, it can be easier to manage. (The few people who don't get through it tend to fly home at that point, even though they would have done better to stick it out a few more weeks till it passed.) Culture shock is to overseas living what Wednesday is to the workweek.

I certainly went through it during my year in Costa Rica. At a certain point I just felt separate, even judged, for being an American everywhere I went. Then, one day, I realized that the only thing that all Americans have in common, the only thing that makes them American, is their citizenship. There is nothing else that all Americans have in common. From then on I no longer felt any of the pressure I used to feel as the representative of all things American, because I wasn't. I was also able, then, to get closer to the Costa Ricans in my life, because I realized they weren't some monolithic foreign other, either.

There are also some quite good books out there on culture and etiquette for each country. Those are enormously helpful to read before going, and while there, too. Different country, different rules, different views of life. It is always helpful to learn about these ahead of time!

I used to work at an exchange program here for students who came from Spain and Latin America, and it drove the Spanish students nuts that the host family would pick them up at school, drive them home, and then stay in all afternoon and evening. They were used to going home, maybe hopping on a scooter, and going into town with friends. Quite a number of them smoked, too, though that has probably changed quite a bit in the past 25 years.

-----

Tuesday, June 3, 2014

Nemnanait

Wishing a happy Chinese No Internet Day to one and all:

We will never tire of repeating it: The freedom of opinions about doctrine has never been fatal to any people, but all the events of modern history substantiate, down to the last piece of evidence, the dangers and risks that nations have run when some faction has succeeded in taking control of the press, has dominated the government, and by taking advantage of this, has silenced through terror those who could have enlightened it.

But governments never learn, in spite of so many repeated examples. Always stuck in the present moment, they neglect the future….

We conclude our reflections then, recommending to those entrusted with power that they be persuaded that, when they raise opinions to the status of crimes, they open themselves to punishing talents and virtues, to losing their way, and to making illustrious the memory of their victims.

—José María Luis Mora

And we'll be saying a big "Hello" to all intelligent lifeforms everywhere, and to everyone else out there, the secret is to bang the rocks together guys!
—Douglas Adams, The Hitchhiker's Guide to the Galaxy

Thursday, March 13, 2014

Natural seasonal allergy relief

I used to have horrible allergies to grass pollen that lasted through all of June and most of July, requiring me to begin with pseudoephedrine (Sudafed) for the early weeks, then adding loratidine (Claritin) when the sudafed alone was no longer enough. (Beginning with claritin meant having it lose its effectiveness just when I needed it most.) I am not a doctor, but that is my experience over many years of being miserable.

Two years ago, I had no allergies beyond a manageable sniffle on a couple days. Last year I had one bad allergy day (down from the normal 50 days) when I made the mistake of eating lots of chocolate (and a few other things, like cheese, and oil-and-vinegar salad dressing), but I knew that I was going off the list and, sure enough, the allergies did come back with a vengeance, just for that one day.

If you are tired of pounding down medication for weeks at a time for your seasonal allergies, there is another alternative. You can just not have allergies in the first place.

I found this out when, for other reasons, I had to follow a low-histamine diet for a time. If I made the mistake of eating something that was high in histamine, like an English muffin (yeast), or Grape Nuts (yeast), my heart would race, so I had a built-in histamine detector. Rather than rely on stressing my heart, however, I looked for information on foods to avoid in order to keep my histamine levels low. There are a few lists out there, but many are incomplete, confusing, or vague, which caused me to restrict my diet unnecessarily or just left me confused about whether I might be able to eat something.

The best list was one I found at this website: http://www.histaminintoleranz.ch/en/introduction.html (http://www.histaminintoleranz.ch/) It lists close to 400 ingredients and individual foods along with their likely effects on your histamine levels (0-3 scale).

The unpleasant thing about a low-histamine diet is that it means completely eliminating an unbelievable number of your favorite foods, at least for the duration of allergy season, such as hard cheeses, almost any canned food (no vinegar, no flavor enhancers, almost no preservatives), yeast breads, tomatoes, avocados, alcoholic beverages, chocolate, black tea, coffee, citrus (oranges, lemons), most nuts, shelled beans, mushrooms, soy sauce, mustard, tofu, sausage, smoked or dried meats, pizza, etc. In effect, any food that is made by allowing or inducing something to spoil in some way (fermentation, drying, curing, preserving). It still leaves a lot of food you can eat, but you will definitely feel the loss of your favorites, it will be close to impossible to find foods you can safely eat at restaurants, and it will seem like 80% of the grocery store is suddenly off limits. To be fair, you can probably eat a certain number of items marked with a number "1" on the list without much trouble (with the possible exception of most yeast breads). The trick is always to keep your histamine levels low enough that you avoid having your histamine "cup" running over when allergens provoke your immune system. (Again, that is my non-medical understanding. For medical questions and advice, consult your doctor.)

Following a low-histamine diet is a sacrifice, but to be allergy free and medicine free (and side-effect free!) is worth the effort! Your friends and family will also find you kind of annoying during allergy season, but just do your best to supply your own food needs, and to not talk about it much (steer the conversation away from it), and they may just be able to tolerate that you are not joining them in whatever they are eating (or drinking) at the time.

My own diet during grass pollen season consists of:

  • Whole grains (oatmeal, white rice, brown rice, whole grain cereals with vitamin E as the only preservative)
  • Quick breads (muffins, pancakes, waffles, cake donuts), heat-and-serve flour tortillas (without preservatives)
  • Apples, potatoes, blackberries, blueberries, grapes, carrots, celery, cucumbers, melons (not watermelon), yams, fresh artichokes, broccoli, corn (maize), bok choy (pak choi), green beans (all vegetables fresh, not canned)
  • Milk, butter, water, and dulce de leche ice cream
  • Instead of my usual hot beverages at the coffee shop, steamed milk or hot apple cider (non-alcoholic)
  • Occasional eggs or chicken
It is not an exciting time of year culinarily, but I am not miserable, I can be outside, I can take walks, I can garden, I can open the window on hot days (coincidentally high-pollen days); in short, I can actually enjoy some of the best days of our short summer in this land of nine months of clouds and rain that is western Washington (state). And I don't have allergy symptoms or—not any better—allergy medication side effects. It does take some sacrifice, but it is worth it to be able to enjoy the summer!