Irish in America

Happy St Patrick’s Day!

I’ve got some pretty good Irish heritage going on in my house.  In fact, I’m the least Irish member.  The dog is actually an Irish immigrant, the husband’s completely Irish.  The little lord has more than me, and (in the words of my mother) I’m a mutt…albeit a mutt with a good helping of Irish.

Anyway, living in Boston I tend to forget that Irish heritage is not ubiquitous in the US.  I found this map that shows that my skewed vision is at least somewhat justified:

It appears I do actually live in a place where Irish heritage is more prevalent.  Then I saw this map:

So not only do I live in a region that’s heavily Irish, but I apparently have spent the past 10 years in zip codes that were 30% Irish or more.  
Always interesting to explore your own potential perception skews.
And speaking of perception skewers, who’s up for an Irish car bomb? How about in cupcake form?

Friday Fun Links 3-15-13

First and foremost, beware the Ides of March.

Ever wanted to see what Kurt Vonnegut looked like in high school?  Here you go!

Now the important stuff….how to pick the best seat at a restaurant or dinner party.  Read this so things like this won’t happen.

Now more unimportant stuff….how to make a cat avatar.

Now that we know how to make cats, why not make the cast of Game of Thrones?

I’m happy that’s coming back soon.

More pi anyone?

I should have clarified in post earlier today, that I was only wishing everyone a happy American Pi Day….or any others who use month/date/year convention.

For those of you using date/month, we’ll see you back here on April 31st.

For those of you preferring fractions, we’ll see you on July 22nd.

For those of you who try to make things universal by writing things like 14MAR13, y’all just screwed yourselves out of a holiday.  You’re not invited to my mole day party either.

So basically you can justify celebrating 3 different types of pi days.  I think that’s excellent.  I like pi.

Wednesday Brain Teaser 3-13-13

I’m falling behind in mentioning correct answers, so today I’m giving both a problem and an answer….two in fact.  Pick which one you thought of first.

6÷2(1+2)=?

Think about it. 
 Think about it.

Apparently the answer’s been a little controversial.

Sugar (oh honey honey)

Last week reader panjoomby pointed me to an interesting study that correlated a countries sugar consumption to their rates of major depression.  Apparently that gives a correlation of .948.

Any time there’s a correlation that high, I’m going to get a look on my face that’s an interesting cross between curious and suspicious and that causes me to get wrinkles between my eyebrows.  I decided to take a look around for the full study, and found a copy here.  Basically the authors took data from the Food and Agricultural Organization  and correlated them with the results from a 1996 paper by Weissman et al published in JAMA called Cross-national epidemiology of major depression and bipolar disorder.

I couldn’t find a full free version of the mental health study, but I did find this update by the original author where she described what the study did (they surveyed people in the various countries for symptoms matching those for major depression, DSM III version)

A few things struck me about this study and it’s near-perfect correlation (shown below):

  1. Only six countries were used for the correlation.  The original study on depression, they studied 10 countries:  Canada, U.S., Puerto Rico, France, Italy, West Germany (it was 1991), Lebanon, Taiwan, Korea, and New Zealand.   They clarified that Taiwan and Puerto Rico had no sugar consumption data.  Ultimately, their line consisted of Korea, France, Germany, US, Canada and New Zealand.  West Germany and Lebanon were not mentioned.  West Germany I presume something about it not existing any more, but Lebanon concerned me, as it was suggested it had very high rates of depression.  When I pulled my own data from the FAO, it looked like Lebanon’s sugar consumption was similar to Canada’s.  That would have change things a bit.
  2. The country anchoring the bottom of the line is dramatically culturally different from the other 5 countries.  When I got my degree, I actually had to take an entire class on culturally sensitive counseling.  In it, we were reminded how many mental health standards were written either by North Americans or Europeans and how they really didn’t fit some cultures very well.  Asian cultures are notorious for under reporting symptoms, and for giving different names to things to avoid stigma.  This was admitted by the authors to be a weakness, but looking at the chart makes you realize this correlation would not be nearly as good if Korea wasn’t in the mix.
  3. The only source of sugar they counted was sugar.  The FAO reports honey consumption.  And lots of fruits and date consumption.  I get why you wouldn’t throw fruit in there, but it seems to me that there are a few other sweeteners that might change the numbers.    Any hypothesis that posits that processed cane sugar can cause dramatic mental health issues should probably ponder what (if any) effect a different type of sugar could have, and if adding it in changed anything.  I mean, they mentioned dates in their first paragraph for heaven’s sake.
  4. Every country on this list has to have a certain level of infrastructure to consume sugar and to be survey for depression.  Sugar tends to be more abundant in countries that have more food.  Countries that have more food tend to be better for researchers to set up shop in.  Countries without either are not included.  There’s some suggestion that quite a few poor countries might have really high depression rates thanks to malnutrition and otherwise terrible conditions.  That would definitely skew the line, and raise more questions about poverty rates in the originally studied countries.
None of this should imply that I’m a big fan of sugar.  I’m not.  I don’t tolerate it well.  If you’d like to see an example of what I look like when I eat it, please see below:

DON’T PANIC

Douglas Adams would have been 61 today.

As someone who still envisions the words “DON’T PANIC” in large friendly letters every time I get myself in a dicey situation, I thought I’d throw a few of his more memorable quotes out there for you, complete with when I tend to use them in my every day life:

Quote I say (at least in my head) every time I have flown, ever:
“It can hardly be a coincidence that no language on earth has ever produced the expression “As pretty as an airport.”

Quote I ponder when watching people on public transportation:
“There is a theory which states that if ever anyone discovers exactly what the Universe is for and why it is here, it will instantly disappear and be replaced by something even more bizarre and inexplicable.There is another theory which states that this has already happened.”

Quote I think of when I’m lying on the couch and realize I’m thirsty but my water is in the dining room:
“Space is big. You just won’t believe how vastly, hugely, mind-bogglingly big it is. I mean, you may think it’s a long way down the road to the drug store, but that’s just peanuts to space.”

Quote I think of most often when I’m tripping over something or falling down stairs:
“There is an art, it says, or rather, a knack to flying. The knack lies in learning how to throw yourself at the ground and miss. … Clearly, it is this second part, the missing, which presents the difficulties.”

Quote I feel best describes my adolescence:
“A learning experience is one of those things that say, “You know that thing you just did? Don’t do that.”

Feel free to add your own favorite quote in the comments.

Hey good lookin’

Confession time:  back in 2006, I tried online dating for a few months.  It was a stricter site…one where you had to be matched with people before you could see their information, and I figured it couldn’t hurt to try.  I never actually met up with anyone I met there (met my husband through friends before it got to that point), but I had some interesting revelations before I quit.  For most of the time, my main profile picture was a kind of funky/artsy photo a friend had taken of me from a distance.  I liked the picture quite a bit, so I didn’t think twice about putting it up.  About a week before I quit the site however, someone took a picture of me that was also cute, but it was just of my face.  I decided to put it up as my main picture, not thinking much of it.

I don’t think I checked the site again for a few days, but when I got back to it, I found I’d gotten quite the influx of messages.  Some of them were from guys who had access to my profile for a month.  I had unintentionally stumbled on to a truth of the online dating world: picture type matters.

I was thinking of this when I got forwarded this story from the WSJ best of the web column with the subtitle “The average woman has average looks, the average man is unsightly”.  It’s a take on this 2009 OkCupid blog post that shows that OkCupid users rank women on a normal distribution, and men on a right skewed distribution (the dotted lines show the ranking, the solid lines show how many messages they get):

Now, there’s some really interesting stuff going on here, some of which both articles touched on….but there’s a few things I’d like to highlight:
  • Neither article acknowledged the possibility that the average female user of a dating site might actually be more attractive than the average male user.  Repeat after me: this is not a random sample.  This is not a random sample.  This is NOT a random sample.  Everyone who puts up a profile was self selected.  You’d need a study on a random population before you could determine that women were harsher in their ratings.  People sign up for dating sites because they want something more than is available in their daily life.  If a highly attractive 30 year old male and 30 year old female were both considering signing up, the 30 year old female would likely have considerations around the biological clock issue that would push her to sign up faster than the 30 year old male.  Some people still see online dating as stigmatized, so pressure matters.
  • Are the women really more attractive, or do they just pick better pictures?  In the story I kicked off with, I mentioned that the picture mattered.  I was (obviously) the same person in both pictures, and they were taken 2 months apart…and yet it seems likely by my response rate that men would have rated my appearance differently in the two photos.  When academic studies look at how we rate attractiveness, they generally control for this by providing uniform head shots.  In the OkCupid post, they show examples of “average” women and men.  The average women appeared to have tried harder with their photos.
  • Men might have a more refined rating system. A few months ago I saw a link to a study that suggested that women had a more finely tuned rating system for humor than men.  The link had some sort of comment with it about how it was trying to make men look bad, but I read it differently.  We’re always hearing that women aren’t as funny as men because men use humor to attract a mate.  Thus it would only make sense if women had the better rating system.  It’s being used on them.  Men would not need a well refined rating system…they’re the ones using, not assessing.  Same thing here.  The OkCupid stats showed that men message the most attractive women 11 times more often than the least attractive ones, for women’s messages it’s only 4 to 1.  If ratings matter more to men, they’ll have developed more nuance (ie the 2-4 range will have more meaning).  Anecdotally, my male friends almost always include a rating of whatever girl they’ve most recently met (“she’s a total 9/dimepiece/HB8”).  My female friends seem more binary.  Either he’s attractive enough for them or not.
Anyway, those are my thoughts.  Well, not all my thoughts.  After reading about dating sites all morning, my most pronounced thought was “Gee I’m glad I’m married, this looks like a lot of work.”  Love you honey!

Friday Fun Links 3-8-13

Do you feel like getting away?  Got your passport handy?  How about those in other states?

Here’s some really pretty artistic gifs that kind of made my day.

Other amusing moments of the day include 17 kids who will change the world.

I guess I’m in a “kids are fun” mood today because I also liked this:

And I, I will survive…maybe

Cancer Treatment Centers of America came under some serious fire today for their reporting practices around survival rates of their patients.  For those unfamiliar, CTCA is a for-profit cancer treatment center that advertises heavily on TV about their high survival rates and has multiple locations throughout the US.

The accusation of data manipulation include:
  • Not accepting patients whose prognosis is too bleak so that their death won’t count in their stats
  • Encouraging Medicare and Medicaid patients not to come there (approximately 14% of their patients are Medicare, your average oncology center is 50% Medicare)
  • Targeting richer patients whose added resources, better overall health and (likely) earlier detection will lead to better survival all on their own
  • Excluding large portions of the patients they do treat from their data
  • Reporting survival rates in terms of 4 year survival, not the industry standard 5 year survival
The charges are heavy, especially because the higher than average survival rate is a cornerstone of their advertising.  I took a look at one of their survival rate pages, and it does indeed only go through year 4, rather than the standard 5.  It also appears that they toss any patient who got any care anywhere else ever in the course of their diagnosis, and more strangely “excluded any patient whose medical records had missing information”.*  This left them with only 45 people to calculate prostate cancer survival rates from.

Apparently, CTCA has heard the criticism and is recalculating some of their stats:

Xiong said he is doing new survival calculations using more recent data from CTCA, trying to make sure the comparison to the national database is rigorous. The new results, Xiong said, are expected to be posted on CTCA’s website this month. 

For some cancers, CTCA will still have better survival rates, he said. For others, “the survival difference in favor of CTCA is no longer statistically significant” after adjusting for several differences between CTCA’s patients and those in the national database.

Now, I’ve talked before about hospital ranking and how difficult it is, but this story really got to me.   We’re living in a time in the US where hospitals are under increasing scrutiny to lower their costs, and rightfully so.  However, in our effort to achieve the triple aim (right treatment, right time, right price), we have to make sure we’re working honestly.  Increasing survival rate through innovation is awesome, increasing survival rates by only treating the population most likely to survive is atrocious.

This is why many hospitals are reluctant to release their statistics.  It’s easy to skew things if you try, and it’s even harder for the public to understand what this skewing means.  In education, teacher often complain their now “teaching to the test”…..do you really want a doctor who’s “treating for the stat”?

*Interestingly, when my workplace talks about our survival rates, we actually have a “lost to follow up” category we add in.  I’m curious what those numbers would be here….since I’m assuming that’s what “missing medical records” means.  Why not release the numbers of how many that is?