Second Opinion | Are you jealous, or simply envious?
Hello and happy Saturday! Here’s this week’s round-up of eclectic and under-the-radar health and medical science news. If you haven’t subscribed yet, you can do that by clicking here.
Are you jealous,or simply envious? Is a serial killer the same as a mass murderer? Those are among the top 50 psychological terms that people get wrong, according to a professor at Emory University in Atlanta.
Scott Lilienfeld has compiled a “listicle” of commonly confused terms as part of his ongoing effort to improve psychological literacy.
“We felt that writing this article was important, because far too often both laypersons and even specialists use psychological terms carelessly,” he told us. “Sloppy language can fuel sloppy thinking, and vice-versa.”
What tops the list of Lilienfeld’s pet peeves? The slang use of “schizophrenic” for one.
“It always distresses me when I see journalists confuse schizophrenia with multiple personality disorder, or misuse the term “schizophrenic” to refer to having many minds about something,” Lilienfeld said.
“People with schizophrenia do not have multiple indwelling personalities, despite what many laypersons believe.”
“Another one that gets my goat is the confusion of asocial with anti-social.”
(Hint: Anti-social behavior is potentially dangerous. Asocial behavior is just no fun.)
“When people behave anti-socially, they do things like rob banks and cheat on their taxes; when they behave asocially, they turn down all of their party invitations.”
“People are also frequently confused about emotional terms — confusing envy with jealousy is one of my favourite examples. Envy involves two people (“I’m envious that you are going to the U2 concert tomorrow night”), whereas jealousy involves three people (“I’m jealous that you are going to the U2 concert with Jim”).
From “A Compendium of Frequently Confused Term Pairs”
A study is not necessarily an experiment.
Study: Any kind of psychological investigation.
Experiment: A specific type of study in which participants are randomly assigned to groups and in which the researcher manipulates an independent variable.
Prevalence is not the same as incidence.
Prevalence: The proportion of individuals in a population with a given condition.
Incidence: The rate of new cases emerging over a specified time.
A serial killer is not a mass murderer.
Serial killer: Someone who kills multiple people in a string of incidents that are separated by “cooling off” periods.
Mass murderer: Massacres a large number of people in a single incident.
Lilienfeld says he’s aiming his list at scientists and academics, but he hopes the general public will also pay attention.
“This is especially important with respect to terms dealing with mental illness, where data show that the public often holds a plethora of misconceptions.”
The compendium of confused term pairs follows an earlier paper listing the top 50 terms Lilienfeld wishes people would simply stop using altogether. That list included “lie detector tests,” which don’t detect lies. Instead, they detect arousal. And people should stop talking about “scientific proof” because it can never be achieved, “as all theories can in principle be overturned by new evidence.”
(For a funny lesson on the difference between “negative reinforcement” and “punishment” Lilienfeld’s paper links readers to a scene from the TV show The Big Bang Theory.)
‘The world is our laboratory’
Remember that controversial study we told you about a few weeks ago announcing that saturated fat is healthy? And did you see this week‘s headlines about a Lancet study that showed 30 minutes of any kind of exercise five days a week can prevent death?
Those are the latest in a flood of research coming from a unique Canadian study that is tracking the health of 200,000 people from 25 countries around the world over several decades.
It’s a colossal international collaboration that is co-ordinated by a group of scientists and analysts at McMaster University in Hamilton under the direction of Dr. Salim Yusuf, a cardiologist and epidemiologist.
After a career in cardiology research, Yusuf knew hundreds of academics and doctors all over the world. He was also aware of a fundamental research flaw — that most of the deaths happen in low- and middle-income countries, yet most of the data is gathered from patients in wealthy countries.
So in the late 1990s, he tapped into his network of contacts and set up the Perspective Urban and Rural Epidemiological Study (PURE) to compare a variety of different health, lifestyle and environment factors across low, middle and high-income countries.
The research teams have dodged crumbling buildings in earthquake zones, navigated cultural and religious traditions, gathered blood and urine samples from people living in war zones and made sure that what’s called a “heart attack” is the same condition in India, China and Kazakhstan.
“Our principle is science: we don’t get involved in the politics,” Yusuf told us. “We follow local regulations and rules. We may have to jump through extra five hoops in one country compared to another.”
Yusuf tells the story about one community in Pakistan that was afraid of the machine they were asked to blow into, called a spirometer, which measures lung function.
“They got brainwashed that when they blow into the spirometer their light is being sucked away, so we just had to say OK, we’re not going to do it in these communities,” Yusuf said.
One of the biggest hurdles for the researchers in the field is poverty and lack of resources including electricity.
Still added up, they have managed to establish medical files on 200,000 people ages 35 to 70 all over the world. Each person goes through a two-hour data collection process, answering a questionnaire about health and lifestyle. They have urine and blood tests, plus a series of physical measurements including blood pressure, height, weight, lung function and body fat.
Teams of researchers also collect data about the various environments where the people live assessing, how much they walk, what food they eat, what does that food cost. They also measure pollution, both indoor and outdoor.
“Trying to understand the factors that influence people’s routine activities is important,” Yusuf said. “Every three years we recontact people to look at changes in key habits. And we find out if they’ve developed a certain disease or if they’ve died.”
So far the PURE group has published more than 50 different research papers, with another eight accepted by journals and getting ready to go to press. Plus 30 more studies are being prepared for publication over the next two years.
Back at the PURE headquarters in Hamilton, Yusuf’s ongoing challenge is finding funding. The study has cost about $45 million dollars, not including infrastructure and salaries of the international teams. He has cobbled together a pool of 80 different funders.
“We have philanthropy foundations, peer-reviewed grants and industry mostly pharma,” he said. “We don’t have any food industry funding in Canada. But around the world each group is quite free to seek funding from any source except the tobacco industry.”
And when they crunch the data back here in Canada, what they’re seeing sometimes challenges dogma, as they did with their conclusion that eating saturated fat improves health. But sometimes their findings support dogma as it did this week with their finding that exercise prevents death.
“Our diet data has got people both shouting hurrah as well as riled up and attacking us because some of the things that we’ve found goes against the tide.”
He expects the study will outlast him. “I hope it goes beyond my time,” he said. Ideally they would like to keep the study going until half of the group they started with have died. That means it will have to keep going for another 25 years.
“Can we do it? I don’t know. Right now, I’m aiming to keep the group together for the next 10 years.”
Study: Sales reps don’t help MDs find better drugs
Don’t expect to learn about the most effective new drugs from pharma sales reps. That’s the advice to Canadian doctors in a study published in CMAJ Open.
In Canada, pharmaceutical companies are not allowed to advertise drugs directly to consumers the way they do in the U.S. Instead, drug promotion here is directed at doctors. Drug company sales representatives visit doctors’ offices and new drugs are advertised in medical journals.
About two-thirds of Canada’s doctors make time to listen to sales pitches from drug companies, according to study author Dr. Joel Lexchin. But his new research suggests they won’t learn much, because the drugs they’ll be pitched are no better than the drugs they already know about.
“Some doctors see sales reps because they’ve been seeing them for so long they’ve become friends. Some doctors see sales reps because it’s a nice break,” Lexchin told us. “But if you are seeing them to hear information about new drugs then you are wasting your time, in my view.”
“What it’s showing is that the most heavily promoted drugs are the ones that do not bring any additional therapeutic value,” said Marc-André Gagnon, who studies pharmaceutical and health policies at Carleton University.
Added up, Gagnon says it means the old blockbuster business model is still in place, where companies heavily market new patented variations of older off-patent drugs to beat generic competition.
“Most of the drugs that do bring therapeutic advance are specialty drugs, niche drugs for rare diseases,” Gagnon said. And those drugs don’t need as much promotion.
He said this research indicates a need for an independent source of information for doctors about new drugs.
Lexchin said he decided to investigate the therapeutic value of highly promoted drugs in Canada after reading a study by a Yale researcher that was published in BMJ in last May.
That study concluded “the most aggressively promoted drugs in the U.S. are less innovative,” and less likely to be considered first line treatments.
Should any of this matter to patients? “I think patients should care,” Lexchin said, adding that there’s a risk they’ll end up paying too much for the newest drugs if their doctors have been influenced by the sales pitch.
Innovative Medicines Canada, the pharmaceutical industry association, has a self-regulated code of ethics that requires sales reps to provide accurate information about their products to doctors.
“Members must provide full and factual information on products, without misrepresentation or exaggeration. Statements must be accurate and complete,” it states.
WHO: Not enough new drugs to fight superbugs
When a group of experts at the World Health Organization (WHO) took a close look at which new antibiotics are coming on the market, the assessment was grim. They discovered that “potential treatment options are lacking for the most critical resistant bacteria.”
In February the WHO released a list of priority pathogens — the worst of the deadly new superbugs — the ones for which new drugs are most urgently needed.
But after reviewing the publicly available data about which new drugs are coming, the WHO experts warned that’s not going to be good enough.
“The review shows that the current clinical pipeline is still insufficient to mitigate the threat of antimicrobial resistance,” the report stated. What’s coming are simply variations on existing drugs, it said, calling them “short term solutions.”
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