Sunday snippets - a short blog round up

It's been some time since I did a blog round-up. That's partially a reflection of time pressures. I haven't been able to follow along in the way I used too, although I hope to do better.

Clare Belshaw has created a new web site to provide a platform for her various interests. Her blog is now included in the new site.

Sketches and vignettes from la Dordogne is a new web site on my list. I mainly know where the Dordogne is in physical terms from the Tour de France, although I remember the history. Must go there one day. Have a browse. Sixtene writes well. 

Yvonne Perkins Stumbling Through the Past is, as the name says, a history blog. Like many of us, Yvonne doesn't write all the time, thirteen posts so far this year, so you don't need to check it on a daily basis. But have a browse and if you like it, add it to your visit list. I was pleased to see. by the way, that Yvonne recognised the role played by Indian soldiers at Gallipoli - Indian Soldiers Fought at Gallipoli.

John Hawks' weblog remains a superb resource for those of interested in the ancient human past. Seriously, this is a very good blog indeed. If you haven't visited, please do.

The History Blog remains one of the most fascinating history blogs of all.Consider this post, Artifacts recovered from HMS Erebus dive or this one Scythian gold vessels found with opium, cannabis residue. Interesting.

On Canadian History, I continue to browse Christopher Moore's History News on a very regular basis.It gives me different perspectives.

After a longish break in posting, marcellous has suddenly sprung to to life in If a tree falls with a retrospective round-up. The introduction says it all:

Lest an unblogged concert suffer the same fate as an unheard falling tree, I’m returning to blog life with a bit of a catch up. This has turned into a bit of a marathon post.

Mmmm!

I have come to the end of the time I allowed myself for this morning's post and, again, have barely scratched the surface.

At the moment at a personal level I have an efficiency campaign running. One aspect of it is my blog reading. I was once so efficient.I had my extensive blog list well structured on Explorer by categories. Now that Explorer is in terminal decline and I have switched platforms, it's much harder.

Memo to Microsoft. In wishing to preserve and maximize the value of what you had,you stuffed your future. But that's a topic for another post.    
   

  

Saturday Morning Musings - introspection flowing from schools and Rugby

This morning's muse has been sidetracked by schools and rugby..

My old school TAS (The Armidale School) has decided to go co-educational.There have been girls in the primary section for some time. As an old boy, I was invited to comment prior to the decision. I decided not to. There was nothing useful that I could say. Personally, I would have preferred the school to remain single sex, partly for sentiment, more for reasons that were irrelevant to the primary question.

Thinking of the school as a business entity, I could see the reasons that were driving the decision. My concern lay in the way that it might affect Armidale's two remaining girls boarding schools in an increasingly localised education market place. We have already lost one girl's, one boy's, boarding school.How do you say this makes perfect sense from a business perspective, but I don't want you to do it because of its potential adverse effects on NEGS and PLC? How do you say that I hold that view even though it may add to your problems in developing TAS?

 The draw for the NSW GPS (Greater Public Schools) rugby competition has been released. TAS Firsts are playing in the thirds competition. It is very hard now for the school to compete at the first level because of differences in the number of boys playing at TAS as compared to the Sydney schools. The Thirds competition is a new competition to ensure inclusion of the minnows (Sydney Boys High, Sydney Grammar and TAS) in the competition.

I have attended most games for the last two years and wrote last year's competition report for the Green & Gold Rugby Forum. TAS won the inaugural competition, were equal first last year and should be competitive this year on pre-season form. My feeling is that the school will win, although this is the first time I have said so in public.

I have just entered the match dates in my forward plan. However, I find my enthusiasm down. I have written before about the strangeness I feel on attending matches. It's good sport, I get excited because I do support my old school, but I now have no direct connection.

I think that sport is a shared thing. This is a shot from the last Rugby World Cup in New Zealand. Helen (eldest daughter) with Rugby friend. Helen paid so that we could go to watch at least one match together.

Wandering round the sidelines at the GPS matches, I see no-one I know Living in Sydney and with the passage of time, I am too far removed now to know people. Unless I know people or have adopted performance mode, I am also naturally shy. People don't always realise that, for I have learned to perform when I have to.

I exchange some remarks on the sideline, but basically spend the hours alone. Then I come home and try to write up the results. At that point, I get some interaction.

This post has become a little more introspective than I had intended when I started writing. This weekend I need to work out just how I am getting to Europe, again to see some Rugby World Cup games with Helen. The trip itself is another present, but there are all sorts of consequential and cash issues to be resolved. Still, I am looking forward to it.

        
         

That Australian life - the NSW nanny state

Tyler Brûlé's swinging attack on.the impact of Government restrictions on the texture of Australian life has attracted attention. I quote:

Australia is fast becoming "the world's dumbest nation" because of nanny state rules and restrictions, says Canadian journalist and magazine publisher Tyler Brûlé. 

He argued that Australians were increasingly being "mollycoddled" through health and safety laws, and that our cities were at risk of becoming over-sanitised. 

"This country is on the verge of becoming the world's dumbest nation. There will be a collapse of commonsense here if health and safety wins out on every single discussion," he said.
"People think it's a little bit nuts here."

I think that he is pretty right, although I would have thought that Canada suffers from the same disease. Here local government has become more and more a delivery arm of State based regulation and control. However, that got me thinking on a different if related topic.

It used to be the case that Melbourne was more restrictive than Sydney, Victoria more tightly controlled than NSW. Then things switched and I was wondering why. It wasn't until freer Melbourne with its growing life style started really threatening regulated Sydney to the point that Mayor Clover Moore that certain restrictions started to be relaxed.

There have been some really funny decisions in NSW, like creating a regulatory regime that encouraged drinking palaces while stopping pavement living. I am not talking about the clubs here, that's a different question, but the rise of the poker pubs along with the creation of cost structures that meant that only big venues could afford the regulatory cost burden. Yes, there has been a burgeoning of cafe strips, but itis very localised.  

So what is it about NSW?

 

UNSW grandly challenged

We appear to be heading into the University strategic planning cycle. The Australian Financial Review uses the headline "UNSW to set itself grand challenges" to introduce Tim Dodd's story on the planning process at the University of New South Wales.

The primary aim appears to be propel the University into the top 100 on the global ranking scales as measured by the Times and Jiao Tong indexes. UNSW wishes to join the four Australian universities already there - Melbourne, Sydney, Queensland and the ANU. I hadn't realised that it wasn't there, nor had I regarded UNSW as an up and comer vieing with Monash in seeking entry to this group. So I have learned two things already from the process.

Apparently, the green discussion paper circulated within the University outlines a strategy with three goals - academic excellence, economic and social impact and operating globally through research and international education. .The paper suggests more interdisciplinary research and stronger engagement with with industry and government to ensure research is successfully applied and produces economic benefit."We will be working extensively and seamlessly with industry, business and government, having become to 'go-to' university for a wide range of partners and funders."

The University could be a leader in digital learning technologies and should be the centre of a dynamic, entrepreneurial start-up community. International student numbers will be expanded via a combination of offshore teaching with digital learning. Various strategic alliances are proposed, with a possible "Grand Challenges Institute" to bring world leaders and experts together to identify solutions to Australia's and the world's biggest problems.

Various productivity improvement options are canvassed including extending scheduled study through summer with four ten week annual teaching blocks, shifting research resources from low to high priority areas, creating more teaching only positions while offering more blended learning and purely on-line courses.

While I don't have access to the green paper itself, I can see it in my mind with its diagrams and pastel colours, its interconnected goals and aspirations.I wonder where students fit in, whether there is room for the pursuit of knowledge for its own sake including the areas I am especially interested in. .

This is one area where I accept that I am irredeemably old fashioned. The people who have most influenced me, whose knowledge I have drawn from and built on day after day down the years, would not (I think) have survived at UNSW. They wouldn't have wanted to be there.The need to meet agreed performance objectives flowing down from on high would have been totally inconsistent with their sometimes slow and reflective thought patterns.

Is there still room in a world where universities are first businesses concerned with organisational survival and growth for a university that is first a university?  I would like to think so. As I said, I am irredeemably old fashioned.

Thesis, hypothesis and scientific method in history

Note to readers: This post began as my Sunday Essay post, but I ended up rewriting it entirely. So now its both Sunday Essay and Monday Forum!

Recently on this blog we have been talking about evidence based approaches. In a postscript on
The application of evidence based approaches 2 - A note on evidence based policy, I referenced an article that came via Club Troppos' Nicholas Gruen: The Trouble With Scientists. I have been musing on that and, more broadly, the issues raised by my regular commenters on evidence based approaches.

I suppose that I could put the questions in my mind this way: how do we know what we we know, how do we know that we are right, how do we test that we are right, how do we correct when we are wrong?

By training I am both an historian and economist. Let me start with the history part in this post.

As an historian, I try to discover and tell the story of things that I am interested in. This involves analysis of evidence, the development of patterns and relationships that I can express mainly in writing for myself and the reader.

As an historian, I have always been uncomfortable with the thesis or hypothesis approach where that is defined first and then tested against the evidence. I am a curious person, I want to know what happened, why it happened, not prove a particular point. So I ask questions of the evidence. What happened? Why did it happen? What was connected? The idea that I must start with something that I want to "prove" or "test" or even that I must start with a single question makes me quite uncomfortable.

In working, I am always conscious of the problems of selection, perception and bias. This affects the questions I ask, the evidence I select and, to a degree, the way I approach the evidence. Working my way through, I work out the story that best represents the evidence as I see it. But am I right?

There are simple things that I can do to test my work. I don't especially want to refute my own work,  but I do apply certain simple tests that I have learned from experience are important.

The first is simply a date check. This may sound quite self-evident, but if a follows b, then it's sensible to check the dates of a and b. I said that date checking may sound self-evident, but we live in a world in which the idea of dates in history is sometimes treated in a rather cavalier fashion. You have to do it though. I still remember my total embarrassment a few years back when a simple later date check forced me to put a line through a total line of argument that I actually thought was rather good. I still blush.

 The second linked thought is to look at time linkages. Again, this seems self evident; a may follow b, but is there enough passage of time to make any connection between a and b? This is especially important if you are arguing causation rather then connection. Sometimes, a specific focus on time delivers apparently unbelievable results.

This is true of both the establishment of the Armidale Teachers' College and New England University College. I was very suspicious of some of the dates, I just thought they couldn't be right, but when I checked I suddenly thought how the bloody hell did you do that, it couldn't be done today. Our systems wouldn't allow it. The speed of action had suddenly became part of the story itself.

The third test is simply geography. This is a quite remarkable one that I was unconscious of  for a very long while even though I was interested in geography. At the simplest level, it's just this.Get out a map. Look. Think about climate. Look. What does it all mean for your story?

Let me give you an example. Those on the first fleet almost starved after arriving at Sydney. All the early explanations focused on things like lack of skills or equipment or the convict system. The reality, it seems, was that there was a drought, an El Nino event. Now the climate knowledge came later, but the drought stuff could, I suspect, have been picked up from the records if one had asked the right questions.

No matter how well I analyse the evidence, I know that my first pass description is my  hypothesis, a story based on evidence for later checking and refutation.

Those who wish to test my conclusions, the story I have told, may use the same evidence but operate in in a different way. They may test my story for internal inconsistency. Do the bits hang together? They may ask different questions of the same evidence, coming at the same pattern from a different angle. More often, they will find new evidence that challenges my view, leading to a new position. .

Sometimes, one can be very lucky. History builds on itself. I am still a bit staggered that some of the conclusions I drew in my history honours thesis, I was only 21, actually went on to form key building blocks in later analysis by people of far greater academic stature than me. My thesis wasn't especially well received at the time, .it got me a 2-2, but it has survived to the point that I am now using it and the subsequent discussion including opposition to create an entirely new hypothesis that can, in turn, be tested.

Quite remarkably, really! Bu that's what the study of history is about.

Later, I will extend this discussion by looking at economics.  

Saturday Morning Musings – refugees, diplomatic trolls, the Middle East war

I am sorry that I haven’t posted since Tuesday.

The problem of the stranded migrant boats may have been resolved for the moment, but Mr Abbott’s dismissive “nope,  nope, nope” has become another strain point with Indonesia. This is Neil Whifield’s view on the matter: Random Friday (Thursday) Prime Minister. Neil provides a link to a piece by the Melbourne Age’s political editor Michael Gordon that is worth a browse for its different perspective. The Jakarta Globe has a short piece (the comments go both ways).

This piece from the Jakarta Post provides a broader picture of the human tragedy, giving a human face to some of Michael Gordon’s points. The picture of Somirahatun and her baby comes from the Post.

Regardless of what can or should be done, I thought that Mr Abbott’s comments were crass, unwise and inhumane.

Two interesting pieces on the Lowy Institute blog. Richard Gooding’s Diplomats, trolls and memes looks at the influence of twitter on diplomacy. I hadn’t come across the concept of diplomatic trolls before! I guess that it’s another small sign of what I have come to think of as the instantizing of life. It’s actually very frustrating, for it leaves people with the attention span of  a gnat.

When the kids were young, I commented on the way that their groups always had to be in touch with each other. I thought that it was very tribal. You know, messaging: where are you, I’m on my way, nearly there etc.  Then they grew out of it, well more or less. I wish the same were for true for their elders.

I really don’t know some managers or executives I have observed get any real work done at all. They are just so busy keeping in touch, responding, demanding, rushing, meeting; life is a busy whirl of constant interaction in which instant response however shallow is the requirement, Still, perhaps that’s a matter for another post.

The second Lowy post I wanted to refer to was Vanessa Newby’s Summer in Lebanon: Holidays, beaches, clubs...and war?. This followed an earlier post by Bob Bowker, Assad's regime is brittle, and it may fall fast, written before the fall of Palmyra.

I have always wanted to visit Palmyra. It looks as though I many not get the chance now.  I find the destruction by IS of so many ancient monuments personally confronting. However, more worrying is the spread of conflict. I think that we should stop using the term terrorist, for the so-called war on terror has now evolved into a full scale if ill-defined sectarian war being fought on multiple fronts with multiple ripple effects.

Not a pretty prospect. 

Postscript

The Melbourne Age had a powerful editorial this morning on the stranded migrant boat issue: Nope is not good enough, Mr Abbott.The words I used in this piece to describe Mr Abbott's comments were crass, unwise and inhumane. As an Australian, I felt a deep sense of personal shame at Mr Abbott's comments because he is my nation's leader.

The application of evidence based approaches 2 - A note on evidence based policy

This brief note continues my discussion on what are called evidence based approaches. At the start of  The application of evidence based approaches 1 - Evidence Based Medicine, I wrote:

The discussion on Monday Forum - more on evidence based approaches looked at some of the issues associated with evidence based approaches. One of the issues from my viewpoint in that discussion lay in the need to distinguish between the importance of evidence and the application in practice of what are called evidence based approaches whether in medicine, management or public policy. I thought therefore that it might be helpful, at least to me, to consolidate some previous writing on the topic, starting with evidence based medicine.

I have repeated these words to emphasise that I am concerned with the application of particular models, ways of thinking. The Wikipedia article on evidence based public policy is not especially good, but it does refer to the transmission of the particular form of the idea from  medicine to public policy.

A good expression of the idea in an Australian context comes from this Australian Public Service Commission piece, there is no date but I think its 2009, featuring Gary Banks. In her introduction, Public Service Commissioner  Lynelle Briggs  states:

Evidence-based policy-making, while not a new concept, has recently become more prominent in public debate in Australia. The Prime Minister has called it a key element of the Government’s agenda for the public service. He wants policy design to be driven by analysis of all the available options, and not by ideology. This explicit endorsement by the Prime Minister provides us with a valuable opportunity to advance the cause of evidence- based policy-making in the APS.

In Australia, the potential application of evidence based approaches drawn from medicine to policy dates back to at least 1998. As happened with me, it seems to have spread first from medicine to the idea of a discipline of practice and then beyond. 

Mr Banks and the Productivity Commission have played an active role in popularising the application of the concept.in the public policy sphere, claiming lineal responsibility for its application back to the old Tariff Board. In fact, the concept is much older than that. The economic historian C R Fay used the term evidence based public policy in 1919, and by then the approach was quite old. 

The differences between the old and new approaches is that evidence based public policy now involves the application of a highly structured top down model that, to my mind, is riven with potential contradictions that arise from its misapplication. 

I recognise that I have to argue this, I am as prone as anyone else to management fads and fancies. Someday I should write a mea culpa post looking at all the things that I have argued for that I then found did not work in practice. Because I have been a practitioner  working across a number of fields, I have found myself badly bitten by the very things I had espoused. The problem, to my mind lies not in the concepts as such, but always in their sometimes blind misapplication.

In my next post in this irregular series, I will look at evidence based management.

Postscript

I should note, for the record, that I have a very high opinion of the work done by the Tariff Board though its various guises to the Productivity Commission today.

Postscript 2

This link came from Nicholas Gruen: The Trouble With Scientists.There are several points within it that bear upon our current discussion so I wanted to record it for later use.

   .

Monday Forum - a very jaundiced forum

This Monday I really found myself out of ideas on just what to suggest as a Forum topic.

We could, I suppose have another go at Mr Abbott's views on refugees. It's hard to believe that Australians were once appalled when the Malaysian military forced Vietnamese boat people back into the water to drown. But then, we were admitting so many at the time. .

The sheer scale of the problem in the Mediterranean is hard to comprehend. At our purely local level, the militarization of Customs and the Immigration Service through Border Force, all the tough talk, is costing us quite a lot of money as well as harshening the fabric of our society.

The longer term problem for the Government is that if everybody else turns the boats around in the same way,  the flow of refugees etc to this country is likely to increase. There would come a point, and it might be sooner than we think, where the pressure would become unstoppable.

Still, we have been down this path before. Or we could talk about Parkinson's Law of Government. In my variant, as Governments can make less real difference their activities expand in areas where they might still have some control or at least where some form of political pay-off might be possible. One effect is that social control legislation explodes

But that would be jaundiced, so we might ask instead why Governments can no longer provide infrastructure in the way they did in the past. The only infrastructure now, well perhaps not the only but a lot, is that where someone can be made to pay for use.

Oh dear, I'm jaundiced again. Still, the problems with under-investment in the rail network that delivers the NSW wheat crop have been obvious for some time.

Perhaps I should stop and hand this Forum over to whatever jaundiced view you might have.

Postscript

kvd suggested  that a G&T was a good solution,  He provided this link.Winton Bates suggested that "Perhaps our leaders are utilitarians who sincerely believe that they can reduce total human suffering by discouraging people from getting on boats to seek a better life".: This is the Wikipedia entry on Utilitarianism.

Are Messrs Abott and Morrison utilitarians?



 

History revisited 2014 columns now on line

As regular readers will know, I write the weekly history column for the Armidale Express. This photo is of the 1965 Freedom Ride at Moree.

Most weeks, I have to turn out 500 words. It's not always easy. I get tired and the deadline seems too difficult, especially in the early hours of Friday morning when I have left it to the last moment.

I mention this now because I have finally brought the last of the 2014 columns on-line: 45 columns, over 22,000 words.

Obviously the standard varies. Further, I am writing for a local audience. I try to present things in a broader context, but the local is always there. Still, you may find the columns interesting, The column entry points are:

• 2012 columns, 13
• 2013 columns, 43
• 2014 columns, 45

I hope that you find something of value in them.

Train Reading - Introducing The Travels of Marco Polo

My train reading used to be very disciplined. There was one simple rule. I had to pluck a book of my shelves that I had not read before and then read it until it was finished. No matter whether or not I liked it, it had to be finished.

It's taken me down some interesting by-ways. However, in the last few years my train reading has become spasmodic, less rigorous.

There are particular reasons for this. My main reading time is too and from work. It's hard to train read in the traditional sense when you are deeply embedded in, to take a current example, the late Pleistocene and what it meant for the Aboriginal settlement of New England. Material connected with that topic tends to dominate the brief case. Random reading is crowded out.

Feeling in need of something different this week, I plucked The Travels of Marco Polo off the shelves.Yes, no doubt I should have read it before, it's a famous travel piece, but I hadn't. I was far more familiar with the game Marco Polo, something I used to play with the kids and their friends. Mmmm, I wonder whether I will ever do that again?  It was fun.

My copy of  The Travels is the Penguin Classics edition translated and introduced by Ronald Latham. I don't know a lot about Ronald Latham, although he was clearly a well known classicist.
By melding various accounts together into a coherent story, he created what appears to have become something approaching a best seller. First published in 1958, the book was reprinted in at least 1959, 1965, 1967, 1972, 1974 and 1978 (my copy).

Marco Polo was born in Venice on 15 September 1254. Wikipedia reports that he learned the mercantile trade from his father and uncle, Niccolò and Maffeo, who travelled through Asia, and met Kublai Khan. In 1269, they returned to Venice to meet Marco for the first time. The three of them embarked on an epic journey to Asia, returning after 24 years. The map shows their journey.

There has been some controversy about the accuracy of The Travels. It was written after Polo's return to Venice, dictated to a fellow inmate Rustichello da Pisa while they were prisoners of the Genoans (1296-1298)  Rustichello da Pisa, described by Ronald Latham as a romance writer, incorporated tales of his own, as well as other collected anecdotes and current affairs from China.

I'm not sure the accuracy question matters greatly. It remains one of the great travel epics, painting a picture of a vast world that was then little known to those who lived in Europe.

Problems with ATAR

The ATAR or Australian Tertiary Admission Rank is still the main scoring system used in admitting students to Australian universities, although its importance has declined in recent years as many universities have defined alternative admission paths. Like many ranking systems, it's also become a competitive weapon in pecking order rivalry between universities and a topic of some controversy with some senior academics arguing that too many low ATAR students are being admitted to university..

Now George Messinis and Peter Sheehan from Victoria University have released a report based on VU student performance pointing to problems with relative ATAR scores as a subsequent predictor of university performance. This piece in The Conversation sets out the results. There is a link to the full report. The comments are interesting too

I'm not sure that we have learned something we didn't know, but its still a worthwhile piece. . .

That Australian Life - visiting workers, Aboriginal remote communities plus an El Nino event

Australia is large and diverse country. There were two recent ABC Four Corners programs that reminded me of that.

The first, Slaving Away, dealt with the working conditions of visiting workers on some large Australian farms. You will find the transcript here. I tried to stand back from the emotional overlay, it was quite hyped up, and listen to the facts. Two themes seemed to emerge.


The first was visiting workers, mainly young people, being paid less than the minimum wage. At the moment, this is $16.87 per hour. There was a thread about being paid less than award wages, but I lacked the information to be able to make a judgement on that.

The second was the role of labour hire companies. I can see why these would have emerged.They make it easier for employers. I actually work through one at the moment, Randstad, and they seem to do a pretty good job. But in the seasonal workforce case, there really seem to be some cowboys. Further, there also seem to be cases of misuse of power including harassment.

I had less sympathy for the long hours, physical exertion  and sometimes difficult living conditions because they are a feature of seasonal work. In the end, and I am guided here by the views of Nationals MP Keith Pitt, I concluded that there was a very real problem.

The second Four Corners program, Remote Hope, dealt especially with remote Aboriginal communities in WA's Kimberley region. You will find the transcript here.This was just plain depressing. This is an almost impossible area to comment on, but I will try my hand later.

And, maintaining the gloom,  the Australian Bureau of Meteorology has concluded that Australia may be entering an El Nino event. More on that too later.    

Budget Night in Australia

Tonight Australian Treasurer Hockey will release his second budget. I haven't attempted to follow the various pre-announcements nor will I be listening to the budget speech.

That's a big change for someone who used to be something of a budget junkey. I have many memories of budgets past. I first started listening as a child, that's a sad admission I guess, because (or so my parents informed me) I wanted stuff to discuss with my grandfather. Later in Canberra I had a professional interest.

Those original budget speeches could be pretty boring, but they actually contained the information you needed to understand the budget. That's no longer true. It's all packaged now, shortened for TV, dominated by message. You can actually listen to the budget speech and at the end have no real idea of the changes that  have been made that affect you. It's only later that you find out.

So tonight I will do as I have done many times before. I will listen to the reaction to the budget, both political and from those who have been in the budget lock-up and have therefore had access to the papers. Then I will go on-line and actually read the budget papers.

To those outside Australia, the budget is meant to be "secret" until its delivered. The old reason for that was to prevent people taking advantage of changes, like going out and buying stuff before prices went up or shifting cash off-shore. That's still there, although there are so many leaks or pre-budget announcements now that some of the secrecy has lost its point.

The point of the budget lock-up is to allow people access to the budget papers so that they are ready to comment or analyse following the budget speech. That's actually a very good thing. It's why journalists and others have their analysis ready to go straight after the speech.

For my part, I like to do my own analysis. I find that I pick up things that others have missed or, alternatively, that I wish to place different weight on things. So that's what I will do tonight.

Postscript

For those interested, Peter Martin in the Canberra Times has a very good explanation of the budget papers themselves.
 

Monday Forum - the unexpected things of life

I'm not feeling like being too serious this Monday. It doesn't suit my mood. Before going on, AC put up a companion post on the discussion that Winton and I were having earlier on whether or not Europeans were sadder - A sad, sad post. Its a very good post.

So leaving that aside, what are the things in your life that were unexpected, that you remember all those years later? I have many. I suspect that you do too!

The application of evidence based approaches 1 - Evidence Based Medicine

The discussion on Monday Forum - more on evidence based approaches looked at some of the issues associated with evidence based approaches. One of the issues from my viewpoint in that discussion lay in the need to distinguish between the importance of evidence and the application in practice of what are called evidence based approaches whether in medicine, management or public policy. I thought therefore that it might be helpful, at least to me, to consolidate some previous writing on the topic, starting with evidence based medicine.

By way of background to what follows, one of my major interests over the last quarter of 2006 and the first quarter of 2007 lay in the development of what I called a discipline of practice, a discipline focused on the way professionals practice their profession. This drew me into a discussion of evidence based approaches, starting with evidence based medicine.

The material that follows in this post consolidates the three posts on evidence based medicine that I wrote at the time. For time reasons, I haven’t attempted a complete edit, just some simplification. In later posts, I will look at the application in management and public policy.

INTRODUCING EVIDENCE BASED MEDICINE

Evidence-based medicine (EBM) is an attempt to more uniformly apply the standards of evidence gained from the scientific method, to certain aspects of medical practice. Specifically, EBM seeks to apply judgements about the inductive quality of evidence, to those aspects of medicine which depend on rational assessments of risks and benefits of treatments (including lack of treatment). According to the Centre for Evidence-Based Medicine, "Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients."[1] Cited from Wikpedia.

In this post I want to continue my discussion on the development of a discipline of practice, a discipline focused on the way professionals practice their profession, by introducing in a preliminary way the case of evidence based medicine.

I first came across the concept in 1998 when I started as CEO of the Royal Australian (now Australian and New Zealand) College of Ophthalmologists. My instinctive first reaction was to say that's odd, I thought that all medicine was evidence based. In fact, that's far from true.

To understand this, we need to look at the way in which doctors are trained, as well as the way in which new medical approaches develop.

As with all professions, training starts with the previous body of knowledge relevant to that practice. For practical reasons, much of this has to be taken for granted. The trainee professional simply has to learn those elements required to begin practice.

The trainee then has to learn to apply that knowledge in practice. In the case of medicine this is done especially in hospitals working under the supervision of a qualified doctor who passes his/her knowledge and experience onto the trainee while checking their application. Again, the trainee is acquiring the current wisdom.

These broad processes continue throughout a professional training that can, in the case of medical specialists, extend as long twelve or thirteen years.

Once the doctor begins practice, he/she continues to learn from experience with patients. Doctors also learn through contact with other doctors and are expected to maintain a program of continuing professional education to keep them in touch with latest developments. Similar approaches and programs apply in other professional areas.

None of this will seem strange to any professional from any discipline. Yet in the case of medicine the process has proved to be seriously flawed. Evidence based medicine attempts to address these flaws.

OVERVIEW OF EVIDENCE BASED MEDICINE

Evidence-based medicine (EBM) is the integration of best research evidence with clinical expertise and patient values ... When these three elements are integrated, clinicians and patients form a diagnostic and therapeutic alliance which optimizes clinical outcomes and quality of life. Centre for Evidence Based Medicine

While this quote focuses on medicine, it also captures four key elements relevant to all professions and professionals.

The first element is research evidence, essentially what works and why.

The second element is professional expertise, our capacity to understand and apply our professional knowledge in the circumstances of the particular case.

The third element is the patient or client, each with their specific attitudes and needs.

The final element is the integration of the first three elements - the diagnostic and therapeutic alliance - to provide the solution that best meets client needs.

Before continuing my analysis I should note that the Australian Broadcasting Corporation's Radio National has just completed a rather good two part series - Facing the Evidence - on evidence based medicine. The first part is available here in transcript, the second here.

Returning to my theme, when you look as I did in my last post at the standard way all professionals are trained, you can see that that training focuses on the transfer of existing knowledge and skills to the new professional, knowledge and skills that that professional then applies. The professional then builds on this base through practice, at the same time using various professional development activities to try to keep in touch with new developments.

But what happens if that existing knowledge base is in fact wrong? How might this arise? To quote from the first part of the ABC program:

Every day doctors and other health professionals use treatments that are harmful, or fail to use therapies that have been proven to work. In the US there is so much medical error that Congress has directed the Institute of Medicine to develop a strategy to improve the quality of care. In its initial report the Institute noted perhaps as many as 100,000 Americans die every year from medical errors, including the use of inappropriate treatments. That's much more than from car accidents, breast cancer or AIDS. Many more suffer side effects and unnecessary costs

How could this happen?

Part of the problem here lies simply in the placebo effect, that fact that patients respond just to the fact of treatment. So the treatment appears to work, thus supporting the original judgment.

Part of the problem also lies in the fact that individual outcomes can be affected by so many variables and over a considerable time horizon so that the fact of adverse outcomes may not be clear in an individual case or, if clear, may be due to a whole variety of factors external to the treatment itself. There is a linked issue here that relates to the size of the population.

Given that individual outcomes vary greatly, the fact that there is a problem and its scale and scope may only become clear if you look at a population as a whole. That is, the individual professional may have no easy way of detecting the problem in his/her individual cases.

A further problem lies in the nature of the models used.

All professions use models to try to explain a complex world. In economics, for example, models are a common method used to analyse economic behaviour and to suggest possible responses at firm and public policy levels. In the case of medicine, biological models are common.

The problem with all models is that they involve selection of key variables and the specification of relations between those variables. Get either wrong, and outcomes may be very different from those projected by the model.

Doctors have always been concerned about adverse or unexpected outcomes.

In 1972 Professor Archie Cochrane, a Scottish epidemiologist published Effectiveness and Efficiency: Random Reflections on Health Services. This plus Cochrane's subsequent advocacy caused increasing acceptance of the concepts behind evidence-based practice. Cochrane's work was honoured through the naming of centres of evidence-based medical research — Cochrane Centres — and an international organisation, the Cochrane Collaboration.

The explicit methodologies used to determine "best evidence" were then largely established by the McMaster University research group led by David Sackett and Gordon Guyatt. According to the Wikipedia article on evidence based medicine, the term "evidence-based medicine" itself first appeared in the medical literature in 1992 in a paper by Guyatt etal. (Guyatt G, Cairns J, Churchill D, et al. [‘Evidence-Based Medicine Working Group’] "Evidence-based medicine. A new approach to teaching the practice of medicine." JAMA1992;268:2420-5. PMID 1404801)

From this point, the spread of the concept and its subsequent inclusion in professional training was rapid.

As with any other approach, evidence based medicine has its own methodological problems. However, it also has important lessons for other fields of professional practice.

PROBLEMS WITH EVIDENCE BASED MEDICINE

In my last post on evidence based medicine, I suggested that professional training focused on the transfer of existing knowledge and skills to the new professional, knowledge and skills that the professional then applied. The professional subsequently built on this base through practice, at the same time using various professional development activities to try to keep in touch with new developments.

I then posed the question what happens if that existing knowledge base is in fact wrong, looking briefly at the reasons why this proved to be the case in medicine, a discovery that had led to the development of evidence based medicine. I concluded that, as with any other approach, evidence based medicine had its own methodological problems. However, it also had important lessons for other fields of professional practice.

The Quality Movement and Quantification

In a series of posts on my personal blog, I explored some of the changes that had taken place in public administration since the war, looking at the influences on those changes.

In one of those posts I looked in part at the way in which standards, the Quality Movement and the importance of measurement had become major global influences. I also suggested that the outcomes here had not always been positive.

Evidence based medicine forms part of the global standards and quantification revolution and suffers from some of the same weaknesses. These weaknesses need to be recognised.

Problems with Evidence Based Medicine: Perception Bias

The first problem can be called simply perception bias.

Evidence based medicine is neither value nor perception free. The questions selected for test and evaluation, a process that can be very expensive, are influenced by prevailing views. Valuable alternatives may be excluded simply because they fall outside conventional wisdom. As evidence based medicine becomes the dominant mode, the effect may, as it has been in other areas, to actually narrow fields of investigation and action.

This links to a second problem, one that I have discussed before, the tendency for all professions to see answers within a frame or world view set by their profession.

A lawyer will give you a legal answer to a problem, a doctor a medical answer. If you have a back problem and see a surgeon, he/she is likely to think about surgical solutions. Go to a chiropractor with the same problem and he/she is likely to recommend spinal manipulation. So professional background helps determine the way the problem is defined, the solution applied.

This flows through into the application of evidence based approaches because the things tested are generally set within the frame of the tester. So evidence based medicine focuses on the efficacy of medical treatment and may leave non-medical alternatives aside.

Problems with Evidence Based Medicine: Causation

As part of my history honours year in my first degree I studied philosophy of history under Ted Tapp. Ted was a reflective man who required us to think about, to debate, the philosophical underpinnings of science and scientific method.

One core problem was the difference between correlation (a and b) as compared to causation (if a then b).

This problem applies in evidence based approaches. Just because a study shows an apparently strong relationship between a treatment and positive patient outcomes does not necessarily say anything about the causal relationship between the two. This has to be deduced and further tested.

Problems with Evidence Based Medicine: Problems of Epidemiological Studies

By its nature, evidence based medicine deals with large groups, populations.

As trials become larger and more complex, it becomes more difficult in statistical terms to establish significant relationships, to separate the effects of different variables. This creates another problem, the establishment of a clear relationship between the outcomes of trials at population level and subsequent application at individual level. As the Wikipedia article notes:

Critics of EBM say lack of evidence and lack of benefit are not the same, and that the more data are pooled and aggregated, the more difficult it is to compare the patients in the studies with the patient in front of the doctor — that is, EBM applies to populations, not necessarily to individuals.

This can create very real difficulties for individual clinicians, leading Tonelli to argue in The limits of evidence-based medicine that:the knowledge gained from clinical research does not directly answer the primary clinical question of what is best for the patient at hand.

Tonelli concludes that proponents of evidence-based medicine discount the value of clinical experience.

Problems with Evidence Based Medicine: Impact of the Observer

Another problem with evidence based medicine, one often seen in all evidence based approaches, is the way the observer affects the observed. This happens at several levels.

The first problem is that the simple act of participation in the trial may have some and not clearly seen impact on individual outcomes. In medicine, this is usually managed by use of a control group using a placebo. The efficacy of the treatment is then measured by the difference in outcomes between the control group and those receiving the treatment.

A second linked problem is the impact on patient behaviour of the trial itself. By their nature, clinical trials are closely managed. This means that patient compliance with the treatment routine is likely to be high.

This need not hold in subsequent clinical use since ordinary patients are more likely to fail to follow treatment processes by, for example, failing to take medication exactly as prescribed. This means that actual patient outcomes may not be as good as the trial results.

Problems with Evidence Based Medicine: Limitations in Application

A further problem is that the most rigorous gold standard approaches dictated by evidence based medicine can only be applied in narrowly defined circumstances, leaving a range of medical approaches that have to be tested by less rigorous means.

This should not matter so long as the limitations are recognised. In practice, it risks introducing two distinct distortions into the medicine and the health system. The first is the risk that investigation may be biased towards those things that can be measured through more rigorous techniques, reducing thought and investigation in areas less amenable to measurement. The second related risk is that treatment itself may become biased.

At clinician level, this links back to my earlier point about perception bias. Doctors trained in evidence based medicine may, consciously or unconsciously, come to focus in treatment terms on those things that can be measured, ruling out other less easily measured options.

This tendency may be reinforced by actions from those managing or funding the provision of health care services who may refuse to allow/pay for certain types of services notwithstanding the views of individual clinicians.

Conclusion

These problems do not detract from the potential value of evidence based medicine, but they do illustrate the need for care in application or the cure may be worse than the disease.

That Australian life - taking the $2 a day food challenge

A friend is undertaking the $2 dollar a day challenge: "Eat on $2 a day for five days, raise funds and help end extreme poverty." I wrote this in response:

To Alison McLaren. Will give donation Wednesday, but now a few suggestions based on my own experience. I am posting here (on my personal Facebook page) rather than commenting because I can write longer. 

Two comments. First, it depends on how near to you the supermarkets are. If you have to shop at the corner store, things are harder. Second, it depends on what condiments etc that you start with.At $2 per day, you have to factor replacements in. 

So, what's cheap? Bread and milk. For $4, you can get a loaf plus a large milk container thanks to the supermarket wars. May not be good for farmers, but it helps those with no cash. Then consider rice and lentils. Boiled rice for lunch, fried rice for dinner. 

The cheapest meats are sausages and chook. Especially chook. Forget free range, a battery produced hen at eight dollars will give you five meals. Look at the discount area in the meat section. Sometimes you will find very cheap cuts there that you can cook at once. 

Baked beans are quite expensive. You can get a tin of Italian tomatoes, I think, I haven't checked today, for 99 cents. That can go on two slices of toast. Much better than baked beans, and under $2. 

If you are really poor, you have to spend a lot of time walking and choosing. No impulse buys. Often the green grocers are cheapest because they will have cut price stuff near the use buy date that the supermarkets would have thrown out. Like a large bag of carrots for $1.99. You might hate carrots, but at twenty cents a carrot it's hard to go by. Potatoes are another standby,  you will sometimes find them for less than a two dollars a kilo. Remember, the Irish survived on them.  

Hate potatoes? Add some margarine - $1.79 IGA Sunday. That can go on your toast as well. 

It's not that you can't live on $2 per day for food, but it just takes so much time that might be spent on other things, like finding some more income.It's much easier to go for cheap fast food and hang the expense.

In response Walter Adamson, an old Ndarala colleague wrote:

Chicken is a good deal as you said, and throw all the remains to make a stock into which you add use-by marked down chicken sausages and use-by marked down chopped vegetables or cold-slaw plus those carrots you mentioned and potato garlic pepper bay leaf and you have 3 or 4 more meals.

All good stuff. But I would add a few more qualifications beyond the condiments you have at home and the distance to the supermarket.

One is your existing kitchen equipment. A slow cooker helps enormously. Keep it on and just throw the stuff in. Of course, and this brings me to my second qualification, you have to be able to pay for electricity. Otherwise you are cooking outside in a pit in the garden with whatever wood you can find.

Now here is my challenge. What would be your weekly menu? What have I forgotten?

Postscript

I mentioned at the start that a friend was undertaking the $2 day challenge. Her name is Alison McLaren. As I write, donations in support are still open. You can find the details here.

Are Europeans sadder?

Proper cheer-up from Chris Richardson and the boys at Access Economics on the future of the Australian economy. It pays to remember that they have a very good eye for the dramatic headline. Who could forget (well, actually, most have) their dramatic disaster call during the GFC when the real numbers were going in the opposite direction?

This doesn't mean that Australia doesn't have a budget problem. It does. However, it pays to take a calm approach to the issue.

On a different matter, Winton Bates has had some interesting posts lately. Why are old Americans more satisfied with their lives than are old Europeans? looks at happiness measures by age and country. The post title is a little misleading, I think. It should read why are older Europeans less happy than those in certain countries. However, Winton chose his title because of the weight accorded to population rankings.

One of the things that appears to be important for older people is social support, the backing that comes from family and friends. However, it's not clear to me that this is different between Europe and other places, I know of no evidence that the level of social support is different in Europe. If I'm right, we are dealing with apparent perception differences.

Europe, of course, is a very varied place so one has to be careful about averages and generalisations. Those in the older group, 60+ and especially 70+ have experienced enormous social upheavals. The Second World War, communism, the break-up of the communist system, troubles in the Balkans and so it goes on. In a way, Europe as a whole is a continent of refugees. Whole families were destroyed, connections to people, place and history lost.

Perhaps it's not surprising that older Europeans are less happy. I haven't looked at the demography, but I would suspect that for many the family support networks are weaker, more people are alone because so many of the extended connections died. Then, too, as we grow older we focus on the past, refreshing older memories of people and places lost. That can become a sad process.

We know this in Australia now, we see it around us although we don't always recognise it. I went for a walk on Sunday morning. It was quite early. There was an old Greek lady. Alone, stooped, dressed all in black, she was using a walking stick to hobble up to the Greek Orthodox Cathedral. From her age, she must have come to Australia as a young woman early in the Australian mass migration process after the War. I said good morning, Startled, she gave me a shy smile and said good morning in heavily accented English..

Things are always more complicated than the statistics allow.

Monday Forum - more on evidence based approaches

In yesterday’s post, Sunday snippets - problems with evidence based public policy, I expressed my reservations about the weight currently placed on evidence based public policy. I thought, therefore, that I might make it the subject of today’s Monday Forum.

Looking back over past posts, It seems that I first wrote on evidence based approaches at the start of 2007. I was especially interested in the application of evidence based approaches in medicine and their spread to other areas. I also found an early comment from 2tanners on the topic, so he has been consistent. It was such a nice story that I am repeating it again:

"Just on evidence based Scottish doctors, perhaps the most famous is Sir Arthur Conan Doyle, who used to emphasise the importance of observation and evidence in medicine as a medical lecturer.

One of his favoured tricks was to take a beaker of foul tasting fluid, dip his finger into it, taste it, pull a face and then ask the class to do the same. Only after they had all tasted the fluid did he take them to task for not noticing that he had dipped one finger, but tasted another. Unlike them. :)" 

I don’t have time to summarise that earlier material, but I pointed at the time to some of the problems that could arise from the blind application of the approach. Two quotes to illustrate:

"In Real world medicine a Scottish doctor expresses his concerns about the application of evidence based medicine in a UK context. In doing so, he makes a distinction between the measurable and immeasurable, suggesting that the focus on the measurable could blind.

He has a point. Part of the reason for the development of evidence based medicine lay in the need to challenge and test previously accepted medical nostrums. However its blind formalised application can distort practice to just the measurable. This holds especially where application is mandated through formalised Government rules".

And again:

"In his interview Professor Sutton defines evidence based management as the simple willingness to find the best evidence you can, and then act on it. But this is not always easy: It's hard to tell what's right and what's wrong, and anybody can be a management expert. It's a signal-to-noise ratio kind of problem: There's just too much stuff out there. And what sells best is by no means the best way to actually practice management. 

He goes on: People are attracted to brand-new ideas and things. The way most knowledge is developed is that people build on one idea, or on nothing at all. A consequence is that the same new things get discovered every six or seven years, and just relabeled. Think of business process reengineering, which is built on a whole lot of earlier ideas."

Taking these quotes as an entry point, I wondered about your own experience with the application of evidence based approaches. As always, feel free to wander!

Sunday snippets - problems with evidence based public policy

There has been quite a robust discussion on my post Indonesian executions - reflections on the death of eight prisoners, including Bali nine organisers Myuran Sukumaran and Andrew Chan. I have promised to write something to disentangle all the issues, at least as I see them. Not a for and against piece, just a forensic teasing out. Maybe tomorrow.

I worry sometimes when discussion becomes too personal. Among other things, I am concerned that new commenters might be frozen out. However, I have learned to stand back. When I began, I thought of comments as a discussion between me and my commenters. In fact, it's a discussion among them. My key role is to provide a platform plus content to spark discussion. Of course I become involved in the discussion, but I don't have too.  

The longest discussion threads come from a more current topic where people have views that they want to express. Some of my more personally satisfying reflective or historical pieces attract no comments. Why should they? They are actually not pieces that you can make a lot of comments on unless you are particularly interested in the topic. Still, they provide part of the content that draws people to the blog and are central to search engine traffic.

As part of a discussion on the D E Stevenson group, a US member wrote:

I don't like to be in the "everything was better when I was young club, because so many things were not better. In fact many things were much worse. But many things were better and certainly accessibility to education (without monstrous debt) was one of them. And the middle class was so much stronger and young people could get a good start in life so much more easily. And my government did not seem to be in a state of being bought by those with the money to buy it. Some of these issues really disturb me.

This is a US perspective. However, one of the things that I have noticed is the way themes and attitudes occur across western countries. I am constantly surprised by this,  but should not be. Each country is affected by the same economic and political forces, by the same trending ideological structures that set a fame for policy making.

Here in Australia, and I quote, " the number of university graduates with large debts is growing but fewer graduates are earning enough to pay back their loans – fresh evidence that today's new graduates are struggling to find full-time work and are receiving lower starting salaries than their predecessors."

Another common theme across the group at present is the decline in benefits offered to seniors including senior discounts. I have been a member of this group for the best part of fifteen years, a long enough period to bring many group members into the senior category. Senior is not a word I like, but it is the common official term across the countries represented.

Changing directions, in Western Australia, Premier Colin Barnett has been forced to qualify his words on the forced closure of remote Aboriginal communities. In fairness to Mr Barnett, this is not the first such clarification.

The WA Government's plans have led to demonstrations round the country. This is the Armidale protest.

Now in an apparent segue, I want to introduce the concept of evidence based public policy, something that was referred to in the comments on the Indonesian execution post.

The first reference I have found to evidence based public policy dates to 1919, but Governments have always used evidence to inform decisions. To do otherwise would be silly. However, the structured almost mantra like belief  is new. It's also arse end about.

Obviously, you have to use evidence to form your views. However, the real value of evidence based public policy comes in assessing the results. If you base your perceptions and actions only on the past, if that determines what you do, then you won't do new things. Better to do and then assess.

Looking at policy towards Australia's Aboriginal peoples since 1788, I keep thinking how could you think that? This has been evidence based public policy at its worst, and it's still happening. .