DC crash of Air Florida was 25 years ago

There are some additional references that supplement today's The Washington Post article regarding the changes in aviation and hospital safety since that day 25 years ago tomorrow when Air Florida flight 90 failed a slushy takeoff and crashed into the Potomac.

The article "A Crash's Improbable Impact" by Del Quentin Wilber describes the change from the rugged individual model of cockpits and operating rooms to a much safer model that emphasizes less ego and more listening to what staff are trying to say.

But some experts believe it took the spectacular crash of Air Florida in the Potomac to drill the lessons home and spur widespread use of what was then a revolutionary training regime, later to be known as Crew Resource Management.

Soon, airlines were teaching the Air Florida crash as a textbook example of what can go wrong when pilots do not communicate and listen properly.

Actually, Crew Resource Management is evolving into a science known as the University of Texas "Threat and Error Management", described in this British Medical Journal (BMJ) paper and this BMJ slide show that I refer to in prior posts analyzing the crash of Comair Flight 5191 in Kentucky last August.

PIlot John Nance's National Patient Safety Foundation should be mentioned as well, bringing aviation safety lessons into hospitals systematically. And University of Michigan Professor Karl Weick's work on organizational "mindfulness" is also required reading in how things go wrong and why. (One case of wildfire safety research is linked here and here.) Weick has written extensively about organizational "sensmaking under pressure".

Serious students of High Reliability Organizations have entire web sites with a deep literature on what actually works and what doesn't to make complex operations safer for us all, as well as some in depth white papers on the Web, such as MIT's John Carroll's ""Organizational Learning From Experience in High-Hazard Industries: Problem Investigation as Off-Line Reflective Practice" that explore what can go wrong and how to stop it. (I wrote a very short summary of that here.)

One very serious learning organization that deals with high-stakes life-and-death situations daily isn't hospitals, but the US Army. Those who don't believe that listening to subordinates (management's "theory Y") can work in practice and be compatible with maintenance of hierarchical control and mission control should read the US Army's Leadership Field Manual (FM 22-100) and see how they have merged the two successfully into a command and leadership doctrine.

Back on the hospital level, introduction of these techniques is now being taught in "Patient Safety" courses at schools such as Johns Hopkins by researchers such as Albert Wu, Laura Morlock, and Peter Pronovost - who won last year's JCAHO Eisenberg award for work in ICU safety. This is downstream work of the Institute of Medicine's "To Err is Human" study estimating almost 100,000 patients were dying each year from avoidable mistakes in hospitals, most of which arose from failures of communication.

One the reasons that many counselors are required for understanding and victory is that complex adaptive systems defy our intuition and often produce unexpected side-effects that humans tend to resist dealing with. This is clearly documented by Jay Forrester in his classic testimony to Congress referenced in my prior post here.

The trick in short is that commanders need to build trust in their men and women between high-speed missions if they expect their troops to listen and follow them blindly when it matters the most. The flip side is that very often the troops at the front are more in touch with reality than their commanders, and a pathway upwards for discordant or discrepant information has to be provided to update the mental model of what's going on.

The third reason for a whole-body learning organization is that sometimes the pilot in command simply loses it, but that shouldn't cost the mission. If you read the transcript to Air Florida flight 90's last minutes, the part not mentioned in the article, the pilot appears to have moved 60 seconds ahead in time and already be in the river: he simply repeats over and over "It's so cold" as the plane careens to its death.

technorati tags:safety, aviation, reliability, accident, mindfulness, Weick, Morlock, Pronovost, Forrester, Army, leadership

Law of unintended consequences

The field of Systems Dynamics studies counter-intuitive social systems where the result of an action is exactly the opposite of what you would expect. 

The typical result of this surprisingly common problem is that policy makers may see a problem which they don't realize is caused by their own actions, and therefore increase that action precisely when they should be decreasing it.

The classic paper in this field is Jay Forrester's congressional testimony:
 "The Counterintutive Behavior of Social Systems",
http://web.mit.edu/sdg/www/D-4468-2.Counterintuitive.pdf

Quoting the abstract:

Society becomes frustrated as repeated attacks on deficiencies in social systems lead only to worse symptoms. Legislation is debated and passed with great hope, but many programs prove to be ineffective. Results are often far short of expectaions Because dynamic behavior of social systems is not understood, government programs often cause exactly the reverse of desired results.

The Systems Dynamics Society is working to make that type of understanding much more common among all educational levels, including K-12.  Schools of Public Health have now included "Systems Thinking" in the "MPH Core Curriculum", as of this year.

Still, penetration of these skills into routine use is going agonizingly slowly. The original work was published over 50 years ago.   Only in March, 2006 did "Systems Thinking" make it to the American Journal of Public Health.

One thing that is clear is that the simple process of meeting together to organize what is known and make a qualitative "causal loop diagram" is often very valuable even in its own right. (See "Business Dynamics" by John Sterman.)

The US has a full Master's and PhD program in System Dynamics at Worcester Polytechic Institute in Massachusetts, with a distance-learning option.

The British have made somewhat more progress, and an excellent review is here rearding system dynamics and the UK National Health System ( NHS ) written by Eric Wolstenholme.

technorati tags:SD, systemdynamics, systems, systemsdynamics, systemsthinking, MPH, Forrester, counterintuitive, socialsystems, society, policy, modeling, modelling

California Central Valley prepares to freeze

Brace for subfreezing

Sacaramento Bee - Jan 11, 2007

Emergency officials braced to help the needy and homeowners scrambled to buy pipe insulation as a Siberian cold front crept into California.

There remains a slim chance for snowfall in Sacramento and other low-lying areas tonight, with a 20 percent chance of precipitation. But below-freezing temperatures are a more immediate concern.

The low temperature in Sacramento tonight is expected to be 27 degrees. And that's the good news.

Temperatures are predicted to drop to 25 degrees Friday night and 26 degrees Saturday night. Winds of 10 to 20 mph through Friday will make the cold feel worse, dropping perceived temperatures into the teens.

The National Weather Service issued a freeze watch covering the entire Central Valley for Friday night through Saturday morning. This means plants and pipes could freeze, and pets and vulnerable people should be protected.

"We could definitely see some snow flurries, but we're not expecting snow to accumulate in the valleys," said Steve Goldstein, a forecaster with the National Weather Service in Sacramento. "The big concern really is the cold temperatures."

Keeping in mind last July's heat wave - blamed for more than 140 deaths in California -- state and local officials Wednesday mobilized "warming centers" for anyone who needs refuge from the cold.

"We are very concerned about people who don't have enough heat in their homes or are homeless," said Sacramento Mayor Heather Fargo.

"We want to make sure that nobody in Sacramento is left out in the cold, literally," said county Supervisor Roger Dickinson.

Isleton has posted notices that its firehouse and community center are available to anyone whose heating system fails.

"The cold is dangerous," said Dr. Mark Horton, California's public health officer. "There are certain subgroups that are particularly vulnerable: children, the elderly, people with respiratory conditions. Check in on those folks to be sure they're being looked after and cared for appropriately."

Horton warned people not to use any outdoor heat source inside a home, such as a barbecue or cook stove, which can cause deadly carbon monoxide gas to accumulate.

Brace for the Cold

Sacramento Bee (sacbee.com - registration required)

Warning: With the nightly low temperatures predicted to drop below freezing in the next several days, local officials are urging residents to take precautions.

Home and hearth:

• Review family emergency plan.

• Replenish emergency supply kits, check radio and flashlight batteries.

• Have extra blankets.

• Pay special attention to infants, children, seniors and those with disabilities.

• Winterize your house, barn, shed or any other structure that may provide shelter.

• Move family pets indoors or to an enclosure out of the elements.

• Move plants indoors or cover with blankets or plastic to prevent freezing.

• Maintain a sufficient supply of heating fuel.

• Insulate pipes and allow faucets to drip during cold weather to avoid freezing.

• Keep fire extinguishers on hand, and make sure everyone knows how to use them.

• Do not bring heating devices into the home that are intended for outdoor use, such as barbecues and other cooking equipment or other fuel-burning devices. These items can produce deadly carbon monoxide.

• Learn how to shut off water valves (in case a pipe bursts).

Cold weather wear:

• Wear several layers of loose-fitting, lightweight, warm clothing rather than one layer of heavy clothing. The outer garments should be tightly woven and water repellent.

• Wear mittens, which are warmer than gloves. Wear a hat. Cover your mouth with a scarf to protect your lungs.

Pay attention to symptoms:

• Confusion, dizziness, exhaustion and shivering are signs of hypothermia. Seek medical attention immediately.

• Gray, white or yellow skin discoloration, numbness or waxy skin are symptoms of frostbite. Seek immediate medical attention.

• In the case of overexposure to freezing temperatures, remove wet clothing and immediately warm the body with a blanket or warm fluids.

Key Web sites:

• Governor's Office of Emergency Services -- http://www.oes.ca.gov

• Red Cross -- http://www.redcross.org

• State Department of Health Services -- http://www.dhs.ca.gov. Source: Yolo County Public Information Office

WARMING CENTERS

For the cold spell predicted for the area through the weekend, Sacramento city and county officials will open four warming centers:

• Ethel MacLeod Hart Multipurpose Senior Center, 915 27th St.;

• Oak Park Community Center, 3425 Martin Luther King Jr. Blvd.;

• Clunie Community Center, 601 Alhambra Blvd.;

• Robertson Community Center, 3525 Norwood Ave.

The centers will be open from 8 a.m. until 9 p.m. If needed, those needing shelter at closing time will be transported by Regional Transit to overnight accommodations.

(photo credit: runs_with_scissors )

technorati tags:Sacramento, freezing, weather, centralvalley, farming, crops, citrus, homeless, poverty, immigrants, disaster, preparedness, globalwarming, climatechange, California

Software implementation failures

Here's another weblog on analysis of software implementation failures, to see what we can do to reduce that outcome.

Rearranging the Deck Chairs

by author Michael Krigsman

All too often, large software projects are like ocean liners in a sea of icebergs, going full speed ahead while the officers and crew focus on narrow technical details. Then Bang! The project smashes into an obstacle that should have been anticipated and suddenly everyone is underwater. The Deck Chairs blog is dedicated to identifying the causes of project failures and suggesting better ways to navigate around the icebergs. The picture across the top banner is the Titanic, inspiration for this blog’s title.

As president of Cambridge Publications, I oversaw the development of tools and methods for improving software implementations on really large, global projects. I’ve worked with SAP, IBM, and a bunch of other companies on these issues. As president of Asuret, I consult to make IT projects more successful and less risky.

I’m also on the Board of Directors (and treasurer) of the America’s Cup Hall of Fame and the Herreshoff Marine Museum, located in Bristol, RI. If you are in the Newport area come take a look. Bristol is a lovely town and the museum is situated right on the water — it’s really worth a visit.

Michael Krigsman

President
Asuret Inc.
Brookline MA USA
617-487-4134 ext. 18

Sample weblog entry from there:

SOA Web Services: Failures on the horizon  (Dec 8, 2006)

In a recent InformationWeek survey, 24% of respondents from large corporations said their SOA projects “fell short of expectations.” Of these, 55% said the reason for failure was that the SOA initiative “introduced more complexity into their IT environment” — ironic , given that one of the benefits touted by SOA proponents is that it reduces complexity.

technorati tags:SOA, IT, healthcareIT, leadership, projects, projectmanagement, management, success, failure, business, successfactors, factors, SOAP

On being "turing complete"

The Caltech Project Von Neumann defines "Turing complete" this way:

A language is considered Turing Complete if it is able to compute any function computable. It is still counted even if it takes the language a huge amount of time and memory to complete this function. It is somewhat important to try to make the Alife Engine turing complete so that we can try to maximize the possible behaviors evolvable in the creatures.

While Caltech is exploring simulations with artificial life ("a-life"), or self-regulating processes that in my terms are MAWBA ("may as well be alive"), my previous post here used the term Turing Complete regarding the actual, hierarchical, fractal, multi-level ladder thingie on which  humans occupy some middle rung.

As a prior post noted, if we assume, one way or another, that the world around us incorporates some very powerful design patterns, then we would expect recursion and a Turing Complete multi-level emergent computational ability to be one of them, as the Caltech project does for a-life. 

In other words,  we don't want to repeat the mistake Marvin Minsky made regarding perceptrons and single-level neural networks as being incomplete,which set Artificial Intelligence back 15 years.  Minsky, of course, later retracted his error, recognizing that 3 level neural nets can be complete, if they also include feed-forward.

Similarly, it seems silly to continue to explore single or two level versions of  "multilevel models" for human beings in social context (which is all that really matters for public health.) There is solid reason to believe, on general principles, that the emergent, evolving beastie is 3-levels, with feed-forward, or more complex than than.

Because each level can succeed in breaking loose from the levels below it, and taking on a mostly independent life of its own,  there is no way this can be "determined" upwards from "selfish genes."   Only by including vertical feedback and feedforward pathways that span 3 levels, that smear out "causality" via phase-lock loops,  can we achieve Turing completeness, and we should assume "Life" has figured that much out by now.

Especially, if even artificial life models at Caltech have figured that much out.

Conclusion - it is not possible to find a solid "causal pathway" from Dawkins and Darwinian evolution with "selfish genes" until you look upwards and include at least two higher levels of hierarchical organizational groupings, that are co-evolving independently. That whole gemisch is perfectly capable then, of being Turing complete, and figuring out what even most CEO's of US corporations can't -- that global altruism is a higher-level and more fit, longer-range better solution than local selfishness.

In the long run, in the large scale picture, we are all collaborating, not competing, and our co-evolution is mutually beneficial.   Coherent solutions to the US Army problems require coherence and integrity;  coherent solutions to nuclear power plant operations or aircraft cockpits require coherence and integrity across multiple levels of management, not just a single level.    Then, innovative solutions are visible.  Then, we are all Turing complete.

So, in that view, there is no surprise that humans are hard-wired to have emotions that drive them to altruism or larger group survival pathways, away from local dog-eat-dog competition models. The savage battle for local fitness misunderstanding is based on not seeing the higher levels that are operating in parallel defining the rules for the locally "selfish" interactions.

Also, in this view, it is not at all surprising to find massive depression and even the human version of apoptosis (cell suicide) resulting from philosophies (such as materialism) or behaviors that cause "individual" humans to break "free" of the "bonds" to other humans and the larger computational engine and be "rugged individuals."

Computer networking people figured out last century that networks of collaborating smaller computers have massively more power than trying to make a single "supercomputer".  LIfe doesn't try to make an "amoeba" with a single-cell that spans the earth - a model that doesn't scale up.   Life transitions to "multicelluar" forms at or around this point.  That's what humans need to see as the design pattern that works.

We need tightly knit teams that work as one, and there is where humans are hard-wired to find joy, happiness, fulfilment, and the abilty to crank out products that fill the bottom line.

technorati tags:positivepsychology, multilevel, hierarchy, alife, artificiallife, caltech, turing, completeness, turingcomplete

Positive Psych - Happiness 101

D.T. Max has an 11-page piece on the Positive Psychology movement, titled Happiness 101 in the New York Times magazine section today. (Jan 7, 2007)

The growing field is the area of specialization of Martin Seligman

Seligman, who at 54 had just been elected president of the American Psychological Association and was renowned for his hard science — most of his research had been in depression — decided to put his considerable talents into finding out “what made life worth living.”

Seligman’s book, “Authentic Happiness,” published in 2002, lays out the field’s fundamental principles and has been translated into nearly 20 languages. Last year’s annual positive-psychology summit in Washington attracted hundreds of academics working in the field or interested in doing so

Excerpts:

...the various building blocks of positive psychology: optimism, gratitude, mindfulness, hope, spirituality.

Positive psychology brings the same attention to positive emotions (happiness, pleasure, well-being) that clinical psychology has always paid to the negative ones (depression, anger, resentment). Psychoanalysis once promised to turn acute human misery into ordinary suffering; positive psychology promises to take mild human pleasure and turn it into a profound state of well-being.

“Under certain circumstances, people — they’re not desperate or in misery — they start to wonder what’s the best thing life can offer,” says Martin Seligman, one of the field’s founders, who heads the Positive Psychology Center at the University of Pennsylvania. Thus positive psychology is not only about maximizing personal happiness but also about embracing civic engagement and spiritual connectedness, hope and charity.

A nice review of Barbara Fredrickson's "broaden and build" theory is presented, with a review of he work in Michigan with Compuware to improve productivity.

For Fredrickson, this was evidence that positive emotions lead to broader thinking. The participants were also tested for what is called global-local-visual processing. When asked to look at a design on a computer of three squares arranged in a triangle, those who had watched happy-making film clips tended to see the broader pattern — i.e. the triangular pattern — while the angrier subjects saw only the squares. (The neutral ones saw some of each.)

Incidentally, a nice piece by Fredrickson in Science and Theology News is still cached and can be found with a Google search on "Barbara Fredrickson broaden and build."  Even from the title "Joy and love genetically encoded"  it's clear she's struggling with how to fit altruism and positive traits into the reductionistic Darwinian model that tries to make everything explainable by Dawkins' "selfish genes" - that is, a single-dimensional fitness-for-survival  function operating at a single level of biolife.

I've argued here before that a multi-level model with co-evolving fitness functions is almost certainly a stronger model, and, for those who care, "Turing complete."
(see my prior posts "The God Delusion by Dawkins", "Looks like UP to me" and "Technical comment on up Darwin and Dawkins")

The Times skips over most of the work on the impact of positive psychology on team performance and on high-reliablilty organizations.  See my post "Virtue drives the bottom line" for references to academic studies in that area.

Some more tibdits from the Times article today:

Participants contrasted the “hedonic treadmill” with “the meaningful life.”

...researchers at the University of Kentucky  ... showed positive emotions correlated to a 10-year increase in life span, greater even than the differential between smokers and nonsmokers.

Seligman’s Web site, authentichappiness.org, has a 240-question test to help determine whether your gift is for creativity, bravery, love or something else.

Over time, positive psychologists, led by Christopher Peterson, settled on 24 virtues — or character strengths, as they prefer to call them — including courage, modesty, spirituality and leadership.

And some criticisms

critics are often most disturbed by what they perceive as its prescriptive nature. “There is way too little evidence of stable, long-term benefits — and lack of harm — to justify large-scale incorporation of positive psychology programs into schools

[is it just:] If you are not optimistic, fake it.

But where Maslow and Rogers relied primarily on qualitative research for their theories, Seligman and his colleagues hope to establish positive psychology — and thus the nature of happiness itself — on firmer scientific ground.

Indeed, the sectlike feel of positive psychology can be hard to shake off

Two criticisms as troubling as the problem of positive psychology’s religiosity are 1) that it is not new — psychology always cared about happiness and 2) that the publicity about the field has gotten ahead of the science, which may be no good anyway.

technorati tags:Positivepsychology, psychology, depression, therapy, CBT, happiness, joy, virtues, Fredrickson, Seligman, Cameron, Dawkins, Darwinian, religion, science

California's New Health Care proposal

California Health care plan facing opposition

Sacrmento Bee  (California State Capital)  [registration required]

By Aurelio Rojas

January 6,2007

Even before Gov. Arnold Schwarzenegger formally unveils his health care plan Monday, fellow Republicans in the Legislature are vowing to block any plan that provides coverage for illegal immigrants...

But if the past is, indeed, prologue, Republicans could hold up the budget as they did last year until Schwarzenegger and Democratic lawmakers gave up on a proposal to provide $23 million for county programs that insure children, including illegal immigrants.

Providing universal health coverage for children in California who do not have insurance could cost the state $250 million to $400 million a year, according to various estimates.

Sen. Dennis Hollingsworth, R-Temecula, said such a proposal would not make economic sense, "because we're staring at a budget deficit that's several billion dollars."

According to the nonpartisan legislative analyst, California is facing a $5.5 billion deficit in the fiscal year that begins July 1.

Ruth Liu, Schwarzenegger's associate secretary for health policy, said the administration is still "developing all components" of the plan.

Schwarzenegger has made health care his top priority. He says he wants all uninsured Californians -- children and adults -- to have insurance, with individuals, government, employers, medical providers and insurers sharing the costs. That would cost an estimated $12 billion a year -- and the governor has been steadfast in his opposition to raising taxes.

In other California news,  strange weather patterns may bring snow to parts of California next week that haven't seen snow since 1976.    Weather, and water, are critical issues to California, for tourism, agricultural, and public health reasons.

The Sacramento Bee noted a new DVD flood-plain video this week in the suburb of Natomas that highlights the fact that much of that region is a flood plain.  In fact, it is little appreciated that much of the California capital district area around Sacramento is protected by levees and is actually below sea level, as was New Orleans.    Any change in weather patterns brings a new risk of flooding.

In the Sacramento Bee there was an article and a whole series following Katrina related to the flooding issues. This is from the article "Tempting Fate: Are we next" published in the Bee on October 27, 2005.  (For reference, Hurricane Katrina hit in late August, 2005)

There is, however, no major city in America more at risk of a catastrophic New Orleans-style flood than Sacramento.

 Compared with other big cities, Sacramento is marked by a potentially deadly combination of geographic, hydrological and demographic factors unmatched anywhere in the United States.

Take a look at the collection of strikes against us:

• We sit at the confluence of two major rivers, the Sacramento and the American.

• They drain vast watersheds that begin high in the mountains, meaning a major flood would come with staggering volumes and ferocious velocities.

• Huge sections of Sacramento - including miles of neighborhoods, the downtown commercial center and the state Capitol - rely on levees to keep from going under in times of high water.

• Unlike other cities that sit on high ground or bluffs above rivers, much of flood-prone Sacramento sits lower than the levees and the rivers at flood stage.

• Sacramento's levees offer less protection than those in many other cities.

Officials worry they could fail or overtop if a large late winter or early spring storm system brought more water than they were designed to handle. Warm "Pineapple Express" systems are especially feared, because they can sidle up against the mountains, rain for days, and cause too much snow to melt at once and barrel down river corridors.

•... According to the Sacramento Area Flood Control Agency, more than 300,000 people and 140,000 structures are in the direct path of a serious flood in Sacramento.

In the eyes of the nation's top flood experts, only one other big city could rival Sacramento for the top catastrophe-prone title.

And it [New Orleans]  has been largely destroyed.

Will the weather get worse, not better?   Max Mayfield, who just retired as Director of the National Hurrican Center had this to say:

Hurricane Center Chief issues final warning

LA Times

January 3, 2007

MIAMI — Frustrated with people and politicians who refuse to listen or learn, National Hurricane Center Director Max Mayfield ends his 34-year government career today in search of a new platform for getting out his unwelcome message: Hurricane Katrina was nothing compared with the big one yet to come.

Mayfield, 58, leaves his high-profile job with the National Weather Service more convinced than ever that U.S. residents of the Southeast are risking unprecedented tragedy by continuing to build vulnerable homes in the tropical storm zone and failing to plan escape routes.

And he argues that his dire predictions don't have to become reality.

The technology exists to build high-rise buildings capable of withstanding hurricane-force winds and tropical storm surge more powerful than those experienced in the last few years. Much of Hong Kong's architecture has been built to survive typhoons, and hotels and apartments built in Kobe, Japan, after a 1995 earthquake devastated the city are touted as indestructible, he said.

What is lacking in the United States is the political will to make and impose hard decisions on building codes and land use in the face of resistance from the influential building industry and a public still willing to gamble that the big one will never hit, he said.

technorati tags:California, CA, healthcare, Sacramento, flooding, disaster, preparedness, builders, immigrants

Obesity linked to intestinal bacteria

Blame fat on the bacteria - again

By Thomas H. Maugh II

Los Angeles Times Staff Writer

January 6, 2007

Bacteria in the intestines can modify the body's chemistry to alter the amount of food that becomes stored as fat, according to a finding in mice reported this week that could help in controlling obesity.

A team [Geoffrey Gordon and Ruth Ley] from the Washington University School of Medicine in St. Louis had reported last month that obese mice — and humans — have an unusually high proportion of a family of intestinal bacteria that are exceptionally efficient at breaking down complex sugars in the diet into a form that is readily absorbed. The upshot is that the bacteria make more calories available to the body from a given quantity of food, leading to weight gain.

The same group reported in the current Proceedings of the National Academy of Sciences that the bacteria also play a more direct role, manipulating body chemistry to increase the amount of food stored as fat...

The bacteria suppressed production of a hormone called fasting-induced adipose factor,

The bacteria also suppressed production of another enzyme, called adenosine monophosphate-activated protein kinase, which is used by the body to burn stored fat for energy. Lower levels of the enzyme make weight loss more difficult.

The net effect is that the bacteria not only make more calories available to the body, they encourage the body to store that energy as fat and keep the fat on.

One interesting "systems" feature of this result is that it may reveal another pathway, off the normal maps, for psychosocial factors, particulary social stress, to use to influence obesity - which we know happens.

It was only relatively recently realized that another bacteria (H. pylori) was heavily involved in human development of peptic ulcers.

Both of these may be cases where our "biomedical model" of the boundaries of a human being's physiology turn out to be too restrictive, and we need to expand the boundaries outwards to include topologically external factors and even other species as having a directly linked ecological effect on "human" digestion.

That, in turn, supports the mental model I've suggested, that any factor, regardless how distal, that can get itself into a phase-lock loop with human physiology has to be, mathematically, considered as "real" and as "part" of human physiology as organs such as the liver. In a very real regulatory feedback loop control sense, the closer we look, the less it appears that "we" are separate individuals walking around with big gaps between us, and between us and "other species."

The implications are that to study epidemiology or to design health interventions, we need to be guided by a map of regulatory feedback control space, not just a map of the physcial world our unassisted eyes report to us. That makes impacts on "personal health" that are "caused" by changes in social interaction, now well documented, to be less mysterious and more "obvious."

Link to NPR audio coverage of same story and many related stories on the epidemic of obesity.

CNN Coverage.

CDC - Centers for Disease Control and Prevention - on Overweight and Obesity in general.

(Photo credit - jege which I selected because I thought the key point here was the psychological resistance to meeting a new species and realizing we need to include it in our lives.)

technorati tags:Ley, Gordon, Obesity, microbial, ecology, bacteria, systems, overweight

Prince George's Hospital System in the ICU

Prince George's Hospital System is Desperate for Cash

(Prince George's County, Maryland,  USA ( Yahoo interactive map))

By Rosalind S. Helderman
Washington Post Staff Writer
Saturday, January 6, 2007; B01

excerpts:

A leading Maryland senator warned this week that the financially troubled Prince George's Hospital system faces imminent shutdown if it does not receive a $5 million cash infusion soon.

The county-owned system serves 180,000 patients a year, many of them poor and underinsured, at Prince George's Hospital Center in Cheverly, as well as a regional hospital in Laurel and other clinics...

A total shutdown would wreak havoc on medical care across the region, forcing indigent patients to flood other regional hospitals. The Prince George's Hospital Center also operates Maryland's second-busiest trauma center.

 

technorati tags:PrinceGeorges, Maryland, hospitals, traumacenter, indigent, insurance, uninsured, homelandsecurity, regionalcare, Washington, DC, surge, capacity, preparedness, healthcare

Medical Tourism ramps up in China

Preparing for the 2008 Olympics in Beijing, China, is an occasion for increasing the capacity as well for "medical tourism" in general. There's plenty of business opportunity here for lower cost health care, for, say, California residents, abroad at prices substantially below those that health care plans in the US can offer on US soil.

This is a perfect example of a public health problem where "system thinking" is necessary. An attempted regulatory process to improve quality and to control costs in the US, based on a mental model of a passive world, executed in a "complex adaptive system", has exactly the opposite "unintended side-effect" of driving care and dollars abroad. There are long-lived assumptions of planners that are lagging well behind current actual events, so their "dashboards" are out-of-date. Plans that make sense if you put the problem boundary at the edge of the USA no longer make sense if the boundary is moved to the planet as a whole. Welcome to the 21st century!

It will be interesting to see how that plays out. So far, the USA unions have resisted what they see as "inferior" care abroad, but the US-based Joint Commission International has started accrediting foreign programs so those concerns may be alleviated, in which chase the price differential may determine the outcome. There is an interaction with US care, because if the Certificate of Need process in the US limits the growth of hospitals here, but doesn't stop them from expanding unboundedly abroad, then crowding here will tend to drive patients abroad.

There may be enough data available now to get past the hype and fantasy and see how fast this is really growing and what the 5-10 year projections look like. Systems dynamics models and simulation are probably required to make any credible projections at all in this active space.

A Google search on "medical tourism" turns up a number of sites that are already glad to offer "portal" services in arranging for lower-cost care abroad (after including air-fare and hotel accomodations.) See also "Medical Tourism Growing Worldwide."

Dec 12-16, 2006, Singapore hosted the first International Medical Travel Conference.

Ms Geraldine Chew, General Manager, Avail Corporation says, “This is the first global medical travel event in Asia. The event will not only provide an education platform for those who are already in the business of medical travel or going to embark on one, but healthcare providers, medical travel agencies and other parties will also have the opportunity to establish ties and clinch business deals through our exclusive networking sessions, one-on-one meetings and exhibitions.”

To help grow and develop this new industry, the conference will also witness the soft launch of the International Medical Travel Association. The association aims to bring together the international community of medical travel organisations, creating opportunities for networking, business development and knowledge sharing on best practices among members, and ultimately to protect and promote the rights of international medical travelers. The association, the idea of which has received widespread interest, will take the occasion of the conference with its many participants to hold its first general elections and discuss its role and contribution to the Medical Travel industry.

That travel association will complement IAMAT, tihe International Assciation for Medical Assistance to travellers, which helps people already travelling abroad locate medical care.

The question is, can US healthcare manage to lower its total cost, or will it go the same way as manufacturing and many service industries that have simply flowed abroad when the price differential became too great to resist? As the manufacturers said, it's hard to keep a business in the US paying $17.00 an hour when you can find workers abroad doing work just as good for $1.70 a day.

The concept that other countries could have care competitive with the USA is one that is difficult for doctors and hospitals in the USA to accept or find credible, but it was hard for General Motors to believe that some Japanese auto company would ever compete with it, let alone dethrone it from first place, so skepticism by providers of services is not a persuasive argument. In fact, lack of realistic planning for a growing medical tourism component of care for US citizens might lead to very poor policy decisions.

And, given that the US health care bill is over $1 trillion a year, larger than the Defense Department, even a 20% or 30% loss of business to rising competition abroad could make a sizable dent in the Gross Domestic Product.

For 50 million uninsured Americans, or even insured ones with increasingly large co-pays, there may not even be a choice - $55,000 in the USA for knee replacment they can get done in Singapore or Dehli for $4,000, by doctors trained at Johns Hopkins or Mass General,makes a pretty compelling icase if you only have $5,000 in the bank. As efforts ramp up to increase co-pay in the US, it will drive even more business abroad.

Speedy international travel is another factor. If clogged emergency rooms in Los Angeles mean a 12 hour wait for service, it might be faster to take a cab to LAX and a 747 to Singapore and get service there. On a larger time scale, if elective surgery takes months to schedule in the US or Canada, and under a week to schedule abroad, another market segment may take the path of least resistance.

A few weeks ago a friend of mine had a broken arm set, and another had an abdominal pain checked out in Emergency rooms in the US, and were each billed $6,000 for 6 hours. If I had to pay that out of pocket I'd consider temporarily splinting the arm and flying to Beijing to get it done for $1,000 plane fare and $500 hospital and doctor costs, using the passport that the US now requires everyone to have anyway who leaves the US, even to go to Canada or Mexico. (one more barrier to travel removed as an unexpected side-effect of anti-terrorist policies.)

The price differential keeps going up, the quality differential keeps going down, and the other hurdles such as arrangements, passport, or ability to find someone else who's gone abroad are all dropping. There will be horror stories, but there are horror stories here too. Obviously there will be a learning-curve and ramp-up or shake-down, but the trend is clear. The more the burden of cost is shifted to consumers (patients) in the USA, the more they're going to shop around on the Web and ask why they are not going abroad to the same places they trust to build their electronics and cars.

Sooner or later, some state like California is going to make such travel one of the cafeteria plan options and encourage people to do it, and this will take off. If business gets large enough and constant enough, someone will start "medical 747 service" from LAX to Beijing or Singapore, with specially outfitted 747's that have medical staff and a small operating theater on-board and that do all the preliminary exam work on the way across the ocean, removing yet one more hurdle.

The real question seems to me is whether international hospital chains will move into this niche and make it very easy for patients to pick from a cafeteria of pre-qualified hospitals, some in the US and some abroad, under the same third-party coverage. If that happens, stand-alone hospitals in the USA that have no correspondent hospital abroad will be at yet a new disadvantage for survival.

Here's the news from Beijing this morning.

Hospitals gear up to treat foreign visitors
By Zhang Feng (China Daily Online)
Updated: 2007-01-05 10:49

Beijing doctors treating foreign patients during the 2008 Olympics will be required to speak English and also write prescriptions, medical records, and costs list in both Chinese and English.

The move is part of a plan by the Beijing local health authority to boost the city's health services and make them more visitor-friendly during the Games.

More than 20 hospitals in Beijing, which include the People's Liberation Army General Hospital and the China-Japan Friendship Hospital, have been selected as special foreign treatment centers during the 2008 Games.

These hospitals are rated the best in the capital and will continue to import better medical equipment, improve service standards, and enhance staff training in the lead up to 2008, according to Jin Dapeng, director of Beijing Health Bureau.

All doctors and staff at these hospitals will learn English and other languages in order to better communicate with foreign clients. Multi-lingual first-aid volunteers will also be recruited.

The Health Bureau will collaborate with banks to ensure foreign patients can use international credit cards in the hospitals.

Foreign patients can also enjoy traditional Chinese medical services, such as acupuncture, massage, and herbal medicines.

The improved health network will include a response plan for public health emergencies, disease prevention and control systems, better medical treatment and health monitoring and widespread public health information.

"Our goal is to ensure that there would be no outbreak of serious epidemics, no big public health accidents. We must have the ability to quickly control them if they appear," Jin said.

He said systems would be set up to ensure every injured or ill person is given timely first aid and treatment.

Beijing's emergency medical aid center will upgrade its global positioning system used for ambulances. The Health Bureau will cooperate with the aviation department to provide air rescue services during the Games.

Jin said a food safety monitoring system covering all Olympic Games' districts and counties will also be set up this year. Food and drinking water in the Olympic village, stadiums, hotels and restaurants will be strictly monitored.

He said a reporting and emergency response system covering intestinal and respiratory diseases has been established and will be continuously strengthened to prevent infectious diseases.

technorati tags:medicaltourism, travel, hospitals, healthcare, costs, containment, costcontainment, China, India, uninsured, California, medicalcare

Military falling away from GOP

Weaning the Military from the GOP

LA Times

January 4, 2007

BURIED IN THE NEWS last week was one of the most potentially significant stories of recent years. The Military Times released its annual poll of active-duty service members, and the results showed something virtually unprecedented: a one-year decline of 10 percentage points in the number of military personnel identifying themselves as Republicans. In the 2004 poll, the percentage of military respondents who characterized themselves as Republicans stood at 60%. By the end of 2005, that had dropped to 56%. And by the end of 2006, the percentage of military Republicans plummeted to 46%.

technorati tags:military, republicans, army, governance, government, command, doctrine, sideeffects, consequences, systems

Influenza in USA - Map - CDC report Dec 23rd 2006

Data tends to be about a week old by the time it's available, longer if a holiday is involved. The map shown is for the week ended Dec 23, 2006, which is the latest available.

Historical influenza (flu) data is available from the CDC website here.

technorati tags:CDC, influenza, flu, USA, GIS, epidemiology

Dawkins and his competition with God

"All models are wrong, but some models are useful" is the motto of many biostatistical groups.

It's actually not necessary for a model to be correct to give us insight by even thinking about applying it to a situation.  Sometimes it's useful to successively apply a whole checklist of models or frameworks to compare what each of them suggests.

The battle over unvarnished Darwinism as espoused by Richard Dawkins that wrote on a few days ago continues to reverberate in my mind.

I think that one useful model to view this with, not necessarily right but definitely useful, is the pure marketing and "competitive product" view.

In that model, humans have a need or a "niche" that they spend resources on, in our case under consideration that would be "Religion" and what Dawkins calls "God."     He, and of course Oxford University, and most of the rest of the product vendor called "Science" (in this model), have an alternative product that would either fill that same niche, or is blocked from being purchased by what is currently in that niche (ie, religion.)

And, the Science (trademark ) brand notices it is recently losing market share to the Religion(tm) brand, and wonders why.

Dawkins, and others, viewed in this framework, are effectively asserting that "the customer is stupid" and "the customer is wrong" and their own product (Science (tm)) is obviously superior.

That type of response to loss of market share is pretty much what General Motors has been doing for the past 30 years, as Toyota and Honda persistently ate a larger share of  GM's lunch.  This year or next, but very soon, Toyota will pass GM - and as all American's have been repeated taught for some baffling reason,  if you can't be number one, you might as well commit suicide. Investors will bail out screaming.  Civilization as we know it will come to an end.

In GM's case, it would be good for their sales if they ever stopped wailing about how unfair life is, and got down to the business of business and looked at what the consumers were buying, and why, and adjusted their product line to that.

In the case of Science (tm),  the bundle of attributes they are selling doesn't seem to appeal to their potential customer base.

At least some energy should be put into an honest and frank exploration of what the needs are of humans on every scale,  and why the Science(tm) product line doesn't meet those needs, as judged by customer's feet.

Or, like GM, they will sink slowly but persistently into the "has been" category.  Science(tm) takes place in a social context - a fact of life that is as "inconvenient" to Scientists as Global Warming is to politicians.   Science(tm) rose to power and access to a good chunk of the national budget and respect on a set of promises and implicit or sometimes explicit promises of a "better life" for people, groups, companies, nations, and the planet.

Maybe, the customers are looking at the actual outcomes, not the Boardroom powerpoints, and, from their point of view,  the promised "better life" just doesn't seem to be there.

I can hear in my mind some Scientists replying "But, that's not our problem!"

Actually, it is.

technorati tags:science, religion, commerce, business, marketshare, marketing, competition

Technical Comment on "up", Dawkins, Darwinians

Dawkins and other myopic Darwinians are operating under the assumption that the fitness metric evolution utilizes is a scalar field in a flat metric.

in terms of General Relativity or Hilbert space, "up" is only well-defined in a flat metric with zero curvature. Once you let the metric be curved, or even multiply connected, the best you can do (!) is to define a local "more fit" direction, and even that may vary among observers with different velocities or observational positions or scales of observation.

Attempting to reduce multiple dimensions to a single dimension is a "Procrustean" activity, invalid - but done all the time as we attempt to find the "best" spouse, or house, or investment, or sports team, or job, or employee, or political candidate.

We have to stop trying to force the world to come down to the level of our tools. We need to start trying to improve our tools up to the level of the world around us.

Then, we'll be able to see what's going on much better. Scientific tools are a great idea, and we need more and better tools, but in the meantime the conclusions drawn from them should be no stronger than the demonstrated validity and calibration of those tools on the type of problem in question.

I suggest recomputing the behavior of evolution if the fitness metric space is a generalized Hilbert space, even simply connected, but at a higher rank than a scalar field.  For example, suppose "fitness" is defined as a 5-dimensional field,  corresponding to sublocal fitness at two levels, local fitness, group-fitness, and supergroup fitness.  Then, what kind of pathways are there through that space over a billion years?

technorati tags:Hilbert, up, fitness, evolution, Darwin, Darwinian, Dawkins, dimension, rank, tensors, Hilbertspace

Looks like "up" to me

Recent posts on "free will" led me to writing a parable for our time.

Once upon a time there was a scientist who discovered that things always go "downhill", and he was sad. He went to the town square to share his sadness.

There he met a young couple returning from the ski slopes, flushed with enthusiasm after their wonderful afternoon. He told them they had only gone downhill, trapped in the clutches of gravity all day -- so they became sad too.

He met a young woman who had spent the afternoon in a sailplane, soaring up and down the valley, riding thermals high into the sky and soaring down again to race the sailboats on the lake, all going back and forth downwind. He managed to defuse her joy as well, pointing out that sailplanes and sailboats, lacking engines, can only go downhill.

Finally, he met a mathematician coming from the art gallery where he had been studying M.C. Escher's painting of Waterfall, Hofstadter's strange loops, and a set of those funny dice that beat each other in a loop forever with no "best one". For that poor soul, directions seemed to be tangled together and refused to stay in their proper places. Still, at last, here was an audience with mathematical skill! The scientist shared how, even though the visible universe used to be a formless sea of hydogren and now was filled with trillions of fascinating objects and life-forms, it was really, if one figured entropy properly, all simply going "downhill". The mathematician refused to be depressed and just replied "Yes, isn't intuition terrible? He'd heard that bumblebees couldn't fly either. What a shame."

Unable to depress anyone else this sunny afternoon, the scientist brooded as he walked back up the mountain to his cottage. Finally, unable to take life any more, he hurled himself off a cliff and fell, downhill of course, to his death. After his funeral and a brief period of mourning, the town actually brightened up quite a bit without the constant drone of gloom, and everyone else lived happily ever after.

technorati tags:parable, down, up, downhill, entropy, sailplane, escher, dice, depression, gloom

Free will forced to reveal itself

Sometime in the 1970's I joined the Institute on Religion in the Age of Science (IRAS) and went to a conference out on Star Island on "Determinism versus Free Will."   I've been following that centuries or millenia old discussion for the last 30 years, watching it evolve as science develops new tools and concepts.

One thing that is definitely true about this debate is that it can consume an unbounded amount of time with little visible progress or outcome, although headache may be common.

The motif has resurfaced again in many ways, from organizational theorists wondering how to change a culture to produce safer or more reliable or more predictable outcomes, to public health pondering where to intervene in poverty or depression -- how far upstream to go in the "Russian doll" type of nested contexts that carry "causality" upwards and out of sight.

Meanwhile, of course, social engineers and Madison Avenue ad executives and politicians work the other end,  seeking where to alter context to produce a political outcome that they find desirable that the people in the middle perceive as having been freely decided. Tobacco, fast-food, and drug companies spend billions of dollars to change the outcome of the exercise of "free choice' on the part of consumers while claiming that a concern for constitutional protection of free will is their own driving force.  This is, needless to say, a major concern of public health at this time,when trying to figure out how to get people to stop smoking who want to, but are caught up in a larger determining network.

The fact is that all local interactions take place on a larger contextual playing field, which can be tipped somewhat to favor one outcome over another in a way that is not instantly obvious to those on the field.  It has been said that hypnotists can't make a person do something he wouldn't do in normal life, such as murder someone, but they can change the perceived context so the person does the desired activity because they perceive that, say, the person they are killing is really some sort of dangerous reptile.

Both context and content are always at work, but context is much harder to see, and the context of the context even harder, etc., even though it is just as real and perhaps even more determining of the outcome.

People make all observations in their own reference frames, but they are notoriously unaware of how biased and warped those reference frames can be, because, from within them, they look unbiased and flat.

The problem becomes even more extreme when a collection of people locally all remove diversity and take on the same warp, which now can't even be noticed by the fact that others are looking at one strangely when suggesting some bizarre idea.  Groupthink rules.   This is exactly the risk and danger that "safety cultures" and high-reliability organizations have to try to overcome.

And, of course, people in the middle of thousands of such contexts try to reverse engineer the equation and figure out why they do what they do, especially when it's not what they wanted to do in the first place.   Over 2/3 of the USA's health care expense is due to "lifestyle choices" such as smoking, drinking, exercise, drugs, but we have to ask what, in turn "causes" those choices?  It's increasingly obvious that the concept of "an individual" is a tricky one, as more and more of the causality moves upwards to peer-groups and context.

So, we're back to the nature versus nurture controversy again,  genes versus upbringing. If there's one major lesson I'd say we can learn from "systems thinking" it's that the word "OR" should be eliminated when feedback loops are involved.   Wages influence prices and prices influence wages in a spiral but the term "cause" is not applicable -- there are two intervention points and either works just fine, thank you.  The math is very familiar to anyone who ever built analog electronic circuits, which is fewer and fewer of us today.

I highly recommend that a reader who hasn't checked out my earlier post on marvelous machines driven by context should do so.  Picking from there a very simple example, to illustrate the problem of "OR",  consider the water faucet and the idea that you can go and open the faucet and water will come out (hopefully.)     So, we might ask, WHY (on a deep level) do the water molecules "decide" to come out of the faucet at that time? Is it due to local interactions? Or is it caused by some remote, alleged "water tower" that contains water and is alleged to transmit a desire, across huge distances, to the local water molecules that somehow forces them to move out of the faucet at that time?

The correct answers are more "yes" and "both", not one or the other.  Again, I highly recommend tuning and calibrating one's mental concepts about "causality" on the examples I give there, which are extremely simple and totally visible,  before venturing out into the wilds of human existence, free will, and determinism. 

If your concepts don't work or help you with easy problems, why would you trust them on hard problems?

I don't plan to get sucked in, (against my will),  to a length debate at this time on free will, but I did want to note the Times article, and at least one or two references for follow up.

Today's New York Times article is linked here:

Free Will:  Now You Have It, Now You Don't

By Dennis Overbye

Jan 2, 2007

Excerpt:

“Is it an illusion? That’s the question,” said Michael Silberstein, a science philosopher at Elizabethtown College in Maryland. Another question, he added, is whether talking about this in public will fan the culture wars.

“If people freak at evolution, etc.,” he wrote in an e-mail message, “how much more will they freak if scientists and philosophers tell them they are nothing more than sophisticated meat machines, and is that conclusion now clearly warranted or is it premature?”

Daniel C. Dennett, a philosopher and cognitive scientist at Tufts University who has written extensively about free will, said that “when we consider whether free will is an illusion or reality, we are looking into an abyss. What seems to confront us is a plunge into nihilism and despair.”

How comforted or depressed this makes you might depend on what you mean by free will.

For what it's worth, I personally am a big believer in free will and find their "plunge into nihilism and despair" to be totally unwarranted, but I will leave most of that discussion for another day.

Here's one alternate reference, selected from Google hits, a  STARS conference on  "downward causality" in emergent systems, a theme I touched on yesterday when talking about pixels forming images that then get a life of their own and turn around and start ordering the pixels around. 

My own arguements in prior posts are that this phenomenon is widespread and scale-invariant, meaning it is a basic physical property of nested regulatory feedback loops and we should expect to find it manifesting itself at every scale, from sub-atomic to trans-galactic.    We can therefore, if that is true, use the powerful principle of "symmetry" to compare results and insight across disparate fields of research.

So, for example, we might go to the level of a corporation and see how a founder of a company could make a company to serve him, but shortly end up being thrown out by the company which has now decided to go off on its own in some other direction.

The impact of culture on the bottom line, or success on the battlefield, is another important area of research that needs the insights from this hierarchical causality mathematics. See my post "Virtue drives the bottom line" on hard-headed corporations and the US Army and their use of these principles.

Or, in the delightful book "Systemantics",  John Gall talks about how academic faculty members had once hired staff to fetch writing supplies, and, in some sort of turnabout, the staff became administrators and started telling the faculty what to do.

technorati tags:freewill, determinism, context, feedback, systems, hierarchy, IRAS, Gall, virtue, society, will, freedom, advertising, ads, MadisonAve, control, command, politics, hypnosis, mesmerism

The God Delusion by Dawkins

My holiday break read, that I'd like to review today was Richard Dawkins' new book The God Delusion (2006).

It's important for me to state upfront that I'm writing this as a person with one foot in the science camp and one in the religious camp,seeking a synthesis of the best of both. This piece is from the scientific perspective.

Dawkins is a scholar at the University of Oxford, in England, and an opinion-leader for the New Atheist movement. In his view, having seen recent world events that he attributes to "extreme religion" he takes the position that we'd be far better off without even "moderate"religion, as he perceives it to be a breeding ground for extremism.

In his view, religion as a whole has no obvious function or value or Darwinian "merit" and is most likely, in his mind, just some side-effect. Still, his book spends some time considering why religion is so wide-spread in every culture, from a Darwinian perspective.

On the plus side, I heartily endorse his plea for civilization - can't we all take a break and stop killing each other while we consider politely why reasonable and well-intentioned people in different camps appear to get such disparate readings on what's going on?

On the negative side, I think Dawkins, while well-intentioned and trying to be fair and balanced, is blind to his own blind spots regarding possible benefits of religion.

I'm not disputing his evidence that religion, in some cases,has tangible harm and leads to violence; but I do dispute his oversimplifying and poorly examined assertion that all religion is harmful and has no corresponding benefits on any scale.

First, he uses terms in a slippery fashion, variously attacking "God", "religion", "belief" and behavior. He admits he's not a sociologist.

Dawkins himself asserts what goes on in a person's home should be his own business, and we can assume his and Oxford's view of academic freedom support the principle that what goes on in his own mind should be his own business (no "thought crimes") and only when beliefs turn into antisocial behaviors are there issues.

In that vein, by his own arguments, his academic attack on the internal academic structure of religious beliefs of non-academics is largely irrelevant. Most of the world has neither the training nor inclination to build mental structures that are pleasing to academics.

So, it is not really the beliefs per se, but the "behaviors and practices" that Dawkins finds appalling, that he seeks to modify by heading upstream and applying a social engineering intervention of removing God and religious beliefs from everyone. In his mind, we should treat religion as if it were an public health epidemic of a virus that causes stupidity, violence,and large-spread death.

I suppose that conclusion would follow immediately if we accepted his premises that religion has no positive value and serves no purpose, but his case consists primarily of hand-waving and ignoring evidence. He seems to be speaking to his own choir.

So, OK, let's apply some public health methodology to this problem.

First exactly how did he determine that religion has no value? He didn't do a focus group or household survey to ask people for subjective opinions on the matter. (He wouldn't like the answer she'd get.) He didn't do a facility survey at local churches or mosques. And he certainly didn't do a controlled experiment by taking a group of people who "had religion", removing their faith somehow, and comparing the "before and after" states to show the effects.

Still, what magic did he use to diminish to zero even rock-solid effects of religion?

Take, for a simple illustration, the Latter Day Saints(Mormons) of Cache County, Utah, USA. This highly studied group, identified by their religion, has a life expectancy about 10 years longer than the average US citizen, possibly due to the fact that their religion prohibits smoking and drinking alcohol.

Now, theoretically, it may be true that a similar improvement in life-span would be observed if the whole New Atheist group similarly gave up smoking and drinking-- but atheist groups don't seem to show that kind of cohesion and norm-setting capacity for modifying their member's behavior. The group intervention from "Weight-Watchers" might come close, but the religious Alcoholics Anonymous would probably claim that religion is an important factor in their success.

Still, many people would say that the LDS group's religion"gave them the strength" to sustain healthy life styles, in the midst of a culture saturated with messages pushing them to smoke and drink. There is, incidentally, in this example, no need for "prayer"or "divine intervention", and no need for their belief system to be"correct" in some theological sense. That's not the question. The question is, whether "religion" ever has some "benefit" measured on a tangible, outcome scale such as morbidity and mortality.

Doesn't this single counter-example disprove Dawkin's argument that religion has no positive benefit? My reading is that, if asked, Dawkins would join many classical biomedical epidemiologists who dislike "distal causality" and say that the benefits are due to life-style changes, not due to "religion." On this type of grounds, I think, he manages to dismiss a huge number of examples that can be raised where "religion" has been beneficial to people.

Institutionalized religions, with large scale cultural norms, are very different animals that internal personal philosophies, and almost certainly have very significant impacts mediated by those cultural norm sand social pathways with multitudes of feedback loops across space, time, and scale. They are also, in a connectionist sense, large computing engines that digest perceptions and make sense of the world with some learning capacity over time. There are many pathways for benefits to occur besides miraculous alterations of the laws of physics. Even these he dismisses with his broad brush strokes of trying to eradicate mental models that don't work for him.

I can understand his interest in economy, and wishing that such benefits and "morale strengthening" would flow without all the infrastructure of religion. Curiously, that doesn't seem to happen easily. More power to him if he can disentangle the religion from the social norm and life-style components, and package and sell just the "good stuff" with none of what he calls "bad"stuff. I'm not going to hold my breath. Solitary individuals don't stand much chance going against social tides.

I would assert that Dawkins is urging a dangerous large-scale social intervention that would remove a behavior modifying factor of moderation. His proposed intervention seems far more expensive, less likely to succeed, and perilous in the downside, than an alternative of focusing effort on making the existing religions somewhat more flexible and self-policing and tolerant so that they can keep their own populations from becoming extreme.

Even from a martial arts or strategy point of view,deflecting a blow is far less trouble than stopping one in its tracks. Worse,from a "systems thinking" point of view, we have to worry about whether the violence we see is, in fact, being caused by the exact activity we are using because we think it will lessen the violence.

Dawkin's suggestions of an all out assault on even moderate religion certainly runs a risk of generating far more hostility than it dampens.

Dawkins sees that all those impacts are very distant from the level of his "selfish genes" and dismisses them as extraneous,but then even he has second thoughts around page 169 and starts to look against "Group Selection". He's unconvinced by the math, identifies himself as "Those of us who belittle group selection", but admits that at this point even Darwin had to pause.

As such, he's excluding not just single-level "group selection", but long-term multilevel hierarchical selection pressures from small group, neighborhood, large-group, species, ecosystem, and biosphere. He doesn't deal with the amplifying effects over a billion years of any feedback loops at all for what are locally small effects, neglecting the lessons from physics that "weak forces" such as gravity, over large space and time, can end up dominating "strong forces" such as electromagnetism for shaping outcomes.

Also, he only indirectly mentions the Santa Fe Institute, experiments in"artificial life", and mathematical experiments via computer simulations of what the impacts can be on evolution in electronic worlds from morphic shaping from "above" at even very small levels. In the "selfish gene" world, even"culture" doesn't seem to exist. I haven't read his book extended phenotype, but his description of it seems to open the door, which he doesn't go through, to such larger scale entrainment of local perception and behavior.

We seem on many biological and social levels to have archetypes that are as if many pixels form an image, and then the image gets a"life of it's own,", lifts up its skirts, and turns around and starts telling the pixels what they are allowed to do. We need to study that more.

And, I'll suggest that we need to avoid the Minsky catastrophe. Marvin Minksy set back the world of Artificial Intelligence andNeural Nets ("Perceptions") at least a decade by "proving"that neural nets couldn't solve certain problems. His mistake, that he ultimately realized and retracted, was that he had looked at one and two layer networks. It turns out that networks with three or more layers that included feed-forward, could,in fact, form a complete computing device and solve all such problems. He stopped too soon. In my mind, the same mathematics apply to looking at one and two layer "group selection" models - until we get to N-layer models with feedback and feed-forward, we're going to miss the prize. The fact that Dawkins sees no effect on a gene + group two-level model is not persuasive of anything except that he didn't look very hard.

I'd think one of the strongest arguments against the "intelligent design" movement he detests (interpreted as "fixed creation of the end product") is that the most intelligent programmers these days solve problems using "evolutionary programming." It can be much more economical and powerful and elegant to "grow" a solution than to"build" a solution.

In summary, Dawkins says "I don't see what you guys claim you see at all, you must be gullible." My reply is, "Your tools were designed for looking downwards. They're demonstrably blind to complex adaptive systems dominated by feedback and context effects. They can't detect distal causality from above in even simple cases. When you get better tools, come back and let's explore the "up" direction together."

In the meantime I remain concerned that the"respect" he suggests we should abandon for religion is precisely the moderating element that is preventing all out global warfare over religion.

It is certainly simpler to say "we're right and you're wrong", but it is probably not the way to calm the waters. Saying "We're right and your whole culture should be extinguished" is alarmingly close to exactly the thinking Dawkins sees so clearly in his enemy, and so poorly in his colleagues.

(Photo credit - Victor Nuno )

technorati tags:Dawkins, GodDelusion, God, religion, atheism, science, systems, feedback, multilevel, causality, simulation, SantaFe, Islam, Muslim, Christian, ID, warfare, peace, mediation, moderation