Yet another underreported medical scandal — the overmedicated elderly

“Add Dx of schizophrenia for use of Haldol,” read the doctor’s order, using the medical shorthand for “diagnosis.”

But there was no evidence that Mr. Blakeney actually had schizophrenia.

Antipsychotic drugs — which for decades have faced criticism as “chemical straitjackets” — are dangerous for older people with dementia, nearly doubling their chance of death from heart problems, infections, falls and other ailments. But understaffed nursing homes have often used the sedatives so they don’t have to hire more staff to handle residents…

The share of residents with a schizophrenia diagnosis has soared 70 percent since 2012, according to an analysis of Medicare data. That was the year the federal government, concerned with the overuse of antipsychotic drugs, began publicly disclosing such prescriptions by individual nursing homes.

Today, one in nine residents has received a schizophrenia diagnosis. In the general population, the disorder, which has strong genetic roots, afflicts roughly one in 150 people.

Schizophrenia, which often causes delusions, hallucinations and dampened emotions, is almost always diagnosed before the age of 40.

Here is more from the NYT, not unrelated to issues of guardianship of course.  Furthermore, this tale does not exactly fit the usual “not enough medical care for the poor” narratives, and perhaps that is why the issue has not caught on more.  The medical profession even appears to be slightly…suboptimal in its ethical procedures.

For the pointer I thank Michelle Dawson.

The Ig Nobel Prizes

img-z2-1_357.jpgThe Ig Nobel Prize in Economics this year went to Pavlo Blavatskyy for Obesity of politicians and corruption in post-Soviet countries:

We collected 299 frontal face images of 2017 cabinet ministers from 15 post-Soviet states (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine and Uzbekistan). For each image, the minister’s body-mass index is estimated using a computer vision algorithm. The median estimated body-mass index of cabinet ministers is highly correlated with conventional measures of corruption (Transparency International Corruption Perceptions Index, World Bank worldwide governance indicator Control of Corruption, Index of Public Integrity). This result suggests that physical characteristics of politicians such as their body-mass index can be used as proxy variables for political corruption when the latter are not available, for instance at a very local level.

The Transportation prize went to researchers led by Cornell University’s Robin W. Radcliffe for determining that it is safe to transport an airborne rhinoceros upside down.

Other prizes here.

You may laugh but don’t forget that the great Andre Geim won an Ig Nobel prize in 2000 for levitating a frog and then won a Nobel prize in 2010 for graphene. I consider this one of the greatest accomplishments in all of science.

Photo Credit: Journal of Wildlife Diseases.

Why are American talk shows so much worse than British ones?

Sam Enright emails me:

My girlfriend is American, and she’s been struck by how the UK panel shows – QI, Would I Lie to You, 8 Out of 10 Cats – are so much better than the American ones, and play to the lowest common denominator less. There don’t seem to be a lot of panel shows in America per se, but the closest thing is late night shows, and so far as I can tell, they’re all terrible. A lot of whining about politics. Previously good comedians like Trevor Noah or John Oliver seem to become remarkably un-funny upon becoming hosts of US shows. Yet America has no deficit in producing quality films and TV in general. Do you have a theory about this? Are there culture-specific cues that I’m not picking up on? Is the American elite more competitive and therefore more politically unified, and does this filter down to there being a remarkably narrow range of views you can implicitly endorse in American comedy? Is it all just that the BBC has good taste in what it funds?

I don’t watch enough television to have an informed opinion, but my general intuition is often that the American market has all sorts of hidden corners and niches, many of them stupid, so often there are especially high returns to “selling out.”  In Britain, maybe it is more the case that “the TV customers you see are the TV customers you get”?  This hypothesis, while it can lead to cultural dumbing down, is also consistent with the U.S. market as especially good for new product introduction, and not just because population is high.  Any opinions on the TV issue?

*Beautiful World, Where Are You?* — the new Sally Rooney novel

It is really good, and more subtle than one might have expected.  Imagine Ireland’s #1 left-wing writer imbibing the brew of Ross Douthat over the last few years and putting it all into fictional form, and convincingly at that.  I don’t just mean the Mass scene and the pornography discussion, it is the consistent theme running throughout the book.

The tale ends up as a true case for cultural optimism, albeit with some reasonable qualifications.

Here is a good New Yorker review by Lauren Michele Jackson.  The title of the book is excellent as well.

Saturday assorted links

1. Rationalist baby names?

2. New Brazilian econ Ph.D student at UC Davis is in fact very famous.

3. Robby Soave on vaccine mandates (NYT).

4. The demand for academic economists is rebounding.

5. Australian vaccination progress could be doing better — incentives matter!

6. Adoption and IQ.  It is still my view, by the way, that very large cultural changes can alter IQs quite a lot, as evidenced by the Flynn Effect.  That is one reason why economic development often is so difficult.

7. Final summary and published version of Robin Hanson, et.al., grabby aliens paper.

My appearance on the Ezra Klein Show

Talking with Ezra is always both fun and enlightening for me, here is his partial summary of the episode:

So we begin this conversation by discussing the case for and against economic growth, but we also get into lots of other things: why Cowen thinks the great stagnation in technology is coming to an end; the future of technologies like A.I., crypto, fourth-generation nuclear and the Chinese system of government; the problems in how we fund scientific research; what the right has done to make government both ineffective and larger; why Cowen is skeptical of universal pre-K (and why I’m not); whether I overestimate the dangers of polarization; the ways in which we’re getting weirder; the long-term future of human civilization; why reading is overrated and travel is underrated; how to appreciate classical music and much more.

Here is the link, full transcript here, definitely recommended!

Street-Level Responsiveness of City Governments in China, Germany, and the United States

This paper presents evidence from parallel field experiments in China, Germany, and the United States. We contacted the mayor’s office in over 6,000 cities asking for information about procedures for starting a new business. Chinese and German cities responded to 36-37 percent requests; American cities responded to only 22 percent of requests. We randomly varied the text of the request to identify factors that affect the likelihood of receiving a response. American and German cities were more responsive to requests from citizens than foreigners; Chinese cities did not discriminate on this basis. Chinese cities were more responsive to requests from men than women; German cities did not discriminate on this basis and American cities had a slight bias in favor of women. Cities in all three countries were more responsive to requests associated with starting a construction business than a green business, but especially Chinese cities. Chinese cities were more responsive when the mayor was being considered for promotion than after a promotion decision, suggesting the importance of promotion incentives in China, but low responsiveness to green investment suggests limited incentives for environmental improvement. We argue that the response patterns are consistent with simple political economy theories of democracy and autocracy.

That is by Ekkehard A. Köhler, John G. Matsusaka, and Yanhui Wu.  Via the excellent Kevin Lewis.

Secret Danish markets in everything

Denmark has paid the UK an undisclosed sum to accept 23 Afghan refugees who worked as interpreters for the Danish state for eight years.

According to a report by Swedish broadsheet Svenska Dagbladet, the interpreters were granted a residence permit in the UK after twelve of them had their visa applications to Denmark rejected and eleven wanted to travel to the UK themselves.

Even though the interpreters were technically employed by the British military, they worked for the Danes, wearing Danish uniform and received a Danish salary.

The amount — paid for in secret by the Danish state — has been calculated according to what it would cost the British to evacuate the interpreters, integrate them into society and pay social costs for five years. The payment has been confirmed by the Danish Ministry of Defence to SvD.

Here is the full story.

Friday assorted links

1. More on risk-based business cycles.

2. “Residents in apartment blocks locked-down by NSW Health are having their alcohol deliveries policed as part of a policy to limit the number of drinks being consumed each day.”  It seems that quite a few of these people want more than six beers a day.

3. Claims of a fusion breakthrough at MIT.   And building Arcadia, a new science funding institution.

4. What do Germans fear the most?

5. How effective is the China crypto trading ban?

6. Wild vs. lab rats.  And Havana Syndrome update?

7. Someone compares me to Thrawn.

A new hurdle for vaccine development

Unless countries that have purchased vaccine doses and companies that have already brought vaccines into use agree to find ways to resolve the problem, manufacturers that trail the first wave of producers may not be able to prove that their vaccines work. Not only will that slow efforts to vaccinate the planet, it will block development of next-generation vaccines, and it will stymie efforts to answer key public health questions, like whether boosting with a different vaccine would generate better protection, or whether giving smaller — fractional — doses could protect more people more quickly…

The problem stems in part from the fact that at this point in the pandemic, it isn’t considered ethical to test new vaccines against placebos; instead they would have to be tested against one of the existing shots. But getting one’s hands on licensed or authorized vaccines for study purposes is nigh on impossible; all available doses have been snapped up by countries keen to vaccinate as many of their citizens as possible.

Contracts for those doses contain rigid stipulations about how the vaccines can be deployed. The doses often have to be used in the country that made the purchase; when the Biden administration wanted to share AstraZeneca doses with Canada and Mexico in March, it loaned the doses to get around the restrictions. Contracts also often stipulate that doses that have been purchased must be used for outbreak control, not for research purposes, Lurie said.

Here is the full story by Helen Branswell.  Obviously there is a market-oriented solution here, if only we care enough to implement it…

The “multiplier,” circa 2021

A recent U.S. Chamber of Commerce survey found that 88 percent of commercial construction contractors reported moderate-to-high levels of difficulty finding skilled workers, and more than a third had to turn down work because of labor deficiencies. The industry could face a shortage of at least two million workers through 2025, according to an estimate from Construction Industry Resources, a data firm in Kentucky.

The pandemic has compounded labor shortages, as sectors like construction see a boom in home projects with more people teleworking and moving to the suburbs. Contractors have also faced a scarcity of supplies as prices soared for products like lumber and steel.

Here is the full NYT article.  And this I found interesting for other reasons:

Infrastructure workers tend to be older than average, raising concerns about workers retiring and leaving behind difficult-to-fill positions. The median age of construction and building inspectors, for instance, is 53, compared with 42.5 for all workers nationwide. Only 10 percent of infrastructure workers are under 25, while 13 percent of all U.S. workers are in that age group, according to a Brookings Institution analysis.

So men are going to college less and also working on infrastructure less?  Hmm…

Returning to the main point, one reason I often am skeptical of multiplier talk is that the same economists and analysts recommend the same policies when the multiplier is…um…not so high.

Emergent Ventures winners, sixteenth cohort

Phoebe Yao, founder and CEO of Pareto, “a human API delivering the business functions startups desperately need.”  Here is the Pareto website.  She was born in China, formerly of Stanford, and a former classical violist.  (By my mistake I left her off of a previous cohort list, apologies!)

BeyondAging, a new group to support longevity research.

Sam Enright, for writing, blogging, and general career development, resume here.  From Ireland, currently studying in Scotland.

Zena Hitz, St. John’s College, to build The Catherine Project, to revitalize the study of the classics.

Gavin Leech, lives in Bristol, he is from Scotland, getting a Ph.D in AI.  General career support, he is interested in: “Personal experimentation to ameliorate any chronic illness; reinforcement learning as microscope on Goodhart’s law; weaponised philosophy for donors; noncollege routes to impact.”

Valmik Rao, 17 years old, Ontario, he is building a program to better manage defecation in Nigeria.

Rabbi Zohar Atkins, New York City, to pursue a career as a public intellectual.  Here is one substack, here is another.

Basil Halperin, graduate student in economics at MIT, for his writing and for general career development.

Gytis Daujotas, lives in Dublin, studying computer science at DCU, for a project to make the Great Books on the web easy to read, and for general career development.  Here is his web site.

Geoff Anders, Leverage Research, to support his work to find relevant bottlenecks in science and help overcome them.  A Progress Studies fellow.

Samantha Jordan, NYU Stern School of Business, with Nathaniel Bechhofer, for a new company, “Our platform will accelerate the speed and quality of science by enabling scientists to easily manage their data and research pipelines, using best practices from software engineering.”  Also a Progress Studies grant.

Nina Khera, “I’m a teenage human longevity researcher who’s interested in preventing aging-related diseases, especially those related to brain aging. In the past, I’ve worked with companies like Alio on computation and web-dev-based projects. I’ve also worked with labs like the Gladyshev lab and the Adams lab on data analysis and machine learning-based projects.”  Her current project is Biotein, about developing markers for aging, based in Ontario.

Lipton Matthews, from Jamaica, here is his YouTube channel, for general career development.