A few diabetes papers of interest

i. Cost-Effectiveness of Prevention and Treatment of the Diabetic Foot.

“A risk-based Markov model was developed to simulate the onset and progression of diabetic foot disease in patients with newly diagnosed type 2 diabetes managed with care according to guidelines for their lifetime. Mean survival time, quality of life, foot complications, and costs were the outcome measures assessed. Current care was the reference comparison. Data from Dutch studies on the epidemiology of diabetic foot disease, health care use, and costs, complemented with information from international studies, were used to feed the model.

RESULTS—Compared with current care, guideline-based care resulted in improved life expectancy, gain of quality-adjusted life-years (QALYs), and reduced incidence of foot complications. The lifetime costs of management of the diabetic foot following guideline-based care resulted in a cost per QALY gained of <$25,000, even for levels of preventive foot care as low as 10%. The cost-effectiveness varied sharply, depending on the level of foot ulcer reduction attained.

CONCLUSIONS—Management of the diabetic foot according to guideline-based care improves survival, reduces diabetic foot complications, and is cost-effective and even cost saving compared with standard care.”

I won’t go too deeply into the model setup and the results but some of the data they used to feed the model were actually somewhat interesting in their own right, and I have added some of these data below, along with some of the model results.

“It is estimated that 80% of LEAs [lower extremity amputations] are preceded by foot ulcers. Accordingly, it has been demonstrated that preventing the development of foot ulcers in patients with diabetes reduces the frequency of LEAs by 49–85% (6).”

“An annual ulcer incidence rate of 2.1% and an amputation incidence rate of 0.6% were among the reference country-specific parameters derived from this study and adopted in the model.”

“The health outcomes results of the cohort following standard care were comparable to figures reported for diabetic patients in the Netherlands. […] In the 10,000 patients followed until death, a total of 1,780 ulcer episodes occurred, corresponding to a cumulative ulcer incidence of 17.8% and an annual ulcer incidence of 2.2% (mean annual ulcer incidence for the Netherlands is 2.1%) (17). The number of amputations observed was 362 (250 major and 112 minor), corresponding to a cumulative incidence of 3.6% and an annual incidence of 0.4% (mean annual amputation incidence reported for the Netherlands is 0.6%) (17).”

“Cornerstones of guidelines-based care are intensive glycemic control (IGC) and optimal foot care (OFC). Although health benefits and economic efficiency of intensive blood glucose control (8) and foot care programs (914) have been individually reported, the health and economic outcomes and the cost-effectiveness of both interventions have not been determined. […] OFC according to guidelines includes professional protective foot care, education of patients and staff, regular inspection of the feet, identification of the high-risk patient, treatment of nonulcerative lesions, and a multidisciplinary approach to established foot ulcers. […] All cohorts of patients simulated for the different scenarios of guidelines care resulted in improved life expectancy, QALYs gained, and reduced incidence of foot ulcers and LEA compared with standard care. The largest effects on these outcomes were obtained when patients received IGC + OFC. When comparing the independent health effects of the two guidelines strategies, OFC resulted in a greater reduction in ulcer and amputation rates than IGC. Moreover, patients who received IGC + OFC showed approximately the same LEA incidence as patients who received OFC alone. The LEA decrease obtained was proportional to the level of foot ulcer reduction attained.”

“The mean total lifetime costs of a patient under either of the three guidelines care scenarios ranged from $4,088 to $4,386. For patients receiving IGC + OFC, these costs resulted in <$25,000 per QALY gained (relative to standard care). For patients receiving IGC alone, the ICER [here’s a relevant link – US] obtained was $32,057 per QALY gained, and for those receiving OFC alone, this ICER ranged from $12,169 to $220,100 per QALY gained, depending on the level of ulcer reduction attained. […] Increasing the effectiveness of preventive foot care in patients under OFC and IGC + OFC resulted in more QALYs gained, lower costs, and a more favorable ICER. The results of the simulations for the combined scenario (IGC + OFC) were rather insensitive to changes in utility weights and costing parameters. Similar results were obtained for parameter variations in the other two scenarios (IGC and OFC separately).”

“The results of this study suggest that IGC + OFC reduces foot ulcers and amputations and leads to an improvement in life expectancy. Greater health benefits are obtained with higher levels of foot ulcer prevention. Although care according to guidelines increases health costs, the cost per QALY gained is <$25,000, even for levels of preventive foot care as low as 10%. ICERs of this order are cost-effective according to the stratification of interventions for diabetes recently proposed (32). […] IGC falls into the category of a possibly cost-effective intervention in the management of the diabetic foot. Although it does not produce significant reduction in foot ulcers and LEA, its effectiveness resides in the slowing of neuropathy progression rates.

Extrapolating our results to a practical situation, if IGC + OFC was to be given to all diabetic patients in the Netherlands, with the aim of reducing LEA by 50% (St. Vincent’s declaration), the cost per QALY gained would be $12,165 and the cost for managing diabetic ulcers and amputations would decrease by 53 and 58%, respectively. From a policy perspective, this is clearly cost-effective and cost saving compared with current care.”

ii. Early Glycemic Control, Age at Onset, and Development of Microvascular Complications in Childhood-Onset Type 1 Diabetes.

“The aim of this work was to study the impact of glycemic control (HbA1c) early in disease and age at onset on the occurrence of incipient diabetic nephropathy (MA) and background retinopathy (RP) in childhood-onset type 1 diabetes.

RESEARCH DESIGN AND METHODS—All children, diagnosed at 0–14 years in a geographically defined area in northern Sweden between 1981 and 1992, were identified using the Swedish Childhood Diabetes Registry. From 1981, a nationwide childhood diabetes care program was implemented recommending intensified insulin treatment. HbA1c and urinary albumin excretion were analyzed, and fundus photography was performed regularly. Retrospective data on all 94 patients were retrieved from medical records and laboratory reports.

RESULTS—During the follow-up period, with a mean duration of 12 ± 4 years (range 5–19), 17 patients (18%) developed MA, 45 patients (48%) developed RP, and 52% had either or both complications. A Cox proportional hazard regression, modeling duration to occurrence of MA or RP, showed that glycemic control (reflected by mean HbA1c) during the follow-up was significantly associated with both MA and RP when adjusted for sex, birth weight, age at onset, and tobacco use as potential confounders. Mean HbA1c during the first 5 years of diabetes was a near-significant determinant for development of MA (hazard ratio 1.41, P = 0.083) and a significant determinant of RP (1.32, P = 0.036). The age at onset of diabetes significantly influenced the risk of developing RP (1.11, P = 0.021). Thus, in a Kaplan-Meier analysis, onset of diabetes before the age of 5 years, compared with the age-groups 5–11 and >11 years, showed a longer time to occurrence of RP (P = 0.015), but no clear tendency was seen for MA, perhaps due to lower statistical power.

CONCLUSIONS—Despite modern insulin treatment, >50% of patients with childhood-onset type 1 diabetes developed detectable diabetes complications after ∼12 years of diabetes. Inadequate glycemic control, also during the first 5 years of diabetes, seems to accelerate time to occurrence, whereas a young age at onset of diabetes seems to prolong the time to development of microvascular complications. […] The present study and other studies (15,54) indicate that children with an onset of diabetes before the age of 5 years may have a prolonged time to development of microvascular complications. Thus, the youngest age-groups, who are most sensitive to hypoglycemia with regard to risk of persistent brain damage, may have a relative protection during childhood or a longer time to development of complications.”

It’s important to note that although some people reading the study may think this is all ancient history (people diagnosed in the 80es?), to a lot of people it really isn’t. The study is of great personal interest to me, as I was diagnosed in ’87; if it had been a Danish study rather than a Swedish one I might well have been included in the analysis.

Another note to add in the context of the above coverage is that unlike what the authors of the paper seem to think/imply, hypoglycemia may not be the only relevant variable of interest in the context of the effect of childhood diabetes on brain development, where early diagnosis has been observed to tend to lead to less favourable outcomes – other variables which may be important include DKA episodes and perhaps also chronic hyperglycemia during early childhood. See this post for more stuff on these topics.

Some more stuff from the paper:

“The annual incidence of type 1 diabetes in northern Sweden in children 0–14 years of age is now ∼31/100,000. During the time period 1981–1992, there has been an increase in the annual incidence from 19 to 31/100,000 in northern Sweden. This is similar to the rest of Sweden […]. Seventeen (18%) of the 94 patients fulfilled the criteria for MA during the follow-up period. None of the patients developed overt nephropathy, elevated serum creatinine, or had signs of any other kidney disorder, e.g., hematuria, during the follow-up period. […] The mean time to diagnosis of MA was 9 ± 3 years (range 4–15) from diabetes onset. Forty-five (48%) of the 94 patients fulfilled the criteria for RP during the follow-up period. None of the patients developed proliferative retinopathy or were treated with photocoagulation. The mean time to diagnosis of RP was 11 ± 4 years (range 4–19) from onset of diabetes. Of the 45 patients with RP, 13 (29%) had concomitant MA, and thus 13 (76.5%) of the 17 patients with MA had concomitant RP. […] Altogether, among the 94 patients, 32 (34%) had isolated RP, 4 (4%) had isolated MA, and 13 (14%) had combined RP and MA. Thus, 49 (52%) patients had either one or both complications and, hence, 45 (48%) had neither of these complications.”

“When modeling MA as a function of glycemic level up to the onset of MA or during the entire follow-up period, adjusting for sex, birth weight, age at onset of diabetes, and tobacco use, only glycemic control had a significant effect. An increase in hazard ratio (HR) of 83% per one percentage unit increase in mean HbA1c was seen. […] The increase in HR of developing RP for each percentage unit rise in HbA1c during the entire follow-up period was 43% and in the early period 32%. […] Age at onset of diabetes was a weak but significant independent determinant for the development of RP in all regression models (P = 0.015, P = 0.018, and P = 0.010, respectively). […] Despite that this study was relatively small and had a retrospective design, we were able to show that the glycemic level already during the first 5 years may be an important predictor of later development of both MA and RP. This is in accordance with previous prospective follow-up studies (16,30).”

“Previously, male sex, smoking, and low birth weight have been shown to be risk factors for the development of nephropathy and retinopathy (6,4549). However, in this rather small retrospective study with a limited follow-up time, we could not confirm these associations”. This may just be because of lack of power, it’s a relatively small study. Again, this is/was of personal interest to me; two of those three risk factors apply to me, and neither of those risk factors are modifiable.

iii. Eighteen Years of Fair Glycemic Control Preserves Cardiac Autonomic Function in Type 1 Diabetes.

“Reduced cardiovascular autonomic function is associated with increased mortality in both type 1 and type 2 diabetes (14). Poor glycemic control plays an important role in the development and progression of diabetic cardiac autonomic dysfunction (57). […] Diabetic cardiovascular autonomic neuropathy (CAN) can be defined as impaired function of the peripheral autonomic nervous system. Exercise intolerance, resting tachycardia, and silent myocardial ischemia may be early signs of cardiac autonomic dysfunction (9).The most frequent finding in subclinical and symptomatic CAN is reduced heart rate variability (HRV) (10). […] No other studies have followed type 1 diabetic patients on intensive insulin treatment during ≥14-year periods and documented cardiac autonomic dysfunction. We evaluated the association between 18 years’ mean HbA1c and cardiac autonomic function in a group of type 1 diabetic patients with 30 years of disease duration.”

“A total of 39 patients with type 1 diabetes were followed during 18 years, and HbA1c was measured yearly. At 18 years follow-up heart rate variability (HRV) measurements were used to assess cardiac autonomic function. Standard cardiac autonomic tests during normal breathing, deep breathing, the Valsalva maneuver, and the tilt test were performed. Maximal heart rate increase during exercise electrocardiogram and minimal heart rate during sleep were also used to describe cardiac autonomic function.

RESULTS—We present the results for patients with mean HbA1c <8.4% (two lowest HbA1c tertiles) compared with those with HbA1c ≥8.4% (highest HbA1c tertile). All of the cardiac autonomic tests were significantly different in the high- and the low-HbA1c groups, and the most favorable scores for all tests were seen in the low-HbA1c group. In the low-HbA1c group, the HRV was 40% during deep breathing, and in the high-HbA1c group, the HRV was 19.9% (P = 0.005). Minimal heart rate at night was significantly lower in the low-HbA1c groups than in the high-HbA1c group (P = 0.039). With maximal exercise, the increase in heart rate was significantly higher in the low-HbA1c group compared with the high-HbA1c group (P = 0.001).

CONCLUSIONS—Mean HbA1c during 18 years was associated with cardiac autonomic function. Cardiac autonomic function was preserved with HbA1c <8.4%, whereas cardiac autonomic dysfunction was impaired in the group with HbA1c ≥8.4%. […] The study underlines the importance of good glycemic control and demonstrates that good long-term glycemic control is associated with preserved cardiac autonomic function, whereas a lack of good glycemic control is associated with cardiac autonomic dysfunction.”

These results are from Norway (Oslo), and again they seem relevant to me personally (‘from a statistical point of view’) – I’ve had diabetes for about as long as the people they included in the study.

iv. The Mental Health Comorbidities of Diabetes.

“Individuals living with type 1 or type 2 diabetes are at increased risk for depression, anxiety, and eating disorder diagnoses. Mental health comorbidities of diabetes compromise adherence to treatment and thus increase the risk for serious short- and long-term complications […] Young adults with type 1 diabetes are especially at risk for poor physical and mental health outcomes and premature mortality. […] we summarize the prevalence and consequences of mental health problems for patients with type 1 or type 2 diabetes and suggest strategies for identifying and treating patients with diabetes and mental health comorbidities.”

“Major advances in the past 2 decades have improved understanding of the biological basis for the relationship between depression and diabetes.2 A bidirectional relationship might exist between type 2 diabetes and depression: just as type 2 diabetes increases the risk for onset of major depression, a major depressive disorder signals increased risk for on set of type 2 diabetes.2 Moreover, diabetes distress is now recognized as an entity separate from major depressive disorder.2 Diabetes distress occurs because virtually all of diabetes care involves self-management behavior—requiring balance of a complex set of behavioral tasks by the person and family, 24 hours a day, without “vacation” days. […] Living with diabetes is associated with a broad range of diabetes-related distresses, such as feeling over-whelmed with the diabetes regimen; being concerned about the future and the possibility of serious complications; and feeling guilty when management is going poorly. This disease burden and emotional distress in individuals with type 1 or type 2 diabetes, even at levels of severity below the threshold for a psychiatric diagnosis of depression or anxiety, are associated with poor adherence to treatment, poor glycemic control, higher rates of diabetes complications, and impaired quality of life. […] Depression in the context of diabetes is […] associated with poor self-care with respect to diabetes treatment […] Depression among individuals with diabetes is also associated with increased health care use and expenditures, irrespective of age, sex, race/ethnicity, and health insurance status.3

“Women with type 1 diabetes have a 2-fold increased risk for developing an eating disorder and a 1.9-fold increased risk for developing subthreshold eating disorders than women without diabetes.6 Less is known about eating disorders in boys and men with diabetes. Disturbed eating behaviors in women with type 1 diabetes include binge eating and caloric purging through insulin restriction, with rates of these disturbed eating behaviors reported to occur in 31% to 40% of women with type 1 diabetes aged between 15 and 30 years.6 […] disordered eating behaviors persist and worsen over time. Women with type 1 diabetes and eating disorders have poorer glycemic control, with higher rates of hospitalizations and retinopathy, neuropathy, and premature death compared with similarly aged women with type 1 diabetes without eating disorders.6 […] few diabetes clinics provide mental health screening or integrate mental/behavioral health services in diabetes clinical care.4 It is neither practical nor affordable to use standardized psychiatric diagnostic interviews to diagnose mental health comorbidities in individuals with diabetes. Brief paper-and-pencil self-report measures such as the Beck Depression Inventory […] that screen for depressive symptoms are practical in diabetes clinical settings, but their use remains rare.”

The paper does not mention this, but it is important to note that there are multiple plausible biological pathways which might help to explain bidirectional linkage between depression and type 2 diabetes. Physiological ‘stress’ (think: inflammation) is likely to be an important factor, and so are the typical physiological responses to some of the pharmacological treatments used to treat depression (…as well as other mental health conditions); multiple drugs used in psychiatry, including tricyclic antidepressants, cause weight gain and have proven diabetogenic effects – I’ve covered these topics before here on the blog. I’ve incidentally also covered other topics touched briefly upon in the paper – here’s for example a more comprehensive post about screening for depression in the diabetes context, and here’s a post with some information about how one might go about screening for eating disorders; skin signs are important. I was a bit annoyed that the author of the above paper did not mention this, as observing whether or not Russell’s sign – which is a very reliable indicator of eating disorder – is present or not is easier/cheaper/faster than performing any kind of even semi-valid depression screen.

v. Diabetes, Depression, and Quality of Life. This last one covers topics related to the topics covered in the paper above.

“The study consisted of a representative population sample of individuals aged ≥15 years living in South Australia comprising 3,010 personal interviews conducted by trained health interviewers. The prevalence of depression in those suffering doctor-diagnosed diabetes and comparative effects of diabetic status and depression on quality-of-life dimensions were measured.

RESULTS—The prevalence of depression in the diabetic population was 24% compared with 17% in the nondiabetic population. Those with diabetes and depression experienced an impact with a large effect size on every dimension of the Short Form Health-Related Quality-of-Life Questionnaire (SF-36) as compared with those who suffered diabetes and who were not depressed. A supplementary analysis comparing both depressed diabetic and depressed nondiabetic groups showed there were statistically significant differences in the quality-of-life effects between the two depressed populations in the physical and mental component summaries of the SF-36.

CONCLUSIONS—Depression for those with diabetes is an important comorbidity that requires careful management because of its severe impact on quality of life.”

I felt slightly curious about the setup after having read this, because representative population samples of individuals should not in my opinion yield depression rates of either 17% nor 24%. Rates that high suggest to me that the depression criteria used in the paper are a bit ‘laxer’/more inclusive than what you see in some other contexts when reading this sort of literature – to give an example of what I mean, the depression screening post I link to above noted that clinical or major depression occurred in 11.4% of people with diabetes, compared to a non-diabetic prevalence of 5%. There’s a long way from 11% to 24% and from 5% to 17%. Another potential explanation for such a high depression rate could of course also be some sort of selection bias at the data acquisition stage, but that’s obviously not the case here. However 3000 interviews is a lot of interviews, so let’s read on…

“Several studies have assessed the impact of depression in diabetes in terms of the individual’s functional ability or quality of life (3,4,13). Brown et al. (13) examined preference-based time tradeoff utility values associated with diabetes and showed that those with diabetes were willing to trade a significant proportion of their remaining life in return for a diabetes-free health state.”

“Depression was assessed using the mood module of the Primary Care Evaluation of Mental Disorders questionnaire. This has been validated to provide estimates of mental disorder comparable with those found using structured and longer diagnostic interview schedules (16). The mental disorders examined in the questionnaire included major depressive disorder, dysthymia, minor depressive disorder, and bipolar disorder. [So yes, the depression criteria used in this study are definitely more inclusive than depression criteria including only people with MDD] […] The Short Form Health-Related Quality-of-Life Questionnaire (SF-36) was also included to assess the quality of life of the different population groups with and without diabetes. […] Five groups were examined: the overall population without diabetes and without depression; the overall diabetic population; the depression-only population; the diabetic population without depression; and the diabetic population with depression.”

“Of the population sample, 205 (6.8%) were classified as having major depression, 130 (4.3%) had minor depression, 105 (3.5%) had partial remission of major depression, 79 (2.6%) had dysthymia, and 5 (0.2%) had bipolar disorder (depressed phase). No depressive syndrome was detected in 2,486 (82.6%) respondents. The population point prevalence of doctor-diagnosed diabetes in this survey was 5.2% (95% CI 4.6–6.0). The prevalence of depression in the diabetic population was 23.6% (22.1–25.1) compared with 17.1% (15.8–18.4) in the nondiabetic population. This difference approached statistical significance (P = 0.06). […] There [was] a clear difference in the quality-of-life scores for the diabetic and depression group when compared with the diabetic group without depression […] Overall, the highest quality-of-life scores are experienced by those without diabetes and depression and the lowest by those with diabetes and depression. […] the standard scores of those with no diabetes have quality-of-life status comparable with the population mean or slightly better. At the other extreme those with diabetes and depression experience the most severe comparative impact on quality-of-life for every dimension. Between these two extremes, diabetes overall and the diabetes without depression groups have a moderate-to-severe impact on the physical functioning, role limitations (physical), and general health scales […] The results of the two-factor ANOVA showed that the interaction term was significant only for the PCS [Physical Component Score – US] scale, indicating a greater than additive effect of diabetes and depression on the physical health dimension.”

“[T]here was a significant interaction between diabetes and depression on the PCS but not on the MCS [Mental Component Score. Do note in this context that the no-interaction result is far from certain, because as they observe: “it may simply be sample size that has not allowed us to observe a greater than additive effect in the MCS scale. Although there was no significant interaction between diabetes and depression and the MCS scale, we did observe increases on the effect size for the mental health dimensions”]. One explanation for this finding might be that depression can influence physical outcomes, such as recovery from myocardial infarction, survival with malignancy, and propensity to infection. Various mechanisms have been proposed for this, including changes to the immune system (24). Other possibilities are that depression in diabetes may affect the capacity to maintain medication vigilance, maintain a good diet, and maintain other lifestyle factors, such as smoking and exercise, all of which are likely possible pathways for a greater than additive effect. Whatever the mechanism involved, these data indicate that the addition of depression to diabetes has a severe impact on quality of life, and this needs to be managed in clinical practice.”

May 25, 2017 Posted by | Cardiology, Diabetes, Medicine, Nephrology, Neurology, Papers, Personal, Pharmacology, Psychiatry, Psychology | Leave a comment

Books 2016

Below I have posted a list of the 156 books I read to completion in 2016, as well as links to blog posts covering the books and reviews of the books which I’ve written on goodreads. At the bottom of the post I have also added the 7 books I did not finish this year, as well as some related links and comments. The post you read now is unlikely to be the final edition of this post, as I’ll continue to add links and comments to the post also in 2017 if/when I blog or review books mentioned below.

As I also mentioned earlier in the year, I have been reading a lot of fiction this year and not enough non-fiction. Regarding the ‘technical aspects’ of the list below, as usual the letters ‘f’ and ‘nf.’ in the parentheses correspond to ‘fiction’ and ‘non-fiction’, respectively, whereas the ‘m’ category covers ‘miscellaneous’ books. The numbers in the parentheses correspond to the goodreads ratings I thought the books deserved.

I did a brief count of the books on the list and concluded that the list includes 30 books categorized as non-fiction, 20 books in the miscellaneous category, and 106 books categorized as fiction. As usual non-fiction works published by Springer make up a substantial proportion of the non-fiction books I read (20 %), with another 20 % accounted for by Oxford University Press, Princeton University Press and Wiley/Wiley-Blackwell. Some of the authors in the fiction category have also featured on the lists previously (Christie, Wodehouse, Bryson), but other names are new – new names include: Dick Francis (39 books), Tom Sharpe (16 books), David Sedaris (7 books), Mario Puzo (4 books), Gerard Durrell (3 books), and Connie Willis (3 books).

I shared my ‘year in books’ on goodreads, and that link includes a few summary stats as well as cover images of the books (annoyingly a large-ish proportion of the non-fiction books have not added cover pictures, but it’s even so a neat visualization tool). With 156 books finished this year I read almost exactly 3 books per week on average, and the goodreads tools also tell me that I read 47.281 pages during the year. As I don’t believe goodreads includes the page counts of partially read books in that tool, this is probably a slight underestimate but it’s in that neighbourhood anyway; this corresponds to ~130 pages per day on average (129,5) throughout the year, or roughly 900 pages per week. The average length of the books I finished was 309 pages, again according to goodreads.

Since I started blogging, I have published roughly 500 posts about books I’ve read – I actually realized while writing this post that the next post I publish on this site categorized under ‘books’ will be post number 500 in that category. As should be obvious from the list below, as a rule I do not cover fiction books on this blog, aside from in the context of quote posts where I may occasionally include a few quotes from books I’ve read (I decided early on not to include links to such posts on lists like these, as that would be too much work). In the context of quotes I should probably add here to readers not already aware of this that I recently decided to move/copy a large number of quotes from this site to goodreads, and that I now update my goodreads quote collection more frequently than I do the quote collection on this blog; at this point, my quote collection on goodreads includes 1347 quotes. For a few more details about this aspect of the goodreads site, see incidentally this post.

Both Dick Francis and Connie Willis were introduced to me by the SSC commentariat and this link includes a lot of other author recommendations which might be of interest to you. I should perhaps also note before moving on to the list that I have recently added a not-insignificant number of books to my list of favourite books on goodreads. I have (retrospectively) slightly modified my implicit selection criteria for adding books to the list; previously if a book had taught me a lot but I did not give it a five star rating or I figured it wasn’t at least very close to perfect, it wasn’t going to get anywhere near my list of favourite books. I figured recently that perhaps I should also include on the list books which had taught me a lot, books that had changed my way of looking at the world, even if they were not very close to perfect in most respects. I’m still not quite sure what is the best categorization approach, but as of now the list includes some books which did not feature on the list in the near past and I figured I might mention the list explicitly here also because people perusing a list like the one below are presumably in part doing it because they’re looking for good books to read, and my inclusion of a book on that list can still at least be taken to be a qualified recommendation of the book.

1. 4.50 from Paddington (4, f). Agatha Christie.

2. Explaining Behavior: Reasons in a World of Causes (1, nf. Bradford Book). Goodreads review here.

3. Hickory Dickory Dock (3, f). Agatha Christie.

4. Death Comes As the End (3, f). Agatha Christie. Short goodreads review here.

5. At Bertram’s Hotel (3, f). Agatha Christie. Very short goodreads review here.

6. A Caribbean Mystery (3, f). Agatha Christie.

7. A Rulebook for Arguments (Hackett Student Handbooks) (1, nf. Hackett Publishing). Very short goodreads review here.

8. The Clocks (2, f). Agatha Christie.

9. Third Girl (2, f). Agatha Christie. Very short goodreads review here.

10. The Misanthrope (2, f). Molière. Very short goodreads review here.

11. The Secret Adversary (2, f). Agatha Christie. Short goodreads review here.

12. The Social Psychology of Nonverbal Communication (2, nf. Palgrave Macmillan). Goodreads review here. Blog coverage here.

13. N or M? (2, f). Agatha Christie. Goodreads review – with spoilers – here.

14. The Emergence of Norms (4, nf. Oxford University Press). Goodreads review here. Blog coverage here.

15. By the Pricking of My Thumbs (2, f). Agatha Christie.

16. The Godfather (4, f). Mario Puzo.

17. Partners in Crime (1, f). Agatha Christie. Short goodreads review here.

18. Elephants can Remember (1, f). Agatha Christie. Short goodreads review here.

19. Hallowe’en Party (1, f). Agatha Christie. Short goodreads review here.

20. French Leave (4, f). P. G. Wodehouse. Short goodreads review here.

21. A Few Quick Ones (3, f). P. G. Wodehouse.

22. Ice in the Bedroom (4, f). P. G. Wodehouse.

23. Over Seventy (4, f). P. G. Wodehouse. Short goodreads review here.

24. The Secret of Chimneys (2, f). Agatha Christie.

25. World Regions in Global Context (1, nf. Prentice Hall). Very long (600+ pages of content). Goodreads review here.

26. Something Fishy (3, f). P. G. Wodehouse.

27. Do Butlers Burgle Banks? (3,f). P.G. Wodehouse.

28. The Mirror Crack’d from Side to Side (1, f). Agatha Christie. Boring story, almost didn’t finish it.

29. Frozen Assets (4, f). P. G. Wodehouse.

30. A Cooperative Species: Human Reciprocity and Its Evolution (5, nf. Princeton University Press). Goodreads review here. Blog coverage here.

31. If I Were You (4, f). P. G. Wodehouse.

32. On the Shortness of Life (nf.). Seneca the Younger.

33. Barmy in Wonderland (3, f). P. G. Wodehouse.

34. A Gentleman of Leisure (3, f). P. G. Wodehouse. Very short goodreads review here.

35. Pearls, Girls and Monty Bodkin (5, f). P. G. Wodehouse. Short goodreads review here.

36. The Ultimate Quotable Einstein (3, nf. Princeton University Press). Blog coverage here.

37. The Luck Stone (2, f). P. G. Wodehouse. Goodreads review here.

38. Company for Henry (4, f). P. G. Wodehouse.

39. Bachelors Anonymous (5, f). P. G. Wodehouse. A short book, but very funny.

40. The Second World War (5, nf.) Winston Churchill. Very long, the book is a thousand pages long abridgement of 6 different volumes written by Churchill. Blog coverage here, here, here, and here. I added this book to my list of favourite books on goodreads.

41. The Old Reliable (3, f). P. G. Wodehouse.

42. Performing Flea (4, m). P. G. Wodehouse, William Townend.

43. Decline and Fall (3, f). Evelyn Waugh. Goodreads review here.

44. The Devil’s Garden (2, f). W. B. Maxwell. Goodreads review here.

45. The Road to Little Dribbling: Adventures of an American in Britain (3, m). Bill Bryson.

46. Bryson’s Dictionary of Troublesome Words: A Writer’s Guide to Getting It Right (3, nf.). Bill Bryson. Goodreads review here.

47. The Life and Times of the Thunderbolt Kid (3, m). Goodreads review here.

48. Shakespeare: The World as Stage (2, m). Bill Bryson.

49. One Summer: America, 1927 (2, m). Bill Bryson. Goodreads review here.

50. The Sicilian (3, f). Mario Puzo.

51. Fools Die (3, f). Mario Puzo. Short goodreads review here.

52. Not George Washington (2, f). P. G. Wodehouse. Short goodreads review here.

53. Pre-Industrial Societies: Anatomy of the Pre-Modern World (5, nf. Oneworld Publications). Goodreads review here. I added this book to my list of favourite books on goodreads.

54. The Last Don (4, f). Mario Puzo. Goodreads review here.

55. Fear and Loathing in Las Vegas (f). Hunter S. Thompson. Goodreads review here.

56. Aunts Aren’t Gentlemen (3, f). P. G. Wodehouse.

57. What If?: Serious Scientific Answers to Absurd Hypothetical Questions (2, m. Randall Munroe). Short goodreads review here.

58. Wilt (5, f). Tom Sharpe. Goodreads review here.

59. The Wilt Alternative (4, f). Tom Sharpe. Very short goodreads review here.

60. Wilt On High (4, f). Tom Sharpe. Short goodreads review here.

61. Wilt In Nowhere (3, f). Tom Sharpe.

62. The Wilt Inheritance (3, f). Tom Sharpe. Goodreads review here.

63. Monstrous Regiment (3, f). Terry Pratchett.

64. Porterhouse Blue (3, f). Tom Sharpe. Goodreads review here.

65. The Midden (4, f). Tom Sharpe. Goodreads review here.

66. Human Drug Metabolism: An Introduction (5, nf. Wiley). Goodreads review here. Blog coverage here, here, and here.

67. Vintage Stuff (2, f). Tom Sharpe.

68. Blackadder: The Whole Damn Dynasty, 1485-1917 (5, f). Richard Curtis, Ben Elton, Rowan Atkinson & Jon Lloyd. Goodreads review here.

69. How the Endocrine System Works (2, nf. Wiley-Blackwell). Goodreads review here.

70. Suicide Prevention and New Technologies: Evidence Based Practice (1, nf. Palgrave Macmillan). Long(-ish) goodreads review here.

71. Blott on the Landscape (3, f). Tom Sharpe. Short goodreads review here.

72. Diabetes and the Metabolic Syndrome in Mental Health (2, nf. Lippincott Williams & Wilkins). Goodreads review here. Blog coverage here and here.

73. Palliative Care and End-of-Life Decisions (1, nf. Palgrave Pivot). Goodreads review here.

74. Ancestral Vices (4, f). Tom Sharpe. Goodreads review here.

75. Respirology (2, nf. Springer). Goodreads review here. Blog coverage here.

76. The Throwback (4, f). Tom Sharpe. Goodreads review here.

77. The Great Pursuit (3, f). Tom Sharpe.

78. Riotous Assembly (4, f). Tom Sharpe.

79. Indecent Exposure (3, f). Tom Sharpe.

80. Grantchester Grind (3, f). Tom Sharpe. Goodreads review here.

81. Time’s Arrow (4, f). Martin Amis. Short goodreads review here.

82. One Day in the Life of Ivan Denisovich (4, f). Aleksandr Solzhenitsyn. Short goodreads review here.

83. The Gropes (3, f). Tom Sharpe. Short goodreads review here.

84. The Old Devils (3, f). Kingsley Amis. Goodreads review here.

85. Me Talk Pretty One Day (5, m). David Sedaris. Goodreads review here.

86. Deserts: A Very Short Introduction (3, nf. Oxford University Press). Goodreads review here. Blog coverage here.

87. Naked (3, m). David Sedaris.

88. Holidays on Ice (2, m). David Sedaris. Short goodreads review here.

89. Dress Your Family in Corduroy and Denim (4, m). David Sedaris. Short goodreads review here.

90. Squirrel Seeks Chipmunk: A Modest Bestiary (3, m). David Sedaris. Short goodreads review here.

91. When You Are Engulfed in Flames (3, m). David Sedaris.

92. Barrel Fever (2, m). David Sedaris. Short goodreads review here.

93. Poor Richard’s Almanack (m). Benjamin Franklin.

94. Role of Biomarkers in Medicine (2, nf. InTech). Goodreads review here. Blog coverage here.

95. My Family and Other Animals (4, m). Gerard Durrell. Goodreads review here.

96. Birds, Beasts and Relatives (4, m). Gerard Durrell. Goodreads review here.

97. The Garden of the Gods (3, m). Gerard Durrell.

98. The Gun Seller (4, f). Hugh Laurie. Goodreads review here.

99. The Diary of a Nobody (1, m). George Grossmith. Goodreads review here.

100. The Thirteen Problems (2, f). Agatha Christie.

101. Dead Cert (4, f). Dick Francis.

102. Nerve (3, f). Dick Francis.

103. For Kicks (3, f). Dick Francis.

104. Odds Against (3, f). Dick Francis.

105. Flying Finish (2, f). Dick Francis. Short goodreads review here.

106. The Salmon of Doubt (4, m). Douglas Adams. Short goodreads review here.

107. Enquiry (3, f). Dick Francis. Very short goodreads review here.

108. Blood Sport (3, f). Dick Francis.

109. The Wisdom of Life and Counsels and Maxims (m). Arthur Schopenhauer. Goodreads review here.

110. Forfeit (2, f). Dick Francis.

111. Bonecrack (2, f). Dick Francis. Short goodreads review here.

112. Rat Race (4, f). Dick Francis. Goodreads review here.

113. Smokescreen (4, f). Dick Francis. A very short goodreads review here.

114. The Biology of Moral Systems (5, nf. Aldine Transaction). Goodreads review here. Blog coverage here. I added this book to my list of favourite books on goodreads.

115. Slay Ride (4, f). Dick Francis. Short goodreads review here.

116. Water Supply in Emergency Situations (2, nf. Springer). Goodreads review here. Blog coverage here and here.

117. High Stakes (4, f). Dick Francis.

118. In the Frame (3, f). Dick Francis.

119. Knockdown (3, f). Dick Francis.

120. Trial Run (2, f). Dick Francis. Short goodreads review here.

121. Managing Diabetic Nephropathies in Clinical Practice (4, nf. Springer). Very short goodreads review here. Blog coverage here.

122. Whip Hand (4, f). Dick Francis. Goodreads review here.

123. Risk (2, f). Dick Francis. Goodreads review here.

124. Reflex (3, f). Dick Francis. My long-ish goodreads review includes major spoilers.

125. The Ageing Immune System and Health (3, nf. Springer). Blog coverage here and here.

126. Twice Shy (2, f). Dick Francis. Goodreads review here. (I do discuss a few of the things that happen in the book in my review, but I don’t think it actually contains any spoilers).

127. The Danger (4, f). Dick Francis. In my goodreads review I noted that “this book is one of the best novels by Francis I’ve read.”

128. Banker (2, f). Dick Francis. Short goodreads review here.

129. Proof (2, f). Dick Francis.

130. Break In (3, f). Dick Francis.

131. Integrated Diabetes Care: A Multidisciplinary Approach (4, nf. Springer). Goodreads review here. Blog coverage here and here.

132. Bolt (4, f). Dick Francis. Very short goodreads review here.

133. The Edge (5, f). Dick Francis. Short goodreads review here.

134. Hot Money (2, f). Dick Francis. Goodreads review here.

135. Straight (3, f). Dick Francis. Goodreads review here.

136. Longshot (4, f). Dick Francis.

137. The Complete Yes Prime Minister (5, f). Jonathan Lynn and Antony Jay. Goodreads review here.

138. Neuroplasticity (4, nf. MIT Press). Goodreads review here.

139. Comeback (4, f). Dick Francis. My goodreads review includes major spoilers.

140. Driving Force (3, f). Dick Francis. Goodreads review here.

141. Decider (3, f). Dick Francis.

142. Essential Microbiology and Hygiene for Food Professionals (2, nf. CRC Press). Short goodreads review here.

143. Wild Horses (2, f). Dick Francis.

144. Come to Grief (4, f). Dick Francis.

145. To the Hilt (2, f). Dick Francis.

146. 10 lb penalty (2, f). Dick Francis. Short goodreads review here.

147. Second Wind (2, f). Dick Francis.

148. Shattered (2, f). Dick Francis. Goodreads review here.

149. Under Orders (4, f). Dick Francis.

150. To Say Nothing of the Dog (5, f). Connie Willis. Goodreads review here. I added this book to my list of favourite books on goodreads.

151. Diabetes and the Brain (5, nf. Humana Press). Goodreads review here. Blog coverage here, here, here, and here. I added this book to my list of favourite books on goodreads.

152. Doomsday Book (5, f). Connie Willis. Goodreads review here. I added this book to my list of favourite books on goodreads.

153. ABC of HIV and AIDS (2, nf. Bmj Publishing Group). Goodreads review here.

154. 100 Cases in Psychiatry (2, nf. CRC Press). Goodreads review here.

155. Fire Watch (2, f). Connie Willis. Goodreads review here.

156. Social Behaviour in Animals (3, nf. Springer). Goodreads review here.

Books I did not finish:

The Adventures of Huckleberry Finn (1, f). Mark Twain. Goodreads review here.

Lucky Jim (1, f). Kingsley Amis. Goodreads review here.

Raising Steam (?, f). Terry Pratchett. These days I mostly use Pratchett’s books as a treat, the few remaining books in the Discworld series which I have yet to read I consider to be books which I feel that I have to make myself deserve to be allowed to read. I started out reading this book because I felt terrible at the time, but I decided after having read a hundred pages or so that I had not in fact deserved to read the book, and so I put it away again. Unlike the two books above I do not consider this book to be bad, that’s not why I didn’t finish it.

Anna Karenina (?, f). Tolstoy. As I pointed out in my short review, “so far (I stopped around page 140) it’s been a story about miserable Russians, and I can’t read that kind of stuff right now.” Again, I would not say this book is bad, but I could not read that kind of stuff at the time.

The Language Instinct: How the Mind Creates Language (nf., Harper Perennial Modern Classics). Pinker’s book may be one of the last popular science books I’ll read, at least for a while – I find that I simply can’t read this kind of book anymore (which is annoying, because I also bought Jonathan Haidt’s The Righteous Mind this year, and I worry that I’ll never be able to read that book, despite the content being at least somewhat interesting, simply on account of the way the book is likely to be written). As I noted while reading the book, “I’ve realized by now that I’ve probably at this point grown to strongly dislike reading popular science books. I’ve disliked other PS books I’ve read in the semi-near past as well, but I always figured I had specific reasons for disliking a particular book. At this point it seems like it’s a general thing. I don’t like these books any more. Too imprecise language, claims are consistently way too strong, etc., etc..” My reading experience of Pinker’s book was definitely not improved by the fact that I have read textbooks on topics closely related to those covered in the book in the past (Eysenck and Keane, Snowling et al.).

Physiology at a Glance (?, Wiley-Blackwell). ‘Too much work, considering the pay-off’, would probably be the short version of why I didn’t finish this one – but this should not be taken as an indication that the book is bad. Despite the words ‘at a glance’ in the title, each short chapter (2 pages) in this book roughly matches the amount of material usually covered in an academic lecture (this is the general structure of the ‘at a glance books’), which means that the book takes quite a bit more work than the limited page count might indicate. The fact that I knew many of the things covered didn’t mean that the book was much faster to read than it otherwise might have been; it still took a lot of time and effort to digest the material. I’m sure there’s some stuff in the book which I don’t know and stuff I’ve forgot, and I did learn some new stuff from the chapters I did read, so I’m conflicted about whether or not to pick it up again later – it may be worth it at some point. However back when I was reading it I decided in the end to just put the book away and read something else instead. If you’re looking for a dense and to-the-point introduction to physiology/anatomy, I’m sure you could do a lot worse than this book.

100 Endgames You Must Know: Vital Lessons for Every Chess Player (?, nf. New in Chess). If I just wanted to be able to say that I had ‘read’ this book, I would have finished it a long time ago, but this is not the sort of book you just ‘read’. The positions covered need to be studied and analyzed in detail, the positions need to be played out, perhaps reviewed (depending on how ambitious you are about your chess). I’m more than half-way through (p. 140 or so), but I rarely feel like working on this stuff as it’s more fun to play chess than to systematically improve your chess in the manner you’ll do if you work on the material covered in this book. It’s a great endgame book, but it takes a lot of work.

January 1, 2017 Posted by | Books, Personal | Leave a comment

Diabetes and the brain (I)

I recently learned that the probability that I have brain-damage as a result of my diabetes is higher than I thought it was.

I first took note of the fact that there might be a link between diabetes and brain development some years ago, but this is a topic I knew very little about before reading the book I’m currently reading. Below I have added some relevant quotes from chapters 10 and 11 of the book:

“Cognitive decrements [in adults with type 1 diabetes] are limited to only some cognitive domains and can best be characterised as a slowing of mental speed and a diminished mental flexibility, whereas learning and memory are generally spared. […] the cognitive decrements are mild in magnitude […] and seem neither to be progressive over time, nor to be substantially worse in older adults. […] neuroimaging studies […] suggest that type 1 diabetic patients have relatively subtle reductions in brain volume but these structural changes may be more pronounced in patients with an early disease onset.”

“With the rise of the subspecialty area ‘medical neuropsychology’ […] it has become apparent that many medical conditions may […] affect the structure and function of the central nervous system (CNS). Diabetes mellitus has received much attention in that regard, and there is now an extensive literature demonstrating that adults with type 1 diabetes have an elevated risk of CNS anomalies. This literature is no longer limited to small cross-sectional studies in relatively selected populations of young adults with type 1 diabetes, but now includes studies that investigated the pattern and magnitude of neuropsychological decrements and the associated neuroradiological changes in much more detail, with more sensitive measurements, in both younger and older patients.”

“Compared to non-diabetic controls, the type 1 diabetic group [in a meta-analysis including 33 studies] demonstrated a significant overall lowered performance, as well as impairment in the cognitive domains intelligence, implicit memory, speed of information processing, psychomotor efficiency, visual and sustained attention, cognitive flexibility, and visual perception. There was no difference in explicit memory, motor speed, selective attention, or language function. […] These results strongly support the hypothesis that there is a relationship between cognitive dysfunction and type 1 diabetes. Clearly, there is a modest, but statistically significant, lowered cognitive performance in patients with type 1 diabetes compared to non-diabetic controls. The pattern of cognitive findings does not suggest decline in all cognitive domains, but is characterised by a slowing of mental speed and a diminished mental flexibility. Patients with type 1 diabetes seem to be less able to flexibly apply acquired knowledge in a new situation. […] In all, the cognitive problems we see in type 1 diabetes mimics the patterns of cognitive ageing. […] One of the problems with much of this research is that it is conducted in patients who are seen in specialised medical centres where care is very good. Other aspects of population selection may also have affected the results. Persons who participate in research projects that include a detailed work-up at a hospital tend to be less affected than persons who refuse participation. Possibly, specific studies that recruit type 1 adults from the community, with individuals being in poorer health, would result in greater cognitive deficits”.

“[N]eurocognitive research suggests that type 1 diabetes is primarily associated with psychomotor slowing and reductions in mental efficiency. This pattern is more consistent with damage to the brain’s white matter than with grey-matter abnormalities. […] A very large neuroimaging literature indicates that adults with either type 1 or type 2 diabetes manifest structural changes in a number of brain regions […]. MRI changes in the brain of patients with type 1 diabetes are relatively subtle. In terms of effect sizes, these are at best large enough to distinguish the patient group from the control group, but not large enough to classify an individual subject as being patient or control.”

“[T]he subtle cognitive decrements in speed of information processing and mental flexibility found in diabetic patients are not merely caused by acute metabolic derangements or psychological factors, but point to end-organ damage in the central nervous system. Although some uncertainty remains about the exact pathogenesis, several mechanisms through which diabetes may affect the brain have now been identified […] The issue whether or not repeated episodes of severe hypoglycaemia result in permanent mild cognitive impairment has been debated extensively in the literature. […] The meta-analysis on the effect of type 1 diabetes on cognition (1) does not support the idea that there are important negative effects from recurrent episodes of severe hypoglycaemia on cognitive functioning, and large prospective studies did not confirm the earlier observations […] there is no evidence for a linear relationship between recurrent episodes of hypoglycaemia and permanent brain dysfunction in adults. […] Cerebral microvascular pathology in diabetes may result in a decrease of regional cerebral blood flow and an alteration in cerebral metabolism, which could partly explain the occurrence of cognitive impairments. It could be hypothesised that vascular pathology disrupts white-matter integrity in a way that is akin to what one sees in peripheral neuropathy and as such could perhaps affect the integrity of neurotransmitter systems and as a consequence limits cognitive efficiency. These effects are likely to occur diffusely across the brain. Indeed, this is in line with MRI findings and other reports.”

“[An] important issue is the interaction between different disease variables. In particular, patients with diabetes onset before the age of 5 […] and patients with advanced microangiopathy might be more sensitive to the effects of hypoglycaemic episodes or elevated HbA1c levels. […] decrements in cognitive function have been observed as early as 2 years after the diagnosis (63). It is important to consider the possibility that the developing brain is more vulnerable to the effect of diabetes […] Diabetes has a marked effect on brain function and structure in children and adolescents. As a group, diabetic children are more likely to perform more poorly than their nondiabetic peers in the classroom and earn lower scores on measures of academic achievement and verbal intelligence. Specialized neuropsychological testing reveals evidence of dysfunction in a variety of cognitive domains, including sustained attention, visuoperceptual skills, and psychomotor speed. Children diagnosed early in life – before 7 years of age – appear to be most vulnerable, showing impairments on virtually all types of cognitive tests, with learning and memory skills being particularly affected. Results from neurophysiological, cerebrovascular, and neuroimaging studies also show evidence of CNS anomalies. Earlier research attributed diabetes-associated brain dysfunction to episodes of recurrent hypoglycemia, but more recent studies have generally failed to find strong support for that view.”

“[M]ethodological issues notwithstanding, extant research on diabetic children’s brain function has identified a number of themes […]. All other things being equal, children diagnosed with type 1 diabetes early in life – within the first 5–7 years of age – have the greatest risk of manifesting neurocognitive dysfunction, the magnitude of which is greater than that seen in children with a later onset of diabetes. The development of brain dysfunction seems to occur within a relatively brief period of time, often appearing within the first 2–3 years following diagnosis. It is not limited to performance on neuropsychological tests, but is manifested on a wide range of electrophysiological measures as marked neural slowing. Somewhat surprisingly, the magnitude of these effects does not seem to worsen appreciably with increasing duration of diabetes – at least through early adulthood. […] As a group, diabetic children earn somewhat lower grades in school as compared to their nondiabetic classmates, are more likely to fail or repeat a grade, perform more poorly on formal tests of academic achievement, and have lower IQ scores, particularly on tests of verbal intelligence.”

The most compelling evidence for a link between diabetes and poorer school outcomes has been provided by a Swedish population-based register study involving 5,159 children who developed diabetes between July 1997 and July 2000 and 1,330,968 nondiabetic children […] Those who developed diabetes very early in life (diagnosis before 2 years of age) had a significantly increased risk of not completing school as compared to either diabetic patients diagnosed after that age or to the reference population. Small, albeit statistically reliable between-group differences were noted in school marks, with diabetic children, regardless of age at diagnosis, consistently earning somewhat lower grades. Of note is their finding that the diabetic sample had a significantly lower likelihood of getting a high mark (passed with distinction or excellence) in two subjects and was less likely to take more advanced courses. The authors conclude that despite universal access to active diabetes care, diabetic children – particularly those with a very early disease onset – had a greatly increased risk of somewhat lower educational achievement […] Similar results have been reported by a number of smaller studies […] in the prospective Melbourne Royal Children’s Hospital (RCH) cohort study (22), […] only 68% of [the] diabetic sample completed 12 years of school, as compared to 85% of the nondiabetic comparison group […] Children with diabetes, especially those with an earlier onset, have also been found to require more remedial educational services and to be more likely to repeat a grade (25–28), to earn lower school grades over time (29), to experience somewhat greater school absenteeism (28, 30–32), to have a two to threefold increase in rates of depression (33– 35), and to manifest more externalizing behavior problems (25).”

“Children with diabetes have a greatly increased risk of manifesting mild neurocognitive dysfunction. This is an incontrovertible fact that has emerged from a large body of research conducted over the past 60 years […]. There is, however, less agreement about the details. […] On standardized tests of academic achievement, diabetic children generally perform somewhat worse than their healthy peers […] Performance on measures of verbal intelligence – particularly those that assess vocabulary knowledge and general information about the world – is frequently compromised in diabetic children (9, 14, 26, 40) and in adults (41) with a childhood onset of diabetes. The few studies that have followed subjects over time have noted that verbal IQ scores tend to decline as the duration of diabetes increases (13, 15, 29). These effects appear to be more pronounced in boys and in those children with an earlier onset of diabetes. Whether this phenomenon is a marker of cognitive decline or whether it reflects a delay in cognitive development cannot yet be determined […] it is possible, but remains unproven, that psychosocial processes (e.g., school absence, depression, distress, externalizing problems) (42), and/or multiple and prolonged periods of classroom inattention and reduced motivation secondary to acute and prolonged episodes of hypoglycemia (43–45) may be contributing to the poor academic outcomes characteristic of children with diabetes. Although it may seem more reasonable to attribute poorer school performance and lower IQ scores to diabetes-associated disruption of specific neurocognitive processes (e.g., attention, learning, memory) secondary to brain dysfunction, there is little compelling evidence to support that possibility at the present time.”

“Children and adults who develop diabetes within the first 5–7 years of life may show moderate cognitive dysfunction that can affect all cognitive domains, although the specific pattern varies, depending both on the cognitive domain assessed and on the child’s age at assessment. Data from a recent meta-analysis of 19 pediatric studies have indicated that effect sizes tend to range between ∼ 0.4 and 0.5 for measures of learning, memory, and attention, but are lower for other cognitive domains (47). For the younger child with an early onset of diabetes, decrements are particularly pronounced on visuospatial tasks that require copying complex designs, solving jigsaw puzzles, or using multi-colored blocks to reproduce designs, with girls more likely to earn lower scores than boys (8). By adolescence and early adulthood, gender differences are less apparent and deficits occur on measures of attention, mental efficiency, learning, memory, eye–hand coordination, and “executive functioning” (13, 26, 40, 48–50). Not only do children with an early onset of diabetes often – but not invariably – score lower than healthy comparison subjects, but a subset earn scores that fall into the “clinically impaired” range […]. According to one estimate, the prevalence of clinically significant impairment is approximately four times higher in those diagnosed within the first 6 years of life as compared to either those diagnosed after that age or to nondiabetic peers (25 vs. 6%) (49). Nevertheless, it is important to keep in mind that not all early onset diabetic children show cognitive dysfunction, and not all tests within a particular cognitive domain differentiate diabetic from nondiabetic subjects.”

“Slowed neural activity, measured at rest by electroencephalogram (EEG) and in response to sensory stimuli, is common in children with diabetes. On tests of auditory- or visual-evoked potentials (AEP; VEP), children and adolescents with more than a 2-year history of diabetes show significant slowing […] EEG recordings have also demonstrated abnormalities in diabetic adolescents in very good metabolic control. […] EEG abnormalities have also been associated with childhood diabetes. One large study noted that 26% of their diabetic subjects had abnormal EEG recordings, as compared to 7% of healthy controls […] diabetic children with EEG abnormalities recorded at diagnosis may be more likely to experience a seizure or coma (i.e., a severe hypoglycemic event) when blood glucose levels subsequently fall […] This intriguing possibility – that seizures occur in some diabetic children during hypoglycemia because of the presence of pre-existing brain dysfunction – requires further study.” 

“A very large body of research on adults with diabetes now demonstrates that the risk of developing a wide range of neurocognitive changes – poorer cognitive function, slower neural functioning, abnormalities in cerebral blood flow and brain metabolites, and reductions or alterations in gray and white-brain matter – is associated with chronically elevated blood glucose values […] Taken together, the limited animal research on this topic […] provides quite compelling support for the view that even relatively brief bouts of chronically elevated blood glucose values can induce structural and functional changes to the brain. […] [One pathophysiological model proposed is] the “diathesis” or vulnerability model […] According to this model, in the very young child diagnosed with diabetes, chronically elevated blood glucose levels interfere with normal brain maturation at a time when those neurodevelopmental processes are particularly labile, as they are during the first 5–7 years of life […]. The resulting alterations in brain organization that occur during this “sensitive period” will not only lead to delayed cognitive development and lasting cognitive dysfunction, but may also induce a predisposition or diathesis that increases the individual’s sensitivity to subsequent insults to the brain, as could be initiated by the prolonged neuroglycopenia that occurs during an episode of hypoglycemia. Data from most, but not all, research are consistent with that view. […] Research is only now beginning to focus on plausible pathophysiological mechanisms.”

After having read these chapters, I’m now sort-of-kind-of wondering to which extent my autism was/is also at least partly diabetes-mediated. There’s no evidence linking autism and diabetes presented in the chapters, but you do start to wonder even so – the central nervous system is complicated.. If diabetes did play a role there, that would probably be an argument for not considering potential diabetes-mediated brain changes in me as ‘minor’ despite my somewhat higher than average IQ (just to be clear, a high observed IQ in an individual does not preclude the possibility that diabetes had a negative IQ-effect – we don’t observe the counterfactual – but a high observed IQ does make a potential IQ-lowering effect less likely to have happened, all else equal).

December 21, 2016 Posted by | Books, Diabetes, Epidemiology, Medicine, Neurology, Personal | Leave a comment

A couple of lectures and a little bit of random stuff

i. Two lectures from the Institute for Advanced Studies:

The IAS has recently uploaded a large number of lectures on youtube, and the ones I blog here are a few of those where you can actually tell from the title what the lecture is about; I find it outright weird that these people don’t include the topic covered in the lecture in their lecture titles.

As for the video above, as usual for the IAS videos it’s annoying that you can’t hear the questions asked by the audience, but the sound quality of this video is at least quite a bit better than the sound quality of the video below (which has a couple of really annoying sequences, in particular around the 15-16 minutes mark (it gets better), where the image is also causing problems, and in the last couple of minutes of the Q&A things are also not exactly optimal as the lecturer leaves the area covered by the camera in order to write something on the blackboard – but you don’t know what he’s writing and you can’t see the lecturer, because the camera isn’t following him). I found most of the above lecture easier to follow than I did the lecture posted below, though in either case you’ll probably not understand all of it unless you’re an astrophysicist – you definitely won’t in case of the latter lecture. I found it helpful to look up a few topics along the way, e.g. the wiki articles about the virial theorem (/also dealing with virial mass/radius), active galactic nucleus (this is the ‘AGN’ she refers to repeatedly), and the Tully–Fisher relation.

Given how many questions are asked along the way it’s really annoying that you in most cases can’t hear what people are asking about – this is definitely an area where there’s room for improvement in the context of the IAS videos. The lecture was not easy to follow but I figured along the way that I understood enough of it to make it worth watching the lecture to the end (though I’d say you’ll not miss much if you stop after the lecture – around the 1.05 hours mark – and skip the subsequent Q&A). I’ve relatively recently read about related topics, e.g. pulsar formation and wave- and fluid dynamics, and if I had not I probably would not have watched this lecture to the end.

ii. A update. I’m slowly working my way up to the ‘Running Dictionary’ rank (I’m only a walking dictionary at this point); here’s some stuff from my progress page:

I recently learned from a note added to a list that I’ve actually learned a very large proportion of all words available on, which probably also means that I may have been too harsh on the word selection algorithm in past posts here on the blog; if there aren’t (/m)any new words left to learn it should not be surprising that the algorithm presents me with words I’ve already mastered, and it’s not the algorithm’s fault that there aren’t more words available for me to learn (well, it is to the extent that you’re of the opinion that questions should be automatically created by the algorithm as well, but I don’t think we’re quite there yet at this point). The aforementioned note was added in June, and here’s the important part: “there are words on your list that can’t teach yet. can teach over 12,000 words, but sadly, these aren’t among them”. ‘Over 12.000’ – and I’ve mastered 11.300. When the proportion of mastered words is this high, not only will the default random word algorithm mostly present you with questions related to words you’ve already mastered; but it actually also starts to get hard to find lists with many words you’ve not already mastered – I’ll often load lists with one hundred words and then realize that I’ve mastered every word on the list. This is annoying if you have a desire to continually be presented with both new words as well as old ones. Unless increases the rate with which they add new words I’ll run out of new words to learn, and if that happens I’m sure it’ll be much more difficult for me to find motivation to use the site.

With all that stuff out of the way, if you’re not a regular user of the site I should note – again – that it’s an excellent resource if you desire to increase your vocabulary. Below is a list of words I’ve encountered on the site in recent weeks(/months?):

Copaceticfrumpyelisiontermagantharridanquondam, funambulist, phantasmagoriaeyelet, cachinnate, wilt, quidnunc, flocculent, galoot, frangible, prevaricate, clarion, trivet, noisome, revenant, myrmidon (I have included this word once before in a post of this type, but it is in my opinion a very nice word with which more people should be familiar…), debenture, teeter, tart, satiny, romp, auricular, terpsichorean, poultice, ululation, fusty, tangy, honorarium, eyas, bumptious, muckraker, bayou, hobble, omphaloskepsis, extemporize, virago, rarefaction, flibbertigibbet, finagle, emollient.

iii. I don’t think I’d do things exactly the way she’s suggesting here, but the general idea/approach seems to me appealing enough for it to be worth at least keeping in mind if I ever decide to start dating/looking for a partner.

iv. Some wikipedia links:

Tarrare (featured). A man with odd eating habits and an interesting employment history (“Dr. Courville was keen to continue his investigations into Tarrare’s eating habits and digestive system, and approached General Alexandre de Beauharnais with a suggestion that Tarrare’s unusual abilities and behaviour could be put to military use.[9] A document was placed inside a wooden box which was in turn fed to Tarrare. Two days later, the box was retrieved from his excrement, with the document still in legible condition.[9][17] Courville proposed to de Beauharnais that Tarrare could thus serve as a military courier, carrying documents securely through enemy territory with no risk of their being found if he were searched.” Yeah…).

Cauda equina syndromeCastleman’s disease, Astereognosis, Familial dysautonomia, Homonymous hemianopsia, Amaurosis fugax. All of these are of course related to content covered in the Handbook.

1740 Batavia massacre (featured).

v. I am also fun.

October 30, 2015 Posted by | Astronomy, History, Immunology, language, Lectures, Medicine, Neurology, Personal, Physics, Random stuff, Wikipedia | Leave a comment

Random Stuff / Open Thread

This is not a very ‘meaty’ post, but it’s been a long time since I had one of these and I figured it was time for another one. As always links and comments are welcome.

i. The unbearable accuracy of stereotypes. I made a mental note of reading this paper later a long time ago, but I’ve been busy with other things. Today I skimmed it and decided that it looks interesting enough to give it a detailed read later. Some remarks from the summary towards the end of the paper:

“The scientific evidence provides more evidence of accuracy than of inaccuracy in social stereotypes. The most appropriate generalization based on the evidence is that people’s beliefs about groups are usually moderately to highly accurate, and are occasionally highly inaccurate. […] This pattern of empirical support for moderate to high stereotype accuracy is not unique to any particular target or perceiver group. Accuracy has been found with racial and ethnic groups, gender, occupations, and college groups. […] The pattern of moderate to high stereotype accuracy is not unique to any particular research team or methodology. […] This pattern of moderate to high stereotype accuracy is not unique to the substance of the stereotype belief. It occurs for stereotypes regarding personality traits, demographic characteristics, achievement, attitudes, and behavior. […] The strong form of the exaggeration hypothesis – either defining stereotypes as exaggerations or as claiming that stereotypes usually lead to exaggeration – is not supported by data. Exaggeration does sometimes occur, but it does not appear to occur much more frequently than does accuracy or underestimation, and may even occur less frequently.”

I should perhaps note that this research is closely linked to Funder’s research on personality judgment, which I’ve previously covered on the blog here and here.

ii. I’ve spent approximately 150 hours on altogether at this point (having ‘mastered’ ~10.200 words in the process). A few words I’ve recently encountered on the site: Nescience (note to self: if someone calls you ‘nescient’ during a conversation, in many contexts that’ll be an insult, not a compliment) (Related note to self: I should find myself some smarter enemies, who use words like ‘nescient’…), eristic, carrel, oleaginous, decal, gable, epigone, armoire, chalet, cashmere, arrogate, ovine.

iii. why p = .048 should be rare (and why this feels counterintuitive).

iv. A while back I posted a few comments on SSC and I figured I might as well link to them here (at least it’ll make it easier for me to find them later on). Here is where I posted a few comments on a recent study dealing with Ramadan-related IQ effects, a topic which I’ve covered here on the blog before, and here I discuss some of the benefits of not having low self-esteem.

On a completely unrelated note, today I left a comment in a reddit thread about ‘Books That Challenged You / Made You See the World Differently’ which may also be of interest to readers of this blog. I realized while writing the comment that this question is probably getting more and more difficult for me to answer as time goes by. It really all depends upon what part of the world you want to see in a different light; which aspects you’re most interested in. For people wondering about where the books about mathematics and statistics were in that comment (I do like to think these fields play some role in terms of ‘how I see the world‘), I wasn’t really sure which book to include on such topics, if any; I can’t think of any single math or stats textbook that’s dramatically changed the way I thought about the world – to the extent that my knowledge about these topics has changed how I think about the world, it’s been a long drawn-out process.

v. Chess…

People who care the least bit about such things probably already know that a really strong tournament is currently being played in St. Louis, the so-called Sinquefield Cup, so I’m not going to talk about that here (for resources and relevant links, go here).

I talked about the strong rating pools on ICC not too long ago, but one thing I did not mention when discussing this topic back then was that yes, I also occasionally win against some of those grandmasters the rating pool throws at me – at least I’ve won a few times against GMs by now in bullet. I’m aware that for many ‘serious chess players’ bullet ‘doesn’t really count’ because the time dimension is much more important than it is in other chess settings, but to people who think skill doesn’t matter much in bullet I’d say they should have a match with Hikaru Nakamura and see how well they do against him (if you’re interested in how that might turn out, see e.g. this video – and keep in mind that at the beginning of the video Nakamura had already won 8 games in a row, out of 8, against his opponent in the first games, who incidentally is not exactly a beginner). The skill-sets required do not overlap perfectly between bullet and classical time control games, but when I started playing bullet online I quickly realized that good players really require very little time to completely outplay people who just play random moves (fast). Below I have posted a screencap I took while kibitzing a game of one of my former opponents, an anonymous GM from Germany, against whom I currently have a 2.5/6 score, with two wins, one draw, and three losses (see the ‘My score vs CPE’ box).

Kibitzing GMs(click to view full size).

I like to think of a score like this as at least some kind of accomplishment, though admittedly perhaps not a very big one.

Also in chess-related news, I’m currently reading Jesús de la Villa’s 100 Endgames book, which Christof Sielecki has said some very nice things about. A lot of the stuff I’ve encountered so far is stuff I’ve seen before, positions I’ve already encountered and worked on, endgame principles I’m familiar with, etc., but not all of it is known stuff and I really like the structure of the book. There are a lot of pages left, and as it is I’m planning to read this book from cover to cover, which is something I usually do not do when I read chess books (few people do, judging from various comments I’ve seen people make in all kinds of different contexts).

Lastly, a lecture:

August 25, 2015 Posted by | Biology, Books, Chess, language, Lectures, Personal, Psychology, Statistics | 2 Comments

Partner Violence (II)

As mentioned in my first post about the book, I realized late in the writing process that I’d be unable to cover it in one post, so this post will not cover nearly as much of the book as did the first post and it will not be particularly long. However some of the observations in the last part I found interesting, so I wanted to talk a little bit about them here.

“The definition of violence indicates that the aggressor is the one who deliberately hurts the partner, and the victim is the one deliberately hurt by the partner. The definition is indifferent to the reasons leading up to the act of violence and its goals. I collaborated in a study that examined how partners perceive the violence between them […] In some cases, the research participants argued that the injury was extremely mild. In other cases, they claimed that the injury was not intentional. Some cases combined both arguments. But even when intentionally hurtful behavior was acknowledged, the tendency to reject responsibility and blame was still identified. In such cases, it was argued that the intentionally hurtful behavior is not to be considered as violence if the offender was not an aggressor or if the offended was not a victim. Such cases emphasize that examining behavior in terms of intentional injury to identify violence produces inadequate results; the causality sequence and the conduct of the offender and offended during the incident should also be examined. […] intentional infliction is insufficient to establish violence. […] Despite the limitations […] of the definition of violence as an intentional hurtful behavior, it was […] and still is used by numerous studies to design the individual behavioral observation unit of partner violence.”

On a related note, this part was really interesting to me:

“I had the opportunity to hold a series of sessions with adolescents at the ages of 12–16 within the framework of a project for coping with school violence, conducted in 2007. […] One of the sessions addressed boys’ and girls’ methods of initiating a dating relationship. The students mentioned that when a boy likes a girl, is attracted to her and would like to have an intimate relationship with her, he can approach her and make a direct intimate proposition. If she accepts, then “everyone is happy,” but if she turns him down, then “it is a huge embarrassment.” The session participants explained that such rejection is usually a difficult, humiliating, and intimidating experience, and therefore, many are deterred from initiating in this way. Many boys and girls avoid a direct, clear, and unequivocal approach and prefer other, more indirect methods of “checking” the other party’s willingness to start a relationship with them. These methods often employ violence, which can be interpreted as expressions of either hostility or affection. For example, the boy can playfully grab the girl’s hand while pinning her against a wall. If the girl chooses a hostile, nonreceptive response, the boy will interpret this as evidence that she is not interested in a relationship with him and in most cases will retreat. If the girl chooses to respond playfully or display vague affection and receptiveness, the boy can interpret this as an invitation. A negative response on behalf of the girl will not be experienced as rejection by the boy because he did not express his interest clearly. A positive, tolerant response by the girl can encourage the boy to continue approaching her, maybe with less aggression next time. The students considered this behavior to be an acceptable and reasonable method of dating initiation. […] It is a widespread behavior which many people, and not only adolescents, do not regard as violent behavior (Playful Violence) (Denzin, 1984). Such behaviors are especially frequent among youth and […] may include holding/grasping/pinning down, pushing, and shoving by boys, and pushing, pinching, hair pulling, and mild blows by girls.” (my bold).

Part of why the above observations were interesting to me was that during my own childhood/youth I had no idea such behaviour was an approach tactic, and I was at a loss to explain such behaviours the few times in the past that I observed such behaviours myself. While reading the chapter I suddenly came to realize that I may have been the target of such behaviour myself during my childhood (let’s just say that one particular sequence of events which I had a great deal of difficulty making sense of in the past makes a lot more sense in light of the above observations). My lack of awareness of the relevant social dynamics embedded in such interactions of course means that my response to the approach behaviour may not have been the response I would have employed had I known about these things (due to being completely clueless, I probably treated that girl very badly. Oh well, as Rochefoucauld’s aptly put it: ‘Il n’y a guère d’homme assez habile pour connaître tout le mal qu’il fait’).

“Although most of the quantitative research [on violence] is based on data regarding individual single violent behaviors isolated from the immediate situational context, in many cases, the analyses, the interpretations, and conclusions are performed as if the behaviors are sequenced (the hurtful behaviors of one party are regarded as a defensive response to the violence of the other party). This is similar to looking at a series of photos set in no particular order while trying to make sense of the timeline of the incident that they describe. […] Defining the boundaries of a conflict (where it starts and ends) is crucial to the identification of the relevant interactions to be studied.”

“Swann, Pelham, and Roberts (1987) argued that, as a rule, individuals simplify their interactions by forming, arranging, and perceiving them in “discrete causal chunks.” These chunks affect individuals’ awareness of the effect of their actions upon others, and the effect of others’ actions upon themselves. They form “self-causal chunks” when they believe that their behavior has affected others. They form “other-causal chunks” when they believe that others have affected their behavior. It is likely that in partner violence, most individuals feel that they are responding rather than initiating (Winstok, 2008).”

“Same-gender involvement in conflicts may enhance status, and avoiding a same-gender conflict may diminish it. On the other hand, involvement in conflicts with the opposite gender might work the other way around. For example, a man who avoids aggressive conflict with another man can be regarded as weak or cowardly. A man who gets involved in aggressive conflict with a woman can be regarded as a bully, which is also an indication of weakness and cowardice. […] Women in general are aware of men’s chivalry code by which they are expected not to hurt women (Felson, 2002; Felson & Feld, 2009). […] Men’s chivalry code commitment and their female partners’ awareness of it may increase men’s vulnerability in partner conflicts.”

The comments and results below relate to repondents’ answers to questions dealing with how they thought they would respond in various different conflict contexts (involving their own partner, or strangers of both gender), with a specific focus on the (hypothetical) willingness to escalate, not actual observed conflict behaviour, so you may take the responses with a grain of salt – however I think they are still interesting:

“First, let me begin with the escalatory intention of men in response to the verbal aggression of various aggressors: the highest escalation level was toward male strangers and lower toward female strangers; the lowest escalation level was toward their female partners. The same rates with larger values were found also for the escalatory intentions of men in response to physical aggression by the various opponent types. As to the escalatory intentions of women in response to verbal aggression, the highest level was toward their male partners, and a little less so, but not significantly, toward female strangers. The lowest escalation intention level was toward male strangers. The same rates with similar values were also found in the women’s escalatory intentions in response to physical aggression of various opponents. The most important finding of these comparisons is that relative to the escalation levels of research participants toward strangers, the escalation levels of men toward their partners’ aggression was the lowest, and of women, the highest. […] in intimate relationships, women’s tendency was more escalatory than men’s. […] escalatory intentions of men are more affected by the severity of aggression toward them than those of women. This study provides initial evidence of the lack of gender symmetry in escalatory intentions. In partner conflicts, women tend to escalate more than men.”

August 15, 2015 Posted by | Books, Personal, Psychology | Leave a comment

Random stuff

It’s been a while since I posted anything here so I figured I should at least post something…

i. A few Khan Academy videos I watched a while back:

(No comments)

(Bookmark remark: (‘Not completely devoid of slight inaccuracies as usual – e.g. in meningitis, neck stiffness is not as much as symptom as it is a clinical sign (see Chamberlain’s symptoms and signs…))’

(Bookmark remark: ‘Very simplified, but not terrible’)

(No comments)

ii. I previously read the wiki on strategic bombing during WW2, but the article did not really satisfy my curiosity and it turns out that the wiki also has a great (featured) article about Air raids on Japan (a topic not covered in a great amount of detail in the aforementioned wiki article). A few random observations from the article:

“Overall, the attacks in May destroyed 94 square miles (240 km2) of buildings, which was equivalent to one seventh of Japan’s total urban area.”

“In Tokyo, Osaka, Nagoya, Yokohama, Kobe, and Kawasaki, “over 126,762 people were killed … and a million and a half dwellings and over 105 square miles (270 km2) of urban space were destroyed.”[136] In Tokyo, Osaka and Nagoya, “the areas leveled (almost 100 square miles (260 km2)) exceeded the areas destroyed in all German cities by both the American and English air forces (approximately 79 square miles (200 km2)).”[136]

“In financial terms, the Allied air campaign and attacks on merchant ships destroyed between one third and a quarter of Japan’s wealth.[289]

“Approximately 40 percent of the urban area of the 66 cities subjected to area attacks were destroyed.[290] This included the loss of about 2.5 million housing units, which rendered 8.5 million people homeless.”

iii. A few longer lectures I’ve watched recently but did not think were particularly good: The Fortress (GM Akobian, Chess), Safety in the Nuclear Industry (Philip Thomas, Gresham College), War, Health and Medicine: The medical lessons of World War I (Mark Harrison, Gresham College – topic had potential, somehow did not like ‘the delivery’; others may find it worth watching).

iv. I play a lot of (too much) chess these days, so I guess it makes sense to post a little on this topic as well. Here’s a list of some of my recent opponents on the ICC: GM Zurab Azmaiparashvili, IM Jerzy Slaby, IM Petar Gojkovic, GM Goran Kosanovic, IM Jeroen Bosch, WGM Alla Grinfeld. I recall encountering a few titled players when I started out on the ICC and my rating was still adjusting and stabilizing, but now I’ve sort of fixed at a level around 1700-1800 in both the 1, 3 and 5 minute pools – sometimes a bit higher, sometimes a bit lower (and I’ve played relatively few 5 minute games so far)). This is a level where at least in bullet some of the semi-regular opponents I’ll meet in the rating pool are guys like these. I was quite dissatisfied with my play when I started out on the ICC because I hadn’t realized how tough it is to maintain a high rating there; having a closer look at which sort of opponents I was actually facing gradually made me realize I was probably doing quite well, all things considered. Lately I’ve been thinking that I have probably even been doing quite a bit better than I’d thought I had. See also this and this link. I’ve gradually concluded that I’m probably never ‘going back’ now that I’ve familiarized myself with the ICC server.

And yes, I do occasionally win against opposition like that, also on position – below an example from a recent game against a player not on the list above (there are quite a few anonymous title-holders as well on the server):

Click to view full size – the list to the lower left is a list of other players online on the server at that point in time, ordered by rating; as should be clear, lots of title-holders have relatively low ratings (I’m not completely sure which rating pool was displayed in the sidebar at that time, but the defaults on display for me are 5- or 3-minutes, so for example the international master ‘softrain’ thus had either a 3 or 5 minute rating of 1799 at that time. Do note that ICC requires proof for titles to display on the server; random non-titled players do not display as titleholders on the ICC (actually the formally approved titled accounts obviously do not account for all accounts held by title-holders as some titled players on the server use accounts which do not give away the fact that they have a title).

Here’s another very nice illustration of how tough the X-minute pools are (/how strong the players playing on the ICC are):

Wang Hao
Again, click to view in full size. This is Chinese Grandmaster Wang Hao‘s ICC account. Wang Hao is currently #39 on the FIDE list of active chess players in the world, with a FIDE rating above 2700. Even his 5-minute rating on the ICC, based on more than a thousand games, is below 2300, and his current 3 minute rating is barely above 2000. With numbers like those, I currently feel quite satisfied with my 1700-1800 ratings (although I know I should be spending less time on chess than I currently do).

v. A few words I’ve recently encountered on Anaphora, usufruct, mimesis, amanuensis, peculate, elide, ataraxia, myrmidon, velleity.

vi. A few other wiki links: Fritz Haber, Great Stink (featured), Edward Low (a really nice guy, it seems – “A story describes Low burning a French cook alive, saying he was a “greasy fellow who would fry well”, and another tells he once killed 53 Spanish captives with his cutlass.[6]“), 1940 Soviet ultimatum to Lithuania (‘good article’).

vii. A really cute paper from the 2013 Christmas edition of the British Medical Journal: Were James Bond’s drinks shaken because of alcohol induced tremor? Here’s the abstract:

Objective To quantify James Bond’s consumption of alcohol as detailed in the series of novels by Ian Fleming.

Design Retrospective literature review.

Setting The study authors’ homes, in a comfy chair.

Participants Commander James Bond, 007; Mr Ian Lancaster Fleming.

Main outcome measures Weekly alcohol consumption by Commander Bond.

Methods All 14 James Bond books were read by two of the authors. Contemporaneous notes were taken detailing every alcoholic drink taken. Predefined alcohol unit levels were used to calculate consumption. Days when Bond was unable to consume alcohol (such as through incarceration) were noted.

Results After exclusion of days when Bond was unable to drink, his weekly alcohol consumption was 92 units a week, over four times the recommended amount. His maximum daily consumption was 49.8 units. He had only 12.5 alcohol free days out of 87.5 days on which he was able to drink.

Conclusions James Bond’s level of alcohol intake puts him at high risk of multiple alcohol related diseases and an early death. The level of functioning as displayed in the books is inconsistent with the physical, mental, and indeed sexual functioning expected from someone drinking this much alcohol. We advise an immediate referral for further assessment and treatment, a reduction in alcohol consumption to safe levels, and suspect that the famous catchphrase “shaken, not stirred” could be because of alcohol induced tremor affecting his hands.”

viii. A couple of other non-serious links which I found hilarious:
1) The Prof(essor) or Hobo quiz (via SSC).
2) Today’s SMBC. I’ll try to remember the words in the votey in the highly unlikely case I’ll ever have use for them – in my opinion it would be a real tragedy if one were to miss an opportunity to make a statement like that, given that it was at all suitable to the situation at hand..

July 6, 2015 Posted by | Chess, Diabetes, Epidemiology, History, Immunology, Infectious disease, Khan Academy, Lectures, Medicine, Personal | Leave a comment

(10.000) Words…

“The language denotes the man. A coarse or refined character finds its expression naturally in a coarse or refined phraseology.” (Christian Nestell Bovee)


(Click to view details/full size)

Doff, pabulum, astringent, enervate, mountebank, argot, sluice, sequin, indite, vitiate, simper, tarry, casuistry, saturnine, sidle, meretricious, fugacious, esurient, scabrous, disquisition, winsome, sedulous, badinage, abeyance, effrontery, minatory, synecdoche, lubricious, adjure, asperse, encumbrance, careen, desuetude, syllepsis, limn, bathetic, surcease, taut, tribulation, chrysalis, farrier, vane, virago, rictus, gewgaw, vituperate, curdleichthyology, abrogate, stultify, approbatory, intrepid, nugatory, contumacious, append, vociferate, tenebrous, arrogate, vermilion, descry, sententious, repine, procrustean, undulate, abstemious, palter, iniquitous, endue, lugubrious, obloquy, obdurate, importunate, apotheosis, obviateperegrinate, sacrum, …

In a way it makes absolutely no sense for someone like me to spend as much time on this stuff as I have over the last year or two; I almost never engage in conversations with other people as I rarely interact with other people at all (and also tend to avoid conversations when I do because conversations are usually unpleasant), and when I do both interact and converse with other people I only rarely engage in conversations in English as my first language, and the first language of most of the people with whom I interact regularly, is Danish. If the aim were to improve my vocabulary in order to hide my stupidity (‘make me look smarter’), I’d do a lot better by learning some more fancy-sounding Danish words. As it is, I can’t even remember the last time I last looked up a word in a Danish dictionary, but it’s been at least a few years (if not much more than that). Of course on the other hand I do read a lot of books, and I only read books in English. So it’s probably not a complete waste of time. But I’ve been thinking lately that I might derive a lot more benefit from these sorts of activities, in the sense that more words would ‘stick’, if I actually had to interact with other people in English on a daily basis. It seems to me likely that in a sense my language production capabilities might not be improved as much by these activities as are my language consumption capabilities. What I mean by this is that I frequently encounter new words I’ve worked on in the books I read, but at the same time I’m very rarely forced to ever actually use any of them in conversations with other people, so I don’t. I don’t know enough about linguistics to tell if this distinction between production and consumption matters, but it seems to me that it might. On a related note I’ve recently had the idea that my activities in these areas might implicitly be lowering my opportunity costs of book-reading, compared to personal interactions with others, because these activities make it easier for me to read books but does not at the same time much improve upon my social skills (e.g. conversational skills; though I’m on a related note open to the suggestion that conversational skills and vocabulary size are in some contexts relevant to this discussion in fact perhaps best conceived of as orthogonal variables (which doesn’t help at all…)) – which is hardly what I would conceive of as a desirable outcome. Oh well.

As you should have been able to infer from the screencap above and/or the post title, I’ve by now reached another major milestone (here’s the first one) on the site as I have now ‘mastered’ more than 10.000 words on the site – I figured it made sense to make a post about this and related matters, and this is the post in question. In the time that has passed since I wrote the post to which I link above the site has undergone a few minor changes, but actually most of it works pretty much the same way it did last year; if you’re curious about how the site works and you have not heard about it before, go have a look at that post before reading on. As I have noted before I don’t fully trust the dictionary; or at least I like Webster’s online dictionary better, which is why the links above are all to Webster entries. I’ll often ‘check out’ particular words which I’m curious about after having encountered them on, because sometimes specific interpretations of the words in question are simply wrong, or at least so I would argue; if the site is trying to tell me that a specific word means X, but I ‘know’ that it doesn’t and the Webster entry also provides zero support for this specific usage/interpretation – or actively ‘disagrees’ – then I go with Webster and I’ll get annoyed at the people behind (again). One thing to note when making comparisons here is that in general I believe that the dictionary has a greater ‘range’ of meanings covered, which also means that if you look up the entries to which I link above you might fail to appreciate how many different types of questions that might be required for someone to ‘master’ the words on; if the word has some rare meaning in a very specific context, you can expect to ask you about that before you master the word (and you can expect a subset of those questions to be poorly worded, making you angry at the programmers behind the site). This also means that even if you think you know a word, the site may still cause you some challenges along the way.

I’ve used the site pretty much every week during the last year, though in some periods I used the site very little; the relative inactivity meant that I dropped out of the top 100 list for a while, but over the last weeks I’ve done some more work on the site, and I’m now back in the top 100. So I seem to focus more on improving my vocabulary than do most users on the site, which I actually find somewhat curious given that this tool has apparently been introduced to thousands of children throughout the US. On the other hand I’ve put in a lot of hours when you add them all together (the site actually logging the hours you put in is incidentally a new feature which was not present when I posted my first couple of posts about the site a year ago; I actually didn’t like this feature to start with, in part because I realized how much time I’d spent on this stuff).

The site is in my opinion very bad at explaining how to properly use the site to learn new words in the semi-long run, so I should probably explain why I recently came to ‘rediscover’ my joy of using the site. The main factor rekindling my interest was that I discovered how to use ‘lists’ to focus on new words. If you play the challenge without any bells and whistles and never add lists or anything, you’ll at some point get to a situation where you may well be given 500 questions without ‘mastering’ more than one or two new words; the site will recycle and recycle, asking you hundreds of questions about words you’ve already mastered and occasionally ask you about a new word which you’ll never get enough questions about to actually ever master – this is incredibly frustrating, to the point where I last year decided to send the staff an email suggesting they make changes to the algorithms, because this just seemed insane and probably killed the motivation for a lot of users. You’d put in 20 hours almost without being allowed to actually achieve mastery of any of the new words, then suddenly you’d ‘master’ more than a thousand words one after the other because now suddenly the site could be bothered to finally allow you to show that you’ve mastered those words the site last asked you about last April – or whenever. Or not – I have a suspicion that a lot of users have given up before this point was reached and just said ‘screw this’ before getting to the mastery questions at the end of the line, and that stuff like this may be part of the reason why I’m in the top 100 list now. If this is true it’s sort of sad, because it seems like such a big missed opportunity; what you’d ideally want is not just a site useful for learning a few thousand words after which the way the site is coded will contribute strongly to making many people sick of it, but rather a site which mixes new words and old in an optimal manner which might encourage users to keep using the site in the long run. People may argue about what’s an optimal mix, but I don’t think you can argue with a straight face that the current configuration is anywhere near this point – and if the perceived optimal mix is different for different people, why not allow users to have an influence on this variable in the first place? In a way the site implicitly does, in an admittedly roundabout manner, give people some influence on these sorts of variables via the lists, but I remained unaware of this for a very long time so a lot of users presumably don’t know this. Either way I certainly think I’m justified in assuming that far more care has been taken to optimize the user experience early on than has been taken to making sure the site remains useful even to people who’ve already mastered a lot of words; I’d argue that the site has an excessive focus on review questions, compared to questions about new words, and from personal experience it has seemed to me that this problem seems to get bigger and bigger the more words you learn.

Adding to the problems mentioned above it also does not help that some of the review questions – not many of them, but some – are so poorly thought out that you can’t really tell what the right answer is supposed to be despite knowing very well what the word means, so you risk getting stuck in loops where a substantial proportion of the questions you’re asked are about words you already know at least in part because the questions are bad (if you answer a tricky review question like that incorrectly, you’ll be given quite a few more other questions in the future about this word you don’t care about and don’t want to answer questions about anymore, because an incorrect answer to a review question is always taken by the site as an indication that you don’t understand the word as well as you should, and never as an indication that someone should seriously have a closer look at some of those shitty questions (again, there aren’t that many of them, but they’re very annoying to someone like me)).

So in short, if you’re contemplating using the site or already does, don’t do what I did – instead of just playing the basic challenge, at some point it becomes necessary to instead start exploring the lists. If you add a list to learn, the site will mostly (though not exclusively) focus on the words on the list you’re currently learning, avoiding the outcome outlined above. You can add more than one list simultaneously. I’ll put it bluntly – if you don’t use lists, this site will eventually kill pretty much all desire to use it, because you’ll eventually get to a point where you’ll feel you’re not making any progress and you’ll also at the same time have the distinct impression that the site actively refuses to give you any opportunities to making progress. I can’t be the only person who until recently did not use lists, and frankly without lists this site is a disaster waiting to happen. If you use lists well, it is however a very useful tool.

The site does not help you with grammar – if you know about a site that does, I’d be curious to know about it in the comments below. On a related note I thought I should end this post with this quite amusing quote from Jerome Jerome’s book Three Men on the Bummel, published in 1900:

“In the course of the century, I am inclined to think that Germany will solve her difficulty in this respect by speaking English. Every boy and girl in Germany, above the peasant class, speaks English. Were English pronunciation less arbitrary, there is not the slightest doubt but that in the course of a very few years, comparatively speaking, it would become the language of the world. All foreigners agree that, grammatically, it is the easiest language of any to learn. A German, comparing it with his own language, where every word in every sentence is governed by at least four distinct and separate rules, tells you that English has no grammar. A good many English people would seem to have come to the same conclusion; but they are wrong. As a matter of fact, there is an English grammar, and one of these days our schools will recognise the fact, and it will be taught to our children, penetrating maybe even into literary and journalistic circles. But at present we appear to agree with the foreigner that it is a quantity neglectable. English pronunciation is the stumbling-block to our progress. English spelling would seem to have been designed chiefly as a disguise to pronunciation. It is a clever idea, calculated to check presumption on the part of the foreigner; but for that he would learn it in a year.”

June 1, 2015 Posted by | language, Personal, Quotes/aphorisms | Leave a comment

Providing practical support for people with autism spectrum disorder – supported living in the community

I actually wasn’t planning on blogging this book because of how disappointing it was. Here’s what I wrote in my goodreads review:

“The last few chapters managed to almost push me all the way towards giving the book one star. You can’t just claim in a book like this that very expensive and comprehensive support systems which you’re dreaming about are cost-effective without citing a single study, especially not in a context where you’ve just claimed that activities which usually end up costing a lot of money will end up saving money. If you envision a much more comprehensive support system, you can’t not address obvious cost drivers.

Some interesting stuff and important observations are included in the book, but the level of coverage is not high and you should not take my two star (‘ok’) rating to indicate that I am in agreement with the author. The main reason why I ended up finishing it was that it was easy to read, not that it was a good book.”

There are no inline citations, and examples of things people with ASD might need help with and ways to help them with these problems seem to be derived from anecdotes, not systematic research. The author repeatedly emphasizes that aid should be individualized and focused on the specific needs of the person with ASD, and although this makes a lot of sense it also makes recommendations very difficult to evaluate (it’s a bit like figuring out what’s going on in the context of other areas of psychological research, where therapists will often ‘mix methods’ when dealing with specific individuals, making it impossible to figure out which components of the treatment regime are actually helpful and which are not because even if people were to try to figure this out, power issues would make it impossible to estimate the relevant interaction effects even in theory); though it should be made clear that the author makes no attempt to do this.

I however found some of the observations included and specific points raised in the book to be interesting, and I’ll mention some of these in the coverage below.

“Professional support needs to be developed and executed in partnership with people and families. For support to be successful, all concerned need to be aware of its objectives and agree with the plan and strategies involved.”

I decided to start out the coverage with this quote because the book is full of postulates like these. Often specific cases will be used to illustrate points like these, but don’t expect any references to actual research on such topics – it’s not that kind of book. The approach employed makes the book incredibly hard for me to evaluate; some of the ideas are presumably sound, but it’s difficult to tell which because they didn’t do the research. In theory it’s sometimes easy to see how a given approach mentioned might lead to, or solve, specific problems, but you’ll often get the idea that perhaps there are tradeoffs at play here which the advice included does not take into account, meaning that in specific cases an alternative solution/piece of advice to the one proposed might lead to better outcomes by trading off the problems associated with the approach mentioned and the problems associated with an alternative approach. In some cases you perhaps would ideally prefer the parents of an adult child living outside the home of the parents to not have too much influence on support strategies employed even though they might traditionally have had a significant role to play in the context of support provision, because the family’s approach to problem solving might be counterproductive, in which case a support plan not supported by the parents might still in some cases be preferable to one which would be supported by them. The emphasis on individualized care throughout the book is, it must be said, on the other hand helpful in terms of thinking about such potential problems, but you still have this impression that a lot of the suggestions in the book are really not based on anywhere near a sufficient amount of data or research, and although they’re often ‘common sense suggestions’ it’s quite clear from a lot of different areas of psychological research by now that common sense can sometimes deceive us.

A general problem I have with the book is, I think, that I think the author is too confident about which support approaches/strategies/etc. might, or might not, work – and perhaps a key reason why she seems overconfident is that she’s not provided the research results in the book which one would in my opinion need in order to draw conclusions like the ones she draws, regardless of whether such research actually exists. A related problem is that quite a few of the concluding statements in the book are at least partly normative statements (which I generally dislike to encounter in non-fiction), not descriptive statements (which I do like to encounter). In the book she repeatedly makes claims about what people with ASD are like without referring to research on these topics, so you’re wondering how she knows these things, and whether or not those claims are actually true, or just true for a small subset of people with ASD which she’s encountered or read about. Many of the observations seemed familiar to me (having encountered them either in other textbooks, or having personal experience with the issues mentioned) so I’d be likely to grant that many of the observations are valid, but you are sometimes wondering how she knows the things she claims to know. A big problem is actually the way she covers the material; she covers various topics in various chapters, but the way she does is makes it relatively hard for a reader to know which parts of a given chapter might actually be useful for a specific individual curious about these things; another way to do things might have been to split the coverage up into chapters about support provision for people with low support requirements, and other chapters about support provision for people with high support requirements. It’s made clear in the book that needs are different for different individuals, but you’re often sort of wondering which passages are most relevant to which groups of people with ASD. One might argue that ‘people ought to be able to tell this on their own’, but then we get to the problems that people with ASD tend to be bad at asking for support, perhaps not realizing that they need it, and the problem that people without ASD who do not know much about ASD perhaps have a difficult time figuring out which types of help might be useful in a specific setting. This stuff is difficult as it is, but I don’t think the way the coverage is structured in this book is helping at all with solving these sorts of issues.

Oh well, let’s move on…:

“The ultimate aim of support should be to improve skills and develop strategies to enable the person with ASD to feel in control and better able to cope independently.”

“The fact is that extremely able people with ASD frequently struggle with day-to-day life skills. Very intelligent students cannot organize themselves to launder their clothes, and may get up to find they are all dirty or still wet in the machine from several days ago. This is one of those superficially trivial things that can be a major problem to the person it repeatedly happens to. On a practical domestic front, what may be a massive difficulty for a person with ASD, may be an easily solved problem for someone without it. […] People with ASD like to have regular routines. The ability to adhere to routine is an advantage in many situations, and this skill can be used productively. Structure and organization can be brought to running the household. As a plan is constructed, problems can be considered and systems put in place to deal with them. A planning session when the individual collaborates with support to work out a weekly menu and the necessary shopping plan, gives the person more autonomy, than having someone turn up to go shopping or cook with them. Having someone alongside is sometimes necessary, but has the disadvantage of creating dependence. The individual is empowered instead by being facilitated to complete tasks independently. […] The best support methods promote independence. […] The aspects of forward planning can be incredibly challenging for a person with ASD, regardless of their intellectual level. […] As people with ASD have great difficulty seeing consequences or planning ahead, they may find it hard to become motivated if the gratification is not instant. Things have to be broken down and explained in a practical way.”

“Most people instigate minor changes easily. It may be more convenient to vary a normal routine on a particular day, even pleasurable. I might decide that as it is a sunny day I will go out, and do the housework in the evening. As a supporter for someone with ASD it is vital to remember, that he will not have the flexibility of thought that people generally have and so may need routines to be more stringently adhered to. Such a simple adjustment may not be easy, and it may be preferable to stay with the usual unless there is a strong argument for change. The world becomes easier to interpret if as much as possible is held constant. […] Change is easier to manage if we know it is coming. The better prepared someone is for a change, generally the easier it is to cope. For people with ASD, it helps if the preparation can be as concrete as possible.”

“The paradoxical nature of ASD is demonstrated again in attention span. The person will be absolutely absorbed, blocking out the rest of the world, when he is engrossed in something of particular interest; but at other times his attention span can be low. Most people will recognize the experience of being called away to answer a phone call, or speaking to a visitor and completely forgetting that they were in the middle of doing something. This distractibility is a common experience for those with ASD. […] I often think that ASD is the source of the stereotype of the ‘absent-minded professor’.”

A personal remark on these topics is perhaps in order here, and I add it because it is my impression that mass media portrails of individuals with these sorts of traits are generally if anything favourably inclined; in the sense that distractibility, forgetfulness and these sorts of traits are in those contexts in general traits you smile about and which are mildly funny. My impression is that the first word that springs to mind in these contexts is ‘amusing’, or something along those lines, not ‘annoying’. The downsides are usually to some extent neglected. However I know from Real Life experience that things like forgetfulness and distractability can be really annoying. Forgetting the key to your flat and locking yourself out of your flat (multiple times); forgetting to bring home your laptop from the university and having to go back and get it while worrying about whether or not it’s been stolen in the meantime (it fortunately wasn’t); getting caught up in an interesting exchange on the internet causing you to you forget that you turned on the stove an hour ago (or was it two hours ago? Time flies when you’re engaged in stuff that interests you…), so now you’ll have to spend another hour trying to clean the pot and separate the charred chunks of vegetables and the metal; getting a burn while taking something out of the oven because you were thinking about something else and didn’t pay sufficient attention to the task at hand – these things border from annoying to dangerous, as also noted in the book: “Depending on what we were doing, finding that we have left something in the middle of it can be anything from mildly annoying (left the kitchen half cleaned) to very distressing (left the pan on the hob and burnt the house down).” Similar observations might be made in the context of ‘clumsiness’ (not a diagnostic trait, but apparently often observed) and combinations of these traits. The sorts of things people often find amusing when they happen to, say, cartoon characters are a lot less funny when they happen to you personally, especially if you are having difficulties finding ways to address the issues and other people are impacted by them as well. Problems like these may cause amusement among others, but I know from both personal experience and the experiences of a good friend of mine that they may also cause profound exasperation among the people around you.

“Difficulty with communication is a core problem for those with autism spectrum disorder (ASD). Some people have little or no speech, some have an extensive vocabulary, some make grammatical mistakes, some have a wide use of language – but all people with ASD have problems with communication. These problems are extremely complex, leading to much misunderstanding, confusion and stress. The more sophisticated the person’s language is the greater the problem may be. Ros Blackburn, a highly intelligent British woman with ASD who gives many talks on the subject, highlights that a person’s ability can also be their greatest disability. As a verbal, intellectually able woman, she finds that people do not appreciate the support that she needs in everyday and social situations. The power to have a seemingly normal conversation can cause many troubles for a person with ASD by giving a false impression of their comprehension. […] Care should be taken not to give too much information at one time. People with ASD generally process language slowly and have difficulty handling a lot of verbal input. […] People with ASD work through matters slowly, and speed of discussion is problematic. […] So time needs to be offered to assimilate information before a response is expected. […] For most people with ASD, it is easier to talk if there are fewer people in the group. In a large meeting there is too much to take in, and few silences in which to process what has been said. […] They almost always prefer one to one conversation to group discussion, and small intimate gatherings to parties.”

“We all make blunders in relationships. We misjudge what is acceptable in a situation, mistake another person’s intention or misinterpret someone’s meaning. We then feel upset, isolated and embarrassed. People with ASD are more prone to doing this sort of thing than most – and they do experience the same unpleasant aftermath. […] Coping well is a double-edged sword; the better a person manages, the more likely he is to be judged harshly when he does make a mistake. […]  Some people with ASD are able to think their way through social situations. They teach themselves or have been taught to interpret non-verbal signals. They can use cognition to remember that the other person may feel differently to them, and to compute what their perception and emotions may be. This is a slow, cumbersome method compared to the automatic, rapid assimilation that those without ASD make. Even those who compensate well appear slow, stilted, awkward, and are liable to make significant mistakes.”

“Neurotypical people (NTs) are as lacking in empathy towards people with ASD as vice versa.” This is in my opinion a bold claim and I’m not sure it’s true, but I think she does have a point here. I think it’s likely that NTs often judge people with ASD based on the standards of NTs; standards which may well be impossible for the person with ASD to ever meet, regardless of the amount of effort the individual puts into meeting those standards. She however argues later on in the coverage that: “Most people are not unkind, but are unthinking or, because of lack of knowledge about disability, make incorrect assumptions.” This seems plausible.

“The rigidity of AS thinking and the tendency to obsess means that a worry can escalate and dominate a person’s life. […] As a basic rule of thumb, regular, familiar routines are better stress busters than a novel idea. A holiday, for example, is more likely to add to stress than relieve it.” (This sounds very familiar, and I’ll keep this quote in mind…)

“Many people with ASD remain more susceptible to parental influence than the majority of their peers. […] All people with ASD, including the highly intelligent, are susceptible to being led by others and it is very easy for the person offering support, either knowingly or unwittingly, to lead the person down a route, which is not the course he wants to follow.”

“Social inabilities create problems for people with autism spectrum disorder (ASD) in establishing peer relationships and so naturally accessing the support that evolves between members of groups, such as work colleagues, fellow students or regulars in the pub. Asking for assistance appropriately will be challenging for people with ASD. […] adults often only appear on the services ‘radar’ when they reach crisis point. Forty-nine per cent of adults with ASD are still living with their parents. […] Only 6 per cent of adults with ASD are in full-time employment [no sources provided, US]”

“It is not always possible to tell from meeting a person or even from having regular contact with him that he has autism spectrum disorder (ASD). Individuals therefore face the decision as to whether or not to disclose that they have the disorder. […] Generally disclosure is on a sliding scale. Most people tell close family; whilst it would probably be inappropriate to tell a casual stranger. Some will disclose to professionals, but prefer to keep the information from social contacts. […] There are no easy answers as to who and when to tell. Disclosure to professionals in formal situations appears advisable so that all are aware of the condition and any differences are accepted and planned for. Informal social situations are more fluid and difficult to read.”

“NAS statistics show that only six per cent of people with autism spectrum disorder (ASD) (12% of those with Asperger Syndrome (AS)) in the UK are in full-time employment. This compares with 49 per cent of people with general disabilities who are employed. […] Given the talents which many with ASD have, this is a great loss to the workforce. […] Traits common to ASD, such as conscientiousness, attention to detail, perseverance and loyalty, are great assets to an employer. […] People with ASD tend to be loyal, to stick to routines and dislike change. […] The characteristics of the disorder mean that the individual may not make a good impression at interview. Social skills will not be a forté. […] The employer needs to be aware of any ASD traits the person displays, such as lack of eye contact. Questions may be prepared with support so that they elicit the information needed, but are specific, factual and clear. Broad questions, such as, ‘Tell me about yourself ’, will leave the interviewee floundering. […] Interviews are not always the most appropriate way of assessing candidates, especially not those with ASD.”

The author does not address in the book the specific problems and tradeoffs related to the question of whether or not it’s optimal to disclose an autism spectrum disorder to a potential employer, but rather seems to take it for granted that the interviewee should always disclose, preferably beforehand. I’ve given this a lot of thought, and I’m really not convinced this is always the right approach.

May 17, 2015 Posted by | autism, Books, Medicine, Personal, Psychology | Leave a comment

A (special) chess game (against IM Christof Sielecki)

This evening IM Christof Sielecki, the guy behind the ChessExplained youtube account, gave an online simultaneous display. These are events where a very strong player will take on many opponents at the same time, and then see how well he does against the opposition. According to the original plan he was supposed to play 20 different opponents, but in the end he ended up only playing 18; I was one of the players he played against during the event. He won 17 games and drew one game. I not surprisingly lost my game, but I did hold out for almost three hours and he had some really nice things to say about my play during the game (see comments below). You can watch the entire ‘show’ here if you haven’t got anything better to do (I sort of hope you do…), and you can see my own game against him here (I was black – Christof had the white pieces in all games); it should perhaps be noted that I spent most of my time on the first 25 moves or so and that I got into severe time trouble and was playing basically only on the increment (30 seconds/move) for the last 20 moves of the game.

As mentioned he had nice things to say about my play, and I’m actually quite satisfied with my play even if I lost. A few quotes from his commentary during the game:

“Very solid game here by the black player.” (43 minutes into the game)

“What can I do, this guy is playing very, very solid chess.” (49 minutes…)

“that’s tough, that’s tough business here, it’s not easy at all …this is one of – he’s playing this very, very solidly. […] I have absolutely nothing here.” (after 17…Re7, roughly 1 hour and 13 minutes into the game)

“Ah, yeah, a5 … yeah, what can you do, he’s playing well…” (after 23…a5 – 1 hour, 52 minutes…)

“Ahm, okay. He keeps defending …that guy, he keeps defending very, very well.” (after 35…g6 – 2 hours, 19 minutes)

“I’m kind of trying to win here, maybe in a situation where it’s not justified.” (after 41…d4 – 2 hours, 28 minutes)

“He played a really, really solid defence, this guy” (2 hours 42 minutes in)

March 21, 2015 Posted by | Chess, Personal | Leave a comment

A brief administrative note

People who’re keeping up to date with my reading on the book list or on goodreads would have noticed that I have not read much stuff (especially not non-fiction) lately, and that I’m mostly covering books I read a while back. I assume most people don’t (keep up), but now the rest of you know as well. There are two principal reasons for this recent change: a) I’ve been busy with ‘real work’, and b) (significantly more important) I have been bothered by noise from another flat in the building in which I live for some time. It has become dramatically worse in the last week or two. My impression is that me moving someplace else would be easier to accomplish than having those neighbours kicked out, but I’m conflicted about doing this both because of the time and costs involved, but also because I know it’s a temporary problem as the people causing problems are renters and their contract will expire in August. I’m strongly considering at the moment to move to live at my parents’ place for some time (they have room for me, and they wouldn’t mind); not permanently, but several days each week. At the moment I’m more or less permanently angry and frustrated, and lately I’ve been more or less completely unable to focus. My knowledge of the physiological responses to stress is telling me that my blood pressure is probably through the roof. My roommate is also annoyed by the behaviour of my neighbours and have asked me multiple to complain about their behaviour (so it’s not just me), which I have done; but having Asperger’s and being very sensitive to noise does not help. There’s no way to reach an agreement with these people; diplomacy was of course my first approach, until I realized they just don’t give a shit and just do whatever they want anyway. I told them a few days ago that the noise they were making was not acceptable (it was angering both me and my roommate), and their response to this was to keep making noise for another 3 hours after I’d talked to them, into late in the evening; you can’t reason with people like that.

I’m hoping to find some sort of workable solution to these issues soon. It’s not that I’ve stopped finding blogging or reading/learning stuff interesting, but these problems are seriously impacting both my work and activities related to my blogging. Lately I’ve mostly tried to spend the available hours during which I was able to actually focus on the material on my work, and not on blogging or blogging-related activities, so blogging has been light. The noise doesn’t just encroach upon my work hours, but also upon the hours I have for myself; for example there was audible music coming through the floor yesterday evening until almost 11 PM (on a Monday).

March 10, 2015 Posted by | autism, Personal | Leave a comment

Books 2014

This blogpost contains a list of books I’ve read during the year 2014, as well as links to blogposts on this site which I have written about the books.

Aside from links to relevant blogposts I’ve also added to the list a little information about the books – the numbers in the parentheses are the goodreads ratings I have given the books (for information about how to interpret those ratings, see incidentally the comments here and here), whereas the various letters following those numbers indicate which ‘type’ of book it is – ‘f’ = fiction, ‘nf’ = non-fiction. I have included the names of the publishers of the non-fiction books to the list as it didn’t take any mental effort to add this variable and it seemed to me like it might be relevant information, and I have also added the names of the authors of the fiction books as this also seemed like relevant information which was easy to add. Given that people reading along here can’t be expected to necessarily know all the publishers included, I have provided a link to some information about each of the publishers featured on the list – the link to the publisher is added the first place on the list where the publisher in question is mentioned – in order to make it easier to assess relatively fast which type of book it might be. Aside from these things I’ve written very little about each book; I have added a few other remarks here and there where they seemed relevant, but I’ve tried to keep such comments brief and to the point. If you don’t do this a post like this can get very long very fast.

I have not rated all the books on the list, but I have added the goodreads ratings in the great majority of cases where I have – usually the posts about the book will in the cases where no ratings are provided give you both some idea why I did not rate them and some idea as to what I think about those books. Books I have not rated often had some (to me) problematic features which I’ve felt somewhat ambivalent about. I have not blogged all the books I’ve read this year; this is partly because I decided a while back to limit fiction blogging to a minimum.

On the list below I have only included books which I have read in full and have actually finished, meaning that as usual some books are left out. I hope you’ll find the list helpful in terms of navigating the site and that it’ll make it easier for you to find stuff I’ve written here about things you consider interesting. This is probably also a good place to remind people of the existence of the category cloud in the sidebar (a lot of work went into making it as useful as it is now, so you’ll forgive me for pointing this resource out to you even if you’re already aware of its existence), as well as the search bar; there’s a lot of stuff on this blog at this point, but if you know how/where to look I’m not really sure it’s actually that difficult to navigate the site – at least I seem to manage reasonably well…

Okay, back to the list and the books. After the first 6 months of the year I’d read 53 books. As you’ll be able to tell from the list below, the complete list for the entire year contains 116 books. 46 (~40%) of the books are fiction, if you include both Lichtenberg and Cuppy in this category, which I’ve decided one probably should. That means that 70 (~60%) of the books were non-fiction. In terms of time expenditure this breakdown is of course highly misleading, as I spend much, much more time on non-fiction books than on fiction books.

Whereas I have not blogged all the books I’ve read, I have on the other hand also blogged/reviewed some of the books I did not finish. For this reason I have added an addendum at the bottom of the post with a few of those books and links to relevant blogposts and goodreads reviews. It should perhaps be noted that it usually makes sense to distinguish between two categories of unfinished books; books which are simply bad/terrible, and books which take a lot of work. Do not take the fact that I did not finish a book to necessarily be an indication that the book was bad; maybe it was just very long or took a lot of work (one example: I’ve read over 650 pages of the textbook Sexually Transmitted Diseases so far, yet I’m not even a third of the way through that book yet).

If you want to know what the books I’ve read actually ‘look like’ and you’d like to get some sort of a ‘big picture’ look at what one might think of as my ‘digital book shelves’, goodreads has a list here with cover views of many of the publications which feature on the list below. That list however also includes books I did not finish.

1. Pathophysiology of disease (5, nf. Lange medical text. Long, takes a lot of work compared to most of the other books on this list). I took a few quite long breaks from the book along the way, which is why the posts are somewhat spread out over time. I decided in the end to add all relevant posts about the book here, even the ones which were not written this year. Blog coverage here, here, here, here, here, and here.

2. The Complete Maus (4, f). Art Spiegelman. I was seriously considering not including this one on the list at all (is this even a book?), but on the other hand it took me significantly more time to read this thing than it took me to read Calvino so I figured I might as well add it to the list.

3. Why Women Have Sex (2, nf. Times Books. This is one of a few non-fiction books on this list which are not either academic publications or technical publications. Don’t be fooled by the fact that the book is written by two university professors; the level of coverage here is much lower than that of pretty much every other non-fiction book on this list. Blog coverage here and here.

4. The Fifth Elephant (5, f). Pratchett. Blog coverage here.

5. Chronic Pain and Addiction (3, nf. Karger medical text). Blog coverage here.

6. Handbook of Individual Differences in Social Behavior (4, nf. Guilford Press psychology text. Long). Blog coverage here, here, and here. Note that I changed my mind about the goodreads rating after I’d written the last of my posts about the book.

7. Evolution of Island Mammals: Adaptation and Extinction of Placental Mammals on Islands (4, nf. Wiley-Blackwell biology text). Blog coverage here.

8. Invisible cities (4, f). Calvino. Blog coverage here.

9. Intelligence: A Very Short Introduction (2, nf. Oxford University Press. Short and very easy to read). Blog coverage here.

10. The Oxford Handbook of Health Economics (5, nf. Oxford University Press economics textbook. Long). I added this book to my list of favourite books on goodreads. Blog coverage here, here and here.

11. Death in the clouds (4, f). Agatha Christie.

12. Geomorphological Landscapes of the World (3, nf. Springer. Not easy to read.). Blog coverage here and here.

13. Metabolic Risk for Cardiovascular Disease (3, nf. Wiley-Blackwell medical text). Blog coverage here.

14. Screening for Depression and Other Psychological Problems in Diabetes: A Practical Guide (2, nf. Springer). Blog coverage here.

15. Psycho-Oncology (3, nf. Springer medical text). Blog coverage here and here.

16. The Daughter Of Time (4, f). Josephine Tey.

17. Cards on the Table (5, f). Agatha Christie.

18. A Practical Manual of Diabetic Retinopathy Management (2, nf. Wiley-Blackwell medical text). Blog coverage here.

19. The Cambridge Economic History of Modern Europe: Volume 1, 1700-1870 (3, nf. Cambridge University Press economics text). Blog coverage here and here.

20. Handbook of Cognitive-Behavioral Therapies (2, nf. Guilford Press psychology text). Blog coverage here and here.

21. Personality Judgment: A Realistic Approach to Person Perception (3, nf. An Academic Press psychology publication). Blog coverage here and here.

22. The Remains of the Day (5, f). Kazuo Ishiguro.

23. The Origin and Evolution of Cultures (5, nf. Oxford University Press. Takes a lot of work, but it’s an awesome book – “Highly recommended. Probably the best book I’ve read this year”). I added this book to my list of favourite books on goodreads. Blog coverage here, here, here, here and here.

24. What Did the Romans Know?: An Inquiry into Science and Worldmaking (2, nf. University of Chicago Press). Blog coverage here and here.

25. Bioterrorism and Infectious Agents: A New Dilemma for the 21st Century (3, nf. Springer medical text). Blog coverage here.

26. The Waste Books (2, f(?) – a collection of aphorims). Lichtenberg. Blog coverage here.

27. The Eyre Affair (5, f). Jasper Fforde. Blog coverage here.

28. The Biology of Happiness (nf. Springer (SpringerBriefs)). Easy to read, and also quite short. Blog coverage here.

29. Lost in a Good Book (5, f). Jasper Fforde.

30. The Well of Lost Plots (5, f). Jasper Fforde. Blog coverage here.

31. Body language (nf. Pocket. Like #3, this book is most decidedly not an academic publication, and you can tell). Blog coverage here.

32. Do Androids Dream of Electric Sheep? (3, f). Philip K. Dick.

33. Acute Muscle Injuries (3, nf. Springer medical text). Blog coverage here.

34. Military Geography: For Professionals and the Public (3, nf. Potomac Books/University of Nebraska Press). Blog coverage here, here and here.

35. The Psychology of Personnel Selection (3, nf. Cambridge University Press). Blog coverage here and here.

36. To Kill a Mockingbird (2, f). Harper Lee. Overrated.

37. Impact of Sleep and Sleep Disturbances on Obesity and Cancer (5, nf. Springer medical text). Blog coverage here and here.

38. Lupus: The Essential Clinician’s Guide (4, nf. Oxford University Press). Blog coverage here.

39. Something Rotten (4, f). Jasper Fforde.

40. 100 Cases in Acute Medicine (3, nf. Published by CRC Press – review book for medical students/junior doctors). Blog coverage here.

41. Plant Animal Interactions: An Evolutionary Approach (5, nf. Blackwell Publishing biology text). A really great book, high average goodreads rating. I added it to my list of favourite books on goodreads. Blog coverage here, here, and here.

42. 100 Cases in Clinical Medicine (3, nf. Published by CRC Press – see #40). Blog coverage here.

43. Peril at End House (4, f). Agatha Christie.

44. The Structure of Scientific Revolutions (nf. University of Chicago Press). Blog coverage here.

45. 100 Cases in General Practise (2, nf. Published by CRC Press – see again #40). Blog coverage here.

46. The TET Offensive: A Concise History (3, nf. Columbia University Press military history book). Blog coverage here.

47. Nutrition at a Glance (nf. John Wiley & Sons). Blog coverage here.

48. Poirot Investigates (3, f). Agatha Christie. Unlike the other books by her on the list, this book is a collection of short stories, rather than a novel.

49. Natural Conflict Resolution (4, nf. University of California Press). Blog coverage here, here, and here.

50. First Among Sequels (5, f). Jasper Fforde. Goodreads review: “(Maybe I shouldn’t give all these [Jasper Fforde] books five stars, but as long as they keep being awesome I’ll keep giving them five stars.)“. Blog coverage here.

51. Managing Cardiovascular Complications in Diabetes (3, nf. Wiley-Blackwell medical text). Blog coverage here and here.

52. A Quick Guide to Cancer Epidemiology (nf. Springer – Springer Briefs in Cancer research). Blog coverage here.

53. Murder in Mesopotamia (4, f). Agatha Christie.

54. Discrete Time Stochastic Control and Dynamic Potential Games: The Euler Equation Approach (nf. Springer – Springer Briefs in Mathematics). Blog coverage here.

55. The Big Four (1, f). Agatha Christie. A terrible book.

56. Infectious Agents and Cancer (2, nf. Springer). Blog coverage here.

57. One of Our Thursdays Is Missing (5, f). Jasper Fforde. Blog coverage here.

58. The Mystery of the Blue Train (3, f). Agatha Christie.

59. Utilitarianism (nf. Cambridge University Press). Blog coverage here.

60. Hypoglycemia in Diabetes – Pathophysiology, Prevalence, and Prevention (3, nf. Published by the American Diabetes Association). Blog coverage here.

61. Autism Spectrum Disorder (2, nf. Oxford University Press). Blog coverage here and here.

62. The Emergence of Animals: The Cambrian Breakthrough (4, nf. Columbia University Press). Blog covereage here and here.

63. The Woman Who Died A Lot (4, f). Jasper Fforde. Blog coverage here.

64. Evolution and the Levels of Selection (5, nf. Oxford University Press). Blog coverage here.

65. The Problems of Philosophy (nf. Included in Pojman’s Classics of Philosophy, published by Oxford University Press). Blog coverage here.

66. Skilled interpersonal communication (1, nf. Routledge). Blog coverage here, here, here, here, and here.

67. Death on the Nile (4, f). Agatha Christie.

68. Habituation: Theories, Characteristics and Biological Mechanisms (Neuroscience Research Progress) (2, nf. Nova Science Publishers, Inc.). Blog coverage here.

69. A murder is announced (2, f). Agatha Christie.

70. Metacognition: Cognitive and Social Dimensions (2, nf. Sage Publications). Blog coverage here, here, and here.

71. The True Believer: Thoughts on the Nature of Mass Movements (3, nf. Harper Perennial Modern Classics). Blog coverage here and here.

72. The Gospel According to Jesus Christ (2, f). José Saramago.

73. Aging – Facts and Theories (Interdisciplinary Topics in Gerontology, Vol. 39) (1, nf. Karger). Blog coverage here and here.

74. Ecological Dynamics (4, nf. Oxford University Press). A good book to point to when talking to people who believe biologists don’t ever really use complicated mathematical tools. Good coverage of various basic model concepts. Blog coverage here.

75. The Endocrine System at a Glance (3, nf. Wiley-Blackwell). Very dense – there’s a lot of information in here despite the relatively low page count. Blog coverage here and here.

76. A Pocket Full Of Rye (4, f.) Agatha Christie.

77. Hercule Poirot’s Christmas (5, f). Agatha Christie.

78. An Introduction to Tropical Rain Forests (2, nf. Oxford University Press). Blog coverage here, here, and here.

79. The Body in the Library (3, f). Agatha Christie.

80. Appointment with Death (3, f). Agatha Christie.

81. The Gambler (2, f). Fyodor Dostoyevsky. Technically I didn’t finish the book in which the novel was included because I found the other novel included in that work, The Double, to be completely unreadable; but as The Gambler is a novel in its own right I decided it was okay to include it here.

82. Sad Cypress (3, f). Agatha Christie.

83. 100 Cases in Clinical Pathology (3, nf. Published by CRC Press). Blog coverage here.

84. Adolescents and Adults with Autism Spectrum Disorders (1, nf. Springer). Blog coverage here and here.

85. Taken at the Flood (4, f). Agatha Christie.

86. The Hollow (4, f). Agatha Christie.

87. Sexual Selection in Primates: New and Comparative Perspectives (5, nf. Cambridge University Press). I added this book to my list of favourite books on goodreads. Blog coverage here and here.

88. Murder in the Mews (2, f). Agatha Christie.

89. They do it with mirrors (2, f). Agatha Christie. Way too easy to figure out – close to one star.

90. Unobserved Variables: Models and Misunderstandings (2-3?, nf. Springer – SpringerBriefs in Statistics). Blog coverage here.

91. Astrobiology of Earth: The Emergence, Evolution, and Future of Life on a Planet in Turmoil (3, nf. Oxford University Press).

92. Medical Statistics at a Glance (2, nf. Blackwell Science). Blog coverage here.

93. The Labours Of Hercules (2, f). Agatha Christie.

94. Introduction to Meta-Analysis (4, nf. John Wiley & Sons). Blog coverage here, here, and here.

95. Elementary Set Theory (nf. Hong Kong University Press). Blog coverage here.

96. 365 Ways to Checkmate (2, nf. Gambit Publications). Goodreads review here.

97. Self-Esteem (3, nf. Psychology Press). Blog coverage here and here.

98. The Moon is a Harsh Mistress (f). Robert Heinlein. Almost didn’t read past page 15, the book is silly, but I managed to ignore the silliness long enough to finish it. If you’re interested in reading classic science fiction, Asimov’s stuff is in my opinion much better than Heinlein’s.

99. Appointment Planning in Outpatient Clinics and Diagnostic Facilities (2, nf. Springer – SpringerBriefs in Health Care Management and Economics)). I included a few comments about the book in the third paragraph of this post. More detailed coverage of related topics can be found here.

100. The Stars, Like Dust (4, f). Isaac Asimov.

101. Female Infidelity and Paternal Uncertainty: Evolutionary Perspectives on Male Anti-Cuckoldry Tactics (2, nf. Cambridge University Press). Blog coverage here.

102. The Currents of Space (3, f). Isaac Asimov.

103. An Introduction to the Theory of Knowledge (nf. Cambridge University Press). Blog coverage here.

104. Pebble in the Sky (2, f). Isaac Asimov. Time-travel, telepathy, mind-reading, laughably implausible biology – this book reminded me way too much of Heinlein.

105. Delusion and Self-Deception: Affective and Motivational Influences on Belief Formation (2, nf. Psychology Press). Blog coverage here and here.

106. Robot Dreams (2, f). Isaac Asimov. I prefer his novels to his short-stories, but on the other hand some of the included narratives I simply would not have finished if they’d been longer (many stories were too silly, implausible, etc. for me to like them much).

107. Origin and Evolution of Planetary Atmospheres: Implications for Habitability (2, nf. SpringerSpringerBriefs in Astronomy). Close to three stars, but the poor language of the publication made it difficult for me to justify giving it that rating. Blog coverage here.

108. The Voyage of the Beagle (5, nf). Charles Darwin. The only book on this list which I have now read more than once. Blog coverage here, here, and here.

109. The Big Over Easy (4, f). Jasper Fforde.

110. Evidence-Based Diagnosis (5, nf. Cambridge University Press). Blog coverage here.

111. The Decline and Fall of Practically Everybody (5, f? – I don’t really know how to categorize this one. ‘Humour’ is a more informative category than either ‘fiction’ or ‘non-fiction’). Will Cuppy.

112. The Fourth Bear (5, f). Jasper Fforde.

113. Shades of Grey: The Road to High Saffron (5, f). Jasper Fforde. Goodreads review here.

114. Waiting for Godot (3, f). Samuel Beckett. (Short) Goodreads review here.

115. The Cambridge Handbook of Personal Relationships (2, nf. Cambridge University Press. Long). Please don’t draw strong conclusions about the book based on the 2-star rating before you’ve read my goodreads review. Blog coverage here, here, here, here, here, here, and here.

116. Pyramids (3, f). Terry Pratchett.

Addendum – a few books I have not finished, but which I have reviewed/covered either on goodreads or on this blog:

The Changing Nature of Pain Complaints over the Lifespan (1, nf. Springer). Blog coverage here.

Stranger in a Strange Land (1, f). Heinlein. Goodreads review here.

Sexually Transmitted Diseases (nf. McGraw-Hill Professional Publishing). Blog coverage here, here, and here (I include here only posts written this year – note that the first post to which I link has links to additional coverage as well).

Geophysical Hazards (1, nf. Springer). Goodreads review here. Blog coverage here.

Microeconomic Theory (nf Oxford University Press). Most of what I read of this I read in 2013, but I did spend some time on it in January 2014 as well. Relevant blog post here.

Books I did not finish and did not cover either here or on goodreads (some of these are books I expect to finish in 2015):

An Introduction to Ontology (1, nf. Polity Press). (Well, technically I did review this book, but my goodreads review – “Crap. Not worth your time.” – was perhaps not particularly informative)

The Geometry of Special Relativity (nf. AK Peters).

Chamberlain’s Symptoms and Signs in Clinical Medicine: An Introduction to Medical Diagnosis (nf. CRC Press).

Introduction to Quantum Mechanics (nf. John Wiley & Sons). I’ve talked about this book a few times on the blog, but I’ve never really covered the book in any detail.

The State of Affairs: Explorations in infidelity and Commitment (1, nf. Psychology Press). Again I did technically post a review on goodreads, but once again the review did not add much information about the book.

Cognitive Psychology: A Student’s Handbook (nf. Psychology Press).

Model Selection and Multi-Model Inference: A Practical Information-Theoretic Approach (nf. Springer).

January 1, 2015 Posted by | Books, Personal | Leave a comment

No more posts this year

My computer broke down yesterday evening. I lost all work I had done on the first 300 pages of The Cambridge Handbook of Personal Relationship (probably something like 15-20 hours, depending on how you measure it – I read 170 pages of the book yesterday, and basically I didn’t do much else besides reading the book during the day, aside from taking shortish breaks along the way), which is, painful*. I take frequent backups, but some data loss is inevitable in such a situation as this. It’s also really painful to know that I won’t have a computer available to me during the Christmas days.

The handbook had some really nice stuff on attachment theory and how those concepts relate to (mostly romantic) relationships. There seems to be a lot of evidence that attachment styles affect how people interact with each other, and that these sorts of patterns play a role in terms of how well people do in romantic relationships; Leary et al. covered that kind of stuff as well, but there was some additional detail included here. People who might be categorized as ‘securely attached’ behave ‘the way you’d like to behave’, whereas anxiously attached individuals display problematic behavioural patterns in some ways and avoidantly attached individuals display other problematic behavioural patterns in the context of interpersonal interactions. The reason I’m mentioning this is that I was thinking about this stuff after the computer broke down, because the thought occurred to me that humans may these days form attachments bonds, or at least have dynamic interaction patterns which in some respects resemble those we have with other humans, with non-humans. This is relevant in part because human attachment patterns are not completely fixed over the lifespan, and may have some domain-specificity, a point they also make in the chapter (‘people may find it easier to trust other people in some contexts than in others’, would be one way to think about this; a related point is that some people are easier to trust than others, leading to the observation that securely attached individuals have better relationships than insecurely attached individuals not only due to selection but also due to positive externalities (and the absence of negative externalities such as those related to mistrust and jealousy associated with an anxious attachment style)). Now, the dynamic interaction patterns to which I refer relate to my ‘interactions’ with things like my computer and my modem. I expect my computer and internet to help me when I feel terrible about what a shitty life I have, and I’ve come to rely on those things to help me when I’m in trouble. Over the last year I’ve repeatedly gotten the message that I can’t rely on these things, because they’re simply unreliable. I had unstable internet for months, and then my computer broke down. I used an old computer, known to be unreliable, for a short while, until it turned out to be completely unreliable. I had to get a new one, and so I did. While all this was happening the internet issues persisted, and they persisted even after I had got a new computer. The internet issue was supposedly fixed multiple times, they kept telling me they’d solved the problem, but each time it turned out that it wasn’t actually fixed and that people had been lying to me. I switched internet service provider because of these issues and of course my new computer then broke down shortly after this. I was seriously asking myself a few months ago if I should have two separate internet service providers simply to avoid getting cut off again – the utility hit associated with just being me, alone in my flat, without access to the outside world, is huge. Suicidal-thoughts huge. Now I’m asking myself if I should always have two computers, because then I’ll have an extra when the other one ‘decides’ to become unreliable (I use this word specifically because that was how I was thinking about it, which is part of what’s interesting), as they all do.

The interesting thing is that when I came up with this idea of always having two computers so that I have an extra when the other one breaks down, the first thought I had was that ‘this won’t help, something else I haven’t thought about is obviously going to go wrong and it doesn’t matter what I do to try to prevent it (‘I can’t rely on things like computers and internet at all, or at least not the people who make these things’) – I keep wanting simply to feel safe, to avoid issues like these which keep fucking up my life, and yet I repeatedly fail at achieving this. Maybe I should just stop trying.’ These thoughts are of course not very constructive, but I find them interesting. This kind of stuff really matters in terms of how we think about and interact with the world. If I’d known less about metacognition, had been less self-aware and/or hadn’t been reading the Cambridge handbook, I might not have been aware of how silly/stupid/unhelpful some of the thoughts which ‘came naturally’ to me yesterday and this morning really are.

*Theoretically it might be the case that no data is actually lost and that this is just a minor issue which is easily resolved, but the default position I take these days is that I lost everything on the harddrive I had not backed up elsewhere, that the computer will never work again, and that the people I bought the obviously worthless piece of junk from will probably refuse to follow their contractual obligations in this context. See above for reasons why I might think that way.

December 22, 2014 Posted by | Books, Personal | 4 Comments

Random stuff

i. I’ve been slightly more busy than usual lately, which has had as a consequence that I’ve been reading slightly less than usual. In a way this stuff has had bigger ‘tertiary effects’ (on blogging) than ‘secondary effects’ (on reading); I’ve not read that much less than usual, but reading and blogging are two different things, and blog-posts don’t write themselves. Sometimes it’s much easier for me to justify reading books than it is for me to justify spending time blogging books I’ve read. I just finished Newman and Kohn’s excellent book Evidence-Based Diagnosis, but despite this being an excellent book and despite me having already written a bit of stuff about the book in a post draft, I just don’t feel like finishing that blog post now. But I also don’t feel like letting any more time pass without an update – thus this post.

ii. On another reading-related matter, I should note that even assuming (a strong assumption here) the people they asked weren’t lying, these numbers seem low:

“Descriptive analysis indicated that the hours students spent weekly (M) on academic reading (AR), extracurricular reading (ER), and the Internet (INT), were 7.72 hours, 4.24 hours, and 8.95 hours, respectively.”

But on the other hand the estimate of 19.4 hours of weekly reading reported here (table 1, page 281) actually seems to match that estimate reasonably well (the sum of the numbers in the quote is ~20.9). Incidentally don’t you also just love when people report easily convertible metrics/units like these – ‘8.95 hours’..? Anyway, if the estimates are true, (some samples of…) college students read roughly 3 hours per day on average over the course of a week, including internet reading (which makes up almost half of the total and may or may not – you can’t really tell from the abstract – include academic stuff like stuff from journals…). I sometimes get curious about these sorts of things, and/but then I usually quickly get annoyed because it’s so difficult to get good data, and no good data seem to exist anywhere on such matters. This is in a way perfectly understandable (but also frustrating); I don’t even have a good idea what would be a good estimate of the ‘average’ number of hours I spend reading on an ‘average’ day, and I’m painfully aware of the fact that you can’t get access to that sort of information just by doing something simple like recording the number of hours/minutes spent reading during the day each day, for obvious reasons; the number would likely cease to be particularly relevant once the data recording process were to stop, even assuming there was no measurement error (’rounding up’). Such schemes might be a way to increase the amount of reading short-term (but if they are, why are they not already used in schools? Or perhaps they are?), but unless the scheme is implemented permanently the data derived from it are not going to be particularly relevant to anything later on. I don’t think unsophisticated self-reports which simply ask people how much they read are particularly useful, but if one assumes such estimates will always tend to overestimate the amount of reading going on, such metrics still do add some value (this is related to a familiar point also made in Newman & Kohn; knowing that an estimate is biased is very different from having to conclude that the estimate is useless. Biased estimates can often add information even if you know they’re biased, and this is especially the case if you know in which direction the estimate is most likely to be biased). Having said this, here are some more numbers from a different source:

“Nearly 52 percent of Americans 18–24 years of age, and just over 50 percent of all American adults, read books for pleasure […] Bibby, et al. (2009) reported that 47 percent of Canadian teenagers 15–19 years of age received a “great deal” or “quite a bit” of pleasure from reading. […] Young Canadian readers were more likely to be female than male: 56 percent of those who reported pleasure reading were female, while only 35 percent were male […] In 2009, the publishing industry reported that men in the United States only accounted for 29 percent of purchases made within the adult fiction market, compared to 40 percent of the U.K. market (Bowker LLC, 2009). The NEA surveys also consistently suggest that more women read than men: about 42 percent of men are voluntary readers of literature (defined as novels, short stories, poems, or plays in print or online), compared to 58 percent of women […] Unfortunately the NEA studies do not include in–depth reading for work or school. If this were included, the overall rates and breakdowns by sex might look very different. […] While these studies suggest that reading is enjoyed by a substantial number of North Americans, on the flip side, about half of the populations surveyed are not readers.”

“In 2008, 98 percent of Canadian high school students aged 15 to 19 were using computers one hour a day or more (Bibby, et al., 2009). About one half of those teenagers were using their computers at least two hours a day, while another 20 percent were on their computers for three to four hours, and 20 percent used their computers five hours or more each day […]. More recently it has been reported that 18–34 year old Canadians are spending an average of 20 hours a week online (Ipsos, 2010). […] A Canadian study using the Statistics Canada 2005 General Social Survey found that both heavy and moderate Internet users spend more time reading books than people who do not use the Internet, although people in all three categories of Internet usage read similar numbers of magazines and newspapers”

It was my impression while reading this that it did not seem to have occurred to the researchers here that one might use a personal computer to read books (instead of an e-reader); that people don’t just use computers to read stuff online (…and play games, and watch movies, etc.), but that you can also use a computer to read books. It may not just be that ‘the sort of people who spend much time online are also the sort of people who’re more likely to read books when they’re not online’; it may also be that some of those ‘computer hours’ are actually ‘book hours’. I much prefer to read books on my computer to reading books on my e-reader if both options are available (of course one point of having an e-reader is that it’s often the case that both options are not available), and I don’t see any good reason to assume that I’m the only person feeling that way.

ii. Here’s a list of words I’ve encountered on recently:


While writing this post I realized that the Merriam-Webster site also has a quiz one can play around with if one likes. I don’t think it’s nearly as useful as’s approach if you want to learn new words, but I’m not sure how fair it is to even compare the two. I scored much higher than average the four times I took the test, but I didn’t like a couple of the questions in the second test because it seemed to me there were multiple correct answers. One of the ways in which is clearly superior to this sort of test is of course that you’re able to provide them with feedback about issues like these, which in the long run should serve to minimize the number of problematic questions in the sample.

If you haven’t read along here very long you’ll probably not be familiar with the site, and in that case you might want to read this previous post on the topic.

iii. A chess kibitzing video:

Just to let you know this is a thing, in case you didn’t know. I enjoy watching strong players play chess; it’s often quite a bit more fun than playing yourself.

iv. “a child came to the hospital with cigarette burns dotting his torso. almost every patch of skin that could be covered with a tee shirt was scarred. some of the marks were old, some were very fresh.

his parents said it was a skin condition.”

Lots of other heartwarming stories in this reddit thread. I’m actually not quite sure why I even read those; some of them are really terrible.

December 19, 2014 Posted by | Books, Chess, Papers, Personal, Random stuff | Leave a comment

The Voyage of the Beagle (III)

This will be my last post about the book.

I have for some time, probably roughly since the internet problems I had earlier this year were resolved, structured my reading in a way so that I’ll more or less never read fiction/’pure enjoyment’ books while at home. I now only read fiction when I’m out taking walks, and then I limit my book reading to non-fiction while I’m at home. I take long(ish) walks most days so I guess I still finish a fiction book every week or so at the current rate. This change in my reading habits is relevant to my reading of this book because back when I implemented this change, I’d mentally classified the Darwin book as a fiction book/’pure enjoyment’ book – the kind of book I should only be reading while taking walks. It isn’t really fiction, but it is a very enjoyable book to read and in many ways it’s conceptually really much closer to normal fiction stories than it is to a Springer publication about heart disease or mathematics. As it’s often raining in Denmark, it’s often not convenient to take walks while reading ‘paper books’, and my edition of Darwin is a ‘paper book’; I sometimes bring paper books on my walks, but if there’s a risk of rain I’ll usually much prefer to bring my e-reader, which can deal quite well with a few drops of water. A different problem is that I always highlight and write notes in my books, which means that the more interesting and well-written a paper book is, the more inconvenient it is to bring it on walks; I can’t highlight or take notes while walking (I’ve tried, but it doesn’t work), so I have to stop walking every time I come across an interesting sequence which I’d like to highlight or comment upon, of which there are many more in good books than in bad books, and taking a lot of breaks like that can be bothersome in the long run. Some paper books are also too big/heavy to conveniently bring on my walks; however this particular book is not one of those.

What all of above stuff means is of course that for quite a while I didn’t really read very much in this book because I’d settled on not reading it while I was at home, but I also usually had a different book on my e-reader which it was easier and more convenient to bring on my walks. At the end I decided that I should really read the rest of this book because it’s quite good (before I started rereading the book it was on my list of favourites on goodreads, and it still is), and so I decided to read it at home.

The book is really nice. If you liked the quotes I included either in my previous posts about the book and/or in this post, it’s worth considering taking the time to read the book. I may be wrong, but I could easily imagine this being the sort of book that many people might think to themselves that they’ll read when they get old, but then when they reach the pension age they’ll never get around to actually doing it; if this impression is correct, that’s just a damn shame. Reading books like this one or perhaps something like Mark Twain’s The Innocents Abroad (available for free here) will, aside from giving you some enjoyable experiences in the company of good writers, probably make it easier for you to think about the world in a slightly different manner than the one you’re used to.

The book is full of good stuff and so I had to leave out a lot of good stuff in my posts. Below I have added a few more illustrative quotes from the book.

“I heard also of an old lady who, at a dinner at Coquimbo, remarked how wonderfully strange it was that she should have lived to dine in the same room with an Englishman; for she remembered as a girl, that twice, at the mere cry of “Los Ingleses,” every soul, carrying what valuables they could, had taken to the mountains.”

“The connection between earthquakes and the weather has been often disputed: it appears to me to be a point of great interest, which is little understood.”

“My geological examination of the country generally created a good deal of surprise amongst the Chilenos: it was long before they could be convinced that I was not hunting for mines. This was sometimes troublesome: I found the most ready way of explaining my employment, was to ask them how it was that they themselves were not curious concerning earthquakes and volcanos? – why some springs were hot and others cold? – why there were mountains in Chile, and not a hill in La Plata? These bare questions at once satisfied and silenced the greater number; some, however (like a few in England who are a century behind hand), thought that all such inquiries were useless and impious; and that it was quite sufficient that God had thus made the mountains.”

“Our arrival in the offing caused some little apprehension. Peru was in a state of anarchy; and each party having demanded a contribution, the poor town of Iquique was in tribulation, thinking the evil hour was come. The people had also their domestic troubles; a short time before, three French carpenters had broken open, during the same night, the two churches, and stolen all the plate: one of the robbers, however, subsequently confessed, and the plate was recovered. The convicts were sent to Arequipa, which though the capital of this province, is two hundred leagues distant, the government there thought it a pity to punish such useful workmen, who could make all sorts of furniture; and accordingly liberated them. Things being in this state, the churches were again broken open, but this time the plate was not recovered. The inhabitants became dreadfully enraged, and declaring that none but heretics would thus “eat God Almighty,” proceeded to torture some Englishmen, with the intention of afterwards shooting them. At last the authorities interfered, and peace was established.”

“We did not reach the saltpetre-works till after sunset, having ridden all day across an undulating country, a complete and utter desert. The road was strewed with the bones and dried skins of many beasts of burden which had perished on it from fatigue. Excepting the Vultur aura, which preys on the carcasses, I saw neither bird, quadruped, reptile, nor insect. […] I cannot say I liked the very little I saw of Peru: in summer, however, it is said that the climate is much pleasanter. In all seasons, both inhabitants and foreigners suffer from severe attacks of ague. This disease is common on the whole coast of Peru, but is unknown in the interior. The attacks of illness which arise from miasma never fail to appear most mysterious. […] Callao is a filthy, ill-built, small seaport. The inhabitants, both here and at Lima, present every imaginable shade of mixture, between European, Negro, and Indian blood. They appear a depraved, drunken set of people.”

“Of land-birds I obtained twenty-six kinds, all peculiar to the group and found nowhere else, with the exception of one lark-like finch from North America […] The remaining land-birds form a most singular group of finches, related to each other in the structure of their beaks, short tails, form of body and plumage […] The most curious fact is the perfect gradation in the size of the beaks in the different species […] Seeing this gradation and diversity of structure in one small, intimately related group of birds, one might really fancy that from an original paucity of birds in this archipelago, one species had been taken and modified for different ends. […] With the exception of a wren with a fine yellow breast, and of a tyrant-flycatcher with a scarlet tuft and breast, none of the birds are brilliantly coloured, as might have been expected in an equatorial district. Hence it would appear probable, that the same causes which here make the immigrants of some peculiar species smaller, make most of the peculiar Galapageian species also smaller, as well as very generally more dusky coloured.” [For more on related topics, see incidentally this previous post of mine].

“As I at first observed, these islands are not so remarkable for the number of the species of reptiles, as for that of the [number of] individuals […] we must admit that there is no other quarter of the world where this Order replaces the herbivorous mammalia in so extraordinary a manner. […] by far the most remarkable feature in the natural history of this archipelago [is] that the different islands to a considerable extent are inhabited by a different set of beings. […] The inhabitants […] state that they can distinguish the tortoises from the different islands; and that they differ not only in size, but in other characters. […] I have strong reasons to suspect that some of the [finch] species of the sub-group Geospiza are confined to separate islands. If the different islands have their representatives of Geospiza, it may help to explain the singularly large number of the species of this sub-group in this one small archipelago, and as a probable consequence of their numbers, the perfectly graduated series in the size of their beaks. […] The distribution of the tenants of this archipelago would not be nearly so wonderful, if, for instance, one island had a mocking-thrush, and a second island some other quite distinct genus,- if one island had its genus of lizard, and a second island another distinct genus, or none whatever; -or if the different islands were inhabited, not by representative species of the same genera of plants, but by totally different genera […]. But it is the circumstance, that several of the islands possess their own species of the tortoise, mocking-thrush, finches, and numerous plants, these species having the same general habits, occupying analogous situations, and obviously filling the same place in the natural economy of this archipelago, that strikes me with wonder. It may be suspected that some of these representative species, at least in the case of the tortoise and of some of the birds, may hereafter prove to be only well-marked races; but this would be of equally great interest to the philosophical naturalist.”

“I was much disappointed in the personal appearance of the [Tahiti] women; they are far inferior in every respect to the men.” [Good luck writing anything like that today and getting it published…] […] After the main discussion was ended, several of the chiefs took the opportunity of asking Captain Fitz Roy many intelligent questions on international customs and laws, relating to the treatment of ships and foreigners. […] This Tahitian parliament lasted for several hours; and when it was over Captain Fitz Roy invited Queen Pomarre to pay the Beagle a visit. […] In the evening four boats were sent for her majesty; the ship was dressed with flags, and the yards manned on her coming on board. She was accompanied by most of the chiefs. The behaviour of all was very proper: they begged for nothing, and seemed much pleased with Captain Fitz Roy’s presents.”

“When I showed the chief a very small bundle, which I wanted carried, it became absolutely necessary for him to take a slave. These feelings of pride are beginning to wear away; but formerly a leading man would sooner have died, than undergone the indignity of carrying the smallest burden.”

“Some time ago, Mr. Bushby suffered a […] serious attack. A chief and a party of men tried to break into his house in the middle of the night, and not finding this so easy, commenced a brisk firing with their muskets. Mr. Bushby was slightly wounded, but the party was at length driven away. Shortly afterwards it was discovered who was the aggressor; and a general meeting of the chiefs was convened to consider the case. It was considered by the New Zealanders as very atrocious, inasmuch as it was a night attack, and that Mrs. Bushby was lying ill in the house: this latter circumstance, much to their honour, being considered in all cases as a protection. The chiefs agreed to confiscate the land of the aggressor to the King of England. The whole proceeding, however, in thus trying and punishing a chief was entirely without precedent. The aggressor, moreover, lost caste in the estimation of his equals and this was considered by the British as of more consequence than the confiscation of his land. […] a chief and a party of men volunteered to walk with us to Waiomio, a distance of four miles. The chief was at this time rather notorious from having lately hung one of his wives and a slave for adultery. When one of the missionaries remonstrated with him he seemed surprised, and said he thought he was exactly following the English method.”

“It is impossible to behold these waves without feeling a conviction that an island, though built of the hardest rock, let it be porphyry, granite, or quartz, would ultimately yield and be demolished by such an irresistible power. Yet these low, insignificant coral-islets stand and are victorious: for here another power, as an antagonist, takes part in the contest. The organic forces separate the atoms of carbonate of lime, one by one, from the foaming breakers, and unite them into a symmetrical structure. Let the hurricane tear up its thousand huge fragments; yet what will that tell against the accumulated labour of myriads of architects at work night and day, month after month? […] We feel surprise when travellers tell us of the vast dimensions of the Pyramids and other great ruins, but how utterly insignificant are the greatest of these, when compared to these mountains of stone accumulated by the agency of various minute and tender animals! This is a wonder which does not at first strike the eye of the body, but, after reflection, the eye of reason.”

“Those who look tenderly at the slave owner, and with a cold heart at the slave, never seem to put themselves into the position of the latter”

December 14, 2014 Posted by | Biology, Books, Evolutionary biology, Geography, Geology, History, Personal, Zoology | Leave a comment


I’m spending time at my parents’ place at the moment, and that’s actually the only reason why I’m able to write this blog post; the old laptop I’ve been using finally decided to break down earlier this evening. You should expect limited blogging in the week to come – I’m completely cut off at the moment, far away from stuff like computer stores.

I recently realized that the computer- and internet issues have really made blogging a chore, in a way – I’m reading books I can’t easily blog either because my notes keep getting lost or because I’ve lately deliberately been reading books offline (/AFK) to get around these problems. I used to be able to just write a post when I felt like it, but that’s not been the case for the last month; I’ve felt like I had to blog when I had internet, and if I wanted to write when I did not have internet the best I could do was to make a draft using e.g. Word; and I never liked that option. To make it worse, the updating frequency the blog used to have (I don’t know what’ll happen in the weeks to come) was actually quite high, considering the amount of work that’s put into each post; it’s really been far from trivial to just ‘put together a blogpost while internet is up’. Notes and highlights intended among other things to facilitate blogging coverage later on have as mentioned been lost due to hardware issues, and this is actually a much bigger deal than you might think; it’s not that losing the notes put me completely back to square one, but for practical purposes losing my notes have meant that in order for me to provide the same type of coverage I’ve usually provided I’ve had to basically read some of these books twice. Not really, but close enough for it to feel that way. I’ve spent roughly 12 hours or so on Chamberlain’s Symptoms and Signs in Clinical Medicine over the last few days, and now I can basically start over if I want to blog it the way I’d intended to do it – so instead of a post about that book now, you get this post instead (and I may never blog the book in the amount of detail I’d intended to and would have, if not for these issues). I’m not happy about that, but that’s the way it is. Given that I’ve been thinking about stopping blogging completely lately because it just feels like too much work – it does, now, compared to before – I’ll care a lot less about the updating frequency in the time to come than I’ve done in the past. Blogging should be enjoyable, and it used to be very enjoyable, but these issues have been killing my desire to write here.

October 10, 2014 Posted by | meta, Personal | Leave a comment

Four chess games

I’ve started playing active tournament chess again, at least a little bit. The format of the tournament in which I’m participating at the moment is a rapid format, with 45 minutes per player per game, with two games per round – one game with the white pieces and one with the black pieces, against the same opponent. Below I have posted the first four games I’ve played in the tournament so far – this is a short post, but each game lasted a significant amount of time.

Links to the games: 1 (white), 2 (black), 3 (white), 4. (black).

The two first games are actually, I think, quite instructive in that I played against a much lower rated player and managed to win both games in roughly 20 moves. There’s a reason strong chess players do not lose to beginners and games like these will tell you part of the story of why this is.

The last two games were not particularly great and I certainly was not satisfied with my play in either of those, especially not the second one – I had a winning position out of the opening, yet I somehow managed to blunder a piece in the middle game. 17…Rad8 was a blunder (the idea was 18.Bxc6… Rxd2, followed by 19.Qxd2 and …Qxa1+, and after Qd1 (forced) black takes on a2), whereas after 17…e4! the computer gives black an advantage of roughly -4,5 (an advantage corresponding to almost an entire rook, even though the position is materially balanced – I knew the position was winning, but you still have to find the right moves..). I’d of course missed the check on d5 and Rc1, which were played in the game. I considered taking on d5 after the bishop check, and actually my intuition was correct that this was completely winning (the position is at -2 or so after the exchange sac, according to the engine – this is not surprising as white is basically playing without the rook on h1 and also has an exposed king in an open position) – but in the end I decided not to play this as ‘Kh8 is surely winning as well, and an exchange sac is not necessary here’. I was wrong. Actually the position arising shortly after the blunder around move 20 is a good illustration of how important piece activity is; the position after 20…e4, where black is basically a whole piece down, according to the engine is still better for black (-0.3). Black has a lot of activity for the material, despite this ‘sacrifice’ of course being completely unnecessary.

Given that I’ve won all my games so far it’s not possible to calculate a performance rating yet, but I’d say that in terms of results at least I’m doing okay, though perhaps not much better than could have been expected. Anyway the way this tournament works, the more games you win the tougher opponents you get –  I was the rating favourite in both of the matches I’ve played so far, and that’ll change soon enough; I may easily end up playing against a 2200 Elo opponent next round, so I expect to lose and/or draw some games quite soon. If you’re interested in me sharing more of my games here later on, let me know in the comments – I think that if I don’t get any indications that people reading along here would like to see another post like this one again, this will probably be my last post of this kind. I know some of my readers are interested in chess, at least a little bit, but that’s not the same thing as finding posts like this one interesting.

I should note that the internet issue I have had has now, as far as I can tell, been solved. This should make it much easier for me to blog from now on than it has been for the last couple of weeks.

September 23, 2014 Posted by | Chess, Personal | Leave a comment

Open Thread

Some random observations and some links:

i. I’ve written about diabetic hypoglycemia before – I even blogged a book on the topic just a few weeks ago. So I’ll keep this short. Here’s the key observation from the post to which I link: “Hypoglycemia causes functional brain failure that is corrected in the vast majority of instances after the plasma glucose concentration is raised”.

Functional brain failure is pretty much what it sounds like – the brain stops working. The point I want to make here is that hypoglycemia can strike pretty much at any point in time, including when I’m doing stuff like blogging or commenting. I sometimes develop hypoglycemia while deeply engrossed in some intellectual activity, like reading, writing or chess, in part because in those situations I have a tendency to forget to listen to my body’s signals – perhaps I forget to eat because this stuff is really much more interesting than food, perhaps I don’t really care that I should probably take a blood test now because I’d really much rather just finish this book chapter/chess game/blogpost/whatever. That happens. When it happens while I’m blogging, what comes out the other end may look funny. I occasionally write stuff that’s incoherent and stupid. Sometimes the explanation is simple: I’m an idiot. Sometimes other things play a role as well.

This is a variable you cannot observe, but which I have a lot of information about. It’s a variable I’d like readers of this blog to at least be aware of.

ii. Maxwell wrote this post, which you should consider reading. I won’t pretend to have good reasons/justifications for disliking people I conceive of as arrogant, but I do want to note that I do this and always have. Arrogance is a trait I dislike immensely.

iii. Over the last few days I’ve been reading Okasha’s great book Evolution and the Levels of Selection (I’ve almost finished it and I expect to blog it tomorrow) – so of course when Zach Weiner came up with this joke yesterday, I laughed. Loudly:



(Click to view full size. The comic of course has almost nothing to do with the content of the book, but I’ll take any excuse I can get for blogging that comic…)

iv. The Feynman Lectures on Physics. Available to you, online, free of charge. Stuff like this sometimes makes me think we live in a very nice world at this point.

But then I read posts/watch videos like this one and I’m reminded that things are, complicated.

v. A few Khan Academy lectures:

August 8, 2014 Posted by | Genetics, History, Khan Academy, Lectures, Medicine, Personal, Physics | 9 Comments

Autism Spectrum Disorder (I)


I recently realized that I had actually never read a textbook like this on this topic. I did get some reading materials back when I got diagnosed so it’s not like I’ve never read anything about the stuff (and there was a lot of verbal information back then as well), but as mentioned I haven’t read a text on the topic. It was actually due to the old reading materials in question that I ended up deciding to read this book; I was looking for some other stuff the other day and I ended up perusing some of these materials (which I hadn’t seen in years), and I figured I should probably go read a book on the topic. Now I am.

The book is sort of okay. There are various complaints one might make, the most important one of which in the context of me reading the book is perhaps that children with autism-spectrum disorders grow up and become adults, and adults prefer to read chapters about adult stuff, not stuff about e.g. how to teach the preschooler with the diagnosis social skills. I’ve read roughly half the book at this point, and there’s not in my opinion been enough stuff about the adult setting at this point. Another complaint is that I as usual am somewhat mistrustful when guys like these talk about the conclusions to be drawn from some types of empirical evidence; the coverage has in my opinion been of a decidedly mixed quality in terms of the stuff dealing with behavioural interventions, in the sense that they on the one hand at one point reasonably frankly acknowledge that the evidence is sparse and of poor quality, and on the other hand later on seem to become very excited about a longitudinal study and start drawing big conclusions from that single study – which would be sort of fine, I like longitudinal studies, if not for the fact that the study was based on 6 (!) individuals. Similar things happen elsewhere in that part of the coverage – potential power issues are never mentioned in the book, at least they have not been so far – you find yourself reading about a ‘seminal’ study on 19 individuals, and then you move on to their comments about how there have been several other studies supporting those findings, including a study looking closer at 9 of the individuals involved in the original study. Sometimes it’s hard to know what to think, especially in the situations where the only people evaluating the interventions are the people who came up with them in the first place – this doesn’t seem like a particularly smart way to conduct business, though in some parts of psychology it seems to be more or less standard practice.

The stuff on behavioural interventions has in my opinion been some of the weakest stuff in the book so far, which is why I have not talked about this stuff in my coverage below. Some of the proposed interventions are incredibly expensive, and there’s probably a good reason why such things are usually not covered by public health care systems, however the authors do not really seem to consider economic aspects to be all that important, except to the extent that economic factors unfortunately restrict access to all these nice things we could do for these children; they’re aware that parents may not be able to afford the treatment options which are recommended at this point by people who would benefit from these treatment options being more widely used, but they don’t seem to be aware of the existence of things like cost-effectiveness analyses. It’s one thing to argue that there may be developmental gains to be achieved by early childhood interventions (I’ve previously done work in educational economics and I can tell you that it is a common finding in this literature that you can improve outcomes by throwing lots of money and attention after young children – a finding which should perhaps not be super surprising..), it’s quite another thing to argue that the specific interventions comtemplated are cost-effective. To be fair, cost-effectiveness is incredibly hard to evaluate when you’re contemplating evaluating interventions which may have effects lasting basically the rest of the life of the individual and the intervention is supposed to take place during the first years of a child’s life, but in my opinion you sort of need to at least pretend to try to address this aspect somehow; if you don’t, you’re quite likely to end up in a situation where it seems as if you’re acting as if there’s no (societal) budget constraint, and the authors of this book seem to me to move very close to this position at various points in the coverage.

I knew very little (nothing?) about autism-spectrum disorders before I got the diagnosis – I got diagnosed very late, in my adulthood. It’s sort of funny how you can miss important stuff like this without even knowing, and in a way it relates to a point which came up in my recent post on ethics, specifically the point that ‘bad’ people tend to think they are ‘good’ people, or at least no worse than average. How much do you really know about how good other people are at, say, interpreting nonverbal social signals? Would withdrawal from social interaction make the comparison easier or harder? If you don’t really engage in the normal patterns of non-verbal information exchanges, e.g. eye contact exchanges, during social situations, how are you to know that important information is contained in such exchanges? Individuals seem to make assumptions about these things to a large extent based on what they know themselves (about themselves?), and if you have limitations in these areas it may be difficult to figure out that this is the case; another apt analogy might be children who need glasses early on in their lives – we screen for vision impairment in young children in part because young children don’t know, and may never on their own ever realize, that the world is not supposed to be blurry, and that you’re actually supposed to be able to see all the letters written down on the blackboard.

I thought I should make one thing clear before moving on to the main text, a point particularly relevant considering the comic which I decided to start out with; which is that incompetence should not be equated with/interpreted as malicious intent. It seems to me that many people conceive of people with autism-spectrum disorders as inconsiderate jerks who don’t have a clue – I’ve seen quite smart people state relatively similar things in the past. I dislike the ‘jerk’-model because I try to be thoughtful and considerate when interacting with others, and when these people think that way I feel that they’re devaluing the work I put into this stuff. One important problem which is sort of hard to figure out how to deal with is that I’m well aware that the more thoughtful and considerate I am (…or is it: ‘try to be?’) during social encounters, the more taxing the social interactions may become, and taxing social interactions lead to social isolation and withdrawal. Coming up with a good equilibrium level of effort is not an easy task, and I think one needs to address aspects like these before making strong judgments about things like the jerkishness of specific behaviours. In a way people with social anxiety have similar concerns which other people also cannot observe (in this case it would be excessive amounts of thinking during social situations about whether they are doing stuff right now that may mean that they’ll get rejected by others, which then leads to oversensitivity to clues of rejection, leading to social avoidance because of perceived rejection). Of course people with autism-spectrum disorders may be anxious as well, as also mentioned in the coverage below. The level of self-awareness varies a lot in people with autism-spectrum disorders, but people with relatively high levels of self-awareness may certainly face some constraints and tradeoffs which are not immediately obvious to the outsider and which may actually be assumed by neurotypicals to be absent, given the diagnosis.

The textbook answered one question I’d been thinking about a few times without ever worrying enough about it to actually seek out an answer, which is the question of what the recent diagnostic changes might mean, given that I have a diagnosis which by now has been ‘retired’. It turns out that I was diagnosed with what in the textbook are considered to be the ‘gold-standard tools’, which means that this remark related to the recent diagnostic changes that have taken place seems to answer the question: “The DSM 5 noted that “Individuals with a well-established DSM-IV diagnosis of” “Asperger’s disorder” “should be given the diagnosis of autism spectrum disorder””. I’m not going to ‘ask’ for a ‘new’ diagnosis (/a ‘translation’ of my diagnosis) (and quite aside from what other people like to call this stuff, I like the word ‘eccentric’ a lot better than the word ‘autistic’…), but it’s nice to know which recommendations are being made in this area. Some of the quotes below also relate a bit to these aspects.

I’ve added some quotes from the book below.

“Autism is a developmental neurobiological disorder characterized by severe and pervasive impairments in reciprocal social interaction skills and communication skills (verbal and nonverbal), and by restricted, repetitive, and stereotyped behavior, interests, and activities. […] Autism and autistic stem from the Greek word autos, meaning “self.” The term autism originally referred to a basic disturbance, an extreme withdrawal of oneself from social life, or aloneness. […] The critical point in the scientific history of autism was in 1943, when Leo Kanner published Autistic Disturbances of Affective Conduct, a groundbreaking paper that described the symptoms of 11 children presenting similar behaviors that had not been previously recognized. […] Based on Kanner’s terminology, autism was considered for years a psychosis, and child psychiatrists were using “childhood schizophrenia” and “child psychosis” in autism as “interchangeable diagnoses.” […] A parallel line of inquiry to that of Kanner and Eisenberg is represented by the work of Hans Asperger.”

“In Autism and Pervasive Developmental Disorders, Fred Volkmar and Catherine Lord (2004) distinguished important points of differentiation and similarities between Kanner’s and Asperger’s descriptions. […] In concluding their comparison of Kanner’s and Asperger’s descriptions, Volkmar and Lord pondered whether, despite the relevant differences, it was “scientifically and clinically helpful to classify individuals with these traits into separate categories of autism or Asperger’s disorder, or whether it would be better to treat them as parts of a greater continuum.” The utility of the “greater continuum” has led to the category of autism spectrum disorder to be proposed for DSM-5. […] As a result of [various findings] and the lack of reliability in the community in making distinctions among the ASDs [Autism-Spectrum Disorders] [for example: “Variations in clinical severity among ASD cases are not valid indices of differences in pathophysiology or etiology”], the Fifth Edition of the Diagnostic and Statistical Manual (DSM-5) proposes to collapse all of these clinical syndromes into a single diagnosis of “autism spectrum disorder.” Although this revision is appropriate for community diagnosis, and thus the allocation of clinical and support services, research studies will continue to rely on research diagnostic instruments like the Autism Diagnostic Interview (ADI) and the Autism Diagnostic Observation Schedule (ADOS) [these were both part of my work-up, US] to make categorical distinctions between “autism and not autism” and “autism and autism spectrum disorder” (which includes Asperger’s disorder and PDDNOS [Pervasive Developmental Disorder Not Otherwise Specified]). These distinctions have played a vital role in advancing our understanding of the behavioral and neural profile of ASD over the past two decades”

“Recent studies and reports from the Centers for Disease Control […] have shown an increase in the prevalence of children diagnosed with an ASD to one in 110 […] The reported increase is thought to be attributable to several factors. First, there have been changes in diagnostic practices […] Second, there is greater public awareness of ASD and more case-finding […] Finally, there has been a tendency to diagnose many children with intellectual disability as PDD. […] no evidence currently exists to support any association between ASD and a specific environmental exposure. […] Numerous studies have failed to demonstrate a causal relationship between immunizations, particularly thimerosal-containing vaccines, and ASD […] The CDC (2009) reports the median age for a diagnosis of ASD to be between 4.5 and 5.5 years. […] the ASD diagnosis is four times more common for boys than in girls.”

“The essential features of Asperger’s disorder are severe and sustained impairment in social interaction (criterion A); and the development of restricted, repetitive patterns of behavior, interests, and activities (criterion B); which must cause clinically significant impairment in functioning (criterion C). There are no clinically significant delays in language (criterion D) or cognitive development (criterion E).”

“ASD (excluding Asperger’s disorder) has early language and communication impairment. […] almost two thirds of individuals with ASD also have ID [intellectual disability] […] 15%–20 % of cases of ASD are now linked to genetic or
chromosomal abnormalities […] Fragile X Syndrome (FXS) [is] the most common identifiable cause of ASD and the most common inheritable cause of ID. […] Thirty percent of individuals with FXS demonstrate characteristics of ASD.” [In some other conditions penetrance is even higher – examples that could be mentioned are 15q duplication and Timothy Syndrome, but prevalence is lower in these cases and especially in the latter case some might argue that the autism is the least of that child’s problems..]

Challenging behaviors [in individuals with ASD] may reflect pain that is not communicated verbally […] Challenging behaviors may [also] reflect the child’s difficulty with communication, changes, new places, new situations, new experiences, new sounds, new smells, and new people” [I wonder if you can spot a pattern here in terms of what these children (/people) don’t like? I think an important distinction here is to be made between curiosity and the desire to try out new things. I’m often, hesitant, about trying out new things, yet I’m also quite curious about a lot of things. Be careful which categories you apply here and how they may impact your thinking… In a related vein:] “Insistence on sameness and difficulty with change are common symptoms of an ASD. These behaviors should not typically be considered a behavior done to exert control over others.”

“Psychiatric comorbidity is now acknowledged as quite common in ASD [and] psychiatric comorbidity increases the level of impairment […] There is a handful of questionnaires [aiming at spotting psychiatric comorbidities] that have been developed specifically for use in developmentally disordered or ASD populations. […] none of the measures has the level of research support possessed by questionnaires used in other branches of psychiatry. The vast majority of these instruments have just one study behind their development, or have been studied only by the developer of the instrument. […] one of the main challenges in diagnosing psychiatric disorders in individuals with ASD is the possibility of different presenting symptoms and difficulty in differentiating impairment related to the underlying ASD from impairment due to a separate condition. […] While we do not want to miss true comorbid diagnoses, over-diagnosing comorbidity can be equally harmful. […] Mood disorders, such as depression and bipolar disorder, in ASD have recently begun to receive a great deal of attention […] there are many potential psychosocial stressors that could be possible triggers. For example, higher-functioning individuals who are aware of their deficits and badly desire friends, but lack success in this area, are at particular risk. […] Although there is little research on emotion regulation in ASD, there is clear evidence that emotion regulation is highly variable and often problematic in this population, regardless of psychiatric comorbidity […] Therefore, particularly for mood disorders, it is imperative to consider baseline functioning and not over-diagnose mood disorders when the concern may be more temperamental in nature.”

“Anxiety is considered by some to be the most common comorbid psychiatric concern in ASD […]. The DSM-IV-TR notes that individuals with ASD might have unusual fear reactions, and it is also not uncommon for there to be a general tendency toward anxiety for many individuals with ASD. […] There are many aspects of having an ASD that may lead to this increased risk for anxiety, to the degree that some consider anxiety and the social impairment in ASD to have a bidirectional relationship […] An increase in self-awareness is considered a risk factor for higher anxiety; therefore, anxiety is typically thought of as more common among individuals with ASD who have higher intellectual abilities, and older children, adolescents, and adults.”

“autism may be conceptualized as a disorder of complex information processing resulting from disordered development of the connectivity of cortical systems (e.g., failure of cortical systems specialization) […] approximately 15%–20% of infants with an older sibling diagnosed with autism will ultimately be diagnosable with ASD by three to four years of age. […] [Findings from longitudinal sibling studies] do not support the view that autism is primarily a social-communicative disorder and instead suggest that autism disrupts multiple aspects of development rather simultaneously. […] When both elementary and higher-order abilities in many domains are assessed, it becomes evident that deficits exist in several domains not considered to be integral parts of the autism syndrome, including aspects of the sensory-perceptual, motor, and memory domains. Furthermore, there are enhanced skills and impaired abilities within the same domains as deficits (e.g., memory, language, abstraction). […] Causal explanations for ASD must account for the comprehensive pattern of both deficits and intact aspects of the disorder both within and across multiple domains. […] There is no single primary deficit or triad of deficits, brain regions, or neural systems causing autism. […] Rather, autism broadly affects many abilities at the same time and systematically from its earliest presentation and throughout life. […] This pattern [can] be characterized overall as reflecting a disorder of complex or integrative information processing, which results from altered development of cerebral cortical connectivity in ASD. […] Just as the infant sibling studies have clearly demonstrated, studies of children and adults with autism have also demonstrated a broad but selective profile of deficits and intact or enhanced abilities that all reflect a relationship to information-processing demands. […] it is likely that genes affecting signaling pathways that regulate neuronal organization are strongly implicated in the etiology of autism.”

“ASD is now conceptualized as a developmental neurobiological disorder affecting elaboration of the forebrain circuitry that underlies the abilities most unique to human beings. […] Wiring the brain requires that neurons proliferate, acquire the correct identities, migrate to the appropriate locations, extend axons, and make guidance decisions with a high degree of spatial and temporal fidelity. Converging evidence indicates that more than one of these processes may be altered in various combinations to produce the heterogeneous phenotypes observed in ASD. […] Studies examining head circumference (HC) and brain volume (BV) in individuals with ASD have demonstrated altered brain growth trajectories across the lifespan. […]
• Up to 70 % of infants with ASD exhibit abnormally accelerated brain growth in the first year of life. Approximately 20% to 25% of infants in this subset actually meet formal criteria for macrocephaly (i.e., HC of 2.0 standard deviations above the mean) in the first year.
• BV is significantly larger by two to four years of life, and some children meet criteria for megalencephaly (i.e., BV 2.5 S.D. above mean).
• The first two years of life are usually a period of rapid brain growth in infants as neurons undergo significant postnatal growth in cell size and elaboration (actually overproduction) of axons, synapses, and dendrites. It is possible that this process is exaggerated somehow in at least a subset of ASD.
• Whatever the neurobiological basis, abnormal growth rates in ASD tend to decline significantly after the initial acceleration, causing an apparent “normalization” of BV by adolescence or early adulthood. […]
At the time of maximal brain growth in very early childhood, cerebral gray matter (GM) and white matter (WM) are both increased […] The frontal cortical GM and WM show the most enlargement, followed by the temporal lobe GM and WM and the parietal GM.”

“Thus far, [fMRI and fcMRI] studies have identified underconnectivity with the frontal cortex as a specific characteristic of the altered connectivity in autism, and this characteristic is present across the same wide range of domains of complex information processing that are affected in the disorder, including social, language, executive, and motor processes. […] measures of functional connectivity between specific areas have been shown to reliably predict the degree of impairment in specific domains among those diagnosed with autism. For instance, individuals with poorer social functioning measured by the ADI-R show lower functional connectivity between frontal and parietal cortices. These findings gave rise to the underconnectivity theory in autism, which now has sufficient support that it is accepted as a central feature of the pathophysiology of autism […] Results from these studies are consistent with the notion that autism is a disorder of distributed neural systems (e.g., the connections between structures rather than the structures themselves). […] Diffusion-weighted imaging measures the direction and speed of microscopic water movement in the brain, allowing inferences about the microstructure of the tissue that constrains such movement. These studies have consistently found reduced structural integrity of white matter in adults with ASD, indicating reduced anatomical connectivity […] like measures of functional connectivity, measures of anatomical connectivity derived from diffusion imaging have been shown to reliably predict symptom severity among individuals with autism.”

“In thinking about the genetic basis of autism, it is important to contrast syndromic (or complex) and non-syndromic (or idiopathic/essential) ASD. […] Syndromic ASD includes identifiable autism syndromes with known genetic causes, such as tuberous sclerosis complex, Fragile- X syndrome, Rett syndrome, and Smith-Magenis syndrome.
• Syndromic ASD is associated with a relatively higher propensity for dysmorphic features (including anatomical brain abnormalities), intellectual disability (ID), seizures, and female sex (sex ratios are almost equal).
• Syndromic ASD is also associated with a higher frequency of chromosomal abnormalities in general, many of which have been identified […]. However, it is not yet clear for many of these syndromes which features are typical of autism and which are unique.
Non-syndromic ASD is also called idiopathic autism and consists of cases with and without identifiable micro-deletions or duplications to the DNA. […] individuals with idiopathic ASD are more likely to be male, with sex ratios approximately 1:4 (F:M) but approaching 1:7 in milder cases.”

“Overall, approximately 10 % of children being evaluated for ASD are found to have an identified medical condition with a known genetic lesion such as Fragile X or tuberous sclerosis. An additional 10 % or more have an identifiable chromosomal structural abnormality or copy number variation associated with ASD. […] Recent genome-wide scans using microarray technology have demonstrated a substantial role for small chromosomal deletions or duplications (i.e., copy number variation or CNV) in the etiology of ASD. […] There is [however still] considerable debate concerning the genetic architecture underlying […] the majority of idiopathic autism. Arguments can be made for either the effects of single, but rare Mendelian causes (for which documented CNVs are presumably the tip of the iceberg) or the interaction of numerous common, but low-risk alleles. Genetic linkage and association studies have been traditionally employed to address the latter model, but have failed to consistently identify susceptibility loci.” [An important point I should perhaps make before finishing this post is that if incidence/prevalence of a condition is increasing fast in a population, which seems to be the case here, such an increase is in general considered to be unlikely to only be the result of genetic changes at the population level – that type of pattern is usually indicative of environmental factors playing an important role. It may well be that the ‘average cause’ is different from the ‘marginal cause’, and that it may be a good idea to be careful in terms of which tools to use to explain base rates and growth rates. It might be argued that increased assortative mating among nerds in Silicon Valley has increased incidence locally (I’m sure this might be argued as I’m quite sure I’ve seen this exact argument before…) and I’m not saying this may not be the case, but if close to one percent of the American population get diagnosed, what goes on in Silicon Valley probably isn’t super relevant one way or the other – only roughly 1% of the population live in that area altogether. Even if you were to argue that a similar process is going on everywhere else in the country, it sort of strains belief that ‘something else’ is not going on as well].

July 25, 2014 Posted by | autism, Books, Epidemiology, Genetics, Medicine, Neurology, Personal, Psychology | Leave a comment

Books 2014 (January-June)

The first six months of 2014 are at an end, and I thought it made sense to make a post providing an overview of the books I’ve read during the first half of this year. I decided to be a bit more thorough in this post than I was when I wrote the 2013 book overview post; for example in this post I’ve at least tried to include in the links below all relevant posts I’ve written about the books on the blog, rather than just a subset of them. The corresponding goodreads list is here. Aside from links to relevant posts I’ve also added a bit of information about the books – the numbers in the parentheses are the goodreads ratings I have given the books (for information about how to interpret those ratings, see incidentally the comments here and here), whereas the various letters following those numbers indicate which ‘type’ of book it is – ‘f’ = fiction, ‘nf’ = non-fiction.

I was seriously considering adding other dimensions/categories to the categorization scheme as well, but in the end I decided against doing much of that because such things tend to get messy and I didn’t want to bother with figuring out which other categories might be interesting to include and which books fit into which categories. The only additional variables I added were the names of the publishers of the non-fiction books (it didn’t take any mental effort to add this variable and it seemed to me like it might be relevant information), as well as the names of the authors of the fiction books (-ll-). As people reading along here can’t be expected to necessarily know all the publishers included, I decided to also add a link to some information about each of the publishers featured on the list – the link is added the first place where they are mentioned – in order to make it easier to assess relatively fast which type of book it might be. Aside from these things I’ve written very little about each book; I have added a few other remarks here and there where they seemed relevant, but I’ve tried to keep such comments brief and to the point. If you don’t do this a post like this can get very long very fast.

I have not rated all the books on the list, but I have added the goodreads ratings in the great majority of cases where I have – usually the posts about the book will in the cases where no ratings are provided give you both some idea why I did not rate them and some idea as to what I think about those books. In general it’s safe to say that books I have not rated have some (to me) problematic features which I’ve felt somewhat ambivalent about. On a related note it should be clear from the list that I have not blogged all the books I’ve read this year; this is because I decided a while back to limit fiction blogging a bit – I have however covered all non-fiction books I’ve read this year so far, and many of them I have written more than one post about. Roughly two-thirds of the books I read were non-fiction; of the 53 books on the list there are 18 fiction books and 35 non-fiction books. There are 70 links to book-related posts below, and the great majority (64) deal with the non-fiction books, meaning that I’ve written slightly less than two blog posts about each non-fiction book on average.

On the list below I have only included books which I have read in full and have actually finished, meaning that as usual some books are left out – this is incidentally the reason, in case you were wondering, why the list below looks slightly different from the list on goodreads. The list may also look slightly different because although when writing an early draft of the post I organized the books according to how they were listed on goodreads – i.e. the books are not necessarily listed in the order they were read, or in the order they were covered here on the blog – I did not really care about this stuff when updating the draft later on to include new books I’d read (I should note that given the number of links you need to add and posts that you need to track down, a post like this actually takes a while to write). The category of books I’ve read significant chunks of this year but have not finished include books such as Microeconomic Theory, Ecological Dynamics, and Introduction to Quantum Mechanics, so ’20 pages of light reading’ is not in all cases an accurate characterization of the type of books excluded from the list.

I hope you’ll find the list helpful in terms of navigating the site and that it’ll make it easier for you to find stuff I’ve written here about things you consider interesting. I should note that I occasionally have a bit of trouble keeping track of the stuff I read myself, so this post was not only written for you guys..

Okay, here we go:

1. Pathophysiology of disease (5, nf. Lange medical text. Long, takes a lot of work compared to most of the other books on this list). I took a few quite long breaks from the book along the way, which is why the posts are somewhat spread out over time. I decided in the end to add all relevant posts about the book here, even the ones which were not written this year. Relevant links: 1, 2, 3, 4, 5, 6.

2. The Complete Maus (4, f). Art Spiegelman. I was seriously considering not including this one on the list at all (is this even a book?), but on the other hand it took me longer to read this than it took me to read Calvino so I figured I might as well add it to the list.

3. Why Women Have Sex (2, nf. Times Books. There are two non-fiction books on this list which are not either academic publications (the great majority) or technical publications (#40, 42 and 45) – this book is one of those two books. Don’t be fooled by the fact that the book is written by two university professors; the level of coverage here is much lower than that of pretty much every other non-fiction book on this list). Blog links: 1, 2.

4. The Fifth Elephant (5, f). Pratchett. Blog coverage here.

5. Chronic Pain and Addiction (3, nf. Karger medical text). Blog coverage here.

6. Handbook of Individual Differences in Social Behavior (4, nf. Guilford Press psychology text. Long). Blog coverage here, here, and here. Note that I changed my mind about the goodreads rating after I’d written the last of my posts about the book.

7. Evolution of Island Mammals: Adaptation and Extinction of Placental Mammals on Islands (4, nf. Wiley-Blackwell biology text). Blog coverage here.

8. Invisible cities (4, f). Calvino. Blog coverage here.

9. Intelligence: A Very Short Introduction (2, nf. Oxford University Press. Short and very easy to read). Blog coverage here.

10. The Oxford Handbook of Health Economics (5, nf. Oxford University Press economics textbook. Long). Blog coverage here, here and here.

11. Death in the clouds (4, f). Agatha Christie.

12. Geomorphological Landscapes of the World (3, nf. Springer. Not easy to read.). Blog coverage here and here.

13. Metabolic Risk for Cardiovascular Disease (3, nf. Wiley-Blackwell medical text). Blog coverage here.

14. Screening for Depression and Other Psychological Problems in Diabetes: A Practical Guide (2, nf. Springer). Blog coverage here.

15. Psycho-Oncology (3, nf. Springer medical text). Blog coverage here and here.

16. The Daughter Of Time (4, f). Josephine Tey.

17. Cards on the Table (5, f). Agatha Christie.

18. A Practical Manual of Diabetic Retinopathy Management (2, nf. Wiley-Blackwell medical text). Blog coverage here.

19. The Cambridge Economic History of Modern Europe: Volume 1, 1700-1870 (3, nf. Cambridge University Press economics text). Blog coverage here and here.

20. Handbook of Cognitive-Behavioral Therapies (2, nf. Guilford Press psychology text). Blog coverage here and here.

21. Personality Judgment: A Realistic Approach to Person Perception (3, nf. An Academic Press psychology publication). Blog coverage here and here.

22. The Remains of the Day (5, f). Kazuo Ishiguro.

23. The Origin and Evolution of Cultures (5, nf. Oxford University Press. Takes a lot of work, but it’s an awesome book – “Highly recommended. Probably the best book I’ve read this year”). Blog coverage here, here, here, here and here.

24. What Did the Romans Know?: An Inquiry into Science and Worldmaking (2, nf. University of Chicago Press). Blog coverage here and here.

25. Bioterrorism and Infectious Agents: A New Dilemma for the 21st Century (3, nf. Springer medical text). Blog coverage here.

26. The Waste Books (2, f(?) – a collection of aphorims). Lichtenberg. Blog coverage here.

27. The Eyre Affair (5, f). Jasper Fforde. Blog coverage here.

28. The Biology of Happiness (nf. Springer (SpringerBriefs)). Easy to read, and also quite short. Blog coverage here.

29. Lost in a Good Book (5, f). Jasper Fforde.

30. The Well of Lost Plots (5, f). Jasper Fforde. Blog coverage here.

31. Body language (nf. Pocket. This is the other book to which I alluded in my comments about book #3. This book is most decidedly not an academic publication, and you can tell). Blog coverage here.

32. Do Androids Dream of Electric Sheep? (3, f). Philip K. Dick.

33. Acute Muscle Injuries (3, nf. Springer medical text). Blog coverage here.

34. Military Geography: For Professionals and the Public (3, nf. Potomac Books/University of Nebraska Press). Blog coverage here, here and here.

35. The Psychology of Personnel Selection (3, nf. Cambridge University Press). Blog coverage here and here.

36. To Kill a Mockingbird (2, f). Harper Lee. Overrated.

37. Impact of Sleep and Sleep Disturbances on Obesity and Cancer (5, nf. Springer medical text). Blog coverage here and here.

38. Lupus: The Essential Clinician’s Guide (4, nf. Oxford University Press). Blog coverage here.

39. Something Rotten (5, f). Jasper Fforde.

40. 100 Cases in Acute Medicine (3, nf. Published by CRC Press – review book for medical students/junior doctors). Blog coverage here.

41. Plant Animal Interactions: An Evolutionary Approach (5, nf. Blackwell Publishing biology text). A really great book, high average goodreads rating. Blog coverage here, here, and here.

42. 100 Cases in Clinical Medicine (3, nf. Published by CRC Press – see #40). Blog coverage here.

43. Peril at End House (4, f). Agatha Christie.

44. The Structure of Scientific Revolutions (nf. University of Chicago Press). Blog coverage here.

45. 100 Cases in General Practise (2, nf. Published by CRC Press – see again #40). Blog coverage here.

46. The TET Offensive: A Concise History (3, nf. Columbia University Press military history book). Blog coverage here.

47. Nutrition at a Glance (nf. John Wiley & Sons). Blog coverage here.

48. Poirot Investigates (3, f). Agatha Christie. Unlike the other books by her on the list, this book is a collection of short stories, rather than a novel.

49. Natural Conflict Resolution (4, nf. University of California Press). Blog coverage here, here, and here.

50. First Among Sequels (5, f). Jasper Fforde. Goodreads review: “(Maybe I shouldn’t give all these [Jasper Fforde] books five stars, but as long as they keep being awesome I’ll keep giving them five stars.)“. Blog coverage here.

51. Managing Cardiovascular Complications in Diabetes (3, nf. Wiley-Blackwell medical text). Blog coverage here and here.

52. A Quick Guide to Cancer Epidemiology (nf. Springer – Springer Briefs in Cancer research). Blog coverage here.

53. Murder in Mesopotamia (4, f). Agatha Christie.

June 30, 2014 Posted by | Books, Personal | Leave a comment