Wednesday, April 08, 2015

Exercise doesn't help much:  Australian finding

Medical researchers tend to get very excited even when they detect a very small effect of something.  Below is such a case.  When everything was controlled for in their analyses, they found a pathetic .66 hazard ratio ("the adjusted hazard ratios for all-cause mortality were 0.66").  Statisticians don't usually conclude that something real is going on until the ratio exceeds 2.0.  So the lifespan benefits of taking regular exercise are somewhere between tiny and negligible.  Pity that.

Effect of Moderate to Vigorous Physical Activity on All-Cause Mortality in Middle-aged and Older Australians

By Klaus Gebel et al.


Importance:  Few studies have examined how different proportions of moderate and vigorous physical activity affect health outcomes.

Objective:  To examine whether the proportion of total moderate to vigorous activity (MVPA) that is achieved through vigorous activity is associated with all-cause mortality independently of the total amount of MVPA.

Design, Setting, and Participants:  We performed a prospective cohort study with activity data linked to all-cause mortality data from February 1, 2006, through June 15, 2014, in 204 542 adults aged 45 through 75 years from the 45 and Up population-based cohort study from New South Wales, Australia (mean [SD] follow-up, 6.52 [1.23] years). Associations between different contributions of vigorous activity to total MVPA and mortality were examined using Cox proportional hazards models, adjusted for total MVPA and sociodemographic and health covariates.

Exposures:  Different proportions of total MVPA as vigorous activity. Physical activity was measured with the Active Australia Survey.

Main Outcomes and Measures:  All-cause mortality during the follow-up period.

Results: During 1 444 927 person-years of follow-up, 7435 deaths were registered. Compared with those who reported no MVPA (crude death rate, 8.34%), the adjusted hazard ratios for all-cause mortality were 0.66 (95% CI, 0.61-0.71; crude death rate, 4.81%), 0.53 (95% CI, 0.48-0.57; crude death rate, 3.17%), and 0.46 (95% CI, 0.43-0.49; crude death rate, 2.64%) for reporting 10 through 149, 150 through 299, and 300 min/wk or more of activity, respectively. Among those who reported any MVPA, the proportion of vigorous activity revealed an inverse dose-response relationship with all-cause mortality: compared with those reporting no vigorous activity (crude death rate, 3.84%) the fully adjusted hazard ratio was 0.91 (95% CI, 0.84-0.98; crude death rate, 2.35%) in those who reported some vigorous activity (but <30% of total activity) and 0.87 (95% CI, 0.81-0.93; crude death rate, 2.08%) among those who reported 30% or more of activity as vigorous. These associations were consistent in men and women, across categories of body mass index and volume of MVPA, and in those with and without existing cardiovascular disease or diabetes mellitus.

Conclusions and Relevance:  Among people reporting any activity, there was an inverse dose-response relationship between proportion of vigorous activity and mortality. Our findings suggest that vigorous activities should be endorsed in clinical and public health activity guidelines to maximize the population benefits of physical activity.

JAMA Intern Med.

The way to get more hospital care and reduce waiting times is to close down public hospitals

THE Australian Medical Association is right to be concerned about the impact of the Weatherill Government’s plan to restructure hospital services on the number of hospital beds available to treat patients in Adelaide.

However, bed numbers of are only one of the factors that determine how long patients have to wait for public hospital care.

This may sound strange, but the way to get more hospital care and reduce waiting times is to close down public hospitals. This is part of the logic behind the controversial proposal to shut the Repatriation General Hospital and close the emergency departments at Queen Elizabeth and Modbury hospitals.

The location of public hospitals across Adelaide, as in all major Australian cities, reflects the transportation and medical realities of the 19th century. When the public hospital system was founded in the ‘‘horse and buggy’’ era, every suburb needed its local hospital to provide the community with essential medical and surgical services.

In those days, hospital care was relatively cheap and basic, and it was financially and logistically possible to provide the full range of services then available across all locations. This has become impossible due to the ever-increasing complexity and technological sophistication of hospital services.

Today, it makes more sense to deliver hospital care, particularly hi-tech care, in bigger hospitals like the new Royal Adelaide Hospital, especially given modern transport options and how easy it is for patients to travel to access care.

This has left smaller, older hospitals delivering simpler services that often duplicate those that are available in nearby major facilities. The problem with this is that it is very costly to keep open and maintain ageing facilities such as the Repat.

The impact on the health budget means that funding has to be spread more thinly across the rest of the system and this reduces the overall capacity to care for patients.

It is common to find units in major hospitals that are under-utilised due to chronic shortages of funding for frontline services.

Financial considerations mean, for example, that surgical theatres close at 5pm, and shut down entirely for many weeks over the Christmas and New Year period.

The large number of smaller hospitals scattered across rural areas create similar challenges. It is better to concentrate hospital services in larger regional towns and bring in patients from outlying areas either by road or air ambulance, while allowing most country hospitals to operate more or less as GP and first-aid clinics.

However, hospital closures and reconfigurations are emotive and politically sensitive issues. Local communities are strongly attached to their hospitals. When it suits, both sides of politics pander to these sentiments for political advantage.

But what isn’t understood is the price the whole community pays for keeping hospitals open — longer waiting times and less hospital care for everyone.

The ageing of the population in coming decades will significantly increase demand for public hospital care. The affordability of the system will depend on ensuring hospital services are delivered efficiently.

If we don’t get the basic structure of the public hospital system right, the state government will find it increasingly difficult to pay for the increased amount of care the community needs.

Closing the Repat and similar hospitals will not just improve the finances of the system, but will also enable funding to be reallocated and ultimately help public hospitals treat more patients.


Australian study finds Earth is greener than 10 years ago: Total amount of vegetation found to have increased significantly over past decade

Carbon is good for you

For years we have been told mankind is destroying the planet, felling trees and systematically ripping up forests.  So it may be a surprise to some that Earth is actually greener today than it was a decade ago.

In an authoritative new study, scientists have calculated that the total vegetation on the planet increased substantially between 2003 and 2012.

While tropical jungles are still disappearing – felled for timber and to make way for cattle pasture – tree growth elsewhere has outstripped the loss.

The unexpected findings show that the area of ground covered by plants has increased in Russia, China, Australia and Africa, leading to a net gain in vegetation cover.

Some of this is due to deliberate conservation, such as a huge tree-planting campaign by the Chinese. Elsewhere high rainfalls have resulted in faster growth of shrubs and grasses on the plains of Africa, northern Australia and South America. And the abandonment of large agricultural areas following the collapse of the Soviet Union led to forests reclaiming farmland.

But whatever the cause, the increase in vegetation is indisputably significant.

The Australian team, whose results are published in the journal Nature Climate Change, found the ‘greening effect’ has been so substantial that the world’s trees and plants are storing 4billion more tonnes of carbon than they were a decade before.

Carbon dioxide in the air is sucked up by plants’ leaves and converted through photosynthesis into the food they need to grow, locking the carbon in their wood. The 4billion tonne increase in plant carbon storage is the equivalent of 7 per cent of the 60billion tonnes of carbon dioxide emitted through industry and transport over the same period.

The surprising results – gathered by scientists who analysed 20 years of satellite data – comes after decades of warnings about environmental catastrophe caused by deforestation.

The scientists studied radio waves naturally emitted by the Earth’s surface to calculate the amount of vegetation covering the land. Using satellites, they were able to calculate the way forest patterns had changed over 20 years, which they say is a more accurate way of measuring deforestation than simply surveying land use.

Study author Professor Albert van Dijk, of the Australian National University, said: ‘Previous analyses of vegetation biomass focused on forest cover change. With our approach we found unexpectedly large vegetation increases in the savannas of southern Africa and northern Australia.’

Lead author Dr Yi Liu, of the University of New South Wales, warned that the gains may be easily lost as weather patterns shift with climate change.

He said: ‘Savannas and shrublands are vulnerable to rainfall – one year can be very wet, and more carbon will be fixed in plants, but the next year can be very dry, and then we will lose the carbon fixed in previous years.’ He added that huge vegetation loss is still occurring on the edge of the Amazon forests and in the Indonesian provinces of Sumatra and Kalimantan.

And while the increase in grasslands and pine forests is a rare glimmer of hope for conservationists, it only goes some way to mitigating the ongoing loss of tropical rainforest, which supports more species than any other ecosystem on Earth.


Where the right to speak is howled down

By Peter Baldwin, minister for higher education (1990-93) in the Hawke-Keating government

The University of Sydney is one of Australia’s most venerable higher education institutions. It should be a place where controversial issues are debated freely and openly with the contending sides able to present their cases without intimidation and harassment.

It should be governed by an administration that strongly affirms the importance of free debate and acts swiftly and decisively to protect it if it comes under threat. It should definitely not be a place where mob rule is allowed to prevail or where activist groups get to decide which viewpoints can be expressed.

Can that be said of Sydney University today? Based on an experience I had there recently, it would appear not.

On March 11 I attended a public meeting on the campus addressed by Richard Kemp, the former commander of British forces in Afghanistan. His talk was about the ethical dilemmas that faced military forces opposed by non-state groups.

Kemp was in Israel during the Gaza conflict in July-August last year, and he gave the Israel Defence Forces credit for their measures to minimise civilian cas­ualties during their operations. He found it difficult to envisage what more they could have done given the need to counter attacks deliberately launched from within densely populated areas. In saying this, he did not deny there were ser­ious errors and abuses by some IDF forces, including possible war crimes.

This, it seems, is sufficient to make him a pariah to some of Israel’s more extreme critics. Enough of a pariah to warrant silencing him wherever possible; and sad to say, today’s universities are places where this is possible.

Kemp was able to speak unimpeded for about 20 minutes, at which point 15 to 20 people pushed past a security guard and began loudly chanting “Richard Kemp you can’t hide, you support genocide”, led by a young woman with a megaphone set to maximum volume.

Kemp described the experience in these pages on March 17, so I won’t detail it all again. But at one point the lights went out, leaving some — including me — wondering what was to come next. It was a genuinely frightening experience; a systematic, planned attempt to wreck the meeting. The attempt to suppress speakers perceived as pro-Israeli on campus is part of a wider pattern at Australian universities and internationally spearheaded by supporters of the boycott, divestment and sanctions campaign.

The young woman with the megaphone shouting down Kemp went on to defend the speech rights of Hizb ut-Tahrir, an extremist Islamist organisation that gained notoriety last year when its Australian spokesman pointedly and repeatedly refused during an ABC Lateline interview to condemn the tactics used by Islamic State (mass beheadings, crucifixions, selling women into slavery, and so on).

The clueless young woman with the megaphone shouted about Hibz ut-Tahrir’s opposition to US policy, but this group has a few other ideas such as the following reported in The Australian recently: “The top Australian cleric of extremist Islamic group Hizb ut-Tahrir has ramped up his hate speech in a rant referring to Jews as ‘the most evil creature of Allah’ who have ‘corrupted the world’ and will ‘pay for blood with blood’.”

In the latest tirade to surface, cleric Ismail al-Wahwah — representing an organisation whose stated aim is to take over the world — said recognising Jews constituted the “epitome of evil” because that would “strengthen the cancerous entity”.

The disrupters ludicrously charged Kemp with supporting genocide while they and the rest of the BDS brigade have nothing to say about the open and explicit support of genocide by Hamas, now part of a unity government with Fatah. The Hamas charter adopted in 1988 looks forward (in article seven) to exterminating every last Jew on earth and incorporating “every inch” of Palestine in an Islamic state. Hamas refuses to rescind this foul, evil document despite repeated calls to do so and, on the contrary, relentlessly promotes its genocidal goals in its propaganda and schools.

As someone affiliated with the Labor Left throughout my active political career I find this growing affinity between the far Left and the Islamists one of the strangest and most disconcerting developments of recent times.

The naivety is quite astounding. A quick Google search turned up an article by the megaphone woman on the website of the Trotskyist group Solidarity in which she extols workers’ control in, of all places, post-revolutionary Iran, where all the leftist groups instrumental in overthrowing the shah ruthlessly were crushed by the Khomeneists once they had fulfilled their “useful idiot” role. Some of the people she is defending would gladly stick her head and those of her Marxist colleagues on the end of a pike if they were ever to take over.

Two well-known pro-BDS aca­demics were present: Jake Lynch, director of the Peace and Conflict Studies Centre; and Nick Riemer, a senior lecturer in the English department. Both denied involvement in the disruption but loudly supported it once it began.

How do they justify this stance? They have both gone on the record.

Columnist Gerard Henderson raised the following question with Lynch: “Since you support disrupting the Kemp lecture, do you also think it would be acceptable to disrupt speakers hosted by your centre such as John Pilger and Hanan Ashrawi? If not, how do you justify the double standard?”

Lynch replied: “I would dispute the parallel with John Pilger or Hanan Ashrawi. I have never heard either of them deliver a speech that was disingenuous or deceitful in the way of the remarks by Colonel Kemp.”

Riemer gives a detailed defence of the disruption in a long article in the online journal New Matilda. This piece of casuistic nonsense is worth reading in full as it says volumes about the mentality that defenders of free speech on campus have to contend with these days.

Here is a sample of his “reasoning”: “Many left-wing people, I ­believe, would defend the proposition that protesters have the right to disrupt any kind of public speaker, but that only disruptions of certain public speakers are right.”

Applied to the present case, this means anyone has the right to disrupt a pro or an anti-IDF speaker, but only interruptions of pro-IDF speakers are actually ­justified.

In the first paragraph Riemer asserts a general “right to disrupt” any speaker. This cannot be squared with any reasonable understanding of the right to free speech, the whole point and effect of disruption being to prevent the effective exercise of the latter. Bear in mind that we are not talking about the kind of interjection familiar from parliamentary debates but the systematic drowning out of a speaker with a megaphone and sustained chanting. There was specific provision in the meeting format for questions and critique, but the goal of the disrupters was to censor, not challenge, what Kemp had to say.

Note the second paragraph where Riemer, like Lynch, justifies disrupting the expression of one side of the debate. How does he rationalise this? He asserts the rightness of disrupting speech that is “extreme” or “hateful” or, in an Aristotelian touch, “fails to promote human flourishing”.

To label Kemp’s lucid and well-reasoned presentation as hateful or extreme is just bizarre. As for the stuff about failing to promote human flourishing, perhaps Riem­er should consider that by turning Gaza into an armed camp, launching thousands of projectiles into Israel and pouring huge amounts of cement provided under aid programs into building a subterranean network of attack tunnels, Hamas and its supporters and apologists are failing to “promote human flourishing”.

Riemer goes on: “As such, his (Kemp’s) speech aims at the dismantling of the very democratic freedoms among Palestinians which commitment to the principle of free speech is supposed to embody.”

What “democratic freedoms” would those be? Is he familiar with the increasingly brutal crackdown on dissenters in the territory controlled by the Palestinian Author­ity, with dissidents jailed for long periods for “extending the tongue” against the authority? Or the vicious persecution of Christians, most of whom have now fled the territories? Or the far worse situation in Gaza where dissenters can expect a bullet in the head, where the death sentence is prescribed for homosexuality?

The only country in the region where any semblance of democratic freedoms exist is Israel, where the Arab-aligned parties emerged as the third largest force in the recent elections, where people of all faiths — and none — are safe, and where homosexuals can live free from fear.

Tel Aviv was named as the most popular gay tourist destination in the world recently. This was labelled “pinkwashing” by the BDS brigade, just a cunning Israeli plot to disguise their oppression of the Palestinians.

The intellectual arrogance of the campus BDS supporters, articulated by Lynch and Riemer, is quite astounding. No postmodern questioning of objective truth here; not only is the truth “out there” but Lynch and Riemer are in possession of it and are able to distinguish it from lies and deceit. No need to allow people to actually hear the contending cases presented fully and effectively, even in contexts such as the Kemp lecture where they can be challenged. Defend Israel in any respect and you are a warmonger, callously indifferent to the fate of oppressed people. You need to be silenced.

This is a truly sinister development, and one not confined to Australian universities. Jewish students at Sydney University with whom I corresponded report feeling increasingly insecure and fearful on campus. My sense is that increasingly anti-Zionism is a mask for occulted anti-Semitism.

Will the university administration, led by vice-chancellor Mich­ael Spence, act decisively to defend free speech on campus in response to this outrage? Time will tell, but at this stage the portents are not encouraging.

The university has engaged a firm of workplace lawyers to investigate the incident and the responsibility of individual staff and students and consider all “allegations and counter-allegations”. It is profoundly disappointing, however, that so far the vice-chancellor has not gone on the public record to say that what happened was completely unacceptable and will not be tolerated in future.

There is absolutely no reason a clear statement of principle could not have been made right away. Does the vice-chancellor really need advice from a firm of workplace lawyers before doing this much? Of course decisions about individual culpability should be handled carefully, with those accused given an opportunity to respond to allegations.

Finally, I note a certain inconsistency in the university’s attention to procedural fairness.

In October last year Barry Spurr, a distinguished academic with a long association with the univer­sity, was suspended from his position and barred from the campus within a day following the disclosure of offensive language in some hacked private emails. He was subjected to this terrible public humiliation before being given any opportunity to give his defence that he was speaking in a joking or ironic voice.

No workplace lawyers to consider all sides before taking action in that case.

The common factor in these two incidents was the presence of chanting mobs of demonstrators, in one case silencing someone with whom they disagree, in the other demanding the peremptory sacking of an academic. In one case a panicked rush to action by the vice-chancellor, in the other a drawn-out process with all involved bound by strict confidentiality provisions — a procedural black hole.

It is hard to avoid the depressing conclusion that at Sydney University today mob rule works.


Sydney university boss MAY grow some balls

If the exchange of letters in the Australian (below) is followed up by serious action

Like Peter Baldwin, Sydney University is deeply concerned about events that occurred during Richard Kemp’s lecture on March 11 (“Where the right to speak is howled down”, 2/4). We are in the process of finalising an investigation into the incident, having interviewed more than 20 people and reviewed extensive material.

I’d like to reassure Mr Baldwin, and all those concerned by the events, that we are committed to defending free speech and the right of all staff, students and invited guests to express their views without fear of bullying, harassment or discrimination.

Following thorough processes in such cases is vital. It is imperative that we complete these processes before appropriate actions can be taken. We are committed to ensuring this investigation is concluded as quickly as is possible, and will not hesitate to take appropriate action.

Michael Spence, vice-chancellor, Sydney University, NSW

Peter Baldwin’s defence of the right to speak comes from one whom thugs attempted to silence when he had the guts to help clean up corruption in some of the Labor Party’s inner-city branches many years ago. So, he knows totalitarianism when he experiences it — this time, shamefully, at a leading university with a rich tradition of hosting speakers of many shades of view.

The thugs who disrupted Richard Kemp’s lecture have zero tolerance for views other than those which they, in all their warped myopia, choose should be heard.

Ron Sinclair, Bathurst, NSW

Peter Baldwin is one more distressed responsible citizen seeking to expose the depth of perversion associated with the conduct of those involved in the fracas at Sydney University. I would suggest the effort in seeking to align actions of these individuals with some kind of logic, reason or intelligence, and then attempt to point to the absence or failure of any of these, is a total waste.

What we are witnessing is the emergence of anti-state fundamentalists whose almost fanatical directive is the disruption of Western forms of social and political order, not in far-away places such as Gaza, but in their own country. It is naive to consider that these individuals have any real respect for reason or, indeed, for their purported cause as is evidenced by the contradictions, oxymorons and insanity invariably attached to anything they do or say.

George Carabelas, Mt Barker, SA

I applaud The Australian for publishing the excellent piece by Peter Baldwin. The events at Sydney University are shocking. As an Australian university student I’m ashamed to watch as our elite institutions allow themselves to be dragged into the mud.

At the heart of a nation priding itself on democratic freedoms — not least that of expression — how can our higher education institutions stand for this? This is a stain on the excellency of our education institutions.

Annita Stucken, Sydney, NSW

Peter Baldwin’s call for Sydney University to take action against Jake Lynch and me ignores the fact that disagreeing with him about the nature of free speech is not a sackable offence.

Applied to the protest at Richard Kemp’s talk, Baldwin’s claim that disruptive protest prevents the exercise of free speech gets things the wrong way round. Any reasonable observer would have concluded that the point of the student’s intervention was to promote Palestinian free speech.

Universities are traditionally reservoirs of dissent. No one has the right to use the university as a political venue and expect to be exempted from the conditions of public political action, as Baldwin is asking.

Our critics proclaim their commitment to free speech in the case of Kemp, for whom the columns of the media lie open, but are mute about the more significant restrictions on free speech that the Israeli occupation imposes on Palestinian academics and students.

Nick Riemer, Sydney University

I did not join the protest that stopped Richard Kemp from speaking, as Peter Baldwin states. I did ask the security guards to stop using force to eject the protesters. In that, I was acting in a diligent and conscientious manner.

Jake Lynch, Sydney University


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