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Sex in older age: Can the brain benefit?

We’ve all heard the phrase “use it or lose it,” and there are many other examples in the media of how we can keep our brains sharp as we age. Research has shown that what is good for your heart is good for your brain, in the biological sense – but what about in a romantic sense? Surprisingly, there has been very little research on the links between sexual relationships and cognition in later life. A variety of research findings have shown associations between cognitive functioning and mental, social, emotional, and physical activities in older adults. Some might say that sex life actually impacts upon all of these aspects of health and wellbeing. So maybe it’s time for us to shift focus?

There has been a long history of scientific and medical findings of lifestyle factors that may protect cognitive functions – especially memory – in older age. Memory loss is particularly worrisome for all of us, and this has become a popular topic of debate with the increased public and political focus on dementia.

Some researchers have turned their attention to how cognitive impairment – such as dementia – impacts sexual relationships within couples. This research is enlightening and is integral to our understanding the dynamics of how cognition (and its shortcomings) not only influences intimacy, but also ethical issues of consent, between older couples.

So we can see that impairments in cognitive function can affect sexual relationships in later life. But what if we look at this from another perspective? What if a healthy sex life can actually positively influence brain function in healthy older adults, in a similar way to a healthy diet or exercise? Because research in this area is so sparse, our study has gone back to basics to answer the simple question of whether there is indeed a link between sex and cognition in healthy older adults. After accounting for effects of potential contributory factors (age, education, wealth, levels of physical activity, cohabiting status, general health, depression, loneliness and quality of life), we found a significant association between sexual activity and higher scores on tests of cognitive function in people over the age of 50 years.

Although this finding is extremely exciting, the waters are a little muddied by anomalies in our results. For example, for the women in our sample, there was no association between sexual activity and scores on a number sequencing task (e.g. fill in the blank – “9, 7, _, 3”). Whilst we were unable to pinpoint the cause from our initial analysis, we believe that it could be due to a wide range of biological, social, and psychological reasons. The explanation that we are most excited to explore is that of hormonal influences on brain regions that are responsible for “executive functions,” such as number sequencing. Scientific research has shown that, even before we are born, pre-natal sex hormones impact upon brain development – and hence influence cognitive function throughout the lifespan. We aim to explore this in our next project.

In addition to the questions raised by gender differences in our findings, we still need to address the issue of causality. Just like the proverbial chicken and egg, we do not yet know whether engaging in sexual activity actually leads directly to better cognitive function. Or indeed conversely, it could be that people who have a higher level of cognitive functioning are more likely to engage in sexual relationships in later life. We plan to address this question of causality in a follow-up longitudinal study.

A final question that our study has uncovered is whether we are dealing with a biological or a social phenomenon. We think that the roots of our initial findings could lie within regular surges in arousal and release of sex-related hormones (i.e. biological account), or higher levels of intimacy and companionship (social account). Of course, our answer could lie in a combination of both the social and biological impact of sexual activity on brain function, and the age-old nature vs. nurture debate comes into play here. It would be very interesting to hear your opinions on what you think is going on here: nature or nurture, biological or social, love or sex.

With all the previous research on healthy lifestyles and cognitive function, wouldn’t it be nice to add “healthy sex life” to our checklist for mental and physical wellbeing in older age?

Featured image credit: Old couple by coombesy. CC0 Public Domain via Pixabay. 

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What is our moral obligation to the stranger?

For centuries this question has haunted European thought, and as new fences are erected and bodies wash up on the shores of the Mediterranean its implications reassert themselves with renewed urgency. For over twenty years the outsourcing of migration controls has meant that European publics have been protected from the practical reality of forced displacement and the economic desperation that is now showing up on holiday beaches. Agreements with source and transit countries, readmission agreements, the creation of migration management policies and facilities in countries of origin have kept ethical dilemmas away from the general public. Colonialism with its ongoing legacies of inequality, nationalisms and artificial borders may be a critical drive of contemporary global mobility, but it was largely been relegated to the history books and responsibilities to those caught up in its legacies ignored. However, memories of Iraq, Libya and Syria, and the involvement of European powers and their proxies in the current destabilisation are still fresh. That is, it is difficult to say that the current mass displacement is ‘nothing to do with us’. Raising the question of how the prevention of entry of people from conflict zones is compatible with European responsibilities, or, even more generally, how border controls are compatible with human rights.

The past decade has seen the emergence of trafficking and modern day slavery as a means of managing this contradiction. Anti-trafficking has proved to be a common cause for a wide range of actors, and a rare patch of common ground for those concerned with the rights of undocumented migrants, and state authorities. Anti-trafficking (and more recently, anti-slavery) laws, present the border as a point of humanitarian intervention, where states and NGOs can identify and rescue those subject to abuse. This approach has been very much to the fore in the current situation at Europe’s borders. After a meeting in April of EU Interior and Foreign Ministers discussing the Mediterranean, Italian PM Matteo Renzi called those who enabled the Mediterranean crossings the ‘slave drivers of the 21st century’; UK PM David Cameron blamed criminals ‘managing, promoting and selling this trade, this trade in human life’; while FRONTEX, the European agency charged with co-ordinating the management of the EU’s external borders, described people smugglers as ‘latter day slave merchants’. ‘Slavery’, like ‘trafficking’ appears to capture the combination of mobility, gross exploitation, and ‘foreign-ness’ and it tells a powerful story that everyone can agree on. The European Commission, the Parliament, EU member states, the media, religious groups, trades unions, right and left alike all abhor slavery and want to stop the appalling suffering it generates.

World Day for Social Justice by rikkis_refuge. CC BY 2.0 via Flickr

While the images of slavery may be startlingly similar to those used by anti-slave trade activists of the 17th and 18th centuries, the experiences and contexts of the people involved are quite different. These boats may be crammed and overcrowded, but the people have not been kidnapped from their homes. They have often paid thousands of euros to escape war and violence in Syria, Afghanistan and Eritrea, or they have travelled from Niger and Senegal in search of more opportunities and more sustainable lives. They want to move (O’Connell Davidson 2015). Furthermore, the movement across the Mediterranean today is, in contrast to the 18th century transatlantic slave ships, an illegalised movement. The mobility of transatlantic slaves was an involuntary but legal movement, while the mobility of migrants across the borders of the European Union is a voluntary but illegalised movement.

Thus what the language of ‘slavery’ and ‘trafficking’ does is ignore the crucial point, that is it the enforcement of border regimes that puts people at risk of exploitation and death. That people would of course prefer to get on plane or train with a visa, but that those holding passports from Syria, Iraq, Afghanistan and Somalia, are subject to the toughest visa regimes in the world. Critically the political argument for these visa regimes rests on the fear of a ‘tragedy of the commons’. How will European states be able to preserve their welfare states in the face of such tremendous global need, particularly at a time of retrenchment and austerity? This framing enables us to avoid both the question, how can we afford to intervene militarily but not offer humanitarian protection, and perhaps the even bigger question about growing inequality, not just between states, but between individuals.

Headline image: Trapped by snappED_up. CC BY 2.0 via Flickr.

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What is information, and should it be free?

When we pay our bills using a plastic card, we are simply authorizing alterations to the information stored in some computers. This is one aspect of the symbiotic relationship that now exists between money and information. The modern financial world is byzantine in its complexity, and mathematics is involved in many ways, not all of them transparently clear.

Fortunately there are some bright spots, such as the fact that it is now possible to measure information. This is the result of the pioneering work of Claude Shannon in the 1940s and 1950s. Shannon’s definitions can be used to prove theorems in a mathematically precise way, and in practice they provide the foundation for the machines which handle the vast amounts of information that are now available to us. However, that is not the end of the story.

In 1738 Daniel Bernoulli pointed out that the mathematical measure of ‘expectation’ did not allow for the fact that different people can value the outcome of an event in different ways. This observation led him to introduce the idea of ‘utility’, which has come to pervade theoretical economics. In fact, Shannon’s measure of information can be thought of as a generalization of expectation, and it leads to similar difficulties. As far as I am aware, academic work on this subject has not yet found applications in practice.

In the absence of a theoretical model, many countries (including the UK) have tried to set up a legal framework for information. First we had the Data Protection Act (1998), intended to prevent the misuse of the large amounts of personal data stored on computers. But it is very loosely worded, and consequently open to many different interpretations. (In one case, a police force believed that the Act prevented them from passing on information about a person whom they suspected of being a serial sex offender. This person then obtained employment elsewhere as a school caretaker, and murdered two pupils.) The next step was the Freedom of Information (FoI) Act (2000), which now seems to be regarded as unsatisfactory – on all sides. Those who see themselves as guardians of our ‘right to know’ are dissatisfied with the wide range of circumstances which can be considered as exceptions. Those who see themselves as guardians of our ‘security’ are concerned that attempts to prevent terrorist activities may be compromised.

 We are expected to observe certain rules and regulations about how we use our money, but we are allowed to keep it safe. Will similar rules and regulations about information emerge?

Recently I looked at a question which led me into these muddy waters. The question was a simple instance of a very general one. Suppose a piece of information is only partly revealed to us: it may have been corrupted by transmission through a ‘noisy channel’, or it may have been encrypted, or some important details may have been intentionally withheld. How much useful information can we deduce from the data that we do have?

My example came from the unlikely source of the popular BBC television programme, Strictly Come Dancing. The problem was as follows. In order to determine which contestants should be eliminated from the show, the programme’s creators have devised a complex voting algorithm. First the judges award scores, and these are converted into points. Then the public is invited to vote, and the result is also converted into points. Finally the two sets of points are combined to produce a ranking of all the contestants. But the public points and the final ranking are not revealed on the results show, only the identity of the two lowest contestants. I was able to show that in some circumstances the revealed data can indeed provide a great deal of information about the public vote.

Strictly Come Dancing arouses great passion among its followers, and the lack of transparency of the voting system has led to numerous requests under the FoI Act. Most of these requests have been refused by the BBC, on grounds that appear to be valid in law. It seems that the FoI Act was originally based on some rather idealistic notions. When the Act was passing into law, it had to be converted into a more realistic instrument, and the resulting form of words therefore provides for a large number of exceptions to the general principle. Specifically, the BBC is able to claim that the details of the voting are exempt, because they are being used ‘for the purposes of journalism, art, or literature.’

In my view the FoI Act is simply a shield that deflects attention from the heart of the matter. The public is invited to vote and therefore has good reason to be interested in the mechanics of the voting procedure and its outcome. In addition to details of the method used to combine the public ranking with the judges’ ranking, there are other causes for concern. For example, multiple voting is allowed, and this opens up the possibility of misuse by agents who have a vested interest in a particular contestant.

I began by remarking that there is a close relationship between money and information. We are expected to observe certain rules and regulations about how we use our money, but we are allowed to keep it safe. Will similar rules and regulations about information emerge, and when?

Featured image credit: binary code by Christiaan Colen. CC-BY-SA 2.0 via Flickr.

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Shakespeare and sex in the 16th century [infographic]

Sex was far from simple in 16th century England. Shakespeare himself wed a woman eight years his senior, a departure from the typical ages of both partners. While some of his characters follow the common conventions of Elizabethan culture (male courtship and the “transfer” of a woman from the care of her father to her husband), others show marked indifference toward appropriate gender roles and sexuality. His plays feature strong-willed and sexually-driven women, cross-dressing, and subtle homosexual relationships, most notably Coriolanus and Aufidius in Coriolanus and Rosalind and Celia in As You Like It. His narrative poetry, namely Venus and Adonis, and his Sonnets are at times highly erotic and involve homosexuality, desire, and sexual love. His work demonstrates that tradition is never as established or inflexible as we think.

Download the infographic as a PDF or JPG.

Featured Image: “Olivia, Maria and Malvolio from “Twelfth Night,” Act III, Scene iv” by Johann Heinrich Ramberg (1789). Yale Center for British Art. Public Domain via Wikimedia Commons

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Slavery contracts

Guy and Doll have agreed that Guy will act as Doll directs, and that Doll is entitled to use force or punishment to get Guy to do as she directs if he ever demurs or falls short. Guy is aware that Doll will sometimes use him sexually and punish him for her pleasure; indeed, that is one reason why he chose to submit to her. As Doll is not entitled to violate any legitimate claims of third parties, she does not have the authority to direct Guy to do such things. Both Guy and Doll understand that. But they sometimes play a game in which Doll orders Guy to do such things, to provide Doll with a pretext for punishing Guy severely when he (rightly) refuses to carry out her orders.

Guy has contracted to be Doll’s slave. Such contracts are familiar from fiction and from history; and some people may have familiarity with them in contemporary life. Yet it has been common since the Enlightenment for philosophers to argue that such contracts are impossible. Recent philosophers have used the same arguments to claim that employment and professional armies are also impossible. If the philosophers are right, then we are deluded when we think that there are contractual slaves, employees, and professional soldiers; and people who think that they themselves are contracted slaves or slaveholders, or employers or employees, or professional soldiers, are similarly deluded. I have argued that the philosophers are mistaken.

Many philosophers, including Spinoza, claim that contractual slavery is impossible because a person cannot give to another person his power to control his own actions or decisions. However, Guy never attempted to give Doll his power to control his own actions or decisions. What he gave her was his right to direct his own actions. He thereby undertook the duty to act as she directs. Guy sometimes uses his own power over his decisions and actions to default on that duty so that he can incur Doll’s punishment for bad behaviour.

‘Chained feet’, by PublicDomainPictures. CC0 Public Domain via Pixabay.

Montesquieu, Rousseau, perhaps Kant, and others, argue that, since the slave has no rights against the slaveholder, he has no contractual rights against her, so she has no contractual duties toward him, so there is no contract between them. Here is a counter-example to that argument. A courier and I agree that she will deliver my parcel for a specific payment. I make the payment in advance. I now have no contractual duties toward her, though she has the contractual duty to me to deliver my parcel. There is still a contract between us. If every contract requires a payment, the person who is to become the slaveholder must make the payment in advance, either to the person who is to become the slave (who must consume it before the contract begins or lose his claim to it) or to someone nominated by the person who is to become the slave.

Rousseau, and perhaps Kant, argue that to give up one’s freedom is to give up one’s moral responsibility; so one who becomes a slave thereby becomes ineligible to bear any duties, including the duty to obey his slaveholder. That confuses two senses of ‘freedom,’ namely, the right to direct one’s own actions and one’s free will. When Doll gives Guy an order the execution of which would not infringe any legitimate claims of third parties, Guy has the duty to obey and in that sense is not free to do otherwise. But Guy still has the free will to do otherwise. He is morally responsible and may earn praise for doing his duty or blame for not doing it.

Rousseau contends that the right to direct one’s own actions is essential to human nature, so it is impossible for a human to be without it. But we all recognise that there are humans who do not have that right, at least not fully, such as young children, adults with a serious mental impairment, and incarcerated felons.

Recent philosophers, including Ernst Cassirer, John Rawls, and Randy Barnett have reaffirmed the faulty Enlightenment arguments against contractual slavery. Hillel Steiner, perhaps echoing Kant, maintains that because a slave is a piece of property he is a mere thing or an object; and a mere thing or object cannot be a party to a contract. However, slavery is essentially a relationship between persons: a mere thing, or even a living non-person such as a cat, cannot literally be a slave. Slaves differ from other persons in being owned; and they are in that respect analogous to those mere things that are owned. However, to be analogous to a mere thing is not to be a mere thing.

Featured image credit: ‘Hieroglyphs’, by pcdazero. CC0 Public Domain via Pixabay.

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Confessions of an audiophile

With Valentine’s Day barely a week behind us, we want to celebrate our love of oral history. To help us out, we asked Dana Gerber-Margie to tell us how she ended up in the audio world and why she loves oral history. Dana runs the wildly popular Audio Signal newsletter, and we interviewed her for the blog last October.

Throughout 2016, we’ll be asking these questions to a variety of oral history professionals and practitioners, offering a space to reflect on the things that drew them into oral history. If you’re interested in sharing your own story, contact our social media coordinator, Andrew Shaffer, at ohreview[at]gmail[dot]com.

My interest in oral history actually stemmed from a broad interest in audio itself. It all started because of my father. As an undergraduate at UC Berkeley, I worked as a page at the Bancroft Library. I was often alone in the stacks re-shelving, rearranging volumes, or working on other projects as needed. I was late to the iPod game, but finally bought a little purple refurbished iPod Nano. I loaded up all my iTunes music on it and…got bored within a few days. I mentioned this offhandedly to my dad, and he was the one who said, “Have you heard of this radio show called This American Life?” Like many people, This American Life was my gateway drug.

What really hooked me into the radio world was the 2008 financial crash. I couldn’t stop listening to NPR; This American Life had some amazing shows trying to explore the crash, and I was obsessed with economic podcasts. I was just coming out of college and into the working world, and I think I was partly just trying to come to terms with the new world I was forced to enter. I wanted to understand it. When I wasn’t listening to economics, I got really into New Yorker short stories, storytelling podcasts like The Moth, educational podcasts like Stuff You Missed in History Class, and, of course, the emotionally and mentally intense Radiolab. I suppose what I’m trying to describe is that radio became an enormous part of my life. All walks home, alarm clocks, bus rides, and chores had an audio partner.

I studied Russian History through college, knowing that at the end I planned to attend graduate school for library science to become an archivist. The only contact I had with A/V formats was to re-house a sad set of football films with a bad case of vinegar syndrome, but otherwise it was all paper-based. I worked in Public Services throughout college, and when I finally did start graduate school, I went through it with the plan to work in reference, outreach, and public services. Unfortunately, I was completely naive and over-confident that I’d love Public Services and excel in it. I didn’t focus on rigorous metadata and standards, technical discoverability, hands-on preservation skills, and so on. Towards graduation, I drifted into marketing, because I started to get very worried that I wouldn’t get a job without a Master’s or Ph.D. in History. Throughout this whole time, I still listened to radio and podcasts all the time. It was always in the back of my mind, but my imagination mostly brought me to working at NPR someday.

While this was going on, I was dabbling in other projects. I started a podcast to try and tie my interests of archives and radio together, but I am not a producer at heart. I stopped after 10 episodes. I volunteered on an oral history project to collect stories of radicals in Madison, and at the Circus World Museum, where the archivist needed the most help with digitizing circus heralds. I had an internship with Wisconsin Public Radio in the archives, but I only improved metadata and it all became very routine. I was also a TA in my second year of school, which played into my wish to go into instruction and also paid my out-of-state tuition. I did a lot more random things. My experiences after college were also pretty disparate, so I graduated feeling lost about where I belonged.

Oral history and audio always remind me that other people are living deeply, going through difficult times, and thinking strange or funny thoughts.

I worked in library communications right after I earned my Master’s, writing articles about what people were doing, managing social media, creating marketing campaigns, and I found absolutely no fulfillment in it. Part of that was a toxic workplace, but personally I also found no satisfaction in reading about how to make your Facebook posts go viral. It felt empty to me, and I got to see all the cool projects going on around campus.

I swear this is going somewhere! Because it all came together when a position for Audio Technician opened up, to digitize analog audio. I knew I wanted it instantly. I can’t explain why exactly, except that I was very drawn to the hands-on aspect of it and working with audio. I didn’t have any skills with analog audio, and even told my interviewers this, but the lab needed someone with archival skills to get a handle on all of it. I fell in love with it from day one. I feel like I’m bringing voices back to life when I digitize them. I bring out the reels or the cassettes from the vault, put them on our equipment, and then I’m working everyday to preserve the files. My official title is finally Audio Archivist, and I’ve expanded the work to go well beyond just the digitization. I love managing my own lab, working with patrons, processing collections, making our audio more discoverable. There are always problems and weird stuff going on, but the end product is always this lost sound of the universe brought back to our servers. It’s really addictive. We now have two digitization stations, and sometimes the reels are going backwards, so I don’t even get the chance to listen to a lot of it anymore!

I find audio to be deeply intimate; the podcast community is only now developing ways for listeners to share thoughts and feelings, so most of it has been consumed alone for me to ruminate over by myself. Someone’s voice is right in your ear, speaking only to you. Sometimes producers expertly use sound and music to enhance the experience. In archival audio, there’s an element of time travel to it—that you are in the room listening to a conversation that never imagined it’d be overheard. And listening to oral history is so much more profound than reading transcripts. You can hear the raw emotion coming through. Overall, oral history and audio always remind me that other people are living deeply, going through difficult times, and thinking strange or funny thoughts. I still love to read all the time, and love what my imagination conjures up. I also still really like movies, and getting the chance to see what other imaginations dream up. But audio bridges the two, and seeps into my brain in a way that I’m still imagining and feeling my own feelings but feel like I’m in the mind of the person speaking.

Image Credit: “Bancroft Library HDR” by John Martinez Pavliga. CC BY 2.0 via Flickr.

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Future predictions for stem cell research

We took some time to interview Shaun McCann, a man responsible for carrying out the first ever bone marrow transplant in Ireland, in 1984. Getting to know Shaun, we discussed his formative years, the risks involved in the early days of stem cell transplants, and the trials he has faced in over four decades of medicine. As the author of A History of Haematology: From Herodotus to HIV, we also asked about the specialty as a whole – defining discoveries, unsung heroes – and predictions for the future.

Can you tell us about your early years as a doctor?

I spent all of my adult life (after graduation from Medical School at University College, Dublin), working in haematology. The formative years of my training were at the University of Minnesota and the University of Washington, USA. I learnt to be a stem cell (although it was bone marrow then) transplanter from the late E. Donnall Thomas (a Nobel Prize laureate for stem cell transplantation) at the Fred Hutchinson Cancer Centre in Seattle. The best decision I ever made in these ‘early years’ was to marry my wife – who was a fellow medical student.

What made you decide to specialise in Haematology?

It’s hard to remember what made me decide to specialise, but I think it was the combination of a strong scientific basis combined with clinical medicine. I like to remember that every time you take a blood sample, you are in fact, taking a biopsy of a mesenchymal organ called blood!

You carried out the first ever bone marrow transplant in Ireland, in 1984 – can you tell us more about this?

In the 1980s, stem cell transplantation was not available in Ireland. However, my boss at the time heard a lecture from E. Donnall Thomas – and suggested that it should be. He formed a charity with a patient, the late Eugene Murray. Alongside a number of business men, they raised the money to send me to Seattle, and to fund the Stem Cell Transplantation Programme. After that, bone marrow, now stem cell, transplantation took over my life.

Image Credit: ‘A bone marrow harvest in progress’ from the Navy News Service (US Navy). Public Domain via Wikimedia Commons.

What were the risks associated with this new operation?

It was very stressful at first, as it involved persuading virtually all hospital departments to ‘come on board’. We were doing something against all medical rules – i.e. taking well patients and transplanting them because we thought their leukaemia would relapse. It was traumatic for staff and patients and unfortunately some patients died.

How was your work received at the time?

Because we were doing something new, and relatively un-tested, many people needed persuading. I did a lot of fundraising for a charity which supported all aspects of the transplant programme. This involved a lot of travel within Ireland and the consumption of many pints of Guinness. My outstanding memories are of raffling a heifer (a cow that has never had a calf) in a small Irish town, and sharing the singing stage with the late Liam Clancy of ‘The Clancy Brothers’ (a very famous folk singer in Waterford). The transplant programme was opposed by the Department of Health, and the hospital we were working at tried to stop the programme after the first two years because of the expense. The programme was saved after I launched a public campaign for its preservation.

Were there any difficult times in your career?

One of the most difficult (although also rewarding) periods of my life was when the Minister of Health asked me to run the National Blood Transfusion service in 1995 during the hepatitis C crisis. As the Minister said: ‘this was NOT a career move’ – but as my wife reminded me: ‘you can’t really say NO to a Government Minister!’ Seeing young patients dying from leukaemia, or as a result of complications from a stem cell transplant was always very difficult.

Your recent book details the longue durée of haematology studies. What discoveries have defined the specialty?

I would have to agree with Professor David Nathan of Harvard. I interviewed him for the European Hematology Association a few years ago, and he said that the invention of ‘automated cell counting’ by Wallace Coulter (an engineer), ‘combination chemotherapy,’ and the ‘genetic revolution’ are the three defining events in haematology. These in turn, allowed for greater precision, better treatment outcomes, and more productive research.

Image Credit: ‘Odetta and Liam Clancy playing together for Clonmel Junction Festival, July 2006’, by Junction Festival, CC by SA 3.0, via Wikimedia Commons.

Can you tell us about any unsung heroes?

I have always been fascinated with the history of haematology, and I still wonder why some people have never made it into the canon and others have. For instance, two undeservedly overlooked figures are Norman Bethune (1890-1939) who was very influential in blood transfusion during the Spanish Civil War, and Ibn al-Nafis (1213-1288) who described the pulmonary circulation hundreds of years before Harvey’s account in 1628.

Moving to the present, did your work have an impact on stem cell research today?

Our success led the Department of Health to provide funding, and there is now a state of the art unit in St James’ Hospital. Research I was involved in also resulted in the development of a test to determine the percentage of donor and recipient cells following stem cell transplantation (Chimaerism). The test we developed was used internationally.

In a completely different vein (no pun intended) I was struck at this time, by what I thought was a sense of isolation from the outside world – for patients undergoing stem cell transplantation. I teamed up with an artist, Denis Roche, who came up with the idea of a virtual window in patients’ rooms. I received a competitive grant from the Irish Cancer Society and together with a great team, conducted a large prospective clinical trial to measure its effect (as far as I know this is the largest trial of this type to ever have been undertaken). The result was positive, with reduced anxiety and depression reported, and we published the study in 2011.

What are you working on at the moment?

I spent the last five years running the undergraduate School of Medicine at Trinity College Dublin, where I introduced a module on Medical Humanities – a topic I am still very interested in. This was a totally different role for me, but thoroughly enjoyable. Now I work for the European Haematology Association teaching and carrying out educational podcasts. I wrote a book about wine a few years ago, which I hope to enlarge and insert a number of vignettes about doctors who make wine. My wife and I have a small house in Tuscany, so we spend most summers there (we have a good internet connection so we both can write) – sometimes with our eldest son, his wife, and two children.

Finally, do you have any predictions for the future of stem cell research?

I think we will eventually be able to do away with ‘conditioning treatment’ (currently involving several different chemotherapy drugs) and hopefully have good treatment for ‘Graft versus Host Disease’ (which only occurs after stem cell transplantation). However, I am always struck by the words of Niels Bohr (a Danish physicist who won the Nobel Prize in 1922) who said: “Prediction is difficult, especially if it’s about the future!”

Featured Image Credit: ‘Stem Cell, Sphere’, by PublicDomainPictures, CC0 Public Domain, via Pixabay.

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Why the Agartala Doctrine: offensive defense, not domination

Unlike the Monroe or the Gujral doctrine, this is a doctrine not named after a person espousing it.  It is named after tiny Tripura’s capital town, Agartala, which former Bangladesh foreign minister Dipu Moni describes as the “war capital of the Bangalee nation in 1971.” The Agartala doctrine is a proposed national doctrine that draws on Tripura’s long proactive history of handling its neighbourhood. It differs from both the US Monroe doctrine of dominance and the Indian Gujraln doctrine of unilateral magnanimity. Rather, it is based on the idea of “appropriate response” and has grown out of the line of action chosen by Tripura’s chief ministers from Sachin Singh to Manik Sarkar.  There is a surprising continuity in their policy, based as it is strict reciprocity of action.

Simply put, it translates to “If you’re nice with me, I’ll walk an extra mile to take care of you, but if you’re hostile, I can be just as difficult.”

Shorn of the academic mumbo-jumbo the intellectual elite often  inflict on the nation and end up confusing it, this is a doctrine that is capable of handling the policy confusion — policy paralysis, sometimes — in Delhi on how to handle neighbors like Pakistan.

If you accept the Agartala doctrine, Delhi has to follow a calibrated, nuanced policy of selective engagement with Nawaz Sharif who risked his seat and was deposed in a coup for challenging the army, with civil society, trade and commerce people, with educational institutions and the media.

Do your “Aman Ki Asha” with them. Do your “Aman Ki Asha” with them along the lines of the “Hope for Peace” campaign that Times of India initiated with Pakustan’s Jang media group some time ago.

But then India would simultaneously need to pressurise the US to force the Pakistan army to turn off the terror tap because they have leverage on the Raheel Sharifs and the Shuja Pashas.

By following the lead of Tripura, the current Modi administration would need to rebuild India’s capacity for selective covert action — it should be able to Sargodha with non-state actors to avenge Pathankot. If Mumbai is hit a la 26 November, targets in Karachi will have to be hit.

By following the lead of Tripura, the current Modi administration would need to rebuild India’s capacity for selective covert action – it should be able to use non-state actors to hit the Sargodha air base in Pakistan exactly like terrorists were used to attack the Indian air base at Pathankot. If there is a terror attack on Mumbai like on 26 November 2008, India should be able to use non-state actors like a MQM faction to hit military targets in Karachi.

What did Tripura’s first CM Sachindralal Singha have in mind when he pushed Nehru and then Mrs. Gandhi to back the Bengali struggle in East Pakistan? With separatist rebellions spreading from one Northeastern state to another, Singha told Indira Gandhi to hit back at Pakistan, using the Bengali irredentism that was surely snowballing out of control.

His feelings for fellow Bengalis in East Pakistan surely influenced his decision to push Nehru and then Indira Gandhi to back the Bengali rebellion, which he was sure about, but he was clear if Northeast had to be saved and the multiple Pak-China backed rebellions contained , the only way was to (use his words) “kick Pakistan out of the East.” That paved the way for Indian support for the Bengali nationalist struggle and the ultimate Indian intervention to create Bangladesh.

Spool forward two decades. Wracked by a vicious tribal insurgency, CM Manik Sarkar resorted to an unusually hostile trans-border covert offensive, using surrendered militants and Bangladeshi mafioisi to neutralise the rebel bases inside Bangladesh from 2001 to 04. He still maintains the deniability — he would rather credit all his counter-insurgency success to Bangladesh’s cooperation after Sheikh Hasina took over as Prime Minister. This is in stark contrast to the current chest thumping in Delhi over a single trans-border strike on rebel bases inside Myanmar. Tripura police could manage more than twenty such strikes inside Bangladesh on ATTF and NLFT bases and hideouts of its leaders from 2001 to 04.

Here was a small state fighting back on its own, using surrendered rebels and Bangladesh mafiosi. Not only did the Bangladesh authorities fail to get a wind of it, even Delhi was not told what Tripura police was doing. GM Srivastava would often say surprise was vital and could not be achieved if either Dhaka or Delhi came to know.

But now that Bangladesh is so friendly with Hasina in power, it is all hunky dory. The “appropriate response” is evident in the way Manik Sarkar got India to sell 100MW power from Palatana gas-fired power plant after Hasina helped by allowing oversized cargoes like transformers to be shipped through the Chittagong-Asuganj route. It is always give and take and Bangladesh has no stronger advocate of its interests in India than the shy Tripura Chief Minister.

In the Agartala doctrine, there is no place for bullying a smaller neighbour or attempted dominance like Monroe Doctrine, neither any unilateral magnanimity that characterises the Gujral doctrine.  Agartala Doctrine is all about reciprocity and it is the only way India can handle its difficult, sometimes volatile neighborhood.

Image credit: “Tripura State Museum” by Sharada Prasad CS, CC BY 2.0 via Flickr.

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Who’s really shaping the digital future?

The words ‘digital economy’ conjure images of young, tech-savvy entrepreneurs breaking moulds in a world where technology is disruptive. But could the reality be much more mundane and mercantile?

When Facebook released “Facebook at work” earlier this year, the social networking goliath laid a huge challenge at the feat of LinkedIn, a powerful incumbent that had until then dominated its corner of the market.

The market segment in question – ‘Social Software in the Workplace’ – was recently identified as distinct from the wider social media marketplace by well-known industry analysts Gartner Inc.

Together with the several other sub-markets of social media the firm has identified in recent years, at first glance this seems to emphasise the sheer unstoppable energy of markets for the future digital economy — with the proliferation of not only products but entire product categories.

But could this explosion of new segments have a different source? Dig a little deeper and Gartner’s role appears highly significant.

For more than 30 years, Gartner has been telling the business world what the next thing in technology is. Its analysis works by listing recognised players operating in a new field and depicting them in its (in)famous graphical ranking, the Magic Quadrant.

Image credit: NEC-conference-35 by NEC Corporation of America. CC-BY-2.0 via Flickr.

The Magic Quadrant is central to the firm’s success and a large part of how it’s managed to retain its 30% share of the $4 bn annual market for industry analysis. But while it may be described as amongst the most important and influential pieces of business research produced today, it has (at least) one serious flaw.

Having used the system for more than three decades, Gartner knows just the right number of vendors to depict to construct a graphic decision-makers find useful — somewhere between 10 and 25.

This ‘beautiful picture’ — as the firm’s analysts have taken to calling it — gives CIOs just enough information to gain an ‘at a glance’ understanding of what’s going on in the market without rendering further advice from Gartner redundant.

The trouble is, what happens when there are hundreds rather than tens of players in a given segment? How do they map it then? As one of the firm’s analysts recently explained “…graphically you can, […] we’ve done it, you have 100 dots on the chart but its unreadable. It is just garbage.”

So when they were faced with a Magic Quadrant for ‘Social Software’ which looked ‘too cluttered’ to be a meaningful analytic tool for CIOs, the analysts decided they’d break it into smaller pieces.

Thus three new market segments ‘Social Software in the Workplace’, ‘Externally Facing Social Software’, and ‘Social CRM’ were born. And with them came three more aesthetically pleasing, marketable Magic Quadrants.

Let’s be clear in what we’re saying here. Some of the most important and high profile market segments of the digital economy were not created as a simple result of technological innovation or product differentiation driven by firms stretching boundaries.

These prosthetic markets don’t describe real, organic relationships between vendors and adopter communities. They were created by analysts to compensate for the limitations of Gartner’s signature research product.

We don’t know exactly how many of its 350 or so Magic Quadrants are prosthetic, but the fieldwork we’ve conducted during the past ten years suggests it’s likely to be quite a few.

Nor are Gartner alone in the practice. Its main rival Forrester also configures new markets around the constraints of the ‘Forrester Wave’ — its depiction of around seven to 10 vendors. And given there are now as many as 700 similar firms producing influential research on the digital economy, it may be these prosthetic markets are more prevalent than we think.

These interventions aren’t trivial. They ultimately shape the process of innovation and product development that constitutes the digital economy.

Thankfully many of the savvy tech firms seem to recognise this. But with Facebook at Work, Facebook could easily end up losing out if it isn’t careful.

Not only is its entry late, it seems surprisingly unaware its new ‘Social Software in the Workplace’ battleground has in many respects been by Gartner’s analysts, meaning its dynamics could be very different to an organic marketplace.

It is clear industry analysts are making their mark on the digital future in ways most commentators have yet to fully realise. What is most remarkable is not only how quickly these firms have been able to establish influence over markets and tech vendors, but on what this power appears to rest.

The digital economy is being shaped not simply by the supply and demand of traditional market economics. But it’s also being driven by — as one former analyst recently suggested to me — what needs to be done to keep industry analysts ‘in the game.’

Headline image credit: Facebook Connections by mikecogh. CC-BY-SA 2.0 via Flickr.

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Barbie evokes suffering in girls, scorn in teens and finally gets reshaped

Scholars have long documented the significance in young people’s lives of popular culture ideals. These ideals can come in many forms including fashion models, singers and actresses, video game characters and toys. In the case of dolls, research has revealed that girls form a relationship with favorite dolls in which they develop ideal selves in line with the characteristics of the doll. The dolls are a socializing agent, bringing in the ideals of the larger society to the girl’s private life.

A number of studies have documented the perception among younger girls that Barbie is an ideal, that “it’s good to be Barbie,” and that she commands the good opinion of others. Young girls aspire to be like Barbie. In a study published in the journal Developmental Psychology, girls aged 5 to 8 were exposed either to traditional Barbies, to the Emme doll (size 16) or to no dolls (control). Results indicated that these little girls exposed to Barbie had lower self esteem and poorer body image than those in the comparison groups. These results are troubling because poorer body image is related to a host of issues such as disordered eating and weight cycling.

These same scientists report that the negative body image effect they observed in the younger girls went away in older girls, prompting the authors to conclude that Barbie is aspirational for the littlest girls, but in adolescence she becomes an object of some animosity. Kuther and McDonald interviewed adolescents and found similar results. In fact, the reaction of the adolescent girls and boys these scholars interviewed may surprise you. In contrast with the seriousness with which the younger girls attached to Barbie, the older girls and the boys actually turned on Barbie. Although as younger children, they engaged in more traditional pretend play, as older children the boys and girls showed a tendency to engage in what the authors called “torture play” and “anger play” with Barbies. This included hitting Barbie against the wall, crashing Barbie and Ken into walls, stabbing them, cutting their hair, burning them and leaving them out in the snow. The children experienced a lot of this play as humorous and as rebelliousness against the societal perfection epitomized by Barbie and Ken. Girls made comments like, “They are all perfect and it’s just too much,” and “they should make a fat one.”

These teens are not the only ones not comfortable with Barbie’s looks. For years now, there has been a call from some of us asking for dolls that our little girls play with to look more like we do. Other companies have started to respond to that call. For instance, Lammily describes its dolls as the first to pattern the body shapes after actual average human proportions. The Lammily dolls include more true-to-life colors, faces, and clothes. Their slogan is “average is beautiful.” The Lammily doll was brought to life via a successful crowdfunding campaign in 2014. Their website features videos of little girls talking about how they see the traditional Barbie and how they see the more realistic dolls, with the upshot being that they see more of themselves in Lammily and think she looks more approachable and like a regular person.

There have been other analyses and criticisms. For instance, artist Jason Freeny created an anatomical sculpture of Barbie’s body that showed that her digestive system would not function properly and that she’d be classified by doctors as underweight. Her 5’9” height with 18” waist would not be far from the Guiness Book of World Records holder for the world’s smallest waist, which is 15”. The average American woman’s waist is close to twice that size at 35″.

In 2015, Medical Daily reported that, “Barbie’s body measurements set unrealistic goals for girls; sales plummet.” Medical Daily quoted Mattel CEO Brian Stockton as saying that their sales were dropping rapidly and they were not selling enough dolls. They believed that the landscape had changed and that they were not keeping pace.

So, teens were angry at Barbie, kids were feeling badly in comparison to her, and there was mounting discomfort and even outrage. This March, Mattel releases a new line of Barbies. There are four types of these “fashionista” dolls: curvy, petite, tall, and original. The “curvy” dolls look more like Lammily – resembling more average proportions. The petite, tall, and original dolls are all thin, but they do have more realistic features. They reflect a look of more ethnic diversity not only in skin tone, but also in eye color, hair color, and hair texture.

Some have reported a positive reaction to these new Barbies. Others have called for more change – like Bustle fashion and beauty reporter Georgia Jones who asks where the “fat,” “blind,” or “trans” Barbies are. As a mother of an 11-year-old daughter who has thick, red, curly hair, I am happy that she now has a doll who looks like her. Mattel or other companies may not really care about my child – they may just care about profits. I assume they would make a “fat,” “trans,” “blind” doll if they thought it would make them money. Regardless, as I finish this article, I am going to buy my daughter a doll with beautiful curly red hair like her own and I am going to feel good about doing that.

Featured image credit: Girl looking like doll. (c) Svetography via iStock.

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