The ineffectiveness of employer wellness programs and the importance of randomised trials

New York Times

07 August, 2018


NEW YORK — The gold standard of medical research, the randomised controlled trial, has been taking a bit of a beating lately.

An entire issue of the journal Social Science and Medicine was recently devoted to it, with many articles pointing to shortcomings. Others have argued that randomised controlled trials often can't address the questions that patients and physicians most want answered. I recently wrote about the limitations of the method in studying effectiveness, which is what we care about in real-world situations.

But the randomised controlled trial remains a powerful tool. It's still, perhaps, the best method for conducting explanatory research. In past articles, I have recounted numerous times when hypotheses from observational studies, those based solely on observations of particular groups, have failed to be confirmed by a controlled trial.
Perhaps the greatest strength of the randomised controlled trial is in combating what's known as selection bias. That occurs when groups being studied (intervention and control) are already significantly different after they are "selected" to be in the intervention or not. One of the most elegant examples of why we need such trials came recently in an examination of employer-sponsored wellness programs.

Singapore offers a model for running sovereign-wealth funds well

Excerpts from The Economist's "How to reform the world’s biggest piggy-banks."

 On Singapore's approach and achievements:

Relative to the pack, Singapore is doing well. Its funds have assets of about $770bn—the exact figure is secret. They have made an annual return (in dollar terms) of about 6% over the past two decades, slightly more than an indexed portfolio with two-thirds of its assets in shares and one-third in bonds. Their income pays for a fifth of government spending. The funds are free of scandal and enjoy a solid reputation both in China and the West.

 

There is a clear division of labour. The central bank runs $290bn of liquid reserves. A national piggy-bank manager called GIC runs an estimated $250bn, long-term, diversified foreign portfolio. Then a holding company, Temasek, has the rest, keeping a quarter of its portfolio in stakes in Singaporean firms. It also makes punchy bets abroad.

 

US-China Trade War - China's Missteps

[China response to Trump - their "misunderestimation" of Trump's... stupidity.]

China’s two big mistakes in trade war may lead the country into middle-income trap

After misjudging Donald Trump and misjudging the alliance between Washington and Brussels, Beijing needs to act fast, writes Zhang Lin

Monday, 30 July, 2018

South China Morning Post


Beijing has made two mistakes in the trade war with Washington, for which China will pay a heavy price.

The first is that the Chinese leadership misjudged US President Donald Trump. Beijing wrongly thought that Trump was just a businessman, regarding his trade war threats as bluffing ahead of the midterm elections. But in fact, Washington had already made clear in its National Defence Strategy report – released months before the dispute escalated – that the US would no longer tolerate Beijing’s trade and economic practices. The message was that Beijing could not earn money from the United States while at the same time posing a challenge to it.

Beijing’s second mistake was that it misjudged the alliance between the US and the European Union, and had hoped, unrealistically, to form a united trade front with Brussels against Washington.

Trump finally feels gravity’s unforgiving pull

By Joe Scarborough
 
July 26 2018

The Washington Post


Like generals preparing to fight past wars, politicians constantly construct Maginot Lines to defend frontiers against dangers that no longer exist. For these self-involved politicos and pundits, the last election always seems to be the one that signaled the end of history.

Barry Goldwater’s crushing defeat in 1964 was widely believed to be conservatism’s last stand. The New York Times’s James Restondeclared that the vanquished GOP nominee “has wrecked his party for a long time.” The New Yorker similarly proclaimed, “The election has finished the Goldwater school of political reaction.” And none other than James MacGregor Burns predicted that Lyndon B. Johnson’s landslide “would surely usher in a liberal epoch.”

Republicans would win the White House in six of the next seven presidential elections. What would eventually become Ronald Reagan’s revolution was launched two years after America’s most esteemed journalists declared conservatism dead.

China’s Belt and Road Initiative is falling short

By Financial Times Editors

TODAY

31 July, 2018


China’s Belt and Road Initiative is commonly seen as a programme to fund and build infrastructure in some 78 countries around the globe.

It is also Beijing’s bid to reshape the world by offering an alternative developmental vision to the United States-led world order.

In the Chinese context, it is the linchpin of President Xi Jinping’s grand design to create a “community with a shared future for mankind”.

As such, the Belt and Road (BRI) is officially intended to showcase an open, inclusive form of development which benefits all countries that participate.

To criticise BRI, therefore, is to censure a rising China’s proposition to the world.

Yet there is growing evidence that the infrastructure projects are falling short of Beijing’s ideals and stirring controversy in the countries they were intended to assist.

British farmers worry: Who will pick the fruit after Brexit?

By William Booth and Karla Adam

July 29, 2018

Washington Post


HAREWOOD END, England — After a dozen futile calls to big farms, agricultural lobbyists and labor contractors, we finally found him.

The rarest of the rare, the British berry picker.

Meet Max Hughes, a 20-year-old university student and history major, who is spending his summer harvesting blackcurrants at the Snell family farm in Herefordshire. He rides in the back of a harvester all day, standing beside a Czech migrant and a couple of sun-bronzed Romanian guys, who know very little English.

“No matter, you can’t hear a thing they say over the noise,” Hughes said, gesturing toward the wheeled harvester beside him. Its vibrating metal fingers shake the currant bushes and bring the tart berries via conveyor belt to the sorting table, where Hughes and his teammates discard the leaves, twigs, slugs and occasional mouse — whatever you don’t want to see in a frozen fruit pack.

MH370 The Final Report (July 2018)

Spoiler alert: The conclusion is that there is no conclusion.

Here is the 400+ page report. On page 443, the conclusion is... they are unable to determine the cause of MH370's disappearance.

Here is a 9 minute video on the findings of the report:

DJ's Aviation does not go into any speculation, and respectfully reports the content of the report, and keeps his opinion (if any) out of his commentary, and does not cast aspersions on the Pilot's integrity or imputes any felonious intent or motivation.