Posts by James Green
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Hmmm. I don't know if they do quite what I said. They are 'vortex generators' second last pic on this page. And according to the guy speaking they flick the wind and snow right over the hut, although that's not entirely how their function is described on this page. I think there is/should be some sort of interesting aerodynamics playing to be had.
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I think it depends on just how clever the finalised design is. I was at an Antartic Heritage Trust thing recently, and they had some small wind deflectors that were capable of flicking wind and snow right over Scott's Hutt at Cape Evans. I'm sure their use would be more complicated in a built up space, but that sort of thing seems like it should increasingly become a part of design.
(sorry, unable to find a link to a picture of one. They look like a 2m side length triangle attached in a horizontal plane to a pole).
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I like it, but it does kind of remind me of the Simpsons episode where a screwed up letter from Marj inspires Gehry though...
I'm kind of hopeful that Otago's campus Masterplan is going to cook up interesting rain and weather scheming.
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Hi Craig, thanks for not giving me the benefit of the doubt and jumping straight down my throat, it really made my morning.
What I thought I said was that there are several types of 'adequate' treatment that were withheld, including cone biopsy and hysterectomy. Cone biopsy is apparently done under general anaesthetic, so I assume its not entirely minor, but it does allow women to still have children etc., and is certainly not as radical as hysterectomy. However, Bryder mostly talks about hysterectomy, when I assume quite a lot of them may have only had a cone biopsy for treatment. She made no mention of any figures involved, so I'm certainly not saying she was pulling anything out of her arse. I am suggesting that she overemphasises the most invasive of a continuum of treatments. Of those McCredie et al (2008) in the Lancet Oncology article who were considered to be treated adequately, 33% of those women had a cervix amputation or hysterectomy. Almost all of the remaining 2/3s had a cone biopsy.
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Just a few more thoughts as I've had a chance to digest on the walk home and while cooking dinner.
I thought (contrary to some others here), that the Kim Hill interview was pretty fair. She mostly listened, and some of the things she pushed on I think were fair enough.
In particular, given that Bryder's argument revolves around her conclusion that there was no consensus at the time, I'm surprised that she was very slow to comment on whether she thought there was consensus now, and kind of implied that she thought it better to defer to experts. In contrast, the experts (including Charlotte Paul) seem pretty clear that Green was defying what they considered consensus. Also, I wonder whether Bryder's finding of lack of consensus reflected the fact that she was working in the Oxford library and that those who were disagreeing were British.
Bryder also makes quite a lot of the fact that Green was denying them an invasive treatment which would impair their child-bearing ability. However, I think she exaggerates the proportion that received hysterectomy in the interview. She also claims that a cone biopsy is quite invasive, but I can't comment on that.
Finally, in terms of the 'experiment', apart from the smoking gun mentioned above, various researchers have had very full access not just to Green's patients, but all patients from the period. I'd assume they would have noticed if there was no appearance of Green's treatment not being different to other consultants.
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So I've just finished the interview. I think the extent to which Bryder is right or wrong ultimately depends on the view of what the medical consensus was at the time. It seems Bryder is arguing that even at the time of the Cartwright enquiry that while there was a more established consensus in New Zealand, there was more debate internationally, which means that being judged by the international standards of the time, what he was doing was yet to be proved wrong.
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Oh, in case my Cluedo reference isn't clear, by "I", I mean Dr Williams, and the those accusations seem like a prima facie case of experimentation.
In unrelated news, my dictionary confirms my belief that Bryder is pronouncing 'in situ' rong.
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Finally, on experimentation, it would have been interesting to hear Bryder address this:
"In 1971, Dr Stephen Williams, Pathologist-in-Charge at National Women's Hospital, wrote to Dr George
Wied in Chicago, USA
‘It is unfortunate that our colleague (Green) should have developed an almost obsessional view about the natural history of carcinoma in situ of the cervix, and there is no doubt that his emphatically expressed attitude, coming, as it does from an influential department, has brought confusion to the local scene. I believe that he is sincere, although perhaps bigoted, on this subject. He [Green] bases his conclusions on the statistical interpretations and extrapolations of a smallish series of cases, the composition of which has been questioned. It appears that in a number of cases where invasion has clearly followed the original in situ diagnosis, he has reviewed the histology himself (although he is not a trained histopathologist) and has removed them from his series on the grounds that they were invasive carcinomas from the outset.'In summary, I accuse
Professor Green
in the 1971
with teh statistics
of cooking teh data.
That doesn't sound like an experiment to me. Oh wait... -
Just started listening to a bit of Bryder's interview now.
I think there are a couple of issues there for me.
*Bryder specifically mentions the impact of child-bearing on treatment decisions (particularly emphasising that patient 'Ruth' went on to have 4 children). Thus, if one were to explore the impact of non-invasive treatment, you would expect a lower rate of invasive treatment in younger women. However, the proportion of inadequately treated women does not vary with age.*Bryder also talks of the lack of consensus about treatment. However, Green was wearing a lot of criticism for his views and running against NZ consensus by 1970 (various quotes in Jones & Fitzgerald). Importantly, according to that article, his practice was running counter to others in the same hospital. It's an interesting question in medicine as to what point do doctors get that their pet theory is wrong in the face of changing evidence (see also: John Money). However, Bryder argues that there was still debate elsewhere (esp. in UK)
*Bryder is also big on the "there were no groups". However, there were, because his colleagues in the same hospital were doing something different. He was experimenting, in the 'experimenting with drugs' sense, where there is no control condition.
@ChrisW -- I'm not sure "theoretical" was a put-down. Heslop's article had 1 reference compared to 50 in the other paper. Heslop was also advancing her own theory grounded in her own experience, as opposed to using quotes from people involved in the debate.
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Charlotte Paul, in the article Hilary mentions above, notes the contribution of one of Green's contemporaries, discussing what clinicians of that era knew about science. It talks both of a relatively poor grasp of science, the isolated status of clinicians, and an exhortation by their lead educator (Hercus) to do research.
It was, however, I think, as you deduce, the idea that he had a particularly idea, and that he chose to collect data in support of that idea, which would make it unfortunate research.