Sunday, 29 April 2012

A promise...

If you've been reading my blog for a while, or if you know me in real life, it can't have escaped your attention that I'm very passionate about my parenting choices and the philosophy behind them. I have often heard it said that it is much easier to preach than to practice, and I agree this is almost entirely true of parenting - even for those who have done this, that and the other. Looking back with rose tinted glasses at my journey through intervention-free birth, breastfeeding, bed-sharing, gentle discipline etc. I'm very certain I've edited out the parts where I doubted myself, where I maybe even thought I was a fool for not doing what the books said in the name of maintaining some semblance of a pre-baby identity. 

And so here is my promise: as I am currently 38 weeks pregnant with baby no.4 and have every intention of following all this stuff I blog about and talk about incessantly, I will also endeavour to keep as honest a diary of this experience as I can. I will not hold back on talking about the difficult parts, I will not censor myself and romanticise what I do in order to make it seem more appealing to others. This may mean that sometimes I write uncomfortable truths - uncomfortable for myself to admit in a public domain and for others to read without judgment. I talk a lot about transparency and the need for expectant parents to have realistic ideas about life with a new baby, and so I offer up my no-holds-barred, warts 'n' all stories. 

Can I actually practice what I preach and embrace it as joyfully as my memory likes to tell me I did previously? We shall see....! 

Friday, 27 April 2012

My desire to be well informed...

To follow up on last week's post about making informed decisions, I had to share this picture sent to me by my stepfather. I can identify with it 100%!

Monday, 16 April 2012

What IS an 'informed opinion' anyway?

If there was a 'Curious Orange drinking game', I would have to insist that rule #1 consisted of downing a shot every time I use the words 'informed choice/opinion/decision' or 'evidence-based research'. These two ideas form the backbone of pretty much everything I waffle on and on about in this little corner of cyberspace - but what exactly do they mean and just how do I propose that everyone achieves this standard?

A truly informed opinion (shot #1) is only that if you're confident that you've looked at a particular issue from all available angles, considered the merits and flaws of the evidence on both sides and reached your conclusion based on an accurate summary of the whole picture. Easy, right? Not necessarily. Firstly, you need to know where and how to access the research, how to tell 'good' information from 'bad' information and precisely what you're looking at when deciding whether or not a piece of research is complete and utter bobbins. 

A really good place to start with information is the popular media - that might be the newspapers, television programmes, blogs, or even Twitter and Facebook. 

A practical example - last month, Twitter and Facebook were dominated by the viral YouTube film "Kony 2012" promoted by the Invisible Children organisation. A quick summary for anyone who somehow missed it: Invisible Children is an American charitable organisation whose mission is to bring to justice the leader of the Lord's Republican Army in Uganda, a man named Joseph Kony who is held responsible for the kidnapping and enslavement as child soldiers of 30,000 children over the last 26 years. The film that circulated formed part of their latest campaign to spread awareness of the issue and raise funds for their cause. The video has been watched more than 90million times on YouTube and is now a household name at least throughout the UK and USA. 

However, some other media quickly accompanied the film and Invisible Children campaign, much of it negative publicity about the organisation's ethical ongoings, critique of the film's content and message, and attempting to draw attention to the alternative movements working with the same issue over the previous years. 

So how does this come back to this idea of informed opinions (shot #2)? The basic question is "can you have learned everything you need to know about the history of the LRA in Uganda, the Invisible Children organisation (and whether they're a charity you want to support), the solution to the problem and the alternative perspectives on it PURELY by watching that 29 minute YouTube video?"

Quite simply, the answer is no, you can not. The whole story is complex, not least because of the time span involved, but also the intricacies of the politics behind it, the ethical criticisms of the group behind the film, and the ongoing work from well established alternative groups. The film is asking you to spread the story to your friends and family and encourages you to donate money by buying their campaign paraphernalia. If you do so as a reflex reaction to watching the film, you have not made an informed decision (shot #3). If instead you have treated the film as a starting point for educating yourself, and gone on to read other news articles, coverage from well-established and respected organisations like Amnesty International, researched the claims of unethical business conduct by Invisible Children and THEN decided what to do about sharing the video and/or donating money THEN, my friend, you have reached the golden standard of having an informed opinion (shot #4 -  feeling tiddly yet?)

Ah, I hear you say, but it's not always that easy. What about the more complex issues, like making a judgment call on medical treatments like vaccinations? All that research is difficult to access and/or impossible to decipher!

Yes it can be, if you don't know where to start. Again, a good place to start with accessible, easy to digest information is newspaper articles, blogs like this one and talking to your friends about their points of view. One thing to always, always, always bear in mind is that all these sources of information will contain an element of bias, some may even have a decided agenda. You will not find a balanced assessment of the to-vaccinate-or-not-to-vaccinate argument on an anti-vaccination website or blog. Neither will you find it on a pharmaceutical company's web page. It would be like asking for an impartial discussion about immigration from the Daily Mail! Would you buy a toaster purely based on the description on the manufacturer's website, or would you read the reviews from people who'd bought it, cross-reference that with reviews in Toasters Weekly (yes, I made that up) and THEN pick a model to buy?

So how do you find the 'good' information? Google Scholar is a really handy tool for this. Never heard of Google Scholar? Here's how to find it:

1) Go to your friendly, local Google home page and click the "More" tab

2) Scroll down the page and select the "Scholar" option

3) Type in whatever search terms you're looking for (you might have to play around a bit to find useful results) then hit Search

4) Ta-daaa! Articles relevant to your search keywords will pop up. The red arrows point towards versions that should be fully available without having to try and find a helpful academic type who happens to subscribe to whichever journal you're looking for. Even those that aren't available in full are worth looking at, since the abstract and summary should be free to look at and contain helpful information.

This is a really neat way to get your hands on the original studies that people are on about whenever they say "studies show" and "research suggests". If you're reading an opinion piece and someone uses those words at you, don't feel afraid of asking the question "which studies?" and then going off to read them yourself. Don't let someone else make your mind up for you when the raw data is within your reach. 

So now you've found yourself a bunch of journal articles and academic studies, how on earth do you make sense of them?? I said earlier that looking at abstracts from articles can help, but that is gibberish if you don't know what an 'abstract' (in the non-Picasso sense) even is. 

Your average academic study published online will be broken down into several sections. The first one will be a summary of the key aims of the study, what the researchers expected (or hoped) to find, the major findings and possibly a summary of the methods they used to gather their data. THAT is the abstract. Skimming through that will give you a brief idea of whether or not that piece will be of any use to you. From there, you should find a section of background information, summarising what is already known about whatever subject from pre-existing studies; an in-depth description of the methods used to gather and analyse the data (this bit is important and I will come back to it); a load of statistical gubbins and graphs that nobody really understands in the Results section, and then finally a summary and/or conclusion in which the researchers will discuss their findings and how it relates to what they initially expected to have as an outcome (aka their "hypothesis"). Here, they may also discuss the shortcomings of the study and further areas for consideration. THAT part will be very important when you are evaluating the study's usefulness.

Alright, quick recap: you now know where to find articles and research, and what you're actually looking at when faced with a scary piece of academia. So how do you know if what you've just read is complete nonsense? This may come as a surprise but just because something is published in a journal, doesn't automatically mean it's "good" information. The Lancet published a now infamous study linking the MMR vaccine to autism, though that study has now been disproven in its entirety and the doctor behind it has been struck off the medical register. 

There are two basic ways to decide if a study is any good. Firstly have a look at responses to the article; few studies are ever published without the researchers' peers responding with their own critique and ponderings on the matter. Most online editions will also have a section which shows you other studies which have referenced the one you're looking at, and should give you an idea how well received the research has been by other academics. If the other specialists in the area absolutely pooh-pooh the piece, chances are it's not a very reliable source of information for you and you should move on.

Secondly, and requiring a little more practice, is giving the details of the study - specifically the methods used by the researchers - a really good going over. Look at the sample sizes - you know those stupid shampoo adverts that claim to revolutionise hair-washing and then say at the bottom of the screen that they only surveyed 30 women? That is a terrible sample size. The holy grail of academic studies is gathering a sample which accurately represents the population. Namely, the sample needs to be BIG, it needs to have been selected from all areas of the country and a good cross-section of socio-economic and ethnic groups. If you think the study you're reading uses too few participants for the results to tell you something that could stand as a general statement about everyone in the country, then that is one big thing to remember when you're deciding how far to let it inform your opinion (time for another shot, it's been a while!). 

There are other elements to consider, like evaluating the methods used to gather the data - questionnaires posted out to study participants are generally far less reliable than focus group discussions or interviews. Even statistical data has its flaws ("There are three kinds of  lies; lies, damned lies and statistics" - Mark Twain) but evaluating that takes a lot more practice and knowledge than I have! That is the sort of area where I prefer to rely on the responses from other academics to a study!

So there you go! Hopefully you're now equipped with the basic tools to start challenging people who make statements you don't agree with, but who back themselves up by saying "ahh, but studies show...".  Moreover, I hope that it enables you to bring yourself up to speed with all the latest research into this, that and the other that is important in your life. If you're a parent agonising about whether or not to vaccinate your child, a pregnant woman wading through the breastfeeding/formula feeding quandry, a nerd trying to decide whether to buy a Macintosh computer or a Windows one - whatever the issue, if you've read this and use it as a starting point to give yourself an informed opinion (that's shot #6 right?) based on current research, then I'm happy. 

As a closing note to the 'Curious Orange drinking game', I would like to offer up this statement as the Royal Flush:

"We do the best we can, with what we know to be true at the time"

When your decisions are based on a thorough understanding of the whole issue, when you can confidently say "I decided that after considering all the options and evidence" you will feel one hundred times better for it, because you KNOW all that is to be known. Nobody can account for the things we haven't discovered yet, but when you've really educated yourself about an issue, it's so much easier to be confident in the choices you make. Naturally this doesn't mean that everybody's opinions and decisions will suddenly be uniform! Knowledge is fluid, as is the context in which we as people process it. There are a myriad of external influences that go into shaping someone's decision-making process and the way that one person receives and understands a piece of information can differ wildly to another person. The purpose of making an informed decision (I've lost count of the shots now) isn't to make everyone think the same way, but to endow each person with confidence in the things they choose to believe and do.