## Wednesday, 27 February 2013

### Oh, what's the point?

I think this is one of the most interesting things about the Italian elections. In the following, I've listed the main parties. There are 12 (you could include some more, but I have tried to use the official data from the Italian Home Office and kept only those with a seizable proportion of predicted votes).

1) Partito Democratico (Democratic Party)
2) Sinistra e Liberta' (Left and Freedom): Not present in 2008
3) Centro Democratico (Democratic Centre): Not present in 2008
4) Popolo della liberta' (People of Freedom)
5) Lega Nord (Northern League)
6) Fratelli d'Italia (Brothers of Italy): Not present in 2008
7) Movimento 5 Stelle (5 Star Movements): Not present in 2008
8) Scelta Civica con Monti (Civic Choice with Monti): Not present in 2008
9) Rivoluzione Civile (Civil Revolution)
10) Fare per Fermare il Declino (Do it to stop the decline): Not present in 2008
11) Partito Comunista dei Lavoratori (Comunist Party of Workers)
12) Forza Nuova (New Power): Not present in 2008

There are a few things that actually strike me:
1. I am not sure that there are many more countries where it is necessary to keep track of at least 12 parties as the "main ones";
2. I know I've said this before, but just by looking at the parties' names, one really should give up and forget about any serious political argument;
3. Out of the "main" 12 parties, more than 50% did not take part in the previous general election (2008) $-$ although in many cases, the people who are currently in those "new" parties were already running for office either in other parties, or effectively in the same party which just happened to have a different name, at the time;
4. Interestingly, the votes cast by the Italians living abroad (including yours truly) shows a completely different picture: the Democratic Party is the clear winner and Scelta Civica (led by the former PM Mario Monti) gets nearly twice as much as compared to the votes they got from Italy.

I am not sure what will happen next. In fact, I don't quite know what to expect. Amusing times (may be).

### Culling vs Vaccinating?

I've blogged about this when I saw Christl Donnelly's talk at the UCL Symposium, last year (in a nutshell, the idea is that badgers are potentially responsible for infecting cattle with TB; thus "reducing the chance of contact" between cattle and badgers would reduce the number of infected cows. NB: Cows infected with TB need to be slaughtered, which also has a clear economic impact).

Apparently, the UK government has now decided to pilot badger cull in selected areas of England. But: despite the best effort of the statisticians involved (and Christl was very clear in explaining how difficult was for them to design the trial), the evidence was still not completely conclusive as to whether the cull may produce benefits.

Last year, the government delayed the decision in order to sort out licensing conditions, which are now met. But, as far as I can see, in the meantime nothing has changed in terms of the available evidence. The RSPCA are vehemently protesting, arguing that the way forward is vaccination for badgers (and, in the future, when the bovine vaccine is ready, for the cattle as well), not culling.

Of course I'm no expert, and the issue is quite controversial. But perhaps, given the inconclusive level of the statistical evidence available, it would be good to trial both possible strategies and re-assess the decision-making process when more data on the impact of vaccination are available.

I think I wrote it in my original post already, but I can't help but thinking that this problem would benefit from a proper decision analysis complemented by the evaluation of the expected value of information.

## Wednesday, 20 February 2013

### Organic cannabis

Yesterday I went to the kick-off meeting of a grant I'm involved in. I think it's quite interesting for a couple of reasons: first the content matter.

The idea is to see whether an already existing drug can reduce dependence on cannabis. Cannabis is effectively made up by two components: one (THC) is the substance that gets you high and stoned (and, incidentally, yes: it can lead to psychotic episodes); the other (CBD) is actually much less harmful (in fact, the main clinical hypothesis is that it's beneficial, at least for users with addiction problems).

Now: "industrial" cannabis is mass-produced, typically by criminals, using massive exposure to light. On the one hand, this increases production by many-fold; but on the other hand, too much light destroys all the "good" CBD. So, the reason why cannabis is addictive and potentially not-so-good for you is that most people buy the equivalent of mass-produced Tesco not-so-much beef burgers, while if they bought the organic stuff that Hugh Fearnley-Whittingstall grows in his garden (that's still a metaphor $-$ I don't mean to imply that HFW is a junkie!) they'd be all fine...

From the more technical point of view, I think the study it's interesting because we'll use a Bayesian adaptive design, which will allow us to look at the data (on 3 active dosages and placebo) at several interim points. Based on the predictive distribution that each is the most effective, we'll (hopefully!) get to the point where the others are dropped and the best one is tested against placebo. In addition to that, I managed to include an element of quality of life in the study, so that we could give potential indications on cost-effectiveness too. Should be fun!

## Monday, 18 February 2013

### Fizzy tax

The Academy of Medical Royal Colleges has just put out a set of recommendations to tackle the obesity crisis in the UK, where "1 in 4 adults are classified as obese" $-$ as always, numbers like these are tricky to take at face value and it would be helpful to know more about how they are estimated and what differences are within the overall population. Still, the UK is estimated as the 15th country with the highest average BMI in the world.

I think it's interesting that one of the actions proposed by the document is the introduction of a tax to increase, by up to 20%, the cost of sugary drinks. This finds me very much in agreement and I have ranted about this already; surely the effectiveness of such a policy needs to be carefully addressed and evaluated using empirical evidence (and of course cost-effectiveness methods can be easily brought to bear in this case). But it is obvious in my mind that in the face of a clear and well documented health risk, recent governments have not done all in their power to limit the impact of the problem.

## Monday, 4 February 2013

### ... and we're back!

To be finally back from Mali is kind of weird. It's good, of course. In fact it's great, because I think we were all ready to be back to our more "normal" life. But it's also strange, because it's being such an amazing experience.

Not just because of XY, although of course he's the star. I suppose it doesn't have to be like this (perhaps it's even unlikely to be like this!), but it's incroyable that we've started this journey together with people we barely knew, who by the end have become friends for life. May be for XY and the other two babies it won't be the same and they won't feel like this for each other. But in a sense it doesn't really matter. This is not necessarily about them, just the 6 of us, I think. And the many other people we met in Mali, who we didn't even know when this all started, but share the same special place for us, now.

It feels strange to think of the girls at the check in desks at the airport in Dakar, last night, who were incredibly nice to us, because they thought it was great that we were happy that our babies had la même couleur que leur peau. And that the nanny who spent the time of a dinner with them, cried her eyes out when she had to say goodbye.

It's odd to think of all the frustration for the malfunctioning of the bureaucracy and at the same time of the kindness of the people at the Italian embassy in Dakar, who went way, way beyond the call of duty (the Chief Counsellor and his wife even had us for dinner, on a Sunday) to help us out.

It's definitely strange to think that we've lived for the past month and a half in a country at war. It's strange because we've never felt threatened or in real danger where we were; but since the situation in the North of the country got worse about a month ago, so did many other things, even in the capital. I suppose I hadn't thought about this at the moment, but of course the immediate effect of the war has been to increase the price of many basic goods (eg gas, oil and $-$ probably not as much $-$ food). And the indirect effect of this has been to exacerbate corruption, making everything much more difficult to work.

It's weird to realise that I now (nearly) understand and accept excuses for things not working, that at first I thought were outrageous. I guess it's difficult to accept that you can't have a passport done because tomorrow people aren't working to celebrate the Prophet by eating mutton all day long, and so much that they need to take the next day off sick. But for some strange reason, it makes sense when you're there...

Now Marta and XY are in Italy dealing with the relatives and the final bit of (hopefully much smoother) bureaucracy, while I had to come back home to go back to work (and come to think about it, it's really, really nice to look back and see how brilliant and supportive the people in my department have been). Right now, the plan is:

1. try to climb the mountain of emails in my inbox;
2. take all the stuff out of the suitcases;
3. prepare my lecture for tomorrow;
4. feed the cat, who's still a bit mad at us for being away for so long (but couldn't resist purring when I was cuddling him earlier);
5. go to sleep and try to wake up on time tomorrow morning.