Category Archives: Science and Society

Research into pregnancy, birth and infant care are historically underfunded – and women are paying the price

Research in the UK is overwhelmingly male – male participants, male researchers, and male topics, despite 51% of the population being female. The lack of research on, by, and for this half of humanity has many detrimental effects – not least on the decisions women have to make during pregnancy, childbirth, and child rearing. In my latest book, Informed is Best, I explore the impact of incomplete and biased research in this area, and try to guide parents, and those supporting them, on how to read and judge the evidence that does exist.

Despite many women feeling the pressure to accept interventions during childbirth without question, there are often gaps in the evidence to support their treatment. For example, few studies have explored whether giving antibiotics to women with group B strep during labour can prevent the infection being passed to their baby. There’s also little research into whether electronic foetal monitoring – where a baby’s heart rate is continually monitored during labour – accurately identifies babies being deprived of oxygen. Or if conducting frequent cervical examinations during labour improves birth outcomes.

In an absence of good evidence, a tendency to “err on the side of caution” means that many women have unnecessary interventions during childbirth. Others have to fight to prove that their preferred option is safe, even when this is a biologically normal behaviour such as breastfeeding or safely sleeping with their baby.

Unequal research

This evidence is exacerbated by historic inequalities in which research is conducted and by whom. For many years, women were often excluded from clinical trials because their bodies were seen as too complex due to hormonal fluctuations. Yet those findings from all-male trials were used to determine treatment for everyone.

Research that benefits men is still more likely to be conducted. For example, five times more research is conducted into erectile dysfunction – a condition that affects 19% of men – compared with premenstrual syndrome, which affects 90% of women.

Meanwhile, research into birth and parenting, receives much less funding. Data from the US shows that although 10% of women become pregnant each year, just 2% of research funding is spent on pregnancy research. Likewise, a recent review identified that perinatal health research is still underfunded.

And when it is conducted, it’s not conducted equally. Despite being disproportionately affected by adverse pregnancy outcomes, research often ignores the needs of women of colour – including black women, who are five times more likely to die during pregnancy and birth in the UK.

These inequalities are only worsened depending on who has the opportunity to conduct research. In the UK those who are white, middle class and male are more likely to gain senior academic posts and funding. Around 68% of all professors are white men, and only 0.1% are black women.

When female academics seek research funding, they face further barriers. A recent study showed that funding applications containing words such as “vaccination”, “children” and “health” were 16% less likely to receive a high review score than grants using words such as “detection”, “bacteria”, and “drug”. Women were more likely to use the first set of words and men the latter.

One area where women are more equally funded is in the social sciences. But the discipline’s focus on qualitative methods, such as interviews and observations, is sometimes taken less seriously. Many instead consider randomised controlled trials the best way to conduct research, as the element of behavioural choice and any associated demographic factors, such as age, gender or race, are removed.

However, conducting trials in birth and parenting research can have ethical implications. For example, you cannot randomise mothers to have a vaginal or cesarean birth, or to breast or formula feed. Also, qualitative methods are often better able to understand what is important to women, such as understanding their experiences of having labour induced rather than simply physical outcomes.

Research costs money

Another issue is who funds research. Research costs money – money which often comes from an industry that stands to benefit from the findings. This means that research that doesn’t promote the use of a particular product is further disadvantaged, skewing what data is published. Alternatively, funding sources may be available but ethical issues arise. For example, although the formula milk industry may offer funding to research breastfeeding, many researchers are ethically opposed to taking such funding.

Although industry has played an important part in many health discoveries, research funded by industry is more likely to have outcomes that benefit it. This theoretically shouldn’t make a difference in how research is conducted, but funders can control the release of findings, skewing the balance in their favour. For example, one famous industry-funded study examining whether specific infant formulas could prevent allergies, was found to have falsified data and was subsequently withdrawn.

These layers of power and bias in who funds and conducts research are happening across every area of science. But in the case of birth and parenting research, women are already fighting a system that often focuses on risk, intervention and medical authority. It’s especially important that any research used to inform their care is as free from bias and as full a picture as possible.

It’s also worth noting that a lack of research evidence isn’t necessarily proof that something is not important. One famous example argued that because there were no randomised controlled trials showing whether jumping out of a plane with a parachute or not had any benefit, there was no evidence that parachutes were necessary.

Although satirical, it had a very important point. Continuing to research and gain an understanding of how to better support new parents, particularly including those from under-served communities. Research will always be important. But it’s also important to recognise that it’s not always a full picture – and this can have a serious impact on those affected.

Amy Brown has previously received research funding from the ESRC, NIHR, Public Health Wales, the Breastfeeding Network and First Steps Nutrition Trust. She is author of four books published by Pinter and Martin Ltd – 'Breastfeeding Uncovered: who really decides how we feed our babies', 'Why starting solids matters' , 'The Positive Breastfeeding Book' and "Informed is best'

Source: The Conversation: Technology http://theconversation.com/research-into-pregnancy-birth-and-infant-care-are-historically-underfunded-and-women-are-paying-the-price-126629

Facebook’s not a threat to the UK election

The Cambridge Analytica scandal of March 2018 changed the status of Facebook forever. The revelation that a political consultancy had illicitly gained access to the data of millions of Facebook users forced the company to change its approach to privacy, including its rules and algorithms. The scandal also started a debate about the influence of social media on democracy. This led to several measures to increase the transparency of political campaigning on Facebook and to limit foreign interference in elections.

Eighteen months on and Facebook is under fire again for refusing to more strictly police or even ban political ads. Campaigners are warning the site will have a negative effect on upcoming elections in the UK and Sri Lanka. Yet while many of the changes Facebook has made since 2016 are superficial, there’s good reason to believe the actual threat to democratic processes is limited.

Facebook’s “pivot to privacy” has included increased user control over their data and algorithmic changes that prioritise posts from users’ personal connections over news and public pages. There are also tougher rules for external developers who want to plug their applications into the platform and researchers who want to evaluate collected data.

But several investigations have shown the site still gathers extensive information about its users that continues to leak out through third parties. There is also a lack of transparency and scrutiny over exactly what data the company holds. This makes a joke of Mark Zuckerberg’s new motto, “the future is private”.

One of the most publicised changes was the creation of a searchable political advertisement database, recording every ad posted, who funded it and some data on who it was shown to. While this Ad Library is a laudable idea, the information provided is limited or unreliable.

Some political issue ads aren’t included and some organisations have found ways to obscure their ads’ origins. The library also doesn’t tell you what groups an ad was trying to reach or how it may have been targeted at and viewed by people in different electoral constituencies.

The company has also ramped up its use of fact-checkers, now partnering with over 50 organisations around the world. But these only review news stories posted to the site, not political ads, and the process has been criticised for not being transparent or detailed enough to really be useful.

However, when it comes to problems that lend themselves to technical solutions, Facebook has been effective. Investigations have shown how Russia used fake and automated (bot) accounts to influence American public opinion during the 2016 US election campaign. In response, Facebook developed a system that uses artificial intelligence to remove 99% of all fake accounts, as soon as they are created.

More generally, research has found that fears of foreign interference have been overblown. In the few proven instances of foreign interference, there isn’t sufficient evidence that they swayed voters one way or the other. It’s not even been shown that the Cambridge Analytica scandal, which involved companies in the US, Canada and the UK, made a decisive impact on the 2016 US election or the Brexit vote, despite alleged links to both.

Of course, political manipulation can still come from within a country, which is why people are calling on Facebook to ban or at least fact-check political ads, worried that they will spread false information. But voters are often already saturated with political information of varying accuracy from other sources.

In the UK, much of the media is highly partisan, especially on the matter of European integration, and many voters are already consuming “propaganda” from TV, radio, newspapers and news websites. The willingness of journalists to report politicians’ lies, even while highlighting inaccuracies, means it’s still just as easy and cheap to use press releases, news conferences and public statements as Facebook ads to spread misleading or fake news.

Microtargeting

One thing Facebook does provide is a way to send out highly targeted ads that allow campaigns to say one thing to some voters and another, perhaps even the opposite, to other voters. One of the claims about Cambridge Analytica’s work was that it used psychological profiling and microtargeted ads to manipulate a relatively small number of crucial voters. (Although, again, it’s unclear that this can make a decisive difference to political campaigns.)

To combat the negative effects of microtargeting, several watchdog organisations, such as the campaign Who Targets Me, track and expose online political ads and potential manipulations. This reduces the incentive for campaigns to use them, because it risks exposing parties that send different, perhaps even contradictory, messages to different groups of voters. These parties would lose authenticity, the ultimate currency in digital political communication. On top of this, Facebook is now considering limiting political microtargeting.

There’s still a debate to be had about Facebook’s responsibility to police political messages and fake news. But the actual threat of interference and manipulation in campaigns, such as the upcoming UK election, is rather limited. We should be more concerned about the continued lack of privacy and transparency from Facebook’s data-gathering activities. Without significant new regulation or a mass exodus of users, neither of which look likely any time soon, Facebook’s data-based business model means it’s unlikely to radically reform itself in these areas.

Anamaria Dutceac Segesten does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Source: The Conversation: Technology http://theconversation.com/facebooks-not-a-threat-to-the-uk-election-126943

Free broadband: internet access is now a human right, no matter who pays the bills

The UK Labour Party is promising to provide free broadband internet to every British household by 2030 if it wins the 2019 election. To do this, the party would nationalise the broadband infrastructure business of BT and tax internet giants like Google and Facebook. Whatever you think of this plan, it at least reflects that the internet has become not only an essential utility for conducting daily life, but also crucial for exercising our political rights.

In fact, I recently published research that shows why internet access should be considered a human right and a universal entitlement. And for that reason, it ought to be provided free to those who can’t afford it, not just in the UK, but around the world.

Internet access is today necessary for leading a minimally decent life, which doesn’t just mean survival but rather includes political rights that allow us to influence the rules that shape our lives and hold authorities accountable. That is why rights such as free speech, free association, and free information are among the central rights included in the UN’s Universal Declaration of Human Rights. And, crucially, everyone needs to have roughly equal opportunities to exercise their political rights.

Before the internet, most people in democracies had roughly equal opportunities to exercise their political rights. They could vote, write to newspapers or their political representative, attend public meetings and join organisations.

But when some people gained internet access, their opportunities to exercise political rights became much greater compared to those without the internet. They could publish their views online for potentially millions of people to see, join forces with other people without having to physically attend regular meetings, and obtain a wealth of previously inaccessible political information.

Today, a large proportion of our political debates take place online, so in some ways our political rights can only be exercised via the internet. This means internet access is required for people to have roughly equal opportunities to make use of their political freedoms, and why we should recognise internet access as a human right.

As a human right, internet access should be “free” in two ways. First, it should be unmonitored, uncensored, and uninterrupted – as the UN’s General Assembly has demanded in a non-binding resolution in 2016. Second, governments should guarantee a minimally decent infrastructure that is available to all citizens no matter how much money they have. This means funding for internet access should be part of minimum welfare benefits, provided without charge to those who can’t afford to pay for it, just like legal counsel. (This is already the case in Germany.)

A political goal

In developing countries, digital infrastructure reaching everyone might be too expensive to guarantee immediately. But with the required technology becoming cheaper (more people on the planet have access to a web-capable phone than have access to clean water and a toilet), universal access could first be guaranteed via free wifi in public places. Supply can start off in a basic way and grow over time.

Still, expensive infrastructure isn’t the sole obstacle to universal access in developing nations. The spread of the internet could also be increased by promoting gender equality and literacy and digital skills. Developed nations ought to support these efforts by honouring their commitments to the UN Sustainable Development Goals.

Should everyone in Britain have free broadband in their homes? There are many good reasons to provide the best possible internet access to everyone, such as increasing economic productivity, sharing prosperity more evenly across the country, or promoting opportunities for social engagement and civic participation. And, as such, free broadband for all may be a worthy political goal.

But what is most important is ensuring that everyone has the kind of internet access required for roughly equal opportunities to use their political freedoms. Guaranteed internet access should be considered a human right in our virtual world, whoever ultimately pays the bills.

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Merten Reglitz does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Source: The Conversation: Technology http://theconversation.com/free-broadband-internet-access-is-now-a-human-right-no-matter-who-pays-the-bills-127267