Unjustified Inferences Research Articles

Palfrey, C.The Future for Health Promotion. Bristol: Policy Press. 2018. 224 pp £24.99 (pbk) £24.99 (ebk) ISBN 978‐1447341239

The Future for Health Promotion is the most recent monograph from Colin Palfrey. He sets out to ‘examine the evidence relating to the effectiveness and cost-effectiveness of health promotion policies and projects, specifically but not exclusively in the UK’ (p.1). Highlighting the political context in which there is pressure on the National Health Service to meet an increasing demand for services with decreasing resources, he concludes that health promotion interventions have produced little research-based evidence as to their effectiveness. In order to make this case, Palfrey looks critically at methods of evaluation used within health promotion (chapter 3), strategies for health promotion in each country of the UK (chapter 4) and the principles of health economics (chapter 5). Other chapters provide the historical (chapter 2) and international (chapter 7) context for health promotion in the UK, as well as looking in detail at mental health promotion (chapter 6). The reader is encouraged to question what the purposes of health promotion are, and to recognise the significance of social determinants of health. Within each chapter, Palfrey summarises important reports, policies and conferences, and defines key terms, effectively positioning this book as an introductory text. Bearing this in mind, this intended audience may feel frustrated by the lack of clear structure. Sections within chapters, while interesting in their own right, do not always link to form a coherent argument that one can follow throughout the book. Additional signposting, and in some cases clearer introductions to the subject of each chapter, would be a helpful addition. Although the various chapters include much useful descriptive content (such as lists of mental health charities and settings for mental health promotion), their relevance in this particular text are not always made clear. This is particularly evident in the concluding chapter, which introduces additional topics, rather than drawing together threads from throughout the book. Palfrey attempts to look critically at the stated aims of health promotion, particularly empowerment. He questions how far people are ‘empowered’ if the purpose of health promotion initiatives is to deter people from making the ‘wrong’ choices (p.16). I would agree that the term empowerment needs to be considered critically, and Palfrey does acknowledge that this framing of health promotion ignores the impact structural forces. However, as has previously been argued, analysing the use of ‘empowerment’ involves a multidimensional conception of power (Robertson and Minkler 1994). While it is relevant to question the terminology involved in various initiatives, paying attention to the operation of power allows us to understand why behavioural health promotion is so appealing to governments (Baum and Fisher 2014). Clearly it is important to assess this book on its own terms; Palfrey is writing as an expert on policy evaluation. Nevertheless, readers of this journal may wish to go beyond this text in order to further problematise the underlying principles of health promotion. The issue of how best to evaluate policy is also fundamental to this book. Palfrey is concerned that health promotion policies often have unmeasurable objectives. He critiques performance indicators and randomised controlled trials, pointing to the risk of unjustified inferences in the case of the former and questioning how the latter are evaluated. Specifically, he suggests that too often those working in public health accept the project output as the endpoint, rather than evaluating the outcome in terms of the set objectives. Although this is an interesting point, there seems to be a disconnection between the hypothetical illustrative example, and some of the examples of studies briefly discussed. Palfrey also acknowledges the possible contribution of qualitative research, although he glosses over the potentialities of methods such as interviews and observation with superficial ‘positives’ and ‘negatives’. I was left with the sense that Palfrey has missed the opportunity to consider pertinent issues regarding the future of health promotion research in more depth, at the expense of providing a broad overview. Throughout the book, Palfrey makes claims regarding the lack of evidence or lack of consideration on several key issues. However, he appears to ignore relevant examples. For instance, the introductory chapter refers to ‘the dearth of empirical studies gathering evidence from people living in areas of relative deprivation about their lifestyle’ (p.13). There are many qualitative studies which do just that, and which also address attitudes towards government policies and health promotion initiatives. By not examining this evidence, Palfrey is limited in the extent to which he is able to meet his own aim with this book.

"Infectious Supercarelessness" in Discussing Antibiotic-Resistant Bacteria.

Many bacterial pathogens are exhibiting resistance to increasing numbers of antibiotics making it much more challenging to treat the infections caused by these microbes. In many reports in the media and perhaps even in discussions among physicians and biomedical scientists, these bacteria are frequently referred to as “bugs” with the prefix “super” appended. This terminology has a high potential to elicit unjustified inferences and fails to highlight the broader evolutionary context. Understanding the full range of biological and evolutionary factors that influence the spread and outcomes of infections is critical to formulating effective individual therapies and public health interventions. Therefore, more accurate terminology should be used to refer these multidrug-resistant bacteria.

The creation of facts in the cloud

Like most significant changes in technology, Cloud Computing and Big Data along with their associated analytic techniques are claimed to provide us with new insights unattainable by any previous knowledge techniques. It is believed that the quantity of virtual data now available requires new knowledge production strategies. Although they have yielded significant results, there are problems with advocated processes and resulting facts. The primary process treats "pattern recognition" as a final result rather than using "pattern recognition" to lead to yet to be tested testable hypotheses. In data analytics, the discovery of a pattern is treated as knowledge rather than going further to understand the possible causes of those patterns. When this is used as the primary approach to knowledge acquisition unjustified inferences are made - "fact generation". These pseudo-facts are used to generate new pseudo-facts as those initial inferences are fed back into analytic engines as established facts. The approach of generating "facts from data analytics" is introducing highly risky scenarios where "fiction becomes fact" very quickly. These "facts" are then given elevated epistemic status and get used in decision making. This, misleading approach is inconsistent with the moral duty of computing professionals embodied in their Codes of Ethics. There are some ways to mitigate the problems generated by this single path approach to knowledge generation.

The Wolf Packs in Our Midst and Other Products of Criminal Joint Enterprise Prosecutions

Changes in the law on secondary participation in joint criminal enterprises since 1985 have been driven by a judicial policy aiming to counter a perceived threat to social order from criminal groups. This article argues that these changes enable prosecutions to succeed through the use of tenuous forms of evidence and epistemologically unjustified inferences which juries are permitted to draw from such evidence, a combination which effectively lowers the standard of proof. The lowering of the standard of proof has two effects. First, it makes it easier and cheaper for police investigators to construct prosecution cases, and secondly, it is likely to result in injustice. Many claims have been made that it does indeed have the latter effect. The police view the joint enterprise doctrine as a useful tool, and other parts of the criminal justice system are willing to collaborate with the development and refinement of the tool. This article explores the reasons why support is given to a development which requires such a drastic change in accepted legal standards. The Law Commission justifies these changes by its adoption of a theory that an individual who joins a group engaged in criminal activity changes her or his normative position to that of the group, and so may be held responsible for any crimes committed by any member of the group. However, the theory is unsupported by empirical research. Rather it is grounded in the findings of courts trying cases in which the joint enterprise doctrine is applied, and has its origins in theories which assign to criminal courts the responsibility to identify certain groups as enemies of society. Its application produces the populist characterisation of casual groups of young people as ‘wolf packs’.

Functional brain imaging in gastroenterology: to new beginnings.

With more than 100 studies published over the past two decades, functional brain imaging research in gastroenterology has become an established field; one that has enabled improved insight into the supraspinal responses evoked by gastrointestinal stimulation both in health and disease. However, there remains considerable inter-study variation in the published results, largely owing to methodological differences in stimulation and recording techniques, heterogeneous patient selection, lack of control for psychological factors and so on. These issues with reproducibility, although not unique to studies of the gastrointestinal tract, can lead to unjustified inferences. To obtain consistent and more clinically relevant results, there is a need to optimize and standardize brain imaging studies across different centres. In addition, the use of complementary and more novel brain imaging modalities and analyses, which are now being used in other fields of research, might help unravel the factors at play in functional gastrointestinal disorders. This Review highlights the areas in which functional brain imaging has been useful and what it has revealed, the areas that are in need of improvement, and finally suggestions for future directions.

Unjustified inferences about meta-analysis

Berk (Statistical Inference and Meta-Analysis, 2007) asserts that the results of inferential statistics make scientific sense only if the data to which they are applied were actually generated through random sampling from a defined real population. Because meta-analysis data are not generated in that manner, he claims that the statistical conclusions of meta-analysis are fictional and suggests that conventional research review procedures be used instead. This rejoinder argues that Berk’s position on statistical inference represents a narrow literalism that he fails to justify and that does not reflect the way inferential statistics are used or generally understood in contemporary practice. Consequently, his critique has little significance for meta-analysis or any of the other widespread forms of social science research that apply inferential statistics in similar spirit. Berk’s advocacy of conventional literature reviews omits any explanation of how they would avoid the well-documented deficiencies of that approach or be conducted in a manner that offers any advantage over meta-analysis.

Zen and the art of medical image registration: correspondence, homology, and quality

Nonrigid registration (NRR) is routinely used in the study of neuroanatomy and function and is a standard component of analysis packages such as SPM. There remain many unresolved correspondence problems that arise from attempts to associate functional areas with specific neuroanatomy and to compare both function and anatomy across patient groups. Problems can result from ignorance of the underlying neurology which is then compounded by unjustified inferences drawn from the results of NRR. Usually the magnitude, distribution, and significance of errors in NRR are unknown so the errors in correspondences determined by NRR are also unknown and their effect on experimental results cannot easily be quantified. In this paper we review the principles by which the presumed correspondence and homology of structures is used to drive registration and identify the conceptual and algorithmic areas where current techniques are lacking. We suggest that for applications using NRR to be robust and achieve their potential, context-specific definitions of correspondence must be developed which properly characterise error. Prior knowledge of image content must be utilised to monitor and guide registration and gauge the degree of success. The use of NRR in voxel-based morphometry is examined from this context and found wanting. We conclude that a move away from increasingly sophisticated but context-free registration technology is required and that the veracity of studies that rely on NRR should be keenly questioned when the error distribution is unknown and the results are unsupported by other contextual information.

Size and Age Parameters of Nest Trees Used by Four Species of Parrot and One Species of Cockatoo in South-west Australia: Critique

In their paper, Mawson and Long (1994) measured the diameter of hollow-bearing eucalypt trees used for nesting by several parrot and a cockatoo species, estimated the age of the trees used, and then used the results to recommend changes to forest and woodland management in Western Australia. Unfortunately, their paper presents erroneous information on the estimation of tree age and unjustified inferences are drawn from this ‘data’. We provide a critique of their paper below, in relation to these two issues.

ON THE COMPLETION OF PRIORITY ORDERINGS IN NONMONOTONIC REASONING SYSTEMS

We discuss the structure of nonmonotonic reasoning. We suggest that an important aspect of nonmonotonic reasoning systems is the ordering relationship (preference structure) on the propositions in the knowledge. We suggest that this ordering relationship must be a weak order, a complete and transitive relationship. We provide a comprehensive discussion of some central issues in preference theory. In most real applications of nonmonotonic knowledge bases the ordering relationship available is often not complete. We suggest a mechanism for completing these relationships. The basic imperative used in providing this completion is to do it in such a manner as to add as few unjustified inferences as necessary. To formally accomplish this task we introduce a measure of buoyancy associated with a weak order and suggest that the preferred completion is the one with the maximal buoyancy.

Theory into Practice? Pornography and the Public/Private Dichotomy

'The feminist total critique of the liberal opposition of private and public still awaits its philosopher'.1 So concluded Carole Pateman in an important article written a decade ago. During the intervening years, there has been an explosion of feminist literature reflecting upon issues raised by public/private dichotomies in social and political thought, much of it concerned with legal analysis or questions of legal policy and reform. Yet, notwithstanding this theoretical development, questions around public/private dichotomies have lost little of their power to bewilder, as each confidently asserted critique raises further questions of theory and strategy. Indeed, it sometimes seems that the more we criticize the public/private dichotomy, the more we get trapped within its conceptual framework. In this paper, I want to return to this well-worked terrain with two purposes in mind. First, I want to distinguish several different concerns which have informed feminist preoccupation with the public/private dichotomy. Drawing on feminist political and social theory, I shall explore how each of the different concerns I identify feeds into questions of legal policy. Secondly, I shall turn my attention to one concrete area, namely pornography, in which feminist activism including that directed to law reform has been informed by the public/private critique. Pornography is an issue which, perhaps above all others, has been controversial within feminist thought, and in which issues of theory and strategy connect particularly closely. I hope to shed some light on why the pornography debate has been such a problematic one for contemporary feminism by looking at it again in the light of a more differentiated appreciation of the public/private critique. In particular, I shall try to identify the negative consequences which unjustified inferences from the public/ private critique have had on feminist politics around pornography.

The role of context and inference in the comprehension of social action

In an application of a paradigm from research on constructive memory, subjects read six sentences describing social actions within one of two alternative contexts. They then received a second set of descriptions that represented either partial reproductions of the original sentences, unrelated sentences, justified inferences, or unjustified inferences, the “justifiability” of these latter sentences being determined by the context in which the action was initially described. Subjects in one condition indicated whether the test sentences were identical to the originals, while in a second condition, they rated the consistency of these items with the earlier descriptions. Judgments of consistency were significantly higher than those for exact wording, although in both conditions subjects rated partial reproductions as being closer to the originals than justified inferences, which were in turn given higher ratings than unjustified and unrelated sentences. Results indicate that subjects represented the inferred, context-specific meanings as well as some of their exact details. As a further control, two additional groups of subjects independently rated the justifiability of justified and unjustified inferences and their similarity in wording to the original sentence stems. The relative influence of these two factors on subjects' rating was found to depend on the type of judgment required of subjects.