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How a SIDS Study Became a Media Train Wreck – The Atlantic
Sudden infant death syndrome, or SIDS, “will be a thing of the past,” according to Carmel Harrington, a sleep researcher at the Children’s Hospital at Westmead, in Australia. A press release describes her new study, out this month, as a “game-changing” effort and a “world-first breakthrough” that could prevent future deaths from the tragic illness. Celebrations quickly spread on social media: “THEY FOUND THE CAUSE OF SIDS. Excuse me while I cry for all the parents,” one viral tweet declared. “Closest thing to a miracle in a long time,” said another. The press soon picked up the story. On Friday, a segment on Good Morning America touted Harrington’s “very, very important study” of SIDS, while a story in the New York Post promised that her data would “bring closure to countless parents who have endured the nightmare of losing a child.”
Rarely is a medical research finding a “breakthrough.” But this one – discovering a biomarker in blood that indicates babies’ risk for SIDS – qualifies. https://t.co/EKZBlFvxTx
— Nancy Lapid (@NancyLapid) May 13, 2022
Sadly, these claims are quite absurd. The original research paper, published on May 6, described a small-scale but interesting project: Harrington and her colleagues measured activity levels of a protein called butyrylcholinesterase in dried blood collected from about 600 babies shortly after birth, including 26 who died from SIDS and 30 who went on to die from a different condition during their first two years of life. On average, those who died from SIDS had somewhat less butyrylcholinesterase activity in their blood than healthy newborns did. According to the study’s authors, this suggests that, with further work, the protein “could potentially be used as a biomarker to identify and prevent future SIDS deaths.” If that qualifies as a scientific “miracle,” the bar is inches from the ground.
Even after decades of research, SIDS remains “unexpected, dramatic, and devastating,” as three prominent doctors put it in a New England Journal of Medicine editorial published over the weekend. If researchers had really pinpointed a biological cause for these deaths—as some press reports have claimed—it would salve parents’ anxiety and might lead to future treatments. But one need only read the new paper in its entirety to see they haven’t reached this goal.
At best, the study represents an incremental advance. This is not meant to be an insult; science works in increments. But the numbers don’t suggest that a screening test for SIDS is really in the works, let alone one that will quickly end the scourge of infant deaths. The authors report that protein-activity levels were measured in a range of 1.7 to 23.3 units per milligram for healthy newborns, and from 2.9 to 10.8 for those who died of SIDS. Though the group averages were different overall (7.7 versus 5.6), individual values still overlapped a great deal. In other words, a low protein-activity level at birth could be found in a baby who might end up dying from SIDS, as well as one who would go on to live a healthy life.
I reached out to Harrington and her co-author Karen Waters, a professor of child and adolescent health at the Children’s Hospital at Westmead, to ask about this issue, among others. Measuring the protein “will not work as a universal screening test, for precisely the reasons that you have highlighted,” Waters told me via email. Harrington said that their “finding represents the possibility for the future identification of infants at risk for SIDS” and that the study identifies “a measurable biochemical marker (not cause)” of the condition.
The confusing and controversial status of SIDS as a formal diagnosis adds to the uncertainty. SIDS is considered a “diagnosis of exclusion,” which means that it applies only when other causes have been carefully ruled out, and also that it is likely to comprise a number of different conditions. Some forensic pathologists have abandoned the diagnosis entirely on account of this ambiguity, James Gill, the chief medical examiner of Connecticut, told me. The authors of this month’s study did not have access to autopsy details for any of their subjects, and relied in most cases on a coroner’s assessment that SIDS had been the cause of death.
Even if it were possible to develop a screening test for SIDS, we might not want to use it. As a hospital pathologist myself—which is to say, as a doctor who specializes in diagnostic testing—I know that every form of screening makes mistakes. Sometimes, the benefits from these tools are worth the harm of an occasional error. Cervical-cancer screening, for example, greatly reduces deaths even though pap smears regularly lead to unhelpful results. But a wonky SIDS test would have catastrophic ill effects. A false positive result would terrify new parents. A false negative could lead them to abandon safe-sleeping practices—or far worse, make them seem at fault if SIDS did strike. Even true results might not be much help, because early-detection tests are only as good as the treatments we use in response to them. An aggressive campaign by pediatricians to promote safer sleep practices has caused the number of SIDS deaths to plummet since the 1990s. That campaign’s advice is already given out to everyone, and would not change on the basis of a blood test.
Given that no further interventions would be available for infants flagged as high-risk by a screening test for SIDS, I asked the authors whether it makes sense to measure babies in this way. Waters responded by citing the “fundamental principle” that you should not screen newborns for disease unless you can “affect the outcome for the child.” Harrington has suggested in an interview that the researchers “don’t know the shape of what the intervention will be at this stage.”
If the study’s findings were ambiguous, and its implications dubious, why did the research get so much attention in the media? Many outlets seemed impressed by its connection to The Lancet, founded in 1823, and one the world’s most prestigious medical journals. The SIDS paper did not actually appear in The Lancet, but rather in a lesser-known periodical called eBioMedicine, which happens to be published under The Lancet’s umbrella brand (along with more than 20 other journals). Media coverage glossed over that distinction, though, or ignored it altogether. (Good Morning America managed to combine the two journals’ names into a fictional publication called “eLancet.”) These errors are understandable; prominent Lancet branding on eBioMedicine’s website and web address make it easy to get confused, and journal editors sometimes take advantage of academic prestige to court media attention.
The study’s tenuous connection to The Lancet was just one small part of its appeal. More significant was Harrington’s own story: She’d lost her son to SIDS 29 years ago, and then watched as a friend lost a baby to the same ailment a few years later. Harrington spent the intervening decades trying to discover a way to prevent this tragedy for others. “I made a solemn resolution there and then to leave no stone unturned in my quest to solve the mystery of the Sudden Infant Death Syndrome,” she wrote in a request to crowdfund her research that was first posted in August 2018. Before the study was published this month, the campaign hadn’t received a contribution since 2019; now donations have been pouring in. As of yesterday, the campaign had raised about $50,000, mostly in small increments. “Since we have published our research, I have continued to be overwhelmed by the generosity of the community,” Harrington told me.
There’s no shame in soliciting funds for a good cause, and Harrington’s scrappy effort to keep her research going could be seen to merit praise. But Harrington herself has linked improbable claims about the science to overt requests for money: “To get us there, we need a lot of funding,” she told an interviewer, moments after saying that she “knows” that SIDS will be eradicated in “three to five years’ time.” (The hospital, which manages the endeavor’s charitable account, lent credence to this accelerated time frame in its press release.) An article from the Australian Broadcasting Corporation quoted Harrington making a plea for further backing: “We know what we have to do. It’s just actually getting the funding for it.” But the story, like numerous others, did not provide any appraisal of the research from independent experts, which would have helped inform potential donors. Harrington, in her email to me, reiterated her claim that screening tests and interventions “could be 3-5 years away” with appropriate funding.
Many outlets also neglected to mention the study’s known limitations, as described in the paper. In that context, the authors acknowledge that they examined relatively few subjects, and that the tested blood was more than two years old. Their results could, therefore, turn out quite differently if the technique were put into widespread practice. “There is a lot more work to be done before this can be heralded as a solution,” Waters told me in her email. “As we said in the paper, it offers new directions for research in the field.” Harrington told me that “this finding is only one bit of the puzzle and there is so much more to learn.”
Harrington’s personal accomplishments cannot be dismissed, even if new tests and treatments seem further away than she claims. Most of us never generate a speck of new scientific knowledge. To come back from tragedy, toil for decades, and then produce a promising approach for closer study … well, that may not be miraculous, but it matters all the same.
Doug Ford's election media strategy revealed | CTV News – CTV News Toronto
Progressive Conservative Leader Doug Ford has limited his media exposure throughout the first two weeks of the provincial election campaign – choosing scrums selectively, restricting public appearances and rejecting media interviews.
Political analysts call this the “front-runner” strategy and say it started long before the writ was drawn.
“It’s been a strategy they’ve implemented for, I want to say, a better part of a year and a half now,” Muhammad Ali, a senior consultant with Crestview Strategy, told CTV News Toronto.
“There was a point when Doug Ford was doing daily press conferences and all of a sudden, he just stopped doing those and they became really spaced out.”
At that point, cabinet ministers like Health Minister Christine Elliott became the go-to “bearers of bad news” when it came to pandemic restrictions. According to Ali, this kept the PC leader from being overexposed and saying things off-the-cuff that may be controversial.
“This is an attempt by his team to control how much exposure he gets and to make sure that it minimizes how much he potentially could rock the boat, because at this point, they’re polling so strongly, the only way that they could really collapse, ultimately, is if Doug Ford started saying things that put off voters.”
“And so far it’s working.“
Cristine de Clercy, an associate professor in political science at Western University, called this the “front runner strategy.”
“As the premier and someone who has quite a significant level of name recognition among voters and is a front runner, according to the polls, Mr. Ford has much less incentive to seek interaction with the media,” de Clercy told CTV News Toronto.
Already, Ontarians have had four years to get to know Ford, which de Clercy says dilutes the leader’s incentive to open himself up to potential embarrassment, miscommunication or criticism.
“In fact, some strategists argue that if you’re a leader that’s in a so-called front runner position where it seems you’re doing well, and your party is likely to be elected, then actually, you want to minimize contact with the press.”
De Clercy said that’s because interacting with the media is a two-sided coin. On one hand, it’s an opportunity for a leader to get their message and name out to the public, but on the other, there is a risk of facing public criticism.
In essence, there is more upside for first time provincial leaders, like Liberal Leader Steven Del Duca and Green Party Leader Mike Schreiner, to pack their days with media-friendly events.
Ontario Premier Doug Ford makes an announcement during a campaign stop at the Finishing Trades Institute of Ontario, in North York, Ont., on Tuesday, May 17, 2022. THE CANADIAN PRESS/Christopher Katsarov
This “cost-benefit” analysis, de Clercy explains, means Ford is more willing to engage with the press when he feels he can control the message. Monday night’s debate exemplified this.
Despite disappearing after the first leader’s debate in North Bay, Ford walked out to greet reporters for a scrum after the second election debate in Toronto.
“One way I would interpret that is that he was pleased with his performance, he thought he did well, and he did a good job in presenting his party’s views, and so, he was a little bit more receptive to engaging with the press than if he thought he had done poorly or been treated unfairly in the debate,” she said.
WHAT ABOUT THE OTHER LEADERS?
At Monday’s debate, Del Duca stayed the course with his campaign strategy–to tell “his story” and help voters get to know him better.
In most of his responses, Del Duca tended to make reference to various family members. His election advertisements read the same way, with his wife, children and dogs making a prominent appearance, and in some cases taking up the majority of the timeslot.
This approach is how some politicians “humanize” themselves, Ali said.
“People, when they see the leader of a party, they think of them as sort of like a robot or something. They don’t see them as relatable,” he said.
In an effort to distinguish himself from the Kathleen Wynne government, whose party lost the majority of their seats in 2018, Del Duca has cast the new roster of liberals as being members of the “new” Ontario Liberal Party, with “some success,” Ali said.
Instead of indulging in familial narratives, NDP Leader Andrea Horwath, who has enjoyed a decade’s worth of public exposure in her current position, took a more combative route at the second debate, directing much of her energy towards criticism.
“The strategy of being very critical and sort of feisty in her exchanges with Mr. Del Duca and Mr. Ford clearly reflected that her party is in many ridings, probably as we speak, locked in a very close race with either the Liberals or the PCs,” de Clercy said.
For the Greens, de Clercy says their platform is crafted strategically to reach certain groups of people who are interested in health care, education and community investment in infrastructure, all while pursuing these goals within a comprehensive environmental framework.
Ali, for his part, said he felt like Schreiner was the real winner of Monday night’s debate.
“He came across as the most articulate communicator,” he said.
AN UNSPOKEN PARTNERSHIP
Right before the writ was drawn, Ford shared a podium with Prime Minister–and Liberal–Justin Trudeau to announce an investment in electric vehicle manufacturing, the last of a series of joint events in the province.
At the time, Del Duca argued that Ford was using this as a campaigning opportunity, a claim both the PC leader and prime minister denied.
Since then, Ford has not said anything about the federal government during his campaign stops, insisting at Monday’s debate that he is a team player who will work with whoever is in power in Ottawa.
“What they had long learned from polling was that Doug Ford polls better when he’s doing an announcement with the federal government and he’s working in tandem with him,” Ali said. “And so they’ve intentionally not really made any criticisms, points of contention against the federal government.”
Prime Minister Justin Trudeau, right, shakes hands with Ontario Premier Doug Ford after reaching and agreement in $10-a-day child-care program deal in Brampton, Ont., on Monday, March 28, 2022. THE CANADIAN PRESS/Nathan Denette
Meanwhile, Del Duca has yet to hold an event with the prime minister. Ali warns that Trudeau may be trying to stay out of the provincial election, with the understanding that he will also have to work with whoever is elected premier.
“It doesn’t benefit (Trudeau) and he needs to work with Doug Ford to deliver a lot of sort of the bigger platform pieces,” Ali said.
Meanwhile, federal NDP Leader Jagmeet Singh has spent time in the GTA during the campaign period and even attended a rally with Horwath.
Over half of young people see racist content online about immigrants, poll suggests
OTTAWA — Over half of Canadians under age 35 come across racist or prejudiced remarks about immigrants on the internet, a new survey suggests.
Forty-two per cent of all respondents to the online survey by Leger and the Association for Canadian Studies said they saw or heard racist content about immigrants in cyberspace.
Almost half aged 18 to 34 said they encountered racist remarks about Black people online, and the same proportion heard such remarks about Indigenous people.
About two in five in the same age group said they ran into this type of content about Asian Canadians.
The case of a white gunman accused of massacring 10 Black people in a racist attack at a Buffalo, N.Y., supermarket last weekend has highlighted the role of social media to promote hatred.
The online survey of 1,697 Canadians during the week of April 25 cannot be assigned a margin of error because internet-based polls are not considered random samples.
Jack Jedwab, president of the Association for Canadian Studies, said the indication that younger people are more likely to see this sort of content is unsurprising.
“A lot more young people are exposed to these things because they’re much more active and engaged on social media,” he said.
About 10 per cent of respondents said they often see racist remarks online about different racial groups.
“I don’t think you could argue that one out of 10 is not that high, because it actually represents a substantial number of people who are seeing this type of diatribe on a daily basis in social media,” Jedwab said.
Non-white respondents were more likely than their white counterparts to say they encountered racist remarks online.
About three in five non-white respondents said they came across racist remarks about immigrants, compared to about two in five white respondents.
Jedwab said this degree of exposure to racist content should be cause for concern in light of the recent shooting in Buffalo.
The U.S. Department of Justice is investigating the shooting as a hate crime and an act of racially motivated violent extremism.
Regular exposure to racist and hateful content online can make people desensitized, potentially allowing a fringe phenomenon to become mainstream, Jedwab said.
When asked what they do upon coming across this type of content, young people said they do nothing “because there’s too much of it, and they don’t know where to begin to deal with it,” he added.
The federal government has proposed a law to clamp down on hate speech and abuse by blocking certain websites and forcing platforms to swiftly remove content.
Critics have said this approach could curtail the rights of marginalized groups by having their posts misconstrued as harmful.
This report by The Canadian Press was first published May 16, 2022.
This story was produced with the financial assistance of the Meta and Canadian Press News Fellowship.
Erika Ibrahim, The Canadian Press
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