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Feminism: Sex and gender discussions
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13
RoaringtoLangClegintheDark · 01/09/2024 13:47

endofthelinefinally · 27/08/2024 14:30

There is a thread running atm about Tanni Grey Thompson being forced to crawl off a train. There are lots of posts describing the awful lack of service and disrespect for passengers with disabilities. I bet all the staff have had compulsory DEI training that contains nothing about helping those passengers.

Exactly.

newmummycwharf1 · 01/09/2024 16:24

LilyBartsHatShop · 01/09/2024 13:07

@newmummycwharf1 I actually thing the APGAR paper you link to above is a good exaple of activism replacing evidence based medicine.
I'm not sure if I'm posting this in haste, and will regret being blunt, but as you say you are so high up in the organisation which is driving alot of this research-ajacent activity and policy development, I want to point out that the APGAR test is a screening tool, not a diagnostic tool. So infants with dark skin are not being "diagnosed as cyanotic," they are receiving one less point on a screening tool that then leads to further treatment (if urgent) or investigation, not diagnosis.

I think it's probably just more difficult to quickly and accurately observe cyanosis around the lips of baby with dark skin than light.
Writing up papers about how midwives are marking down babies of women of colour for not having pink enough skin looks great to an audience who have no experience working with newborns. But would you want to be the midwife who says, It looks to me like that infant is oxygen deprived but I won't say anything because maybe I'm just being racist. ?

It is possible that you are more learned on the topic than the vast number of Professors of neonatology and Obs &Gynae involved in conducting the systematic reviews used to inform this policy paper:
https://www.nhsrho.org/research/review-of-neonatal-assessment-and-practice-in-black-asian-and-minority-ethnic-newborns-exploring-the-apgar-score-the-detection-of-cyanosis-and-jaundice/

It is also possible that you are aware that systematic reviews/meta-analysis are a higher level than randomised controlled trials - so the highest level of evidence

If the positive predictive value of a screening tool is lower for a group of people - it is not fit for purpose for that group and needs updating. To most people - that goes without saying. The point is to improve the screening tests to the rate of detection is improve for all babies it is applied and intervention introduced early to prevent negative outcomes including death.

Again - hope that helps.

Review of Neonatal Assessment and Practice in Black, Asian and Minority Ethnic Newborns: Exploring the Apgar Score, the Detection of Cyanosis, and Jaundice

A new review published today by the NHS Race and Health Observatory outlines challenges in neonatal care for Black, Asian and minority ethnic babies, alongside clear recommendations on tackling them.

https://www.nhsrho.org/research/review-of-neonatal-assessment-and-practice-in-black-asian-and-minority-ethnic-newborns-exploring-the-apgar-score-the-detection-of-cyanosis-and-jaundice

anyolddinosaur · 01/09/2024 19:46

@newmummycwharf1 The research you are quoting on diversity of researchers seems to be solely based on citations - but if you want to show off your woke credentials you will be biased towards citing papers with a wider range of authors. And some is just based on opinion - but if you can get others to often cite your opinion as "research" it looks more impressive to some. Citations may be one commonly used way of assessing quality of work but really identifying good research is harder than that. And if you really want diversity the people you are missing are actually the most marginalised in society - poor white men and boys in particular but the disadvantaged in general. Recruiting research staff who will generally be from privileged families doesnt really address that, you need more empathy in your researchers.

If you really want to encourage diversity in research then constantly described organisations as "systemically racist" is not the way to encourage people to get involved. You know that this makes it more difficult to get women to antenatal appointments, to recruit diverse staff. to encourage participants in research and to encourage students to stay in research - but you are still happy to push that line.

There is a very strong sense of justice in most British people, it's why we queue. That means racism is actually a minority. It also means that excessive preferential treatment leads to pushback. You are obviously going to be biased in assessment of what is funded and who does the research because you are putting ideas of a "unique perspective" ahead of choosing good proposals.

newmummycwharf1 · 01/09/2024 20:05

anyolddinosaur · 01/09/2024 19:46

@newmummycwharf1 The research you are quoting on diversity of researchers seems to be solely based on citations - but if you want to show off your woke credentials you will be biased towards citing papers with a wider range of authors. And some is just based on opinion - but if you can get others to often cite your opinion as "research" it looks more impressive to some. Citations may be one commonly used way of assessing quality of work but really identifying good research is harder than that. And if you really want diversity the people you are missing are actually the most marginalised in society - poor white men and boys in particular but the disadvantaged in general. Recruiting research staff who will generally be from privileged families doesnt really address that, you need more empathy in your researchers.

If you really want to encourage diversity in research then constantly described organisations as "systemically racist" is not the way to encourage people to get involved. You know that this makes it more difficult to get women to antenatal appointments, to recruit diverse staff. to encourage participants in research and to encourage students to stay in research - but you are still happy to push that line.

There is a very strong sense of justice in most British people, it's why we queue. That means racism is actually a minority. It also means that excessive preferential treatment leads to pushback. You are obviously going to be biased in assessment of what is funded and who does the research because you are putting ideas of a "unique perspective" ahead of choosing good proposals.

Diversity of researchers includes people from various backgrounds including working class, socioeconomically deprived etc. The conversation here was about racism. The reality of racism does not negate other causes of inequity.

Citations are just that - quoting research, most of which are government white papers with a long list of original papers from across the globe including UK. Many in high impact factor journals. That is how quality of research is judged. And impact on policy, which these research papers have had - including directing major research funding to correct the underlying issues I have flagged.

I am not asking for opinion or wanting people to agree with me. This is work we have done and that has had the required impact. It is for your information - take it or leave it.

You can learn more about systemic racism, diversity needs in research by reading the reference lists. The organisations that train researchers and fund research in the UK have listened and taken action. Not based on emotion but on rigorous methodical research that is actually ongoing but has already delivered results.

This thread has been enlightening and I am glad I was able to share data that is publicly available but rarely viewed by the public. The more that are enlightened, the better.

I will now go back to continue the work I am doing in real life!

anyolddinosaur · 01/09/2024 20:21

*@newmummycwharf1 Really - you think you have "share(d) data that is publicly available but rarely viewed by the public", What you have done is to patronisingly suggest that people spend a lot of time finding information themselves because you are not willing or able to share it. You've provided an excellent example of why people might choose not to engage with research or researchers.

GargoylesofBeelzebub · 01/09/2024 20:43

anyolddinosaur · 01/09/2024 20:21

*@newmummycwharf1 Really - you think you have "share(d) data that is publicly available but rarely viewed by the public", What you have done is to patronisingly suggest that people spend a lot of time finding information themselves because you are not willing or able to share it. You've provided an excellent example of why people might choose not to engage with research or researchers.

🎯

XChrome · 01/09/2024 20:57

LemonyCoughSyrup · 01/09/2024 13:38

This ☝️

would never celebrate this

Also using the word ‘woke’ disparagingly is a massive red flag for me, coming out of anti-equal rights/far right corners of the internet and people saying ‘political correctness gone mad’ etc 🤢

I'm as left as it gets. I have been since childhood, was born into a family of active leftists. However, I think -scratch that- I know, that political correctness has gone too far.
I have been attacked for simply not liking the things currently in vogue among people who consider themselves woke. For example, when the Wonder Woman movie came out and morons were blithering about how "empowering" it was for women, I said it's not, it's just the usual hot women in skimpy clothes. I quickly had a gang of "woke" attackers threatening me. There are tons of examples of leftists who disagreed with the howling woke mob (about things both as trivial as that and more weighty matters) who were attacked and "cancelled" for it.
Just look at this Israel/Palestine craziness. The university woke crowd have rallied in support of Hamas and attacked Jewish students. While I do think Israel is incredibly aggressive, that is inexcusable. The wokies are drunk with power, the power to condemn others and "cancel" them. That's what it's really about.
That's what the left has come to among younger people; doing shit like supporting Hamas and threatening to kill J.K Rowling to prove how virtuous they are, which is ironic af.
I don't recognize this woke left as anything like the old guard, who were the people who really affected change about the things that matter most- income equality, human rights, etcetera. It's performative, hive-minded and staggeringly irrational, obsessed with gender ideology (and whatever else is currently fashionable) and punishing independent thought among their own ranks.
This bullshit only hands right wing scum wins. The current left needs to grow up.

duc748 · 01/09/2024 21:13

Well said, @XChrome It's kindergarten politics. Serious leftists would be more interested in analysing the origins (and finances) of the gender movement.

1dayatatime · 01/09/2024 23:50

@XChrome

The issue I have with the hard left woke is that they are fascist in trying to silence by either threats of de platforming those that disagree with their views whether that be JK Rowling or even Farage.

They are also authoritarian and anti democratic in seeking to outright ban certain political parties such as Reform.

They are undermining an independent judicial system through political interference (two tier policing).

So yes I do see the hard left woke as a serious danger to us all.

XChrome · 02/09/2024 00:51

1dayatatime · 01/09/2024 23:50

@XChrome

The issue I have with the hard left woke is that they are fascist in trying to silence by either threats of de platforming those that disagree with their views whether that be JK Rowling or even Farage.

They are also authoritarian and anti democratic in seeking to outright ban certain political parties such as Reform.

They are undermining an independent judicial system through political interference (two tier policing).

So yes I do see the hard left woke as a serious danger to us all.

There's the authoritarian left and there's the libertarian left. The libertarian left supports freedom of expression. The authoritarian left supports only their freedom to express themselves.
I'm not in the UK, so I'm not familiar with what they are doing to the judiciary. Can you explain?

Signalbox · 02/09/2024 11:59

I think the pro EDI people need to start calling out the crazy excesses of it if they don't want the baby thrown out with the bathwater.

GailBlancheViola · 02/09/2024 12:27

Signalbox · 02/09/2024 11:58

This article is interesting. On a very basic level it highlights why people are starting to push back on EDI. If what is contained in this article is true and not misrepresented in any way it is pretty shocking that this is they type of material aimed at children in the name of EDI. I don't even think that material like this can be said to have it's heart in the right place.

https://dailysceptic.org/2024/09/01/outrage-over-school-textbook-branding-traditional-irish-families-as-bigoted-while-glorifying-diverse-families-and-forcing-kids-to-choose-sides/

That is so offensive I don't know where to start.

Bananaspread · 02/09/2024 13:06

newmummycwharf1 · 01/09/2024 16:24

It is possible that you are more learned on the topic than the vast number of Professors of neonatology and Obs &Gynae involved in conducting the systematic reviews used to inform this policy paper:
https://www.nhsrho.org/research/review-of-neonatal-assessment-and-practice-in-black-asian-and-minority-ethnic-newborns-exploring-the-apgar-score-the-detection-of-cyanosis-and-jaundice/

It is also possible that you are aware that systematic reviews/meta-analysis are a higher level than randomised controlled trials - so the highest level of evidence

If the positive predictive value of a screening tool is lower for a group of people - it is not fit for purpose for that group and needs updating. To most people - that goes without saying. The point is to improve the screening tests to the rate of detection is improve for all babies it is applied and intervention introduced early to prevent negative outcomes including death.

Again - hope that helps.

What a refreshingly open-minded response [sarcasm]. This exemplifies the problem: no engagement with the actual points made, mostly sneering.

LilyBartsHatShop · 02/09/2024 14:22

@newmummycwharf1
“It is possible that you are more learned on the topic than the vast number of Professors of neonatology and Obs &Gynae involved in conducting the systematic reviews used to inform this policy paper:
https://www.nhsrho.org/research/review-of-neonatal-assessment-and-practice-in-black-asian-and-minority-ethnic-newborns-exploring-the-apgar-score-the-detection-of-cyanosis-and-jaundice/

I doubt it. I’d prefer it if you posted without sarcasm because it makes it difficult to follow your argument.

“It is also possible that you are aware that systematic reviews/meta-analysis are a higher level than randomised controlled trials - so the highest level of evidence”
The section of the report comprising a systematic review of studies of APGAR testing in newborns of differing ethnicities only includes six studies, but some of those are really big studies so: good data. What it shows is that a low APGAR score is more likely to be associated with infant mortality for (racialised) white newborn infants compared with (racialised) black newborn infants. However, the association is still there for all infants, “The impact of the Apgar score on neonatal mortality was considered in two large, linked birth-death datasets. The first (Mihoko Doyle et al., 2003) included 6,544,004 infants and the second (Li et al., 2013) included 25,936,357 infants. Both studies found that low Apgar score is predictive of neonatal death across different ethnicities.” (p30 of your linked report).

“If the positive predictive value of a screening tool is lower for a group of people - it is not fit for purpose for that group and needs updating. To most people - that goes without saying. The point is to improve the screening tests to the rate of detection is improve for all babies it is applied and intervention introduced early to prevent negative outcomes including death.”
I thinks it’s dishonest of you to add “including death” at the end of your paragraph. The negative outcomes for BAME newborns are all to do with over-assessment and over-treatment, there is no increased risk of infant mortality for BAME newborns associated with routine APGAR testing.
And I’m not sure that I agree this makes APGAR testing unfit for purpose. If APGAR testing were generating false negatives for BAME newborns I hope it would have been abandoned long ago. I don’t think it’s as clear cut for false positives. One policy and procedure change suggested in your linked report is that all newborn infants (or maybe just BAME newborn infants, I can’t actually tell from the way it’s written) have their blood oxygen levels assessed via use of a pulse oxymeter. This is an objective screen with no regard for skin colour, but it also involves pressing the oxymeter around the infant’s big toe, and it brings another piece of medical paraphernalia into the birthing suite, another beeping machine. There is a big push from birthing mums to only bring in the beeping machines when they’re absolutely needed at the time of birth, and the nice thing about the APGAR screen is that it just involves a midwife looking at bub – which she’s likely to be doing with joy and affection anyway.
Maybe the issue is whether you think midwives don’t give the “well perfused” APGAR point to BAME newborns because they’re racist, or if it’s because it’s harder to tell, looking at a newborn infant with dark skin, that said skin is well perfused. Maybe it’s better to hand the assessment over to the machines, which are thoroughly objective. But I think that’s a moot point (and I don’t think it’s necessary).

“Again - hope that helps.”
This sounds passive-agressive and snarky but I’m not sure what you’re being snarky about.

Review of Neonatal Assessment and Practice in Black, Asian and Minority Ethnic Newborns: Exploring the Apgar Score, the Detection of Cyanosis, and Jaundice

A new review published today by the NHS Race and Health Observatory outlines challenges in neonatal care for Black, Asian and minority ethnic babies, alongside clear recommendations on tackling them.

https://www.nhsrho.org/research/review-of-neonatal-assessment-and-practice-in-black-asian-and-minority-ethnic-newborns-exploring-the-apgar-score-the-detection-of-cyanosis-and-jaundice

LilyBartsHatShop · 02/09/2024 14:54

Just another thing on the recommendation that all newborn infants have their blood oxygen levels screened with the use of pulse oxymeters:
The recommendation is that, because currently BAME newborn infants are exposed to more unnecessary assessments than white newborn infants, therefore all newborn infants should be exposed to an unnecessary clinical assessment procedure that most of them don't need.
My mind isn't made up on this, maybe that is the best way forward. But I'm not convinced and I think it's dangerous hyperbole to say disagreement can only be racism.

newmummycwharf1 · 02/09/2024 15:25

LilyBartsHatShop · 02/09/2024 14:54

Just another thing on the recommendation that all newborn infants have their blood oxygen levels screened with the use of pulse oxymeters:
The recommendation is that, because currently BAME newborn infants are exposed to more unnecessary assessments than white newborn infants, therefore all newborn infants should be exposed to an unnecessary clinical assessment procedure that most of them don't need.
My mind isn't made up on this, maybe that is the best way forward. But I'm not convinced and I think it's dangerous hyperbole to say disagreement can only be racism.

And because 'pink all over' isn't an adequate screen even for White babies - as the report says. Apgar scores where introduced in the 1950s. The recommendation includes a systematic review of other scores that may be more robust. Pulse oximeters are non-invasive and more accurate for everyone (not perfect - so ongoing research there too).

And the reason I am being snarky and no longer engaging on this thread is that the most robust evidence - including systematic reviews is presented and the response is 'hyperbole'. The conversation is not with fruitful or helpful as the evidence provided is not being critically appraised.

So I bow out - live in your bubble, whilst I proactively change mine. That brings me great joy!

anyolddinosaur · 02/09/2024 15:39

Actually I think newmummycwharf1 has gone back to school so doesnt have as much time for mumsnet. Any serious individual would have been pleased to give documented examples of the benefits that diversity has brought - but businesses are cutting back on the gravy train because it hasnt brought those benefits,

I used to employ a lot of people from ethnic minorities. When people faced a lot of discrimination those that managed to make it to applying for the posts I recruited for were frequently better qualified and better motivated than other potential applicants. No positive discrimination as such, they deserved their jobs. They were harder working and more loyal because they feared they'd find it harder to go elsewhere. As discrimination reduced the standard of applicants dropped back to a similar level to other applicants. Now I expect it's fallen below it because the woke have told them to claim discrimination for anything and everything. So "early adopters" did reap benefits from having more diverse employees but that benefit has vanished.

GargoylesofBeelzebub · 02/09/2024 16:07

So I bow out - live in your bubble, whilst I proactively change mine. That brings me great joy!

<<snort>>

Hoardasurass · 02/09/2024 16:17

newmummycwharf1 · 02/09/2024 15:25

And because 'pink all over' isn't an adequate screen even for White babies - as the report says. Apgar scores where introduced in the 1950s. The recommendation includes a systematic review of other scores that may be more robust. Pulse oximeters are non-invasive and more accurate for everyone (not perfect - so ongoing research there too).

And the reason I am being snarky and no longer engaging on this thread is that the most robust evidence - including systematic reviews is presented and the response is 'hyperbole'. The conversation is not with fruitful or helpful as the evidence provided is not being critically appraised.

So I bow out - live in your bubble, whilst I proactively change mine. That brings me great joy!

Sorry but your wrong about pulse oximeters they are highly inaccurate for anyone without white skin infact the darker your skin is the less accurate they are so you would only really improve things for white babies whilst potentially making things worse for black and Asian babies, thus increasing the inequality of outcomes

OP posts:
JandLandG · 02/09/2024 16:53

1dayatatime · 01/09/2024 23:50

@XChrome

The issue I have with the hard left woke is that they are fascist in trying to silence by either threats of de platforming those that disagree with their views whether that be JK Rowling or even Farage.

They are also authoritarian and anti democratic in seeking to outright ban certain political parties such as Reform.

They are undermining an independent judicial system through political interference (two tier policing).

So yes I do see the hard left woke as a serious danger to us all.

What a garbage post.

Who's seeking to "outright ban" Reform?

Two-tier policing? Which right-wing idiot did you pick that phrase up from?

"Undermining the independent judicial system?" I thought that was the Daily Mail day after day when the judges said that your mate Johnson couldn't shut down parliament.

Have I got that wrong?

Clown.

TempestTost · 02/09/2024 17:34

One of the reasons APGAR scores are so useful as a dirt line basic assessment is because they don't actually require any equipment. It really doesn't matter what has gone wrong, if you are in a field, if there has been a hurricane and there is no power, you can do those assessments. They don't work as well if you only do them in emergency situations, it's much better if they are practiced constantly.

That's not to say that if a test that was better should come in it shouldn't be considered though of course downsides should be looked at too. One poster above mentioned reducing beeping equipment - there are also people who think it's much better not to remove the infant from the mother at all if possible which also tends to less invasive approaches.

I think a really interesting question though is whether the bar should be around race based equivalency. WHat if someone invented a new test that meant problems were caught 50% more often, but it worked better for black babies, and was only a 20% improvement for white ones? Would we therefore not want to use it?

Is it a reasonable assumption that it is always possible for treatments and screening tools to work equally well for everyone? For every group? It's a great goal to be able to treat everyone with equal success but surely we know that is not always how it works? It doesn't mean we think they are worth less.

TempestTost · 02/09/2024 17:36

And APGARs are supposed to be a very quick screening, that's part of the point.

TempestTost · 02/09/2024 17:40

anyolddinosaur · 02/09/2024 15:39

Actually I think newmummycwharf1 has gone back to school so doesnt have as much time for mumsnet. Any serious individual would have been pleased to give documented examples of the benefits that diversity has brought - but businesses are cutting back on the gravy train because it hasnt brought those benefits,

I used to employ a lot of people from ethnic minorities. When people faced a lot of discrimination those that managed to make it to applying for the posts I recruited for were frequently better qualified and better motivated than other potential applicants. No positive discrimination as such, they deserved their jobs. They were harder working and more loyal because they feared they'd find it harder to go elsewhere. As discrimination reduced the standard of applicants dropped back to a similar level to other applicants. Now I expect it's fallen below it because the woke have told them to claim discrimination for anything and everything. So "early adopters" did reap benefits from having more diverse employees but that benefit has vanished.

It's an interesting question - the idea that "diversity" brings benefits to a business is pretty much a faith based statement as far as I can see.

Sometimes, some kinds of diversity can. Sometimes, some kinds can cause difficulties. In a lot of instances they are pretty neutral.

A certain amount of diversity of personality and thinking styles can usually be pretty helpful in a workplace. Not always though.