Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial

This is a repost promoting content originally published elsewhere. See more things Dan's reposted.

by BMJ

Conclusion

Parachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention.

However, the trial was only able to enroll participants on small stationary aircraft on the ground, suggesting cautious extrapolation to high altitude jumps.

Representative study participant jumping from aircraft with an empty backpack. This individual did not incur death or major injury upon impact with the ground

As always, when the BMJ publish a less-serious paper, it’s knock-your-socks-off funny. In this one, a randomised trial to determine whether or not parachutes are effective (compared to a placebo in the form of an empty backpack) at preventing death resulting from falling from an aircraft, when used by untrained participants, didn’t get many volunteer participants (funny, that!) until the experiment was adapted to involve only a leap from a stationary, grounded aircraft with an average jump height of 0.6 metres.

Silly though this paper is, its authors raise a valid point in the blog post accompanying their paper:

That no one would ever jump out of an aeroplane without a parachute has often been used to argue that randomising people to either a potentially life saving medical intervention or a control would be inappropriate, and that the efficacy of such an intervention should be discerned from clinical judgment alone. We disagree, for the most part. We believe that randomisation is critical to evaluating the benefits and harms of the vast majority of modern therapies, most of which are unlikely to be nearly as effective at achieving their end goal as parachutes are at preventing injury among people jumping from aircraft.

However, RCTs are vulnerable to pre-existing beliefs about standard of care, whether or not these beliefs are justified. Our attempts to recruit in-flight passengers to our ambitious trial were first met with quizzical looks and incredulity, predictably followed by a firm, “No, I would not jump without a parachute.”  For the majority of the screened population of the PARACHUTE trial, there was no equipoise—parachutes are the prevailing standard of care. And we concur.

But what if we provided assurances that the planes were stationary and on the ground, and that the jump would be just a couple of feet? It was at this point that our study took off. We set out in two groups, one at Katama Airfield on Martha’s Vineyard and the other at the Yankee Air Museum in Ann Arbor. One by one, our study subjects jumped from either a small biplane or a helicopter, randomised to either a backpack equipped with a parachute or a look-a-like control. As promised, both aircraft were parked safely on terra firma. The matchup was, unsurprisingly, a draw, with no injuries in either group. In the first ever RCT of parachutes, the topline conclusion was clear: parachutes did not reduce death or major traumatic injury among people jumping from aircraft.

But topline results from RCTs often fail to reveal the full story.  We conducted the PARACHUTE trial to illustrate the perils of interpreting trials outside of context. When strong beliefs about the standard of care exist in the community, often only low risk patients are enrolled in a trial, which can unsalvageably bias the results, akin to jumping from an aircraft without a parachute. Assuming that the findings of such a trial are generalisable to the broader population may produce disastrous consequences.

Using humour to kickstart serious conversations and to provide an alternative way of looking at important research issues is admirable in itself.

Dan Q performed maintenance for GC7QG1Z Oxford’s Wild Wolf Three

This checkin to GC7QG1Z Oxford’s Wild Wolf Three reflects a geocaching.com log entry. See more of Dan's cache logs.

At community suggestion, replaced containers at waypoints #1 and #2 with smaller, more-discreet variants to help reduce risk of future muggling. A geocacher still shouldn’t struggle to find these containers, though: they’re pretty obvious once you’re looking in the right place!

To Protect Migrants From Police, a Dutch Church Service Never Ends

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by Patrick Kingsley

…[A] marathon church service, which started more than six weeks ago, and hasn’t stopped since, can never take a break.

Under an obscure Dutch law, the police may not disrupt a church service to make an arrest. And so for the past six weeks, immigration officials have been unable to enter Bethel Church to seize the five members of the Tamrazyan family, Armenian refugees who fled to the sanctuary to escape a deportation order.

The service, which began in late October as a little-noticed, last-gasp measure by a small group of local ministers, is now a national movement, attracting clergy members and congregants from villages and cities across the Netherlands. More than 550 pastors from about 20 denominations have rotated through Bethel Church, a nonstop service all in the name of protecting one vulnerable family.

Beautiful story of the Dutch church that’s been running a non-stop service (with over 500 pastors from various denominations contributing in shifts) for six weeks and counting in order to protect from deportation a family who’ve been taking refuge inside. The whole piece is well worth your time to read, but aside from the general joy and good feels that fill it, I was also impressed by how widely it’s inspired preachers to try things that are a little different:

Some preachers simply reuse services and sermons they gave at other churches. But others have used the opportunity to try something new, turning the church into a kind of greenhouse for liturgical experiments.

Ms. Israel read from a modern reinterpretation of the biblical story of King David and his wife Bathsheba, told from Bathsheba’s perspective. One minister incorporated meditative song into her service, and another interspersed prayers and hymns with sermons from Martin Luther King Jr. During one all-nighter, Mr. Stegeman even brought along a harpist.

Of course, let’s not forget that this is another one of those happy-news-stories-with-an-underlying-sad-story. Given that the family in question, according to the article, have successfully appealed against their deportation twice, and furthermore the duration of their stay so far should at least grant the children amnesty under Dutch law, it sounds like their deportation shouldn’t really be happening in the first place! It’s great that a community has come together to protect them, but wouldn’t a better happy story be if the country that’s supposed to be protecting them were doing so, instead, so that the community didn’t have to?

Still; a little cheer there, at least.

If your kid stops believing in Santa this year…

This is a repost promoting content originally published elsewhere. See more things Dan's reposted.

by Imgur

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“In our family, we have a special way of transitioning the kids from receiving from Santa, to becoming a Santa. This way, the Santa construct is not a lie that gets discovered, but an unfolding series of good deeds and Christmas spirit.
When they are 6 or 7, whenever you see that dawning suspicion that Santa may not be a material being, that means the child is ready. I take them out “for coffee” at the local wherever. We get a booth, order our drinks, and the following pronouncement is made: “You sure have grown an awful lot this year. Not only are you taller, but I can see that your heart has grown, too. [ Point out 2-3 examples of empathetic behavior, consideration of people’s feelings, good deeds etc, the kid has done in the past year]. In fact, your heart has grown so much that I think you are ready to become a Santa Claus.

You probably have noticed that most of the Santas you see are people dressed up like him. Some of your friends might have even told you that there is no Santa. A lot of children think that, because they aren’t ready to BE a Santa yet, but YOU ARE.

Tell me the best things about Santa. What does Santa get for all of his trouble? [lead the kid from “cookies” to the good feeling of having done something for someone else]. Well, now YOU are ready to do your first job as a Santa!” Make sure you maintain the proper conspiratorial tone.

We then have the child choose someone they know–a neighbor, usually. The child’s mission is to secretly, deviously, find out something that the person needs, and then provide it, wrap it, deliver it–and never reveal to the target where it came from. Being a Santa isn’t about getting credit, you see. It’s unselfish giving.

My oldest chose the “witch lady” on the corner. She really was horrible–had a fence around the house and would never let the kids go in and get a stray ball or Frisbee. She’d yell at them to play quieter, etc–a real pill. He noticed when we drove to school that she came out every morning to get her paper in bare feet, so he decided she needed slippers. So then he had to go spy and decide how big her feet were. He hid in the bushes one Saturday, and decided she was a medium. We went to Kmart and bought warm slippers. He wrapped them up, and tagged it “merry Christmas from Santa.” After dinner one evening, he slipped down to her house, and slid the package under her driveway gate. The next morning, we watched her waddle out to get the paper, pick up the present, and go inside. My son was all excited, and couldn’t wait to see what would happen next. The next morning, as we drove off, there she was, out getting her paper–wearing the slippers. He was ecstatic. I had to remind him that NO ONE could ever know what he did, or he wouldn’t be a Santa.

Over the years, he chose a good number of targets, always coming up with a unique present just for them. One year, he polished up his bike, put a new seat on it, and gave it to one of our friend’s daughters. These people were and are very poor. We did ask the dad if it was ok. The look on her face, when she saw the bike on the patio with a big bow on it, was almost as good as the look on my son’s face.

When it came time for Son #2 to join the ranks, my oldest came along, and helped with the induction speech. They are both excellent gifters, by the way, and never felt that they had been lied to–because they were let in on the Secret of Being a Santa.”

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First up: why do people post galleries of images of text to Imgur? At that point, you’re taking some information, making it take up more space, be readable by fewer people, be harder to translate, inaccessible to robots, and result in less-readable text. It drives me nuts. Anyway, I converted the original images (which you can find behind the link if you really want) into text, above, thereby improving the entire thing immeasurably.

That minor rage out of the way: I’m not a fan of telling children that Santa is “real” in the first place, but if you’re going to do that, the approach promoted by the author of the above might come a close second. I’ve always seen the concept of Santa as being the representation of the spirit of anonymous gift-giving, and I love it for that reason. Just like the Easter Bunny representing the spirit of hiding chocolate eggs for other people to find, this approach fosters honesty, maturity, and the joy of the season and doesn’t have to detract from the magic of Christmas.

Merry Christmas, everybody.