Vous êtes sur la page 1sur 142

Editorial

Editorial ‘Do not ever quit out of fear of rejection’ Rejected by twelve publishers, a recently

‘Do not ever quit out of fear of rejection’

Rejected by twelve publishers, a recently divorced single mother and living in abject poverty - this is the woman behind the infinitely famous Harry Potter Series. JK Rowling is now a highly successful author and her work continues to inspire millions of children into reading and writing; but she is also someone who epitomises perseverance. After having her manuscript declined by the first publisher she approached, she could have consigned herself to fate and surrendered hope, but instead she persisted in approaching new publishers time and time again, convinced her hand-written manuscript (she did not have the means for a computer) had some merit.

Indeed, perseverance is the prevalent attitude behind all great Olavians. Acknowledging and learning from past mistakes in assessments, classwork and within friendships and continuing with essays, research and projects even in the face of adversity has led to the school’s highly impressive academic record in addition to the strong

relationships developed between peers. This journal’s collection of extended projects, higher projects, prize winning essays, journal articles and society descriptions are a testament to this persistence and have involved hours of research, drafting and re-drafting until perfect.

For our readers we have included a vast array of articles spanning several subject areas. For the historians, Thomas Laver’s extended project on Empires and Miranda Parkin’s second prize winning essay on Grecian masks prove scintillating reads; whilst Alex Bull’s extended project on French Literature during the occupation will also interest English students. For budding- scientists, Josephine Jones’ first prize essay on symmetry and the laws of nature and Harshdeep Gulati’s higher project are well worth reading. Medics should definitely reflect on Kosi Nwuba’s extended project on privatisation and its effect on patient care in the NHS.

The making of this journal was also underpinned by perseverance. From formatting, reformatting to collecting journal descriptions at the busiest points of students’ academic lives, we persisted to complete the journal and to deadline. We also thoroughly enjoyed this task and relished the accumulation of new knowledge through reading the articles on unfamiliar subject areas such as Richard Moulange’s extended project on statistical fallacies. We would like to thank Niko for designing such a brilliant and beautiful cover, Rachel for collecting the society

ST OLAVE’S ACADEMIC JOURNAL

contributions, Olivia, Luke and Richard, the editors of last year’s edition, for making our process far smoother, and also Dawud and Vithushan for establishing this journal five years ago, a testament to St Olave’s emphasis on scholarship.

In the spirit of perseverance, we hope this year’s edition will learn from its predecessors and be ever- more brilliant.

Poppy Kemp and Daniel Maghsoudi

Editors of the St Olave’s Academic Journal 2017

Foreword

With many of our peers graduating and beginning the next chapter of their lives as fully fledged, working adults, this being the fifth issue of the Academic Journal, bears even more importance for us. Its inception was frankly somewhat selfish. We wanted to leave a mark, a legacy of sorts, providing us a lasting connection to some of the best years of our lives. However, thanks to the exceptional students who have contributed articles ranging from dark matter to punk music and everything in between over the years, this journal has been, and is much more. It is a deserved showcase of the immense talent and scholarship seeping through the students at St Olave’s. The many articles and summaries of each society’s activities rightfully display the students’ extraordinary enthusiasm, depth of knowledge and yearning for more, beyond what is

ISSUE 5, SEPTEMBER 2017

offered by the curriculum. Through these endeavours of enrichment, these students, as they transition into the world of work, not only become prospective leaders and change-makers but also become, simply, interesting people. The breadth of this year’s publication is once again humbling and we wish all those who have contributed every bit of success in their future endeavours. We are immensely indebted to the editors for producing another wonderful issue and so thank you. Thank you for allowing us this legacy.

Vithushan Nuges and Dawud Khan

Founders of the St Olave’s Academic Journal

ST OLAVE’S ACADEMIC JOURNAL

Contents

Societies- News

ISSUE 5, SEPTEMBER 2017

Political Economy Society

6

Natural Sciences Society

6

Law Society

6

Debating Society

6

Literature Society

7

Medics Society

7

History Society

8

Maths Society

8

Philosophy Society

8

Arts and Humanities

Why did Greek actors wear masks?

Miranda Parkin (Year 12) - 9

Similarities between DNA and communication

in rugby

Emma Tolmie (Year 12) - 13

Israel and Palestine

The Snoopers’ Charter- A breach of our right to Privacy?

Tanay Vankayalapati (Year 12) - 16

Poppy Kemp (Year 12) - 19

Doughnut Economics; seven ways to think like a 21 st Century economist

Tara Pain (Year 12) - 22

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

Science and Medicine

Is physiological or psychological pain worse?

Symmetry and the laws of nature

Daniel Maghsoudi (Year 12) - 27

Josephine Jones (Year 12) - 30

Extended Project Qualification

Misunderstanding chance - why does it happen and why is it important?

To what extent does privatisation of the NHS effect patient care?

How was French literature used as propaganda during the Occupation?

Which Eurasian or Western empire exerted the greatest power after the fall of the Roman empire?

Richard Moulange (Year 13) - 35

Kosi Nwuba (Year 13) - 49

Alex Bull (Year 13) - 63

Thomas Laver (Year 13) - 87

Higher Project Qualification

Is rehabilitation in UK prisons effective in preventing reoffending?

Oliver Wright-Jones (Year 11) - 103

How will quantum cryptography effect computing?

Manav Babel (Year 11) - 108

Did punk music reflect dissatisfaction of young people in the 1970s?

James Harms (Year 11) - 115

How does music affect the body?

Harshdeep Gulati (Year 11) - 120

Are autonomous cars really the future and can they Dejan Fernandes (Year 11) - 124 be implemented in less than a decade?

ST OLAVE’S ACADEMIC JOURNAL

Societies

ISSUE 5, SEPTEMBER 2017

Saint Olave’s has an array of student-led societies which run every week. These cover a broad spectrum of subjects, and give students the opportunity to learn more about various topics of interest whilst gaining extra-curricular enrichment. The overviews below highlight the fantastic experiences and activities offered by some of these societies in 2017.

Political Economy Society

some of these societies in 2017. Political Economy Society Political Economy Society offers a rich mix

Political Economy Society offers a rich mix of topical discussion with focused talks by both current Olavian’s and guest speakers, on topics ranging from Brexit to drug policies to the economics of football. This diverse range of topics and talks makes attending Political Economy Society an excellent way of widening your knowledge, whether or not you are studying Economics. Moreover, the inclusive nature of the society, where everyone is able to voice their opinions means there is always a broad range of ideas being shared on a weekly basis. Most excitingly, the society boasts a history of inviting distinguished guests to speak. As a recent example, the founder of the Happy Planet Index- Nic Marks, gave an insightful talk into his work of the past decade and how his idea has spread across 178 countries. Ultimately, Political Economy Society is fun yet informative society which runs weekly on Thursday lunchtimes, with more prominent guest speakers lined up for the future.

James Tate

Natural Sciences Society

lined up for the future. James Tate Natural Sciences Society Natural Sciences is one of the

Natural Sciences is one of the biggest societies currently running at the school, and we house a wide range of members from medics to physicists to mathematicians, so everyone is welcome to join. We gather every Friday lunch, hosting student led talks, debate on current affairs linked to science and occasionally invite external

speakers in the form of Old Olavians or experts in their respective fields. The talks have ranged from “An introduction to Special Relativity,” given by an Old Olavian and previous president of the society David Van Egghen, to “Is Medicine Killing Us?” by year 11 student Harshdeep Gulati.

William To (Year 12)

Law Society

student Harshdeep Gulati. William To (Year 12) Law Society Law society meets every week to discuss

Law society meets every week to discuss and debate with others about controversial legal issues and current affairs. It also offers the chance to learn more about studying law, with opportunities to participate in mock trials and listen to talks from external speakers. We meet every Thursday at 1 in room 23, and all sixth form are welcome!

Alexander Martin

Debating Society

sixth form are welcome! Alexander Martin Debating Society Debating Society is the most popular society in

Debating Society is the most popular society in the school. Running every Monday lunchtime, it gives you the opportunity to discuss and debate key and topical issues. We follow a variety of debating styles to make debating at Saint Olave’s as diverse as possible. Debating is the most important skill anyone can have for any job and here you can practice with likeminded passionate individuals. From medic to lawyer; religious to

ST OLAVE’S ACADEMIC JOURNAL

atheist and everyone in-between; we are the number one society for you.

Maksim Richards

Literature Society

one society for you. Maksim Richards Literature Society Come along to Literature society on Tuesdays at

Come along to Literature society on Tuesdays at 1 in room 8 to discuss a range of topics, including drama, film and current affairs, as well as listen to external speakers. All are welcome, regardless of whether you are doing English A level, as an interest in literature is all that is required!

Medics Society

Alexander Martin

is all that is required! Medics Society Alexander Martin Since the new team of presidents took

Since the new team of presidents took over St Olave’s Medics Society in January 2017, the society has continued to be a vibrant and active platform for aspiring medics, dentists and vets to deepen their understanding of all aspects of the medical field. The weekly society meetings on Monday lunchtimes have given us the opportunity to witness many splendid student-led presentations, thought-provoking debates and discussions. We began our tenure as presidents with a presentation outlining major medical headlines and debated some of the issues faced by the NHS such as privatisation and junior doctor strikes. Subsequent meetings of the society played host to a wide range of excellent presentations delivered by students. The talks covered a wide range of topics within the medical field, including ‘Cancer treatments: The role of Nanobiotechnology’, ‘Sickle Cell anaemia’, ‘A brief history of medicine’ to name just a few. These talks not only increased the breadth of understanding and knowledge of the students who gave the talks and those who witnessed them but also provided an

ISSUE 5, SEPTEMBER 2017

opportunity for those who gave the talks to develop their presentation skills in a friendly and supportive environment. In February, members of the society had the privilege to attend the King’s College London Surgical Society’s National Surgical Conference at the Royal College of Surgeons. We listened to three fascinating lectures about innovations in the surgical field delivered by prominent surgeons and spent the afternoon taking part in workshops where we practiced surgical techniques such as suturing and laparoscopy. This conference was the first introduction to surgery for many of us and no doubt has kindled an interest in the field in some of us. Alongside the student-led presentations, we have also hosted several presentations by external speakers. These included a talk by the previous school captain Danny Jenkins, who is currently studying medicine at Cambridge University, during which he offered very useful advice concerning medical applications and an insight into studying medicine at Cambridge. This was followed by a talk given by school captain Kosi Nwuba, in which he described his personal experiences and offered advice concerning medical application. After that, we hosted a panel of successful medical applicants from the current year 13 cohort who shared their own experiences of the application process and gave the prospective year 12 applicants a range of tips to boost their own applications. These talks by successful applicants and medical students have proved to be extremely useful in preparing the current year 12 cohort as they embark on the arduous process of medical application. Lastly, we would like to congratulate all the successful medical, dental and veterinary applicants of the year 13 cohort and wish you all the best as you begin your university studies in September. Also, we wish all aspiring year 12 medics the best of luck as we prepare for our UKCAT exams during the summer.

Medics Society Acknowledgments

We would like to thank Dr. Bradley for her constant support and supervision of the society and also for providing a venue for our weekly meetings. We would also like to extend our gratitude to the many members of the society who have made the society successful through their regular attendance and contributions which include the presentations they delivered and the articles they have written for the journal. We look forward to having your continued support in the 2017/18 academic year.

Jeron Thaiparampil

ST OLAVE’S ACADEMIC JOURNAL

History Society

ST OLAVE’S ACADEMIC JOURNAL History Society St Olave’s History Society aims to go above and beyond

St Olave’s History Society aims to go above and beyond the curriculum, enlightening members on subjects they may otherwise never hear about in a simple and clear way. With several speakers a year including Oxbridge academics and Old Olavians our talks and debates cover a wide

range of topics from Historical Drama: Art or Artefact to The History of International Women’s’

Day. We also encourage thought-provoking debate and questions at the end of every talk, ideal for those wishing to further their interest in history or simply improve on their public speaking skills. We would love to see you all there on Monday lunchtimes irrespective of whether you study history or not!

Maths Society

Poppy Kemp

whether you study history or not! Maths Society Poppy Kemp Brought to you by your Presidential

Brought to you by your Presidential Team of Shavon, Filipa and Ted, Maths Society runs on Tuesday lunches where talks are given on various abstract areas of Maths. From the Möbius Strip to the maths behind the bottle flip, we cover it all in exciting fashion. Furthermore, external speakers often grace us with riveting talks. Recently, the Head of Indirect Tax at brewing company SAB Miller plc gave a thoroughly fascinating talk about his career with great advice about job applications. Legendary ex-Olavian Mathematicians often make guest appearances with presentations you would regret missing. In addition to talks, we conduct fun interactive activities and can promise there'll always be food! Be there or complete the square.

Shavon D’Souza

ISSUE 5, SEPTEMBER 2017

Philosophy Society

Shavon D’Souza ISSUE 5, SEPTEMBER 2017 Philosophy Society Saint Olave’s Philosophy Society, open exclusively for

Saint Olave’s Philosophy Society, open exclusively for Sixth Form, examines ethics, metaphysics, epistemology and logic; all of which are interpreted into the talks that we host. Each week, we have a presentation followed by debates that relate to what the speaker has said. Some presentations we have had include: ‘Is it right to kill someone? Can objective morality exist?’ and ‘Can science exist without philosophy?’; both by the current Presidents, Martin Senior and Cristiano Da Cruz. The former has a focus on ethics and epistemology, with some theology incorporated also; while the latter looks at metaphysics and logic. We have also had the outgoing presidents from last year give their final talk on ‘Existentialism and Nihilism’ which preceded an extensive debate surrounding the intrinsic meaning of life and other related regions of philosophy. We have also hosted a collaboration with Christian Union and Contemporary Issues, with the overall title: ‘Is God dead?’ Given the wide ranging views of our audience, we held an open debate, looking at different aspects such as creation, the afterlife, religious views etc. Other talks include ‘The Harm Principle’, ‘Was Sigmund Freud Right?’, ‘Consequentialism, Utilitarianism and Justice’. We continue to look forward to philosophical talks on cross curricular topics, including the media, art, science and many more…

Cristiano Da Cruz

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

Gladstone Memorial Prize

Miranda Parkin won second prize in the Gladstone Memorial Prize Essay Competition with her essay on Grecian masks.

Why

masks?

did

the

Miranda Parkin

actors

in

Arguably the most iconic convention of ancient Greek theatre, the prosōpon (mask) held a powerful role in both the practical and symbolic spheres of Greek tragedy. Interestingly, masks were not reputed perennial objects by the ancient Greeks themselves, being offered to the altar of Dionysus after performances, demonstrating the immense focus on religion the plays contained. This emphasis on worship was salient throughout the festivals the tragedies were performed in, like the City Dionysia, and the use of masks highlighted this; bringing about a sense of transformation and allowing both actor and audience to participate in honouring the god of the theatre. When attempting to understand why actors in Greek tragedy wore masks, it is important to know what these masks looked like. Depictions of tragedy on vase paintings illustrating theatrical masks remain paramount to our understanding of such objects, considering the paucity of evidence from both literary and material sources. Renderings of masks as shown on the Pronomos Vase (Figure One) suggest a lightweight face mask was used, which covered the entire head leaving only small apertures for the eyes and mouth. This can be seen with the performer lifting up his mask on the vase. These masks were created by a skeuopois, the ‘maker of properties’, and fashioned with cork, linen and wood; then fixed to an actor’s head by a sakkos (soft hood). Paint was used to show the beauty or ugliness of a character. Paint and tragedy were intimately linked, and characters were often shown as painted sculptures or compared with visual works of art. In Euripides’ Helen, the eponymous character wishes she could be ‘rubbed out like a painting, and have again in turn a plainer form instead of beauty’ 1 . The variation in paint, along with the exaggerated features of the mask, would enable the audience to easily identify stock characters such as the tragic hero. The weight of the mask’s value here should not be undermined as Greek tragedies were performed outdoors and there were often thousands of spectators. It would be difficult to determine the identity of characters from the furthest rows, and facial expressions would have

1 Euripides. Helen, line 253

Greek

tragedy

wear

almost certainly been lost. The exaggerated features of the masks assisted the audience in distinguishing individual characters; unique masks were crafted for specific roles such as Pentheus in Euripides’ The Bacchae. In addition, open-air spaces such as the Theatre of Dionysus at the foot of the Athenian Acropolis presented a challenge for both actor and spectator by being deficient in the focus afforded by a modern proscenium arch stage, whereby the audience’s peripheral vision (vision outside the central area of focus) is severely limited due to the dark auditorium. This places the actors on stage directly in the spectator’s foveal (central) vision; something harder to achieve in classical Greek tragedies due to the plethora of distractions ubiquitous to outdoor theatre. The donning of a mask in Greek tragedy (visible because of its exaggerated features) offers a clearer focal point for impassioned communication due to the subconscious attraction to human faces, ergo enabling the actors to stimulate an increased catharsis (the purging of emotions) from the

an increased catharsis (the purging of emotions) from the Figure One: Detail of the Pronomos Vase

Figure One: Detail of the Pronomos Vase depicting the performers of Herakles and Papposilenos. Attic red- figure volute krater by the Pronomos Painter, 400 BCE (Naples, Museo Nazionale Archeologico)

ST OLAVE’S ACADEMIC JOURNAL

audience. The importance of the mask here must

be stressed, as Greek tragedy was a didactic form

of theatre and raised thought-provoking questions in order to collectively cleanse the audience through a release of emotion.

A fundamental reason why actors in Greek

tragedy wore masks also derives from the fact that Greek theatre of the 5 th century BC never included more than three actors in one play after Sophocles’ introduction of the third performer. Since there were no professional actors, performers had to be trained specifically for the plays hence it was cheaper to hire a select few. Despite this, there were no lack of roles in the plays; Sophocles’ Antigone consists of eight speaking characters. The unequal ratio of roles to performers meant actors were forced to multirole, and it was essential to repeatedly switch roles

throughout the performance. The use of masks in Greek tragedy enabled this transition to happen quickly and thus effectively allowed the actors to portray a number of personas. The denial of individuality prevented the audience from identifying one distinct character to a particular actor, granting the performer the power to successfully appear in several discrete roles. Rightly so, the cardinal use of masks must be stressed as actors in Classical Greek theatre were exclusively male. Since there were no actresses, male actors were required to play female roles, disguising themselves through a feminine mask,

as shown in the Pronomos Vase. The distinct

features of individual masks allowed the audience to recognise a character’s gender, age, and social status; with female roles identified by the lighter complexion and higher contrast of the feminine mask, perhaps mirroring the ways in which Greek women whitened their faces. Masks were advantageous for a Greek tragic actor as they helped to display a change in a character’s physical appearance, an example of this being when Oedipus blinds himself in Sophocles’ Oedipus the King. The actor playing this role would enter the skene with his new mask successfully presenting the alteration in his character. In this play, the use of such an object would have helped the tragic actor immensely; gory make-up was easier to place on masks. This would have also reduced the risk of humour; if badly applied, paint would look significantly more comical on the actor’s face. Masks therefore proved incredibly useful for the tragic actor as it allowed a performance of Greek tragedy to run smoothly devoid of slow transitions between roles, as well as preserving clarity concerning the

identification of characters. Because of their worth in practicality, an important reason why actors in Greek tragedy wore masks was because the object made the performance easier for both actor and spectator, consequently contributing heavily to the tragedy’s overall success. Furthermore, masks in Greek theatre enhanced an actor’s personal performance. Masks

ISSUE 5, SEPTEMBER 2017

significantly limited an actor’s vision as his gaze was directed through the small apertures for the eyes, resulting in the optic field becoming considerably narrow. Consequently, the actor’s ability to concentrate would greatly increase, as the minimisation of sight would eliminate a substantial amount of distractions which the open-air theatre would have provided. Masks placed a larger emphasis on the act of akroasis (attentive listening), as well as encouraging the actor to convey his emotions through the tone of his words. Inspired, Aristotle stated in his Rhetoric that acting was ‘a matter of voice’ 2 in which volume, harmony and rhythm were imperative. Scholars even put forward the idea that the mask itself was a resonance chamber; the aperture for the mouth being deliberately carved in a way as to enhance the quality of sound. Although this idea has been widely discredited, the use of the mask would have placed a sizeable gravity on the tone of the actor’s voice, their body language, and the actual dialogue of the play. Denying performers the ability to convey emotions through facial expressions placed them in an unparalleled state of awareness and forced them to concentrate on their body, enabling them to focus the audience through their highly developed presence and movements. The importance of each gesture, each

presence and movements. The importance of each gesture, each Figure Two: The Maenad Stamnos. Red-figure stamnos

Figure Two: The Maenad Stamnos. Red-figure stamnos depicting maenads dancing around an idol of Dionysus by the Dinos Painter, late 5 th c BCE. (Naples, Museo Nazionale Archeologico)

movement of the head, would increase to a much grander scale. The significance of the use of the mask in Greek tragedy is accordingly large, as body language would be easier for the audience to

2 Aristotle. Rhetoric, Book 3, Chapter 1

ST OLAVE’S ACADEMIC JOURNAL

detect than facial expressions, which were lost to those seated in the furthest rows. Actors in Greek tragedy therefore wore masks to improve their own performances, and as a result enhanced the quality of the play.

Although the exact origins of tragedy are debatable, evidence suggests Greek theatre partially stems from the worship of Dionysus, the god of ecstasy and the wild. Dionysus Eleuthereus (the freer) represented the liminality between human and animal, emotion and intellect; providing an escape from daily normality. There are strong links between the rituals performed by the worshippers of Dionysus and the wearing of masks. On the Maenad Stamnos (Figure Two) the god is represented by a mask on a pole draped in a long robe, bearing a strong resemblance to the costume of a tragic actor. Indeed, Dionysus became recognised as the god of the theatre and Aristotle claims in his Poetics that tragedy itself emanated from the dithyramb (choral poem) of the Dionysian Mysteries. Furthermore, although many of Nietzsche’s ideas in The Birth of Tragedy can be dismissed, he unwittingly stumbles upon a plausible reason why Greek tragic actors wore masks. Nietzsche states, ‘In the Dionysian dithyramb man is incited to the greatest exaltation of all his symbolic faculties.’ 3 This links to the aim of tragedy in exploring heightened human emotions and concepts such as death; another theme connected to the rituals of Dionysus wherein maenads would kill and then eat the raw flesh of their prey. Ancient Greeks honoured Dionysus in a multitude of theatrical forms; through plays, music and dance. Actors in Greek tragedy would therefore wear masks to reflect the religious aspects of the theatre; the mask being reminiscent of the rituals of Dionysus Greek theatre could have developed from. Dionysian festivals such as the City Dionysia endeavoured to channel the emotional encounters intrinsic to the deity’s worship in a controlled environment through catharsis, perhaps attempting to restrain the power of this potentially dangerous god through careful release. Actors in a Greek tragedy would wear masks as they were performing something so dominantly Dionysiac that they were required to don the mask, the ‘symbol of Dionysiac rituals’ 4 as stated by Taplin. In these Dionysian Mystery cults worshippers would become intoxicated with wine and lose full control of their emotions, effectively creating a new identity. The transformation into another character achieved by the actors in Greek tragedy through their

3 Nietzsche, F. The Birth of Tragedy, 1995

4 Taplin, O. Didaskalia- The Journal for Ancient Performance, 2016

ISSUE 5, SEPTEMBER 2017

masks was reflective of this sense of metamorphosis. By putting on the mask, a performer was declaring he was becoming part of the story and initiating ekstasis (standing outside oneself). Here, the actors in Greek tragedy used the mask as a form of protection against the ‘danger of acting’. Ancient Greeks considered citizens impersonating the roles of women, barbarians and gods potentially hazardous. Donning the mask stripped the tragic actor of his individuality, thus affording the exemption and authorisation to perform actions deemed inconceivable in the normal life. As William Golding sums up in his novel Lord of the Flies, ‘the mask was a thing on its own, behind which [one] hid[es], liberated from shame and self- consciousness’ 5 . By shedding any remnants of individuality, the actor essentially creates space for the character he portrays, and in his place the tragic character is forged. Actors in Greek tragedy wore masks for a multitude of reasons both practically and symbolically. The use of masks in Greek theatre greatly enhanced the actors’ performances and allowed for a smooth running of the play, contributing heavily to its success. However, perhaps the ways in which the donning of the mask intricately linked the genre of tragedy to the rituals of the Dionysian Mystery cults remains the main reason why the mask became such an iconic convention of Greek theatre. Although the practicalities of the mask were important, the significance of the need to worship the god Dionysus throughout the tragedies prevails as the overriding reason as to why actors in Greek theatre wore masks as Dionysus himself was considered to be the main spectator of festivals such as the City Dionysia, wherein tragedies would have been performed. By enabling the actors to step outside of themselves and take on a new persona, masks firmly stand as a crucial element of Greek tragedy and played a vital role in the worship of the god Dionysus.

Bibliography

Perseus.tufts.edu. (2017). Euripides, Helen, line

at:

http://www.perseus.tufts.edu/hopper/text?doc=Eu r.%20Hel.%20271&lang=original [Accessed 4 Jan.

2017]

253.

[online]

Available

Perseus.tufts.edu. (2017). Aristotle, Rhetoric,book 3, chapter 1. [online] Available at:

http://www.perseus.tufts.edu/hopper/text?doc=Ari stot.%20Rh.%203.1&lang=original [Accessed 4 Jan. 2017].

Nietzsche, F. (1995). The Birth of Tragedy. New York: Dover Publications, p.7

5 Golding, W. Lord of the Flies, 1958

ST OLAVE’S ACADEMIC JOURNAL

Taplin, O. (2016). Didaskalia - The Journal for

Ancient Performance. [online] Didaskalia.net.

Available

http://www.didaskalia.net/issues/vol5no2/taplin.h

tml [Accessed 4 Jan. 2017].

at:

Golding,

edition). London: Faber and Faber, p.66

Meineck,

[online] Athensdialogues.chs.harvard.edu.

Available

http://athensdialogues.chs.harvard.edu/cgi-

bin/WebObjects/athensdialogues.woa/wa/dist?dis =82 [Accessed 4 Jan. 2017].

Berberovic, N. (2015). Ritual, Myth and Tragedy:

Origins of Theatre in Dionysian Rites. [online]

Epiphany.ius.edu.ba. Available at:

https://epiphany.ius.edu.ba/index.php/epiphany/a rticle/viewFile/117/111 [Accessed 4 Jan. 2017]. Greek Theatre. (2017). Costume & Masks.

at:

https://greektheatre.wordpress.com/home/ [Accessed 4 Jan. 2017]. Cartwright, M. (2016). Greek Theatre. [online] Ancient History Encyclopedia. Available at:

http://www.ancient.eu/Greek_Theatre/ [Accessed 5 Jan. 2017].

Hall, E. (2006). The Theatrical Cast of Athens.

Oxford: Oxford University Press. Taylor, D. (1975). Acting and the Stage. London:

G. Allen. The World of Athens. (1984). Cambridge [Cambridgeshire]: Cambridge University Press.

W.

P.

(1958). Lord

(2010). The

of

the

Athens

flies

(Orange

Dialogues.

at:

[online] Available

ISSUE 5, SEPTEMBER 2017

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

Gonville and Caius Linguistics Challenge Essay

Emma Tolmie won first place with in Gonville and Caius College, Cambridge’s first linguistic’s challenge essay competition on the unlikely similarities between DNA and communication in Ruby.

Similarities Between DNA and Communication in Rugby

Emma Tolmie

Perhaps if you are neither a biologist nor a rugby player, the languages associated with the two professions probably seem ludicrously different. Indeed, if you are either, or even both, the concepts of protein synthesis and set plays may appear starkly contrasting. However, I – an A-level Biology student and vice-captain of our school’s girls’ rugby team - find the similarities between the triplet code and the commands used by my rugby team to be very alike; both are systems of communication which allow stored information to be transferred into physical events – although I confess that making a protein is a somewhat different outcome to scoring a try. Firstly, and apologies for the deluge of jargon, I must explain DNA and protein synthesis in order to make this comparison possible. Protein synthesis is the process in which DNA (deoxyribonucleic acid), the polymer whose composition determines almost every aspect of our appearance from skin colour to shoe size, is unwound and used to make the proteins of which our bodies are composed. As of 1953, we have known the structure of this mesmerising chemical, and since this point our knowledge about it has developed in ways of which 19 th century scientists could only have dreamed. Watson and Crick’s ground-breaking paper outlined that the structure of DNA is a sugar-phosphate ‘backbone’ to which four different bases (known as A, T, G, and C) are attached, much like rungs to a ladder. Short sections of DNA, which is found in the nucleus of each cell in our bodies, are called genes, and each gene codes for the production of a particular protein. When a cell experiences a specific triggering factor, a cascade of chemical changes begins

the process known as DNA transcription; an enzyme called helicase temporarily unwinds the double helix, exposing the base sequences of each strand. A shorter molecule known as mRNA (messenger ribonucleic acid) is created using one existing strand of DNA as a template. The information encoded in the order of bases on the original gene is reflected in the order of bases on the strand of mRNA. This strand of mRNA then leaves the nucleus and travels to a part of the cell called a ribosome, where translation will occur. This is how the information encoded for by the sequence of bases is converted into

a chain of amino acids, which is the first

stage in any protein’s ‘life’. Translation begins with a molecule of transfer RNA bringing a specific amino acid alongside the mRNA strand. Which exact amino acid is brought is coded for by a sequence of three bases known as the triplet code. Every possible combination of three of the bases A U* G and C will cause a particular amino acid to be brought to the ribosome to become part of the protein. For instance, if the sequence of bases on a section of mRNA was ‘UCG’ then a molecule of tRNA carrying the amino acids serine would come and attach to the mRNA in the ribosome. When the next amino acid is brought into

place, a stronger peptide bond is formed between the two acids and the first tRNA molecule detaches from its amino acid,

leaving the acids like paperclips in a chain. As more amino acids are brought and added

to the chain, it becomes what is known as a

polypeptide.

In summary, information contained in the DNA in a cell’s nucleus is transcribed into a

ST OLAVE’S ACADEMIC JOURNAL

strand of mRNA, which is then translated by a ribosome into a protein.

*On a strand of mRNA, the base Uracil is used instead of Thymine Although the above is rather long-winded and far more scientific than is necessary in most people’s daily lives, a basic understanding of transcription and translation is required for my linguistic analogy to be comprehensible. The process through which information contained in DNA is transferred into mRNA by transcription and then a polypeptide by translation is similar to the way in which spoken commands work. The speaker thinks of words in their head, then ‘transcribes’ this information into spoken words in order to pass it on to whoever will be carrying out the command. This second person understands the information given to them and ‘translates’ it into a physical action. Like any language, these commands depend on two main factors: that the information is transferred correctly and that the receiver will be able to understand what to do with it. If a small error occurs in the transcription process – for example a molecule of Guanine where there ought to be a molecule of Adenine – then the information transferred from the nucleus to the ribosome would not be the correct information. Similarly, if, when the mRNA reached the ribosome, there was not some form of pre-arranged code (as yet it is unknown how the triplet code evovled) for what to do with the received information, then the information would remain a useless series of chemicals, rather than be transferrable into a valuable protein.

At this point you may be beginning to understand how biology and rugby can be linked. In our rugby team, we have a pre- arranged code of requests and commands which, when spoken out loud, result in a successful pass, dodge, tackle, etc. The very simplest of our commands result in the creation of the simplest actions – or proteins, as far as this comparison is concerned. If a player shouts “short left!”, then the player holding the ball will know to pass to someone who is a short distance away from her on her left. The first player has transcribed their mental phrase into a verbal one, and the second has heard this and translated it into a physical pass. Other

ISSUE 5, SEPTEMBER 2017

commands are more complicated, and involve the amalgamation of more than one command. “Boss, long right” means the ball- carrying player is to pass the ball a long way to the right to the player who shouted, skipping out another player who is between them in the line. The command “boss” is translated into missing out the intermediate player in an attempt to confuse the opposition, and “long right” is translated into passing to this certain location. Similarly, proteins can also be the product of more than one polypeptide; polypeptides which are usually coded for separately are combined in order to make the protein that is right for this particular occasion. In some circumstances, there is room for error or variation, in both DNA and rugby. Although each trio of bases codes for a specific amino acid each time it occurs, there are some trios which code for the same acid – e.g. both UCC and AGC happen to code for the amino acid serine, meaning that two (or even more) combinations can be synonyms. This is referred to as a hidden mutation, because the mistake was made, but the right outcome occurred so it was not noticeable. Likewise, both “boss” and “miss move” are code for skipping out an intermediate player and passing to the next person along. Similarly, both “short left” and “left short” would be understood. However, there are occasions upon which errors are too blatant to remain hidden. This could be a seemingly insignificant substitution of “Left!” for “Right!” or Guanine for Adenine, but the resultant pass or protein is too different to function properly. In DNA, these mutations are not hidden, and are the cause of genetically inherited disorders like cystic fibrosis, and in rugby these errors can mean the opposition takes the ball – neither is an ideal outcome, and can cause the organism/team in question problems. Mutations in DNA are the causes of evolution, giving us different characteristics which make us fitter or less fit for our surroundings and therefore more or less likely to emerge victorious from the constant competition of natural selection. A historical organism may have had a mutated gene (altered information), faulty transcription process (wrong information is passed on), or malfunctioning ribosomes (wrong action is taken) which led to a difference in protein production to its peers. If this mutation happened to be a hindrance in their habitat,

ST OLAVE’S ACADEMIC JOURNAL

they would not be able to outcompete their peers and would not survive, while if it was by chance an advantage, they would live to compete another day. In the same way if a rugby team has an ineffective communication system, consistently poor tactics, or insufficient passing skills they will not win their matches and will be eliminated, unable to proceed in their competitive tournament. If they happen to get lucky by a mistake turning into an advantage, they may go on to win and develop this new tactic to help them win later games. The main difference in the principles of these two languages is that rugby teams can adapt much faster and – crucially – at will. DNA mutation is blindly guided by evolution, and organisms with sequences which result in disadvantageous protein output will die out. If our rugby team loses a match, we have the ability to consciously assess exactly what went wrong and choose to change it. If we couldn’t respond to

ISSUE 5, SEPTEMBER 2017

commands effectively, we can practice our passing. If our tactics were ineffective, we can devise new ones. Finally, if our communication system was flawed, we have the luxurious ability to switch to a different one, one which can translate our ideas into success. The hallmark of a language is that it is a system of transferring information from one person or place to another - which both the systems of transcription/translation and our rugby team’s codes are capable of doing. Despite the fact that DNA is a bank of information contributed to by innumerable life forms over millions of years, while our rugby tactics have developed over the course of two seasons, they each provide us with the ability to adapt to our situations successfully. The key to this success is transferring this stored information into actions, so whether this transfer begins with the enzyme helicase or the referee’s whistle, it is communication which enables our success.

ST OLAVE’S ACADEMIC JOURNAL

Israel and Palestine

ISSUE 5, SEPTEMBER 2017

How the breakup of the Ottoman Empire led to this century-long conflict with no end in sight.

Tanay Vankayalapati

After the end of the First World War in 1918, Europe was facing a crossroads. Whilst Germany had fallen, there was now the decision of how to deal with the defeated nation and its associates. For the Ottoman Empire, which had been the primary Islamic state in the world, and at the height of its powers, held land stretching from the gates of Vienna, through the Balkans, and across North Africa, the decision to split them had already been made. The Sykes-Picot Agreement of 1916, written secretly between the British and the French, agreed the partition of the Ottoman territory, come the end of the war. The British saw this region as vital, not only in providing a clear land route through to the jewel of their Empire in India, but also to negate the growing Russian influence. After the 19 th century was dominated by the so-called ‘Great Game’, a struggle between the two superpowers over Central and Southern Asia, an air of distrust still defined their relationship. To the delight of the British, the newly founded League of Nations gave them the desired land, including notably, the Mandate for Palestine in 1922.

This region would however, be unlike any of the other gained territories. Back in 1917, the Balfour Declaration, named after the then Foreign Secretary Arthur Balfour, had been published, which asserted that Britain would seek to establish a Jewish ‘national home’ in

Palestine, in an attempt to gain the support of the powerful Jewish members of society to try and win World War 1. Now, they had to keep their promise, and in the coming decades, hundreds of thousands of Jews immigrated to the area, arriving initially from the post-revolutionary chaos of Russia and fleeing persecution in Poland and Hungary. This was only exacerbated with the Ha’avara Agreement, approving the movement of Jews from Nazi Germany to the territory, and between 1928 and 1938, 250,000 Jews immigrated to the area. This influx was not however met positively by the local Arab population.

The 1936-39 Palestinian revolts was a largely nationalist movement, which whilst being quelled, was the first time the suggestion of a separate Jewish and Palestinian state reached mainstream attention, and a temporary suspension of new immigrants was imposed. Soon however, the Holocaust not only called this ban into question, but also emphasised the need for a safe space for the Jewish people from persecution, energising the Zionist movement. When the post-war Labour government renegaded on their manifesto promise to create a new Jewish state, the Jewish Resistance Movement launched terror attacks against the British. By 1947, the government was ready to defer control of the issue to the United Nations. The plan devised, setting up an independent Jewish state in Israel, an independent Palestinian state, and

ST OLAVE’S ACADEMIC JOURNAL

special status for the City of Jerusalem, was adopted in May the following year, and deeply angered the Palestinians. A civil war erupted, but the Jewish forces, backed by American sympathisers and Stalin’s Soviet Union, easily won. However, a far greater threat emerged when the Arab League, a group of nations in the area, decided to go to war with the newly founded state of Israel

to back up the Palestinians, in the 1948

Arab-Israeli War.

A year-long conflict ensued, and despite

initial losses, the Israel Defence Forces eventually came out victorious, and an armistice was agreed, with Israel keeping 30% more territory beyond the scope of what they were initially mandated, expanding into Palestinian land. Relative peace was seen as Israel grew and established itself as a major power in the region. This was broken in 1967 as Egypt invaded in the Six Days War, where Israel again routed the Arab forces, this time taking control of more territory, notably, the Gaza Strip, East Jerusalem and the West Bank. As neither side recognised the other’s existence, tensions grew. Illegal Israeli settlements in these territories were set up, whilst the Palestinian Liberation Authority (PLO) led by Yasser Arafat, became famous across the world for resisting Israeli rule.

After a series of further conflicts, US President Jimmy Carter negotiated the Camp David Accords in 1978, which set out a framework for relationship between Israel and Egypt, aiming to secure long-lasting peace in the region. However, internal tensions were still brewing, and by 1987, the first Palestinian Intifada (Uprising) occurred, and whilst violence was a feature, the most notable consequence was the founding of Hamas, the far more religious and arguably more

ISSUE 5, SEPTEMBER 2017

radical Palestinian independence movement, compared to the PLO. This set up the necessity for a peace process to occur with the more moderate elements, and after the election of peace-seeking Israeli Prime Minister Yitzhak Rabin, this was made possible. Under President Clinton in 1993, the Oslo Accords were signed between Israel and the PLO, which outlined the steps needed for a proper Palestinian state to be founded in exchange for the end of all terror operations, and peace was as close as it had ever been. However, radical movements on both sides opposed the deal, and in 1995, Rabin was assassinated by a far-right Zionist group. The elections which followed saw the far right leader Benjamin Netanyahu arise to power, and under his premiership, the Peace Process grinded to a halt. In 2000, he had been replaced by Prime Minister Barak, who was willing to offer a wide array of concessions to solve the issue, but Arafat refused to hear out the proposals as all of his demands were not met, and the talks broke down. Opinions became more partisan and angered, blaming the other side for the failure to achieve peace, and when 1,000 Israeli armed guards marched to the Temple Mount, one of the holiest sites in both Islam and Judaism, conflict erupted, in the Second Palestinian Intifada.

In defence, Israel created a wall around the West Bank, however this was built not in line with the established border, and was seen as an offensive encroachment onto their land by the Palestinians. They responded by electing Hamas to replace the PLO after Arafat’s death in 2006, who presented a far more radical outlook, refusing the right for Israel to exist as a state. Rocket attacks became a staple of their methodology, causing Netanyahu

ST OLAVE’S ACADEMIC JOURNAL

to be re-elected, creating the Iron Dome,

a mobile air defence system, and setting

up violent incursions into Palestinian land.

At the moment, the Israeli-Palestinian conflict is seemingly nowhere near a conclusion, with both sides able to voice serious and legitimate issues with the other. This however, was an issue, which was not born organically, but rather engineered by the split up of the Ottoman Empire by Western powers, in

a region whose intricacies they did not

fully understand, causing a conflict of a

scale they could not have predicted. However, history has shown us that there is hope, and that one day, perhaps those very same powers can play a role in bringing both sides to the table, and resolving the conflict they helped to create.

ISSUE 5, SEPTEMBER 2017

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

The Snoopers’ Charter - A breach of our right to privacy?

Poppy Kemp

1. Introduction

The Snoopers’ Charter, or Investigatory Powers Act (IP Act), 2016 enables forty-eight companies to ‘intercept and hack into millions of ordinary citizens’ communications’ 6 , in the interests of security. However, the Act has amassed vehement opposition with several politicians dismissing it as an encroachment on our right to privacy. Consequently, this article aims to outline some of the Act’s implications for privacy, ultimately arguing that it is not a violation, due to the loose provisions of the European Convention of Human Rights (ECHR) and provided strict safeguards are implemented.

2. What

is

Charter?

the

Snoopers’

In Theresa May’s words, the Charter was drafted to ‘tackle child sexual exploitation, to dismantle serious crime cartels, take drugs and guns off our streets and prevent terrorist attacks’ 7 . Its powers therefore include:

6 Theresa May: Internet data will be recorded under new spy laws, Michael Wilkinson, The Telegraph, http://www.telegraph.co.uk/news/uknews/terrorism - in - the - uk/11974112/New - spying - powers - to - be - unveiled - by - Theresa - May - live.html , 04/11/15 7 Foreword from the Home Secretary, Theresa May, The Investigatory Powers Act, 2016

1. Intercepting data in transit. 2. Hacking electronic devices to acquire communications data. 3. Retention of internet records for 12 months. 8

Although forty-eight government companies including the Serious Fraud Office, the Met Police and Food Standards agency are eligible to enforce these three provisions without a warrant, they are overseen by the Investigatory Powers Commission (IPC) appointed by the Prime Minister. This is headed by Lord Justice Fulfront, a highly experienced international criminal court judge, quashing the fear that a random, untrained civil servant will be able to access their internet history.

3. Implications for Privacy

3.1 What is Privacy?

poses some

implications for privacy, but before establishing what these

Clearly the act

8 The UK Investigatory Powers Act 2016 – what

it will mean for your business, Graham Smith,

Bird

Bird,

https://www.twobirds.com/en/news/articles/2016/

uk/what-the-investigatory-powers-bill-would-

mean-for-your-business, 29/11/16

&

ST OLAVE’S ACADEMIC JOURNAL

are, it is important to understand what privacy is. Privacy is defined as ‘a state in which one is not observed or disturbed by other people’ 9 . It is given under Article 8 of the EHCR (‘private and family life’ 10 ); however, it is not guaranteed because it can be overruled ‘in the interests of national security’ 11 . This vague provision of security justifies the IP Act’s disjoint with privacy.

Internet privacy is similarly arcane. Under the 1995 EU Data Protection Directive our UK Data Protection Act (1998) was introduced ensuring the protection of ‘personal data stored on computers 12 ’. However, as R Agliolo 13 notes, the Act is inadequate in protecting current trends in communications data as it predates social media. The Snoopers’ Charter therefore rests in a vulnerable area of privacy.

3.2 Your

search

accessed

history

can

be

Essentially, the Act allows, albeit highly trained, strangers to access our internet history, often without a warrant. Undoubtedly, there is something highly disconcerting about this and a

9 Oxford English Dictionary.

10 Article 8, European Convention on Human

Rights,

http://www.echr.coe.int/Documents/Convention_E

NG.pdf

11 Article 8, European Convention on Human

Rights,

http://www.echr.coe.int/Documents/Convention_E

NG.pdf

Wikipedia,

https://en.wikipedia.org/wiki/Data_Protection_Ac t_1998, Last accessed 11/08/17

13 Databook: Privacy in the Age of Social Media, Rebecca Agliolo, Per Incuriam, Michaelmas 2016

at

at

found

found

Act,

12

Data

Protection

1998,

ISSUE 5, SEPTEMBER 2017

comparison has been made with police entering a home. Many would argue that the internet is an extension of the home, 14 and therefore is private; yet, in order to search a home, except when ‘a serious or dangerous incident has taken place’ 15 [includes arresting someone and to save someone’s life], a warrant must be obtained. This is not the case with your internet history, revealing a serious disjoint in approach.

3.3 Third Parties

Polls suggest that people do not mind their information being harvested as they have nothing to hide, but ‘did not trust that the data will be kept secure’ 16 [71%, YouGov Poll]. Consumers are not alone with this fear, with social media companies sounding similar alarm bells. The Act requires encrypted social media companies such as Whatsapp and iMessage (Apple) to offer ‘back- door’ encryption, enabling easy access to messages by the security agencies; however, such companies argue this will weaken their security, leading to anyone, including criminal organisations, accessing our information. Apple has declared ‘the key left under the doormat would not just be

14 Young People think the Internet is as Important as Breathing, Dina Spector, Business Insider,

http://www.businessinsider.fr/us/internet-cisco-

poll-2011-11/, 03/11/11

Advice,

https://www.citizensadvice.org.uk/law-and-

Last

accessed: 20/08/17 16 Data available at: Draft Communications Bill, Wikipedia, https://en.wikipedia.org/wiki/Draft_Communicati ons_Data_Bill, Last accessed: 20/08/17

courts/legal-system/police/police-powers/,

15

Police

Powers,

Citizen

ST OLAVE’S ACADEMIC JOURNAL

there for the good guys. The bad guys would find it, too’ 17 , epitomizing these anxieties.

3.4 Importance of safeguards

In regards to both of these concerns, safeguards are imperative to prevent the violation of our privacy; however, many argue that, at present, they are inadequate. For instance, in the legal sphere, counted as a ‘sensitive profession’ due to legally privileged [confidential] material, a warrant, alongside other safeguards, has to be obtained before any information is acquired. Nevertheless, Chairman the Bar, Chantal - Aimeé Doerries QC 18 , still has concerns stating these safeguards are insufficient, and a client’s privacy still has the potential to be breached.

4. Recommendations

The Act therefore needs to improve its relationship with privacy to prevent violations of it from third parties and to improve public trust in the act via two reforms:

Firstly, as Joanna Cherry MP 19 stated, warrants should be obtained

17 Snoopers’ Charter passes into law — what it means, Madhumita Murgia, The Financial Times, https://www.ft.com/content/40d2ede4-

accessed

11/08/17

18 Snoopers’ Charter “Falls Short”, New Law Journal, https://www.newlawjournal.co.uk/content/sn ooper-s-charter-falls-short , 07/12/16

adac-11e6-9cb3-bb8207902122,

Last

19 Snoopers’ Charter passes into law — what it means, Madhumita Murgia, The Financial Times,

https://www.ft.com/content/40d2ede4-adac-

ISSUE 5, SEPTEMBER 2017

for any

convince the public of the Act’s fairness and safety. Secondly, current safeguards should be reinforced. Indeed, this process is happening as after a review, the Act changed its focus to privacy, adding further stringent safeguards and a year later there have been no reported violations via third parties let alone within the trained professions. This also demonstrates how the Act, at present, is not an encroachment on our fundamental right.

act, in order to

use of the

Conclusion

Following the introduction of the Snoopers’ Charter, Baroness Jenny Jones declared ‘It's the end of privacy in the UK 20 and whilst this potentially could happen due to the concerning implications of the Act, providing rigidly imposed safeguards are implemented, (as is starting to take place) no person will see their right violated.

accessed

11/08/17

20 Theresa May: Internet data will be recorded under new spy laws, Michael

The

Wilkinson,

Telegraph,

11e6-9cb3-bb8207902122,

Last

http://www.telegraph.co.uk/news/uknew

s/terrorism- in - the- uk/11974112/New -

spying - powers - to - be- unveiled - by- Theresa - May- live.html , 04/11/15

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

Doughnut Economics; Seven ways to think like a 21 st - Century Economist

Tara Pain

Now, that we as a nation, and yes, I use the pronoun intentionally, are living in the era of the ‘planetary household’, economists and policy makers need a collective and holistic approach to proposals. They need to adapt their models and perspectives of the inevitably dynamic world we live in to ensure that everyone in the planetary household can and will prosper. Kate Raworth sets out these intentions in her book ‘Doughnut Economics; Seven ways to think like a 21 st -Century Economist’, published on the 6 th of April 2017. Having read economics at Oxford University, Kate found herself disillusioned with the mainstream economics taught by her lectures which seemingly “gloss[ed] over the very issues [she] cared about most”. Finding it too embarrassing to call herself an economist, Kate set out to become involved in “real-world economic challenges” and spent the next three years of her life living in Zanzibar experiencing, first hand, the challenges faced by people living in severely impoverished, rural communities. Having worked for the United Nations for four years and Oxfam for more than a decade, Kate realised the obvious: she could not simply walk away from economics for it shapes the world we inhabit.

Instead, she decided to embrace economics and the plethora of its flawed models, as she views them, to re-evaluate one of its core diagrams:

the circular flow of income. And what did she produce? The doughnut.

The doughnut, as shown in the picture below, is a revised model of the circular flow of income and its

is a revised model of the circular flow of income and it s structure is as

structure is as follows:

Below the inner ring – the social foundation – lie critical human deprivations such as hunger and illiteracy.

Beyond the outer ring – the ecological ceiling – lies critical planetary degradation such as climate change and biodiversity loss.

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

Between the two rings lies the doughnut itself. This is the space in which we can meet the needs of all within the means of the planet. It is the “sweet spot” that society aims to move into - the safe and just space for humanity.

Paul Samuelson, an economist and the first American to win the Nobel Memorial Prize in Economic Sciences, famously drew in 1948 the first ever model of the circular flow, which depicted income flowing round the economy as if it were water flowing round plumbed pipes. His textbook – simply titled Economics – was published for the hundreds of thousands of ex-servicemen returning home at the end of the Second World War. Many enrolled in engineering courses, containing an economics module. The text acclaimed vast amounts of attention and eventually “became America’s bestselling textbook – across all subjects – for nearly thirty years”. His success is partly put down to the 70 diagrams in the first edition, which simplified the complexities of many specialist economic equations into diagrams, graphs and charts to be understood by the masses. In economics, the English idiom of ‘a picture is worth a thousand words’ really does serve as a core principle, when translated to ‘a diagram is worth a thousand words’, in explaining economic theory. Raworth’s appreciation of the sheer power of visual framing which she believes to be as influential and if not more influential than verbal framing, is something she hopes to take full advantage of with her new model, the doughnut. She states

“rethinking economics is not about finding the correct model (because it doesn’t exist), it’s about choosing or creating one that best serves our purpose – reflecting the context we face, the values we hold and the aims we have. As humanity’s context, values, and aims continually evolve, so too should the way that we envisage the economy”. In doing so, Raworth intends on shifting the current perspective of politicians, economists, policy makers and influences all around the globe from “today we have economies that need to grow, whether or not they make us thrive…and we are now living through the social and ecological fallout of this inheritance” to “what we need are economies that make us thrive, whether or not they grow”. These fundamental changes are set out in her seven ways to think and include:

1. Change the goal

2. See the big picture

3. Nurture human nature

4. Get savvy with systems

5. Design to distribute

6. Create to regenerate

7. Be agnostic about growth

It is at this stage that you may find yourself asking how and why did economic growth become the most

22
22

ST OLAVE’S ACADEMIC JOURNAL

prevalent policy for the leaders of nations all over the world? During the mid-1930s and following the appointment of Simon Kuznets as the first commissioned economist to the US Congress, Gross National Product became the new measure of America’s national income. Kuznets newly devised calculation not only transformed economics into an empirical science but also changed the way President Roosevelt monitored the success of the implementation of his New Deal policies in response to the Great Depression. The data was also used before entering the Second World War to aid the conversation of the American economy from its primarily industrial focus into an intentionally military one. The success of such policies, which for the most part came down to understanding the data underlying the GNP accounts, meant that by the end of the 1950s, “output growth had become the overriding policy objective in industrial countries”. Later analysis of the data by Arthur Okun, the Chairman of President Johnson’s Council of Economic Advisors, lead to the discovery of a trend which was prevalent amongst the figures – an annual growth of 2% in US national output corresponded to a 1% fall in unemployment. This later became known as Okun’s Law and with this knock on effect of pursing economic growth known, others surfaced subsequently leading to the exponential increase in the focus on economic growth as a policy. However, Raworth argues growth is a ubiquitous noun and GDP a “fickle, partial and superficial term” unable to express the sheer division in wealth amongst a nations citizens, to which I’d agree. Measures that aim

ISSUE 5, SEPTEMBER 2017

to take a more holistic approach when measuring a countries’ economy such as the United Nations Human Development Index I believe, in many circumstances, are much better suited calculations in explaining the reason for pursing growth in the first place. That is, instead of an increasingly expanding economy which continues to grow in terms of monetary value and at the cost of human wellbeing, measures such as the UNHDI which measure the impact of growth on people rather than the economy by taking into account measures such as life expectancy, equitable distribution of income and access to education should be more widely used. If the purpose of growth is to improve the standard of living of a nation’s citizens, then surely we should be using measures that serve to reflect its main aim.

In addition to the first diagram depicted in this article, Raworth has produced another version of the doughnut to show the shortfalls that we, as a planet, are experiencing due to our growth fixated policies. As you can see, climate change, biodiversity loss and land conversion are amongst a few of the overshoots of the ecological ceiling and health, gender equality and political voice some of the largest shortfalls of the social foundation. Raworth outlines the factors which play key roles in determining whether or not we can move into the safe and just space in the doughnut including population, distribution, aspiration, technology and governance. However, as economist Tim Jackson quite bluntly states, we are ‘persuaded to spend money we don’t have on things we don’t need to make impressions that

ST OLAVE’S ACADEMIC JOURNAL

won’t last on people we don’t care about’. This rather pessimistic but shockingly plausible thought serves to encapsulate the unnecessary nature of the consumerist world we’ve come to live in and be active members of, producing the monstrosity of the problem shown in the diagram below. This diagram really is worth a thousand words.

So, why do we need to widen our perspective and how on earth do we go about doing so? As economist Herman Daly once said, negative externalities are those things that ‘we classify as external costs for no better reason than because we have made no provision for them under our economic theories”. Raworth goes on to explain “the systems dynamic expert John Sterman concurs ‘there are no side effects – just effects,’ he says, pointing out that the very notion of side effects is just ‘a sign that the boundaries of our mental models are too narrow, our time horizons too short’”. Globalisation means we are now living in a world

of increasing

global

interconnectedness and can no longer afford to treat these ‘externalities’ as a “peripheral concern ‘outside’ of economic activity”. If we do, the probability of creating an economy that enables us all to thrive would be close to zero. Raworth suggests that due to the dynamic and inevitably volatile nature of the economy, we should “build diversity and redundancy into economic structures to enhance the economy’s resilience, making it far more effective in adapting to future shocks and pressures”. The notion of implementing an Economist’s Oath, similar to that taken by aspiring medics, which outlines ethical

ISSUE 5, SEPTEMBER 2017

principles for the twenty-first-

century economist to abide by, seems

a credible first step that should be taken towards successfully implementing this incredibly challenging goal of widening perspectives. Four preliminary principles, which Raworth outlines include:

1. Act in service to human prosperity in a floundering web of life, recognising all that it depends upon. 2. Respect autonomy in the communities that you serve by ensuring their engagement and consent, while remaining ever aware of the inequalities and differences that may lie within them. 3. Be prudential in policymaking, seeking to minimise the risk of harm – especially to the most vulnerable – in the face of uncertainty. 4. Work with humanity, by making transparent the assumptions and shortcomings of your models, and by recognising alternative economic perspectives and tools.

It is through small changes such as

the ones mentioned above that we will begin on the trajectory towards

entering the sweet spot in the doughnut.

Another interesting question Raworth explores in her book is ‘can there ever be a limit to economic growth?’ Here she unpicks the S curve as a projection of growth and asks the question ‘can we slow growth down by design and not disaster?’ to which she follows with

ST OLAVE’S ACADEMIC JOURNAL

some very plausible and thought- provoking answers. She amends W.W. Rostow’s five stages of growth to six stages of growth (the twenty- first-century update) and explores some possible solutions to the problems we are facing today. These range from the implementation of complementary currencies, to tiered pricing and most controversially, in my opinion, demurrage.

To conclude, Kate Raworth’s plea that “if there is one task that merits the attention of the twenty-first- century economist, it is this: to come up with economic designs that would enable nations coming towards the end of their GDP growth to learn to thrive without it” is something we should all take a moment to consider. It is on this notion I believe that new economic policy can and should be built as earth’s non- renewable natural resources continue to dwindle and we search for alternative ways of sustaining current living standards.

ISSUE 5, SEPTEMBER 2017

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

Is Physiological or Psychological Pain Worse?

Daniel Maghsoudi

To understand whether people struggle more with physiological or psychological pain, we must first be able to clearly distinguish between the two. Physiological pain is defined as a “protective and useful response, enabling the individual rapidly and accurately to localize and withdraw from the pain stimulus, to avoid or reduce tissue damage” [1] This is extremely useful in everyday life, and its importance can be emphasised by looking at congenital analgesia, a condition which means patients lack function of their peripheral nervous system; this results in complete inability to feel pain and leads to a severely decreased life expectancy due to repeat injuries and recurring infections. [2] Without the ability to feel mechanical pain we would be extremely vulnerable to the outside world. Psychological pain, on the other hand, has no physical origin but results in pain to a similar degree to physiological pain, and even stimulates a corresponding area of the brain in the anterior insula and the anterior cingulate cortex. [3] However, whilst physiological pain has clear benefits, psychological pain lacks a clear evolutionary role, and often results in longer term suffering for no palpable improvement to chance of survival or quality of life which would warrant its existence.

How to we feel physiological pain

The ability to feel pain is so fundamental that we have specialised sensory neurons called nociceptors designed for this, which are part of our system of cutaneous receptors in the skin. [4] They are able to detect pain and send this message to the brain via the central nervous system. This message travels as an electrical signal along myelinated neurons. This myelin sheath is a series of Schwann cells which surround the neurons in many layers, and the fatty substance is able to insulate the neurons to reduce dissipation of the electrical signal and increase the speed of conduction. Myelin is what allows us to have such narrow neurons at lengths of almost 2m with still relatively fast conduction of 1-100 m/s; in invertebrates such as squid, a giant axon

almost 1000 times larger is needed for signals to travel similar distances because they simply haven’t ‘invented’ myelin, so much larger axons are required to ensure electricity still conducts through despite much faster dissipation of the signal to surrounding tissues. [5, 6]

Our neurons are unique as they’re nothing like wires: they can be constantly bent and deformed without damage whilst making complex connections to other nerves via dendrites and regularly being reshaped by proteins, particularly in the brain. Unfortunately, also unlike wires, neurons are terrible at conducting electricity; the resistance in an axon from your hand to head is equal to the resistance in a copper wire going from Earth to Saturn and back 5 times. It is as a consequence of this that neurons can actually only carry a signal 3 micrometers without amplification, and this is where action potentials are introduced.

Action Potentials

A typical neurone, without any electricity passing through, has a resting potential of -70mV, meaning the inside is slightly more negatively charged than the outside. When an electrical signal passes through the neurone from nociceptors as a result of an external stimulus, the depolarization stage is initiated. Voltage gated sodium ion channels line the neurone, predominantly in the Nodes of Ranvier, a small gap between one Schwann cell and the next. During depolarization, these gates are opened, triggered by an increase in the voltage from - 70mV inside the axon to above the threshold of - 55mV. Na + ions flood the axon to balance out the difference in charges, dramatically increasing the charge inside to +40mV, and allowing the electrical signal to continue moving by being amplified down to the next group of sodium ion channels. Soon after this rapid increase in voltage, potassium channels open, so K + ions flood out of the axon during repolarisation and reverse this change. [7] By understanding the mechanism by which we can feel pain, we have been able to develop treatments to combat this.

ST OLAVE’S ACADEMIC JOURNAL

How

treated?

can

physiological

pain

be

Several revolutionary discoveries in the late 18 th and early 19 th century led to the development of anaesthesia. Local anaesthetic works over a small area, such as Novocaine (Procaine) shots used by dentists before minor operations. These are a synthesized, harmless form of cocaine which work by blocking the voltage gated sodium ion channels described previously. This means that whilst the nociceptors can detect the pain and a signal is sent, its inability to be amplified by action potentials means the brain does not detect this signal and you therefore do not feel the pain. [8] The other form is general anaesthesia which affects the whole body and not only removes pain but also protective reflexes, allowing doctors to perform surgery without movements or reactions from the patient. They are given as intravenous medication or an inhaled gas, and whilst we do not completely understand its functionality, theories suggest it affects the brain’s to communicate with its different sectors. [9] The anaesthetic can bind to the GABAA receptor in the brain’s neurons, allowing a continuous flow of negative ions into the cell to block electrical signals. [10]

Other forms of medication for physiological pain are painkillers such as aspirin or ibuprofen. When you have an injury, chemicals called prostaglandins are released which lower the threshold at which nociceptors are triggered; this is why even the touch of a shirt on sunburnt skin can hurt so much – the body makes the area extremely sensitive to ensure you protect it and allow it to heal properly. Painkillers such as aspirin work by permanently or temporarily disabling the enzymes Cox-1 and Cox-2, which convert the arachidonic acid released by damaged cells into prostaglandin. By doing this, the pain threshold remains high, not just in the damaged area but throughout the body. [11]

Overall, physiological pain can be extremely harmful and agonizing, but the most significant pain is often short term and our deep understanding of the mechanisms behind its functionality mean a large variety of treatments are available, not only the ones mentioned above but also potentially stronger opioids such as morphine, meaning physical pain is often not too serious or long-term for most people.

ISSUE 5, SEPTEMBER 2017

Psychological Pain

This can include anything from verbal abuse to grief and heartbreak, and whilst the pain created is inextricably linked to the pain we feel from mechanical damage to cells, we have little understanding of how or why we feel this, and there is therefore a serious lack of effective medication to treat it.

The links between mental and physical pain do not only lie in the areas of the brain they affect, but they can also often cause eachother. Chronic pain, which affects nearly half of the British population, [12] has been associated with significantly increased risk of anxiety and depression, whilst these psychological issues can result in further chronic pain from the resulting stress, creating a dangerous positive feedback loop between the types of pain.

One of the physical indicators often associated with the psychological pain of the loss of a relationship is ‘heartbreak.’ There are various potential explanations for why this arises, such as the anterior cingulate cortex causing over-stimulation of the vagus nerve which runs down to the chest and abdomen, tightening the muscles in the region. Furthermore, emotional pain induces stress which suppresses the production of dopamine and serotonin in the body, leading to less so- called ‘happy’ hormones. These are replaced by an influx of cortisol and epinephrine, resulting the brain preparing for ‘fight or flight’ and pumping additional blood to the muscles. This leads to inflammation, a stiff neck, headaches, and the commonly known squeezing feeling in the chest area from muscle contraction and vasodilation in the area.

Psychological pain is also known to have more serious effects, such as severe short-term stressors which cause Takotsubo cardiomyopathy. This is unflatteringly named after a Japanese octopus pot, and results in the sudden weakening of the muscles in the walls of the heart which expands the shape of the ventricle into an ‘octopus pot.’ [13] The causes can range from arguments and fear of public speaking to more serious things such as grief, whilst some cases definitively show that you really can die from a broken heart.

ST OLAVE’S ACADEMIC JOURNAL

Conclusion

Overall, both physiological and psychological pain have their difficulties and set of associated causes and symptoms. However, if a distinction is to be made, severe psychological pain can be worse than physiological pain, as its effects can be more deeply felt, longer lasting, and easily triggered by memories. Additionally, emotional pain simply has no cure other than therapy and simply moving ‘through’ the pain until it subsides. In conclusion, the most important thing to remember is that whilst psychological pain does have some medical and scientific basis, it is predominantly a self- induced, mentally-created pain which can be dealt with through will-power and time alone.

References

[1]

http://medical-

dictionary.thefreedictionary.com/physiological+

pain

[2]

https://ghr.nlm.nih.gov/condition/congenital-

insensitivity-to-pain

[3]

https://www.psychologytoday.com/blog/body-

ISSUE 5, SEPTEMBER 2017

sense/201204/emotional-and-physical-pain-

activate-similar-brain-regions

A.

(2010) ‘Nociceptors: The sensors of the pain pathway’, 120(11). [5] Sims, D. (2014) ‘Inside the Squid

Giant Axon’, The Marine Biologist, (3), p. 28.

[4]

Dubin,

A.E.

and

Patapoutian,

[6]

http://www.understandinganimalresearch.org.u

k/animals/10-facts/squid/

[7]

http://hyperphysics.phy-

astr.gsu.edu/hbase/Biology/actpot.html

[8]

http://www.livescience.com/33731-

anesthesia-work.html

[9]

https://www.drugs.com/drug-

class/general-anesthetics.html

[10]

http://www.medicaldaily.com/pulse/going-

under-how-anesthesia-works-human-body-

364498

[11]

https://www.youtube.com/watch?v=9mcuIc5O-

DE

[12]

http://www.nhs.uk/news/2016/06June/Pages/Al

most-half-of-all-UK-adults-may-be-living-with-

chronic-pain.aspx

[13]

https://www.bhf.org.uk/heart-

health/conditions/cardiomyopathy/takotsubo-

cardiomyopathy

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

Newnham College, Cambridge- Weston- Smith Physical Sciences Essay Prize

Josephine Jones won first place in the Weston-Smith Physical Sciences Essay Prize with her essay on symmetry and the laws of nature.

Symmetry and The Laws Of Nature

Physics aims to establish a set of rules that describe nature precisely and completely. Existing laws have given us a glimpse of her beauty and simplicity, namely that reality is infallible, unyielding and astonishingly symmetric. But what is symmetry? Fundamentally, it is defined as ‘consistency

butterfly

fluttering in a world identical in every direction. We shall explore the importance of this principle through a chronology of scientific theory and evaluate its necessity in understanding the laws of nature.

under

a

tranformation’,

like

a

Symmetry in space and time

Simple yet profound, symmetry demands that physics doesn’t change under a

translation in space or time – universal laws apply equally to Rome in 1989 as they would to Mars in 3050. In figure 1, Rafiki holds Simba x metres above the ground. If the cub has mass m, his gravitational potential energy is mgx. The force acting on Simba is the negative of the derivative of his potential energy with respect

to his position, so F= - " ($%& )

=-mg. If Rafiki

climbs a hill, however, Simba’s potential energy increases by some constant, E to mgx+E. The

. As E is a

force will now be -

"&

" #$% " ' + - "% "%
" #$%
" '
+
-
"%
"%

constant, its derivative

is

zero

and

thus

F= -

" #$% "%
" #$%
"%

− 0 =-mg, which

is the

same as at

the bottom of the hill.

x

mg , which is the same as at the bottom of the hill. x x E
x E
x
E

Figure 1: Rafiki lifts Simba above the

Furthermore, if Rafiki faced the other way, the force acting on Simba would not change. Thus the laws of nature are symmetric under rotations in space.

Inertia presents another space-time symmetry. Newton’s third law of motion states that an object will be in a state of inertia, stationary or travelling at a constant speed when there is no resultant force acting on it. Further, Galilean relativity suggests that physics is the same for any body in such an inertial reference frame.

Galileo believed, however, that time was absolute. Two and a half centuries after his death, Albert Einstein, accepting that time slows when travelling near the speed of light, made the laws of physics independent of acceleration. He wove space and time into a single entity and developed his theory of special relativity to show that ‘distances’ in space-time are identical to all observers. This theory was derived from a crucial symmetric axiom, suggested by Maxwell’s equations of electromagnetism – the speed of light is constant in nature.

ST OLAVE’S ACADEMIC JOURNAL

CPT Symmetry

Parity (P) symmetry states that laws of physics are also consistent under reflections in space. D-carvone and L-carvone are non- superimposable mirror images of one another. While chemically distinguishable, with L- carvone smelling like spearmint and D-carvone like caraway, physically, they are identical. For example, both rotate plane-polarised light by

61º.

Galileo believed time to be like a clock ticking somewhere separate from the universe. Physical laws are mathematically time reversible, however, dismantling Galileo’s ideology. This is T symmetry, in which we can

replace t with –t and those laws are unchanged. The exception is the second law of thermodynamics, which states that the entropy

of a system always increases. Perhaps time,

then, is progression along an entropic gradient,

by which the future is more uncertain than the

past. Arguably, it only seems uncertain because we are unable to consider every particle in a system. If we could, would time appear

reversible?

Experiments have shown, however, that

P and T symmetries are violated in weak

interactions. This helps to understand why

The Standard Model

This helps to understand why The Standard Model Figure 2 : The standard model ISSUE 5,

Figure 2: The standard model

ISSUE 5, SEPTEMBER 2017

anything can exist when matter and antimatter annihilate upon meeting. Differences in how matter and antimatter decay could explain why there is more matter in the universe. But even one exception necessitates we reject these theories as symmetries of nature, what Thomas Huxley would call ‘the slaying of a beautiful hypothesis by an ugly fact’.

That said, in 1900, Max Planck published a paper that marked the birth of quantum mechanics. It was the physicist Paul Dirac who attempted to consolidate this field with special relativity, writing an equation in 1928 to which there are always two solutions

an equation in 1928 to which there are always two solutions (just as 9 can be

(just as 9 can be +3 or -3). This is explained by antimatter; for every particle there is an antiparticle with the same mass but opposite quantum charges e.g. opposite electric charge. A symmetry exists by which matter and antimatter are interchangeable - a car built entirely of antimatter particles will work just as well as a regular one. This is called charge (C) parity and can restore the symmetry of weak interactions. It is now hypothesised that if C,P and T are performed consecutively, the laws of nature remain do indeed remain symmetric.

Dirac’s work also initiated quantum field theory (QFT), which sees the universe as a collection of fields, the excitations of which present themselves as the fundamental particles. In the 1970s, a theory combining 20 th century developments in particle physics was built (figure 2). This is the standard model, which illustrates the relationships between the fundamental particles and the fundamental forces of nature (except gravity). There are two types of matter particle – quarks and leptons, which both have ½ integer spins. The lightest particles make up the first generation and the heaviest the third. There are then the gauge bosons, with integer spins, that are exchanged between matter particles to communicate the electromagnetic, weak and strong forces.

The wave function ( Ψ ) first appeared in the equations of Erwin Schrodinger. Finding the square of a particle’s wave function will give the probability of finding it at that position at that time. The probability density of a system containing two particles, p1 and p2 is

ST OLAVE’S ACADEMIC JOURNAL

thus denoted Ψ(p $ , p & )

standard model states fundamental particles of

the same type are indistinguishable,

2 . There are two

solutions to this equation. We get the symmetric case Ψ (p1,p2)= Ψ (p2,p1) when exchanging particles with integer or zero spin, these are classified as bosons. The asymmetric

2 . A symmetry within the

therefore ! (# $ , # & ) 2 = ! (# $ , # & )

Gauge Theories

Although gauge symmetry is rooted in the 19 th century with the discovery of electromagnetism, it was the development of QFT that highlighted its importance. Some properties of particle fields, are measurable (e.g. the charge), whereas others (e.g. the phase) are not. A gauge theory is one in which there is a group of transformations that can be performed on a field, without changing its observable quantities.

Imagine freezing a satin scarf as it is being shaken in the air. We can use this as a model for an electron’s wave field; there is a high probability of finding the electron at a ‘hill’ and a low probability where there is a ‘dip’. If a watch is placed at each point of space-time on the scarf, the number of times the second hand passes twelve in a given time is called the frequency. The watches are not particularly well made, however, and they begin to slow.

ISSUE 5, SEPTEMBER 2017

case Ψ (p1,p2)=- Ψ (p2,p1) is achieved with particles of half integer spin, which we call fermions. Zero is the only number that is a

negative of itself so we see that the probability of two fermions occupying the same space is nothing. So, again, symmetry is integral to the standard model.

Thus, you may presume the electron’s state has changed as it now has a different frequency. Upon closer inspection, however, you see that the numbers on the watch face are also rotating. Every time the hand moves one forward, the numbers move one back, so the hand passes the twelve with the original frequency. This mystical force interfering with our numbers is called the gauge field. When we accelerate the electron, giving it more energy and thus changing its frequency, the gauge field manifests itself as a physical particle that is emitted from the electron, compensating for the change we have made. The system incorporating both particles thus remains invariant despite our transformation. This is gauge symmetry. I like to compare this to the ‘useless box game’ (figure 3). A switch is flicked, triggering a mechanical arm that flicks it back again, leaving the system unchanged.

arm that flicks it back again, leaving the system unchanged. Figure 3: ‘Useless box’ The gauge

Figure 3: ‘Useless box’ The gauge boson in the example above is a photon. It communicates the electromagnetic force. For example, a photon emitted by one electron and absorbed by another causes them to repel, as shown by the Feynman diagram in figure 4. This theory is called quantum electrodynamics.

Omega-minus is a subatomic particle composed of three strange quarks. We have seen, however, that identical fermions cannot occupy the same point in space. There must be something about these quarks, therefore, making them distingusishable. We call this

colour, and there are three forms – red, blue and yellow. Quantum chromodynamics is a gauge theory concerning colour transformation. For example, a red quark can turn into a blue quark by the emission of a gauge boson called the gluon. The gluon will consist of a red quark

and

antiblue

quark.

gluon. The gluon will consist of a red quark and antiblue quark. an Figure 4: Feynman

an

Figure 4: Feynman diagram of electron repulsion

ST OLAVE’S ACADEMIC JOURNAL

Blue and antiblue cancel out and thus the overal colour of the system is still red. The gluon confers the strong force, which holds particles in the nucleus together.

A third gauge theory called quantum flavour dynamics explains the weak force. A neutron consists of two down quarks and an up quark (udd). One of the down quarks can change its ‘flavour’ to become an up quark by the emission of a W - boson. This particle has a mass eighty times greater than the neutron.

Conservation Laws

Now we have established some of the ways in which nature is symmetric, we must consider the consequences of her being so. In 1915, Emmy Noether proved that every physical symmetry bears a conservation law. Firstly, translational symmetry in space means that momentum is conserved. When Andy Murray hits a ball, the ball exerts a force on the racquet (F1,2) and the racquet on the ball (F2,1). Newton’s third law of motion states that every action has an equal and opposite reaction and thus F2,1=-F1,2. Impulse is the product of the force and time and because both forces act for the same amount of time, the impulse applied to the ball is therefore equal and opposite of that on the racquet. Newton’s second law states that a force on an object is the same as its rate of change of momentum(F= ! (#$ ) ) and hence,

change in

momentum. The sum of the ball’s momentum

impulse is equivalent to the

!&

ISSUE 5, SEPTEMBER 2017

This extra mass is ‘borrowed’ in the form of energy from the vacuum. According to

Heisenberg’s inequality, the product of the time and the energy must be less than the planck constant. The energy can thus only be borrowed for a very short time and the W - boson quickly decays into an electron and a neutrino. We now have a down quark and two up quarks, which is

a proton. In this way, guage symmetries explain the forces between all particles and waves in the universe.

and racquet’s momentum is consequently zero, the same as before the impact, so momentum is conserved. Furthermore, the conservation of energy results from symmetry under a translation in time and states that energy cannot be created or destroyed.

Thirdly, angular momentum is the

amount of ‘drive’ an object has while moving in

a circle. It is calculated by the product of the

radius, mass and velocity. Angular momentum is always conserved due to the invariance of physical laws under a rotation in space. Imagine a ballerina who can pirouette infinitely, holding her arms sideways as she does so. If she retracts her arms, she will turn faster. This is because her radius has decreased so her velocity must increase to conserve her momentum. The ideas of conservation granted by symmetry have been key tools in solving many physical problems.

Breaking Symmetry

The destruction of symmetry is of equal importance. For example, a javelin balanced on its point, can fall at any angle, so the probability distribution is symmetric about the point. If the javelin is disturbed, however, it can only fall in one direction. We say the symmetry has been simultaneously broken. 16

Spontaneous symmetry breaking (SSB) is seen with ferromagnetic materials. At high temperatures, there is rotational symmetry because the spins of the atoms are random. When the temperature is sufficiently low, however, their spins align, breaking the symmetry and creating a magnetic field. In another example of SSB,

and creating a magnetic field. In another example of SSB, Figure 5: There was originally one

Figure 5: There was originally one force that broke into the four fundamental forces

32

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

there was a single force immediately after the big bang. As the temperature cooled and entropy

spontaneously

however, causing the bead to roll into the trough. It is now stable, but the field has a value, meaning it can interact with other fields. This interaction causes the bead to roll up and down the sides of the trough, and it is called the Higgs boson when it does so. On 4th July 2014, the Higgs boson was detected by the Large Hadron Collider (LHC) in Geneva.

increased,

broke into the four fundamental forces we see now. (figure 5)

It is believed that particles are given mass by moving the Higgs field, which is spread through the universe. The potential energy of this field has a shape comparable to the bottom of a wine bottle (figure 6). If a bead is poised on the indent where the field value is zero, there is symmetry. This is unstable and easily broken,

the

force

is symmetry. This is unstable and easily broken, the force Figure 6: The Higgs field can

Figure 6: The Higgs field can be represented by a shape similar to the bottom of a

The LHC, however, has been unable to prove another principle called supersymmetry (SUSY). SUSY suggests that for every fermion, there exists a supersymmetric boson, unifying force and matter. SUSY is an example of how symmetry could solve some of the mysteries of

The Necessity of Symmetry

Symmetry, particularly supersymmetry, has the potential to explain the universe beyond the ability of the standard model. Could this lead to the grand unification theory physicists yearn for? We must question whether the universe is fundamentally symmetric or whether this is a perception (It is proved that humans have symmetry bias and find symmetric faces more attractive.) Do we only demand symmetry of nature because it is easier to understand? Perhaps, but symmetry has been proved through objective experimentation: there have been no signs of CPT violation, the Higgs boson exists and in 2016, LIGO detected gravitational waves, the predictions of a theory built on symmetry. Yet symmetry is mathematical and thus dubious - is mathematics natural or invented?

in

understanding the laws of nature? Symmetry provides a tool with which to simplify and

So

is

symmetry

a

necessity

the universe. For example, dark matter could be the lightest of all supersymmetric particles, which only weakly interacts with other particles. We do not, however, have sensitive enough equipment to validate this yet.

understand the universe. In identifying symmetries, we have built news laws, such as Noether’s theorem. Conversely, other laws, such as Dirac’s equation have revealed the hidden symmetry of reality. Whether these patterns are real or our creation, there is no doubt they form the backbone of modern physics. Yet we have ignored the most astonishing thing of all - the laws of nature themselves. Why should there exist a universal, unchanging set of rules that can predict the future? In the words of Eugene Wigner; ‘it is not at all natural that "laws of nature" exist, much less that man is

able

to

discover them’.

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

Extended Projects

The Extended Project allows A-level students to plan, manage, realise and then review a topic in depth. Many of the dissertations produced by year 13 students are close to the standard of undergraduate level work, and some of the best have been published in this journal.

Misunderstanding chance How does it happen and why does it matter?

Richard Moulange

2. Abstract

The aim of this project was to research different common statistical and probabilistic fallacies: how they work, where they appear, and their significance. They are prolific in our society, but mostly ignored, both because of a lack of mathematical education and a reluctance to confront the issue because they can be used to hold people to account. They are more complex than people might think, but still with a better mathematical curriculum anyone would be able to successfully understand and avoid them. The solution seems to be to educate people about probability and chance not necessarily rigorously, but enough for them to be able to interpret data successfully and not be misled. Misunderstanding chance is a very important issue: it affects many areas of our society:

government, national security, the medical profession, the gambling industry, and others.

2.1 Key definitions

statistics: the practice or science of collecting and analysing numerical data in large quantities, especially for the purpose of inferring proportions in a whole from those in a representative sample. probability: the extent to which an event is likely to occur, measured by the ratio of the favourable cases to the whole number of cases possible

fallacy: a failure in reasoning which renders an argument invalid natural frequency: the joint frequency of two events; an alternative to presenting information in conditional probabilities

First three definitions from Oxford English Dictionary; the fourth from a paper by Gerd Gigerenzer in the British Medical Journal

3. Introduction 3.1 Research Question

I chose to investigate risk, and some of the common misconceptions that appear when interpreting risk, which is usually expressed in terms of statistics and chance. These are examples of fallacies. In particular I am discussing statistical and probabilistic fallacies.

ST OLAVE’S ACADEMIC JOURNAL

3.2 Rationale

The initial rationale was to study a mathematical topic to support my application to university to read mathematics. A problem immediately presented itself: how to discuss mathematics, an often rigid, unyielding topic, based on rigorous proof, in a questioning, discursive way? I considered picking some as yet unsolved problem to discuss, in order to evaluate different approaches and ideas about solving it, but dismissed this because such problems are currently inaccessible to me, and therefore likely to be

difficult for any future audience. So,

I decided I must consider simple

applied mathematics. I chose this area of mathematics because it has a more immediate influence on society and collective public wellbeing than pure mathematics (Magid, 2005, p. 1173). I preferred to research statistical fallacies because they are often simple intuitive mistakes (H. Spirer, L. Spirer, & Jaffe, 1998), and therefore are hopefully easier to explain. More importantly, from undertaking research previously on the misuse of statistics within the medical industry, I knew that it can

have a profound and sometimes devastating impact on the lives and wellbeing of patients (Goldacre, 2012), and that such problems can persist for decades. After some very brief research,

it became apparent that a basic lack

of mathematical understanding has also led to miscarriages of justice

within the judicial system (Royal Statistical Society, 2001), has enabled the gambling industry to hurt millions of people each year (Barron, Greg, Leider, & Stephen,

ISSUE 5, SEPTEMBER 2017

2010), and contributes to expensive and dangerous inefficiencies within the security services (Schneier, 2005). Simple, avoidable mistakes can often have severe consequences both for an individual and a society as a whole, since policymakers are often informed by apparently reliable statistics (Goldacre, 2008). This raises questions about the competence of juries and politicians, and their lack of statistical knowledge. While statistical expertise is not expected, better mathematical education and more investment in the public understanding of risk would perhaps be worthwhile legislative goals. But it is not only untrained people who misunderstand probabilistic science:

doctors—professionals whom we might expect to have a much better, if not expert, appreciation of risk— have been shown to make the same mistakes (Goldacre, 2012). This does lend credence to the suggestion that there are psychological biases at work, particularly in the case of natural frequencies. This could mean it would also be important to investigate these predispositions, in order to highlight when human cognitive “shortcuts” are misleading. Statistical fallacies are also merely interesting to study for their own sake: there is a great satisfaction derived from seeing why an instinctive solution is actually flawed, discovering the hidden subtleties and pitfalls awaiting an unwary assumption. But this is intellectual vanity. False imprisonment, misguided public policy, misidentification of terrorists, and even ineffective medicine have been ignored, even tolerated, because the public is unable to spot easy mistakes.

ST OLAVE’S ACADEMIC JOURNAL

Without better mathematics education, they cannot hold public and private officials to account. Without the public understanding of risk, we make decisions blind.

3.3

Research Question

Ethical

Aspects

of

the

There are no ethical concerns with my research question. However, there will be evaluation of the effectiveness of juries untrained in evidence-based reasoning, and discussion the gambling and tobacco industries, and these issues could be considered controversial.

4. Discussion 4.1 Choosing Misconceptions to Discuss

Which

There are many different statistical fallacies. Strasak, Zaman, Pfeiffer, Göbel & Ulmer (2007) identified 47 different statistical errors common in medical research alone. It is not feasible, or sensible, to discuss them all. Fortunately, Sutherland, Spiegelhalter & Burgman (2013) identified some of the most important fallacies in their advice to non-scientists examining evidence and interrogating advisers. This, coupled with Spirer et al. (1998), allowed me to create a shortlist to discuss, though it is neither complete nor rigorous. I have also tried to discuss more significant fallacies first, although this list that follows is not a definitive order.

4.2 Correlation vs Causation

Consider two events: A and B. If they are correlated, there are six possible relationships between them:

ISSUE 5, SEPTEMBER 2017

A causes B

B causes A

causation)

(direct causation)

(reverse

A causes B and B causes A (bidirectional or cyclic causation)

A causes C which causes B (indirect

causation)

A and B are caused by C (common cause) but are not by each other

No causality between A and B

a

(correlation

is

coincidence)

Simpson’s

confounding variables.

4.2.1

paradox

and

The most significant relationship is the common cause, which is better known as a “confounding variable”, C is overlooked, and A and B are assumed to have a direct or reverse causation. An example of this was that ecologists used to believe poisonous algae killed fish in estuaries; it turned out that the algae grew where the fish died. The algae did not cause the deaths (Borsuk, Stow & Reckhow, 2003). Confounding variables are important because they can mislead people to believe that there is some form of direct causality, and then decisions and solutions are based on this mistake. This mistake was made when doctors interpreted Charig. Webb, Payne & Wickham (1986). Charig et al. (1986) compared two treatments for kidney stones,

ST OLAVE’S ACADEMIC JOURNAL

studying their effectiveness against both larger and smaller stones. They found that Treatment A was more effective than Treatment B at both treating smaller, less severe stones, and larger, more severe stones. However, when the treatments were compared without considering severity, Treatment B appeared more effective.

 

Treatment A

Treatment B

 

93% (81/87)

[Group 1]

87%

Small

stones

(234/270)

[Group 2]

 

73%

69% (55/80)

[Group 4]

Large

stones

(192/263)

[Group 3]

Both

78%

83%

(273/350)

(289/350)

Figure 1: comparing two treatments for kidney stones with respect to size of stone

of

Simpson’s paradox (Julious & Mullee, 1994). This happened for two reasons. First, the sizes of the groups were ignored, so the totals were dominated by the larger groups 2 and 3, as was the fact that doctors usually treated more severe cases with treatment A and milder cases with treatment B. Second, the confounding variable has a significant effect on the percentage success of each group. This is evidenced by group 3 doing worse than group 2 because they had a larger stones, despite their having a more effective treatment. To summarise: the less effective treatment (B) was applied more frequently to milder cases, and appeared more effective, and vice

This

is

an

example

ISSUE 5, SEPTEMBER 2017

versa. This counterintuitive result meant that patients needlessly suffered and died (Julious & Mullee, 1994). It is important to note that here trained medical experts were misled. It is not only the general public who make statistical errors. However, Pearl (2000) argues that one cannot choose the partitioned data. While it is clear in the example above that Treatment A should be chosen regardless of whether the size of the stone is known, Pearl shows that data could be easily partitioned into arbitrary sub-categories and artificially constructed to imply the wrong treatment. Worse still, he shows that with the same set of data, you cannot be sure whether the partitioned or aggregate form is appropriate: each case must be studied individually.

Moreover, Simpson’s Paradox is not limited to complex clinical trial results. Pavlides and Perlman (2009) prove that a 2x2x2 table with uniform distribution will show Simpson’s paradox exactly 1 in every 60 times. Kock (2015) went further to suggest that Simpson’s paradox would occur in path models with two predictors and one criterion variable slightly more than 1 in every 8 times.

Thus, this is a simple, but counter-intuitive result that is very likely to affect ordinary people in their daily lives. Incorporating the study of such phenomena into standard mathematical curricula might be a possible solution. Certainly, scientific and medical professionals should have a more rigorous statistical education. Gigerenzer (2014) identifies severe misunderstandings on the part of doctor and medical researchers, with

ST OLAVE’S ACADEMIC JOURNAL

respect both to correlation and the base-rate fallacy.

4.2.2

Correlation

is

sometimes

useful.

Correlation is necessary in science. Sometimes it is difficult or ethically impossible to run randomised controlled trials that are double-blind, so correlational evidence becomes more useful (Novella, 2009). Since anecdotal evidence and observational and cohort studies are less rigorous, caveats do appear: usually much more evidence is required. But Novella argues that society is too quick the dismiss correlation, in part due to the ubiquitous nature of the phrase “correlation does not imply causation”. Indeed, the tobacco industry has historically relied on dismissing correlational evidence to reject the link between tobacco and lung cancer.

To be clear, the 1951 British Doctors’ Study of 40,701 registered physicians proved in 1956 that tobacco greatly increases the risk of lung cancer, myocardial infarction and other respiratory diseases. This was a cohort study, not a randomised controlled trial. It would now be illegal to run a randomised controlled trial investigating the effects of smoking because researchers would be knowingly exposing participants to severe risks. Thus, cohort studies, which rely on identifying correlations, can be useful.

4.3 Base-rate fallacy

ISSUE 5, SEPTEMBER 2017

The base-rate fallacy is again significant within the medical profession, but also in the case of national security. This fallacy has significant social and economic impacts because billions of pounds are spent each year on counter- terrorism operations. These operations are sometimes far less effective than they appear, and are organised by people who do not have a basic understanding of risk, which compromises their ability to keep the public safe. Indeed, this example highlights the importance of policy- makers having, not necessarily an expert understanding of risk, but the tools to correctly understand and interpret the statistical information they are given. This was the aim of Sutherland, Spiegelhalter & Burgman (2013).

4.3.1 National security.

Mathematically, the base-rate fallacy appears when the relative sizes of population subgroups are ignored when judging the likelihood of contingent events involving the subgroups. Schneier (2012) highlights this when criticising the mass surveillance programmes of the United States National Security Agency. Consider the 300 million people in the United States of America. Suppose that 1 in 100,000 of them is a terrorist (which is likely to be an overestimate). Now suppose the NSA have an unreasonably accurate data-mining programme that correctly identifies terrorists 99.9% of the time. Suppose its rate of false positives is also extreme at 0.1%. Thus in 300 million people, we would expect 3,000 terrorists, of

ST OLAVE’S ACADEMIC JOURNAL

which 2,997 would be identified. But 299,997 innocent civilians would also be chosen, so the chances of randomly picking a terrorist from the short list would actually be just under 1%. But some argue that of course terrorists wouldn’t be picked at random, and thus this system is useful for creating a short list. But no matter what, these 302,994 would have to be investigated further, and police and intelligence services would drown in false positives. Mathematically such data-mining is infeasible. The budget of the NSA is $10 billion each year. According to Snowden (2013) a large proportion of this is spent on data-mining efforts like Prism. There is compelling evidence that these are likely to be very ineffective. Yet Congress continues to fund these programmes because politicians do not understand or choose to ignore the fact that because the risk of terrorism is so small, these methods of security are a waste of money. Of course, an alternative suggestion is that politicians are unconcerned about the mathematics: no matter what the numbers say, it is politically inexpedient to ever suggest a reduction in state security.

4.3.2 Cancer screening.

Effectively the same problem was

practising

given

to

1,000

ISSUE 5, SEPTEMBER 2017

gynaecologists by Gerd Gigerenzer between 2006 and 2007:

A 50-year-old woman, no

symptoms, participates in routine mammography screening. She tests positive, is alarmed, and wants to know from you whether she has breast cancer for certain or what the chances are. Apart from the screening results, you know nothing else about this woman. Approximately how many women who test positive actually have breast cancer?

9 in 10

8 in 10

1 in 10

1 in 100

Figure 2: an unexpected frequency tree for a routine mammography screening.

1. The probability that a

woman has breast cancer is

1%

2.

If a woman has breast

cancer, the probability that

she tests positive is 90%

3. If a woman does not have breast cancer, the probability that she nevertheless tests positive is 9%

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

ST OLAVE’S ACADEMIC JOURNAL ISSUE 5, SEPTEMBER 2017 Only 21% said the correct result of 1

Only 21% said the correct result of 1 in 10 (see figure 1), and nearly half said 9 in 10. This is a very troubling result. While this study was not rigorous, it still highlights a serious problem within our health system. If medical professionals cannot correctly interpret the results of screening tests, then patients could be unnecessarily exposed to painful and risky treatments. Moreover, crucial funding is provided for these screenings when they are less effective than the public realises. Gigerenzer (2007) identified that the National Institute for Clinical and Health Excellence was correct not to fund early detection prostate cancer screening because although the survival rate at first appeared higher in the USA, where this is common, the actual number of deaths per 1000 did not change:

Figure 3: numbers of deaths, false- positives and unnecessary treatments of prostate cancer for men aged 50 or older, not participating vs participating in early detection for 11 years

4.3.3 Natural frequencies.

Although the concept of natural frequency is applicable to any of the fallacies discussed, it seems to fit best here. There is growing evidence that natural frequencies are a much better way of representing probabilities than fractions, percentages or decimals. (Akl et al, 2011). Luckily, Spiegelhalter and Gage, 2015, also found that this was preferred by medical professionals, and supported

40

ST OLAVE’S ACADEMIC JOURNAL

by psychological research (Gigerenzer, 2008). Issues with fractions include

ratio bias and denominator neglect.

A population survey by telephone

(Galesic and Garcia-Retamero, 2010) asked

Which of the following numbers represents the biggest risk of getting a disease:

1 in 100, 1 in 1000, 1 in 10?

In Germany, 28% of responses were

incorrect and in the USA 25% got it wrong. This is problem with using

larger numbers to communicate a smaller risk. But the alternatives

also have their issues. Using 20 out

of 100, for example, could also be

expressed as 200 out of 1,000. But the latter tends to appear bigger (Denes-Raj, Epstein & Cole, 1995) due to human tendency to focus on the numerator. In extreme cases, this leads to denominator neglect:

the media does this every time they focus on one road traffic accident without mentioning that millions of children arrive safely at school each day.

Spiegelhalter and Gage concluded that expected frequency trees were the best way to express natural frequencies in a simple, visual way. For example:

Figure 4: Expectations for 200 women attending or not attending breast screening every 3 years between the ages of 50 and 70.

It is important to note that the

working group which produced the breast cancer expected frequency trees deliberately did not make a

ISSUE 5, SEPTEMBER 2017

recommendation to patients. Alternative views on cancer screening range from those who reject the mathematics in question, to more reasonable groups, such as Cancer Research UK, who misrepresent the mathematics: “for every life saved from breast cancer by screening, around 3 women are overdiagnosed”, and suggest that removing funding for breast cancer screening will lead to a loss of awareness and funding for breast cancer treatment. There is little empirical evidence to support this position, but it does have some merit. But the money might be better spent elsewhere. But the National Institute for Clinical and Health Excellence cannot make that decision: it lies with the Department of Health, led by mathematically-illiterate politicians. It must also be remembered that breast cancer is a politically divisive topic, and defunding such screening could have a political disadvantage. However, there is good evidence that women with a family history of breast cancer should have regular screening from when they turn 40 (Johnson, 2014).

4.4 Prosecutor’s fallacy

There are several different fallacies associated with prosecutors. The most well-known is Meadow’s Law, which was significant in the Sally Clark case. Thus, I will discuss the other two fallacies first.

4.4.1 Argument from rarity.

This is a simple fallacy, but very widespread. Consider a lottery

ST OLAVE’S ACADEMIC JOURNAL

winner who has been accused of cheating. The prosecutor argues that the chances of winning the lottery without cheating is very small, and then assigns this as the chance of the winner’s innocence. The prosecutor fails to take into account the large number of people who play the lottery. This was seen with Paul the Octupus. If Paul did predict football match winners at random, then the chance of predicting six correctly in a row was 1 in 64, which is quite unlikely. But there were probably many animals that were made to do similar predictions all over the world, but the media only focussed on the successful one.

4.4.2 Multiple testing.

Suppose a crime-scene DNA sample is compared against a database of 20,000 men. A match is found, that man is accused and at his trial, it is testified that the probability that two DNA profiles match by chance is only 1 in 10,000. This does not mean the probability that the suspect is innocent is 1 in 10,000. Since 20,000 men were tested, there were 20,000 opportunities to find a match by chance. Even if none of the men in the database left the crime-scene DNA, a match by chance to an innocent is more likely than not. The probability of getting at least one match by chance among the records is:

getting at least one match by chance among the records is: ISSUE 5, SEPTEMBER 2017 4.4.3

ISSUE 5, SEPTEMBER 2017

4.4.3 Meadow’s Law.

This is not a law at all. Roy Meadow was struck off the medical register in July 2005 by the GMC for tendering misleading evidence. In 1999, he was an expert witness at the trial of Sally Clark, was who accused of murdering her two infant sons. Meadow testified that the probability of two such deaths occurring naturally as Sudden Infant Death Syndrome, or cot-death, was 1 in 73 million. He obtained this figure by squaring 1 in 8500: the ratio of cot-deaths to births in affluent, non- smoking families (which Clark’s family could be considered to be). The Royal Statistical Society’s criticism that followed was twofold. First, Meadow assumed that cot- deaths within a single family were statistically independent events. He did not consider that the occurrence of one cot-death might suggest that another infant in the same house would also be vulnerable. In fact, subsequent analysis estimated a probability of 1 in 100 (Hill, 2004). Second, he committed the standard prosecutor’s fallacy:

confusing the probability of “cause given effect”: the true likelihood of a suspect’s innocence, with that of “effect given cause”: the likelihood that innocence will result in observed double cot-death. These two quantities can be equated only when the alternative hypothesis, murder, is almost certain. Murder is a very unlikely event, and double murder of one’s own children still rarer, so this logical leap was completely unfounded. Hill, 2002, attempted to compare the likelihoods of the two likely combinations: two SIDS

ST OLAVE’S ACADEMIC JOURNAL

deaths, and double homicide (other explanations like one homicide and one SIDS were reasonably ignored), and concluded that repeated accidents were between 4.5 and 9 times more likely than repeated murder, suggesting that the chances of Sally Clark’s innocence were between 80% and 90%. However, most importantly, Hill included a caveat: “guilt must be proven on the basis of forensic and other evidence and not on the basis of these statistics alone”. While a jury does effectively judge how likely they think it is that a suspect has committed a crime, this is based on probabilities drawn from specific pieces of evidence related to a case, and not population wide percentages.

4.4.4 Effects.

In the Sally Clark case, a whole courtroom of people many of whom were legal expertsfailed to spot basic statistical errors. As a result, Sally Clark was convicted and spent three years in prison. She developed a number of serious psychiatric problems, including serious alcohol dependency, and died in 2007 from acute alcohol poisoning. These paradoxes, mistakes and counter-intuitive results cause needless suffering and death. Judges certainly need better statistical and probabilistic training (Aitken, Roberts & Jackson, 2010). But the evidence suggests that jurors also ought to understand uncertainty better. Once again, this can only come through better mathematical education and a greater emphasis on mathematics that people will use throughout their lives, such as probability. On the other hand, Clark, 2012, argues that jurors are

ISSUE 5, SEPTEMBER 2017

not meant to be experts: their non-

expertise is what allows them to act

as peers, and that any system to

train jurors in probabilistic methods would be inefficient. This is an

unfair representation of the previous suggestion: better compulsory mathematical education would negate the need for special juror training, and the claim that their lack of mathematical understanding makes them better jurors is unsubstantiated.

4.5 Gambler’s fallacy

The gambler’s fallacy is the mistaken belief that if something happens more or less frequently than normal in the present, the frequency of that event will be opposite in the future, in order for the system to remain “balanced”. This is most commonly associated with gamblers (Jonah, 2009), but this phenomenon can appear in other situations, such as childbirth.

4.5.1 Childbirth.

The gambler’s fallacy has been applied to childbirth for centuries, with expectant parents hoping for a certain sex of child, usually a boy (Barron and Leider,

2010).

In 1796, Laplace observed that fathers would become anxious if several boys were born in their community when their wives were pregnant because it would mean that they would be more likely to have a daughter instead of a son. Another mistaken belief was

expecting a child of a different sex, after having had several children of

a particular sex. There is an

ST OLAVE’S ACADEMIC JOURNAL

alternative explanation for this misconception however: the Trivers- Willard hypothesis (Trivers & Willard, 1973) suggests that female mammals are able to adjust their offspring sex ratio in response to their maternal conditions. In particular, they would invest more in male offspring in better conditions, and in female offspring in worse conditions. Nevertheless, even if this is true, scientific consensus is that sex ratio is nearly completely random (James, 2008), suggesting that expecting a child of a certain sex based on the sexes of previous children is wrong.

4.5.2 Gambling.

Consider the repeated toss of

a fair coin. The outcomes are

statistically independent so no matter the unlikelihood of an individual sequence of heads and tails, all outcomes for a certain number of tosses are equally likely.

The possibility of 5 heads in a row for example is 1 in 32. Someone subscribing to the gambler’s fallacy might think that the next flip would

be more likely to be a tail because

there have been several heads previously. But this would be incorrect: the probability of six heads

in a row and five heads and a tail would be equally likely at 1 in 64. Casinos deliberately encourage clientele to fall for this fallacy by posting the histories of roulette wheels next to the tables (Grint,

2005).

Gamblers see small runs on the boards, which are due only to random variation, and assume these will affect future spins. While it could be argued that this doesn’t decrease their odds of winning at any

ISSUE 5, SEPTEMBER 2017

individual point the chances of red,

green are unchanged Grint found that gamblers were lucky to remain in the casino for longer when they believed that “their luck would turn”. Still, one could say that the casinos are merely providing their customers with more information, allowing them to make an informed decision. But they are aware that they are deliberately trying to manipulate gamblers to make more money. However, there are some situations where having these boards would be useful. Gonzalo Garcia- Pelayo analysed roulette wheel information from casinos all over Madrid and found that some were broken and landed on certain colours more than others. He used this to win $1.5 million over several years, before he was eventually banned.

black and

5. Conclusion

It is clear that people misunderstand uncertainty in many different ways. Often it can involve paradoxes and counter-intuitive resultsclearly psychological biases and heuristic approaches contribute to these misconceptions. It also stems from a lack of probabilistic mathematical education: it is difficult for people to spot these mistakes if they are unaware of them, and they cannot rectify them without being given the intellectual tools to do so. That said, many of this fallacies are very simple, and as shown by the number of mathematics guides written for non- mathematicians, it is possible to teach people to recognise where these mistakes happen, without explaining the rigorous mathematics

ST OLAVE’S ACADEMIC JOURNAL

beneath. These fallacies also appear because data is incorrectly represented. It might be cherry- picked, and only a selection is analysed, or it might be worded in such a way as to play on human bias and misunderstanding. Finally, people misunderstand chance because others deliberately use statistics to mislead and misinform. In today’s society, all important decisions are expected to have numbers to back them up, but when money is involved the validity of those numbers becomes less important. Everyone is affected: the public, members of the judicial system, politicians, and even doctors and scientists. They are unaware of these problems, and do not have the training to confront them. But government policy hinges on non- mathematicians understanding the uncertainty in the data that they are giving and making good decisions that will affect the lives of millions of people. People are wrongly sentenced to life imprisonment based on false probabilities. Drugs can appear more beneficial than they are and people die as a result. But in order to implement better mathematical education, there needs to be a greater understanding of the psychological reasons that humans make these mistakes. I would be very interested in researching these further. The field of heuristics: the study of human decision-making is fascinating, and it would be satisfying to have a deeper, more rigorous understanding of subconscious human biases. Certainly the gambler’s fallacy can be explained by the representation bias, for example, and many other of

ISSUE 5, SEPTEMBER 2017

the fallacies discussed have some roots in heuristics. That said, any research into heuristics should not have the sole aim of identifying such cognitive shortcuts and removing them. There may be situations where they are actually more useful to humans than laboriously calculating the optimal solution. I would also be interested in studying mathematics education more generally. As I wish to study a mathematics degree, it would be both useful and interesting to research how mathematicians learn best. This is linked with heuristics in fact, as mathematical analysis, for example, is a very counter-intuitive area of study. Finally, I would like to know more about some of the actual mathematics underpinning several of the results I have discussed. For instance, there is a vector interpretation of Simpsons’ Paradox which I was not able to discuss here, but I would like to understand. This is also the case with the Bayesian interpretation of the prosecutor’s fallacy, and Bayesian methods more generally. Last, while I feel my original viewpoint is mostly unchanged that these fallacies are numerous, but with careful thought and awareness they can be coped withI have realised that some are much more complicated than I expected. It often took several careful readings to understand even the explanation of why something is fallacious. This makes me a lot more sympathetic to those in other fields suddenly forced to confront tricky paradoxical mathematics. Nevertheless, I still believe that better mathematical education is the key to solving this problem. It was heart-warming to see that David

ST OLAVE’S ACADEMIC JOURNAL

Spiegelhalter’s suggestion of teaching natural frequencies has now been included into the content of the UK Mathematics GCSE.

Bibliography

1. Akl,

E.

A., Oxman

,

A.

D.,

Herrin, J.,

Vist,

G.

E.,

Terrenato, I. & Sperati, F. (2011). Using alternative statistical formats for presenting risks and risk reductions. Cochrane

Database

Reviews, 7(2394).

of

Systematic

2. Barron, G., Leider, S. (2010). The role of experience in the gambler's

fallacy.

Behavioral

Making, 23(1), 117–129.

Journal

of

Decision

3. Borsuk, M. E., Stow, C. A. & Reckhow, K. H. J. (2003). Water Res. Plan. Manage. 129, 271282

4. Campbell, S. K. (2004) Flaws and fallacies in statistical thinking. Mineola, NY: Dover Publications.

5. Charig C. R., Webb, D. R., Payne, S. R. & Wickham, J. E. (1986). Comparison of treatment of renal calculi by open surgery, percutaneous nephrolithotomy, and extracorporeal shockwave

lithotripsy. British Medical

Journal 292(6524),

882.

879–

6. Gigerenzer, G. (2011). The art of risk communication: What are natural

frequencies?.

British

Medical

Journal,

343(6386).

ISSUE 5, SEPTEMBER 2017

7. Hall,

(2012). “Royal

Statistical Society concerned by issues raised in Sally Clark case”.

R.

Significance, 145(1), 24-28.

8. Hill,

(2004). Multiple

sudden infant deaths – coincidence or beyond coincidence?. Paediatric

R.

and

Epidemiology. 18(485),

322323.

Perinatal

9. Huff,

D.

(1993).

How

to

lie

with statistics. New York, NY:

W. W. Norton & Company.

10. James,

W.

H.

(2008). Hypothesis: Evidence that mammalian sex ratios at birth are partially controlled by parental hormonal levels around the time of conception. Journal

of

3–15.

Endocrinology. 198(1),

11. Jonah, L. (2009). How we

decide. New York, NY:

Houghton Mifflin Harcourt. 66. 12. Julious, S. A. and Mullee, M. A. (1994). Confounding and Simpson's

Paradox. British

Journal, 309(6967), 1480–

Medical

1481.

13. Kock, N. (2015). How likely is Simpson’s paradox in path models?

International Journal of e- Collaboration, 11(1), 1–7.

14. Magid, A. (2005). Letter from

the

Editor,

American

Mathematical Society,

1173(3567).

15. Pavlides, M. G. and Perlman, M. D. (2009). How likely is Simpson's Paradox?.

The American Statistician, 63(3),

226233.

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

16. Pearl,

J. (2009). Causality:

Statistical

errors

in

Models, Reasoning, and

medical research

-

A

Inference. Cambridge,

review of common pitfalls.

UK: Cambridge University Press

Swiss Weekly, 137(4449).

Medical

17. Spirer, H., Spirer, L. & Jaffe, A. J. (1998). Misused Statistics.

19. Trivers, R. L. and Willard, D. E. (1973). Natural selection of parental

Boca

Raton,

FL:

CRC

ability to vary the sex ratio

Press.

of

18. Strasak,

A.

M.,

Zaman,

Q.,

offspring. Science. 179(406

Pfeiffer, K. P., Gobel, G. &

8), 90–92.

Ulmer, H. (2007).

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

To what extent does the privatisation of the NHS affect patient care?

Kosi Nwuba

1. Abstract

The National Health Service commonly shortened to the NHS was founded in 1949 by Aneurin Bevan the then health minister. It is the

oldest universal single-payer healthcare system in the world. It is

a tax based healthcare system

publicly funded through taxpayers’

money. Its founding principle is that

the health care provided by the NHS

meet the needs of everyone, is free at the point of delivery and is

distributed according to clinical need rather than the ability to pay. The NHS employees over 1 million people, making it the fifth biggest employer in the world, while serving over 54 million people. Over the last 25 years since Margaret Thatcher's government, and there has been a gradual increase in the privatisation in the

.The

National Health

introduction of private providers of

health care into the NHS mean an increase in privatisation.

An ageing population, increasing life

expectancy and increasing cost of

healthcare re present challenges to

the NHS.

As a result of these increasing pressures, the need to solve them becomes more important. Some see privatisation as a solution to these issues whereas other believe privatisation to be a cause hence it is

useful to know the extent the current privatisation affects patient care.

Service.

Good patient care is ultimately the focus of any healthcare system. Rationing is where the services on offer are streamlined. Current pressures are causing the rationing of services and the distribution of services to more private providers resulting in a reduction in services. Rationing can be beneficial where resources are more specifically allocated fora particular population. On the other hand, it can be detrimental where services are reduced such as local A&Es causing insufficient healthcare availability in particular local populations across the country. The outsourcing of healthcare to private providers leads to the fragmentation of healthcare. The coordination between different parts of healthcare delivery decrease as more healthcare is outsourced. The increase in private ownership of healthcare services leads to inefficiencies such as the private financial initiative whereby the government leases privately built hospitals at significantly higher prices. There is a long-lasting ideology that these private corporations value profit over their patients. However, there is evidence to show that patients are just as likely to receive a bad standard of healthcare at a private healthcare provider as public healthcare provider. However, when you involve financial incentives in the delivery of healthcare, naturally

ST OLAVE’S ACADEMIC JOURNAL

there will be the tendency for firms to cut corners and compromise patient healthcare in order to maximise profit. There are numerous ways in which the privatisation of the NHS can affect health care; both good and bad. The current extent of privatisation in the NHS definitely has affected and is affecting patients. Moving forward, as the extent of the pressures on the NHS increase, there must be a re-evaluation on the way in which private providers are involved in the NHS. Private participation in healthcare can be useful however only in certain situations meeting the needs of patients where the NHS can’t. Minimal private participation is ideal however, there should be some private participation. The privatisation of the NHS must be limited and the way in which healthcare is delivered and organised needs a change.

1.1

Introduction

In this project, I hope to identify the extent of privatisation in the National Health Service (NHS) and then to what extent this privatisation is responsible for failures occurring in the nation’s health system. This will thereby allow me to consider its effect on the healthcare that NHS patients receive. By looking at the effect of privatisation and analysing its possible advantages, disadvantages and how these affect the care doctors are able to give their patients, I hope to conclude the extent to which privatisation hinders the patient care. The National Health Service (NHS) founded in 1948 is the bedrock of the

ISSUE 5, SEPTEMBER 2017

nation. However, today it faces more challenges than it ever has faced before. For example, the population is ageing. One in six of the population currently is aged 65 and over and by 2050 this would have increased to one quarter of the population. Life expectancy is also at its highest level with babies born today having an average life expectancy of 89. It is obvious that the elderly require far more healthcare due to weaker immune systems for example leading to greater susceptibility to disease and this coupled with the increase in births in recent years, piles even more pressure on the national health care system. As the demand for healthcare increases, the ability of the NHS to supply this becomes increasingly strained. Amongst all these challenges, there has been a gradual increase in the privatisation in the NHS over the past 25 years. Privatisation is defined as “the act of transferring ownership of specified property or business operations from a government organization to a privately owned entity, as well as the transition of ownership from a publicly traded, or owned, company to a privately owned company.” [1] So, essentially this means private companies owned by individuals taking over the healthcare of parts of the population on behalf of the NHS. In the NHS, there an incredibly complex system with varying qualities of care and care-providers throughout the nation. The secretary of state overseas the department of health which funds and organises the health and social care in the UK. There is also NHS England responsible for primary care, clinical commissioning groups mainly

ST OLAVE’S ACADEMIC JOURNAL

responsible for secondary care along with several regulatory bodies that ensure standards are maintained as well as the health and wellbeing of patients.

My aim of this extended project qualification is to assess the effect that the privatisation has on the NHS and its capability to deal with the ever-changing demographic and the ageing population i.e. its effect on patients. By analysing and understanding the extent to which the NHS is affected by this, not only will it put me in a stronger position

in terms of knowledge concerning my

desired career path but help me appreciate the privilege of having a

nationwide health service that is free

at the point of delivery.

In the future, as well as going to university to study medicine, I would like to work as a doctor for the NHS

hence the changes to the NHS now

are vital as they will directly affect the conditions in which hopefully I will work in one day. The NHS is at

a crucial stage as the changes now

are crucial to the efficacy of the NHS and its ability to supply universal

healthcare in the future. With political happenings permanently affecting the running of the NHS leading to an increase in privatisation, it is important the NHS keeps up so in twenty years’ time a doctor and patient can continue to rely on the NHS; Britain’s greatest treasure.

2. Discussion

Since Thatcher's government there has been a gradual increase in NHS privatisation over the last 25 years.

Rationing

ISSUE 5, SEPTEMBER 2017

Due to the financial crisis that the NHS finds itself in, there has been a vast increase in privatisation and therefore the rationing of healthcare. Healthcare rationing is essentially limiting the availability of certain healthcare provisions where certain services are withheld although they could probably be beneficial because those services can’t be provided for everyone who needs them [9] .

Healthcare has been outsourced to private companies and along with this has inevitably come a decrease in the variety of services provided. The health secretary Jeremy Hunt has said the NHS needs more money and outsourcing [10] . Clinical commissioning group's (CCGs) are responsible for the commissioning of healthcare services for their respective communities. They were set up as a result of the Health and Social Care Act of 2012 and largely replaced primary care trusts. The financial struggles of the NHS have been well publicised. For example, in 2014, the NHS Trust Development Authority reported a deficit for NHS trusts of £241 million which is £165 million more than the planned deficit was at the beginning of the financial year [11] . The NHS has faced a sustained decrease in the increase in spending in recent past. As the NHS can't afford to provide the sheer magnitude of health services that a whole nation requires, there have been proposals for ward closures and a reduction in the number of beds and reorganisation of A&E and GP care across the country as the NHS aims to deliver 22 billion in efficiency savings by 2020-2021 [12][13] . Therefore by the reduction in the extent of healthcare patients are

ST OLAVE’S ACADEMIC JOURNAL

likely to be affected as the total range of patient care decreases.

2.1 Good rationing

What you gain with rationing is healthcare tailored to the local population. What you will find across the country is a varying demographic

[14] . So, for example, the demographic

in the countryside will be incredibly

different from the demographic in central London and therefore different services will be needed for the two locations. It is the responsibility of the clinical commissioning groups to assess what is needed and allocate the NHS

budget accordingly. The aim is to provide a more efficient and useful healthcare service. Private companies are in a position to

provide services that are required in

a particular region and they can

usually offer more money for contracts and when cash is far spent, this therefore is extremely attractive

to the clinical commissioning groups

who have the legal power to offer up contracts to "any qualified provider ". The private healthcare company

then provide the healthcare to meet the needs of the local population which in turn should benefit the patient. If the CCGs make sensible decisions concerning the allocation of resources, patient across the country should benefit from more specific healthcare provision.

2.2 Centralisation of services

This is where the care on offer is concentrated into specific areas. An example of where this has been particularly beneficial is the high profile case of footballer Fabrice

ISSUE 5, SEPTEMBER 2017

Muamba. During a football match, his heart stopped for over an hour as he suffered a heart attack. Instead of going to the Whittington Hospital, the nearest hospital to White Hart Lane stadium where the match was being played, the paramedics took him to The London Chest Hospital 1.5 miles further away. The reason for this is the centralisation of services. Professor Sir Roger Boyle played a big role in reviewing the heart services and increase the centralisation of cardiac services. The heart attack survival rate has more than doubled in the past 40 years and particularly in the last 15 years and this can be attributed to the centralisation of services. If someone suffers a heart attack they won't be taken to the nearest hospital but rather the best hospital for their condition. In one centralised hospital you can have experienced staff, advanced equipment and specialist professionals.

It would be impossible to replicate this set up at every hospital hence centralisation is key to the improvement of healthcare [15] . For example, in London the number of hospitals able to treat heart attacks is now eight compared to 24 previously. Therefore, rationing is beneficial as although you may have to close down some existing healthcare services such as local A&Es for example, by centralising the services, overall, you will improve patient care as is evident by the increase in heart attack survival rates [16] .

With any social good, ultimately, rationing is inevitable because there are unlimited wants for limited resources and therefore scarcity

ST OLAVE’S ACADEMIC JOURNAL

exists hence certain goods and services must be rationed and therefore not provided because of this issue. Consequently, it is more appropriate to accept privatisation as a necessary result and rather discuss the best way in which to allocate resources and tender out contracts to ensure that the care and treatment of patients is optimised while minimising the expenses.

2.3 Bad rationing

On the other hand, it can be argued that rationing is not the way forward. It's impossible to always get it right hence you often find situations where patients in a region aren’t catered for. NHS England chief executive Simon Stevens said patients were being robbed of 'dignity and compassion' because of a lack of local care.

In the case of centralisation, this is not always advisable. Although it may be beneficial for treating heart attacks and strokes, for common inpatient admissions, outpatient clinics and maternity care it is not the best thing leading to a reduction in local care. With the centralisation of hospital services, a simultaneous investment in primary care services such as general practices is needed however this has not been the case with drastic decreases in their budgets. It is the patients who ultimately suffer from this [17] . There are other ways to improve the NHS deficit without privatising and reducing the services available.

2.4 Profits over patients?

ISSUE 5, SEPTEMBER 2017

Tenet Healthcare is an example of the dangers of private health care providers who seek to maximise their profit at the expense of patient care. This American health care company had to pay almost $400 million in settlements when it was discovered that they were delivering bogus and unnecessary heart surgeries [18] . This is an example of where the incentive of making money has led to a disregard for patient care and in this particular scenario many patients suffered with some even being left paralysed. Patient care is obviously not the primary objective here and it can be argued that even if it is intended to be, the very relevant factor of profit in these situation leads to inefficiencies like this. The ultimate result is the quality of care delivered being compromised.

2.5 Misplaced ideologies

Although profits may be seen to replace the need to prioritise the patient, if you look at patient experience surveys, health and social care patients say they are just as well cared for by privately-run organisations compared to government-run organisations [19] . You are just as likely to receive an unacceptable standard of care when treated by private institutions which dispels some ideological beliefs that the public sector care more than the stereotypically greedy private sector. The Stafford Hospital scandal is an example of where the NHS has failed its patients and been unable to provide an acceptable level of healthcare resulting in several preventable deaths. This was a

ST OLAVE’S ACADEMIC JOURNAL

nationwide scandal in which it was revealed that up to 1200 patients may have died between 2005 and 2008 because of substandard care [20][21] . In 2015 76% of NHS hospital trusts were are adjudged to be either inadequate or requiring improvement. In the NHS system which is a government funded via taxation system it is evident that there are still big negatives in terms of the quality of patient care being administered [22] [23] [24] .

2.6 Independent Sector Treatment Centres (ISTCs)

Independent Sector Treatment Centres (ISTCs) are private-sector owned treatment centres in the NHS used to treat NHS patients free at the point of use. ISTCs have been incredibly beneficial for patients with patient satisfaction very high. Additionally ISTCs although initially being paid too much for the services provided, as time has passed, the number of treatments being given now equal the NHS tariff. The result has been reduced waiting times. In addition to this the ISTC programme is in direct competition with NHS hospitals and therefore this aspect of competition is an incentive for ISTCs and NHS hospitals to improve their standards look for new ways to become more efficient with the ultimate end result being an improved level of patient care.

The introduction of Independent Sector Treatment Centres (ISTCS) was to carry out simple surgery in order to increase efficiency by reducing waiting times for these lower risk routine procedures.

ISSUE 5, SEPTEMBER 2017

However, the introduction of Private organisations such as Nectare and Care UK who ran some of these centres led to big losses. Nectare received £35 million for patients that were never treated because this was the work that they had been contracted to do and so the company was paid in bulk for a certain number of cases. ISTCs contracts were 12% more expensive than the NHS tariff cost on average. The underlying point is, however, that there is money being spent here that could arguably be better invested in other areas more directly involved with patient care but due to this privatisation in the NHS you have these inefficiencies

3.1 Inefficiency 1: Internal Market

An argument against private involvement healthcare is that they causes inefficiencies. By complicating a tax funded system with the introduction of private health providers this leads to several inefficiencies. Administrative costs are a drain on NHS resources. In order to optimise patient care the NHS realistically needs more money invested into it however due to the increase in privatisation, there are arguably several inefficiencies such as the cost of running an internal market. The internal market was essentially the introduction, in 1990, of "trusts "; primary care trusts and NHS hospital trusts. This internal market basically meant hospitals had to compete against each other to get business with NHS hospital trusts acting as the providers and primary care trusts the purchasers forming the purchaser-provider split. The running of an internal market alone costs 10% of the NHS budget

ST OLAVE’S ACADEMIC JOURNAL

each year (£10 billion). It can be argued that the money spent here would be better invested directly in improving patient's health; buying new equipment, funding new medicines and hiring more staff. Patient care could be vastly improved with this money that is being spent running privatisation; a direct impact of privatisation.

3.2 Inefficiency 2: Private Financial Initiative Schemes

Another massively contentious issue is the Private Finance Initiative schemes (PFIs). PFIs were introduced as a way to run government infrastructure projects. They included the buildings of hospitals, roads and schools where essentially private companies would pay for the building of these projects and then lease the buildings back to the government. The benefit of this scheme was meant to be that the government could provide new hospitals without worsening the national debt. However, again, this has resulted in several inefficiencies with severe wastage of money in several areas. As the hospitals are leased back to the government, repayments are astronomically high with interest rates in some cases over 70%. Repayments increase annually and this expenditure is costing the NHS a lot of money. For example, the bill of the cost of the hospital PFI schemes is projected to exceed £79 billion compared to the actual value of building which is £11.4 billion. Additionally, PFI schemes include facility maintenance which essentially means if there is an issue at a hospital, only an agreed contract is allowed to do the work allowing these contractors to

ISSUE 5, SEPTEMBER 2017

overcharge severely for that work.

The cost of PFI has been £301 billion

for building projects were only worth

£54.7 billion meaning there has essentially been £246.3 billion of waste. This sum of money is almost two and a half times the yearly NHS budget. As a result of this, many hospitals are in deficits and in severe danger of being shut down.

4. Fragmentation

With the increase in private providers in the NHS there is a worry that this will lead to the fragmentation of services. Ideally, a healthcare system is an integrated one. Clinical integration is defined as "the means to facilitate the coordination of patient care across conditions, providers, settings, and time in order to achieve care that is safe, timely, effective, efficient, equitable, and patient-focused.” The ability of the NHS to do this is reduced with privatisation because.

The tendering of contracts to private providers leads to fragmentation. When there is competition in the setup, inevitably, this will result in greater divided between providers. However in order to optimise patient care this is not helpful. With elderly patients, for example, they may come in with a variety of different ailments ranging from arthritis to dementia to hypertension and therefore it is important to have providers of certain types of care closely linked with good channels of communication between them in order to optimise the care of the patient. But what you'll find is, with

a fragmented healthcare service,

these providers of different services often won't be in communication and

ST OLAVE’S ACADEMIC JOURNAL

therefore this is to the detriment of the patients who suffer the most [25] .

Christina McAnea, head of health at Unison, at the time said "The government's drive towards NHS privatisation is leaving patients vulnerable to poor care and support at surgery centres like the one at the Lister hospital. It is potentially the tip of the iceberg in terms of the clinical risk of fragmented health services.” [26]

4.1 Innovation

Private interests breed innovation. When you have private companies competing for business this drives the quality up due to the competition. Doctor Devi Shetty an Indian cardiac surgeon set up low- cost hospitals in which he streamlined the processes of heart surgery in order to reduce the cost. He seemingly simplified the complexities of heart surgery to a line of production and it has drastically reduced the price of this heart surgery in India. He runs a "for-profit" hospital in which the price of coronary bypass surgery is almost 70 times cheaper than in the USA with very similar success rates and efficacy. The idea of having to compete with the National Health Service in India albeit a notoriously poor one has resulted in this innovation by Doctor Devi Shetty. Thousands of Indians are now benefiting from this innovation whereas in a government funded system it can be argued this need to be creative and innovative is less incentivised and therefore the care patients receive will not be improved

ISSUE 5, SEPTEMBER 2017

as much. Other examples of ground breaking innovation from the private sector are nanoknife treatment on inoperable tumours, chemosaturation therapy for cancers of the liver and the use of the advance lensAR femtosecond cataract laser to treat eyes [27] .

5. Patient choice

One of the proposed benefits of privatisation is an increase in patient choice. Accompanying the increase in providers is an increase in the choice of the patient. A patient who goes to their GP will be able to discuss the different providers who could deliver the healthcare to them. The aim is that in particular areas that the NHS has particularly struggled, the innovation fuelled by this competition will lead to solutions; the providers have to compete for the preference of the patient. By being able to decide where and when the treatment will take place this allows patients more control over their healthcare. The rise of the Internet has seen an increase in the number of patients having a far greater say in their healthcare and as a result these patients are kept happy because they are more involved in the decisions that concern their well-being rather than just being told by a doctor what to do; an improvement on the care of patients. Greater patient choice in the NHS will help clinical commissioning groups in knowing where to allocate resources in their local area as patients, by the healthcare decisions they make, will help elucidate where there are needs and where resources need to be allocated. The extent of the effect of patient choice on the quality of

ST OLAVE’S ACADEMIC JOURNAL

patient care is debateable however this aspect of competition fuelled by patient choice provides a specific incentive to improve patient care.

However arguably this idea of choice is quite trivial because every provider theoretically should meet NHS expected standards of care therefore it renders this choosing option that patients have as useless. Even if there are varying standards of care, which to an extent are inevitable, and the patient opts for a particular provider, it will be very difficult for the patient to measure and distinguish the positives and negatives of each different provider. Their GP may not even be able to provide them with the full picture. Furthermore, it is very possible GPs may have vested interest in some of the private providers they are able to refer the patient to creating a conflict of interest where the patients care once again may be marginalised.

The idea of competition driven innovation can be counteracted by the fact that smaller businesses running private health care practices may not be able to compete with large businesses that can offer more for contracts out on tender. Bigger businesses can afford to suffer some losses additionally which smaller businesses can't. Naturally clinical commissioning group's will look for the best deal so although the founding idea for competition is that it's more about the best quality healthcare, what eventually results is a situation where the best value for money healthcare usually gets the tender. This is because the fixed price the government wants these companies to compete at becomes

ISSUE 5, SEPTEMBER 2017

secondary as clinical commissioning groups have to manage their budget accordingly and therefore must prioritise their finance leading to his large corporations taking over a great share of the healthcare provisions. Many of the contracts in place under the "any qualified provider" legislation include guaranteed income for the providers which essentially means private healthcare companies can make profits thereby reducing the funding NHS hospitals get. This loss of money to NHS hospitals is an inefficiency and ultimately will affect the patient care of the patients in the hospital.

Measuring patient care is also a difficult thing to you. In this case, any effects whether positive or negative have been booked St. There more objective measure used by the NHS based on performance outcomes however [28] . The quality of healthcare ranges across every different hospital and the general happiness of patients about the care they receive can often be hard to quantify

6. Conclusion

In conclusion, it is very evident that the privatisation of the NHS can affect patient care. The gradual increase in private participation in the nation’s healthcare since the 1990s has ultimately resulted in several inefficiencies. It is quite apparent that market principles and theories aren’t directly applicable in a national health service where the priority must be the quality and efficacy of care that the patients receive.

ST OLAVE’S ACADEMIC JOURNAL

It has been argued that the certain politicians in parliament have vested interests in an increase in the private participation in. For example, in 2014, there were 72 members of parliament who stood to profit from an increase in privatisation in the NHS. Therefore, legislation concerning the NHS that has been passed may not necessarily always have been in the best interests of patients. However, even in circumstances like the failings at Staffordshire hospital, they can actually, to an extent, be attributed to privatisation. This raises the argument that it's actually privatisation causing a lot of the issues with patient care in the NHS rather than privatisation being the solution to a lot of the varying issues. In the first enquiry led by Robert Francis QC in 2010, it was said that there was too much of a priority place on finances as the trust was trying to balance its books following three years of losses and as a result made several cuts including 150 posts all at the expense of patient care. A direct result of privatisation. This is following an increasing impetus for hospitals to be run like businesses. It can certainly be argued that privatisation has its positive affects with ideas such as patient choice and increased competition aimed to drive innovation. The NHS is under immense financial pressures and these financial pressures will inevitably hinder patients. With the ageing population, increasing cost of healthcare and obesity prevalence in the UK, it can be strongly argued that it is vital that the NHS becomes more efficient and there is a need for new money-saving and health improving ideas. The idea that

ISSUE 5, SEPTEMBER 2017

privatisation can solve some issues the NHS itself cannot is a valid one for example ISTCs have helped reduce waiting times for some operations. It is obvious that private healthcare has its benefits and a completely tax funded health system is not necessarily the best and most efficient choice for patients. Ultimately, the patient's health care must remain the priority in every situation regardless. The question of the extent of the effect of privatisation on patient care however cannot answer determining and in what patient care constitutes and deciding how to measure patient care quality. It can be particularly difficult therefore to quantify to what extent patient care is affected by privatisation. Every hospital is different and the increase in private participation has affected different communities differently and therefore to judge this affect whether positive or negative is obviously incredibly difficult. The French healthcare has been rated the best in the world. It operates a national health insurance scheme with both the government and private participation in the healthcare delivered funded by people and their employers. Unlike the British system which is free at the point of delivery, in some instances there are payments at the point of contact however this is largely mitigated by health- insurance which the vast majority of the population have. Also there are exceptions made for the severely ill and poor. This points to probably it being best for there to be both private and government involvement in the deliverance of healthcare however it

ST OLAVE’S ACADEMIC JOURNAL

must be emphasised the importance to only take the positive aspects from each of the providers. It is important to ensure that we maintain the founding NHS principles; the idea that the NHS is for everyone, free at the point of delivery and based on the clinical need. However in this current climate with the pressures the NHS faces there must be adaptation. European nations provide good examples of how the national health service can be for everyone but still affordable so potentially in the coming years then maybe a shift to a more insurance-based health system in the UK to solve some of the issues. I believe however, profit should not be involved as much as possible when it comes to people's health as these two interests usually conflict. The NHS is definitely directly affected by privatisation and probably more negatively then positively at the moment. However privatisation has its benefits and to an extent private providers have their place in national health system. The UK provides the most efficient healthcare per pound spent. There are plenty of areas for improvement however and it is in these situations for example the low relatively low success rate with cancer treatment in the UK or excessive waiting times where constructive private involvement may be welcomed. Therefore, privatisation can be useful and is good only in moderation however. The core principles of the NHS must be maintained and privatisation mustn’t compromise these. After all, despite everything you may hear, the UK has one of the fairest and best healthcare systems in the world [29] .

ISSUE 5, SEPTEMBER 2017

Bibliography

1.

ANON. Privatization.

Available at:

http://www.investopedia.com/t erms/p/privatization.asp. Investopedia. [Accessed July 2, 2016].

2.

Taylor R. God Bless the NHS.

Faber and Faber Limited with Guardian Books 2013.

3.

El-Gingihy Y. How to

Dismantle the NHS in 10

Easy Steps. Zero Books 2015.

4.

Davis J, Huitson O, Lister J, Player S, Pollock AM, Price D, Tallis R, West C, Wrigley D. NHS SOS. Oneworld Publications 2013.

5.

ANON. Junior doctors' row:

The dispute explained. BBC

April 6, 2016. Available:

http://www.bbc.co.uk/news/hea lth-34775980 . [Accessed October 15, 2016].

6.

ANON. Thousands Turn Out In London To Protest Against Privatisation Within The

NHS. The Huffington Post September 6, 2014. Available at:

http://www.huffingtonpost.co.

uk/2014/09/06/thousands-turn-

out-for-the-nhs-on-london-leg-

of-peoples-

march_n_5777588.html.

[Accessed October 15, 2016].

7.

El-Gingihy Y. If you think there is no money for NHS funding you’d be right – PFI has sucked it dry. The

Independent July 13, 2016. Available at:

ST OLAVE’S ACADEMIC JOURNAL

http://www.independent.co.uk/

voices/nhs-funding-pfi-

contracts-hospitals-debts-

what-is-it-rbs-

a7134881.html[Accessed

November 26, 2016].

8. Pollock A. Why A&E

departments are fighting for

their life. The Guardian

January 14 2014. Available at:

https://www.theguardian.com/

commentisfree/2014/jan/14/em

ergency-departments-fighting-

for-life-nhs-

marketisation[Accessed November 26, 2016].

9. ANON. The Grand Unification Theory of Health Care. 2000.

Available at:

http://www.yourdoctorinthefa

mily.com/grandtheory/section2

_1.htm [Accessed November 26, 2016].

10. Waugh P. Jeremy Hunt Has Admitted The NHS Needs More Money As It Faces ‘Very Challenging’ Winter

Pressures. The Huffington Post November 6, 2016.

Available

at:http://www.huffingtonpost.c

o.uk/entry/jeremy-hunt-

admits-nhs-needs-more-

money-autumn-statement-

winter-crisis-philip-hammond-

10bn-

4bn_uk_581f3c0ae4b0c2e24aaf

c910. [Accessed November 25,

2016]

11. Murray R, Imison C, Jabbal J.

Financial failure in the NHS.

The King’s Fund October, 2014. Available at:

https://www.kingsfund.org.uk/

ISSUE 5, SEPTEMBER 2017

sites/files/kf/field/field_publica

tion_file/financial-failure-in-

the-nhs-kingsfund-

oct14.pdf[Accessed November 26, 2016].

12. ANON. UK 'has fewer hospital beds per person than most European countries’. The

Guardian April 16, 2014. Available at:

https://www.theguardian.com/

society/2014/apr/16/britain-

fewer-hospital-beds-european-

oecd[Accessed November 26,

2016].

13. Vize R. The NHS cannot escape its financial crisis without more money. The

Guardian May 13, 2016. Available at:

https://www.theguardian.com/

healthcare-

network/2016/may/13/the-nhs-

cannot-escape-its-financial-

crisis-without-more-money. [Accessed September 1, 2016]. 14. Scheunemann LP, White DB.

The Ethics and Reality of Rationing in Medicine.

CHEST December, 2009. Available at:

https://www.ncbi.nlm.nih.gov/

pmc/articles/PMC3415127/

[Accessed October 15, 2016]. 15. Burrows S, Woolland K.

Centralisation is crucial to achieve better care locally.

Health Service Journal June 5, 2014. Available at:

https://www.hsj.co.uk/commen

t/centralisation-is-crucial-to-

achieve-better-care-

locally/5071616.article

[Accessed November 26, 2016].

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

16. Bloch-Budzier S. NHS cuts

'planned across England'.

BBC August 26, 2016. Available at:

http://www.bbc.co.uk/news/hea

lth-37186455[Accessed

November 20, 2016].

17. ANON. NHS must end mass centralisation, says new boss.

The Guardian May 30, 2014. Available at:

https://www.theguardian.com/

society/2014/may/30/nhs-

england-mass-centralisation-

simon-stevens [Accessed November 26, 2016].

18. Bryant M. US recovered $3.3B in fraudulent healthcare claims in 2016. Healthcare

Mid-Staffordshire. The

Telegraph March 18, 2009.

http://www.telegraph.co.uk/ne

ws/health/news/5008935/NHS-

targets-may-have-led-to-1200-

deaths-in-Mid-

Staffordshire.html [Accessed November 26, 2016] 22. Donnelly L, Turner C, Kirk A. Care Quality Commission:

Three in four NHS hospitals are failing, says watchdog.

The Telegraph October 15,

2015. Available at:

http://www.telegraph.co.uk/ne

ws/nhs/11931401/Three-in-

four-NHS-hospitals-are-

failing-says-watchdog.html [Accessed October 15, 2016].

Drive January 20, 2017. Available at:

http://www.healthcaredive.co

m/news/us-recovered-33b-in-

fraudulent-healthcare-claims- http://www.bbc.co.uk/news/hea

in-2016/434391/ . [Accessed January 25, 2017].

Association. BBC February 18,

23. ANON. NHS 'never events' a disgrace, says Patients

2016. Available at:

lth-35597244[Accessed

November 26, 2016]. 24. ANON. Never Events. NHS England April 1, 2016. Available at:

https://www.england.nhs.uk/p

atientsafety/never-

events/[Accessed November 26, 2016].

25. ANON. Integrated care is key for dementia patients. The

Guardian November 17, 2016. https://www.theguardian.com/

society/2016/nov/17/integrated

19. Pemberton M. 'Superior

private health is a myth. The

Telegraph August 25, 2014.

http://www.telegraph.co.uk/ne

ws/nhs/11053982/Superior-

private-health-is-a-myth.html [Accessed November 26, 2016]

20. Campbell D. Mid Staffs

hospital scandal: the essential

guide. The Guardian February 6, 2013. Available at:

https://www.theguardian.com/

society/2013/feb/06/mid-staffs- -care-is-key-for-dementia-

hospital-scandal-

guide[Accessed November 26,

2016].

patients [Accessed November 26, 2016]

26. Boffey D. Patients 'lost sight' at NHS hospital private clinic.

The Guardian August 12,

21. Smith R. NHS targets 'may have led to 1,200 deaths' in

ST OLAVE’S ACADEMIC JOURNAL

2012.

https://www.theguardian.com/

society/2012/aug/12/nhs-

private-carillion-sight-

clinicenta [Accessed November

26, 2016]

27. ANON. NanoKnife. The

Princess Grace Hospital part of HCA International.

http://www.theprincessgraceh

ospital.com/hospital-

services/services/nanoknife/ [Accessed November 26, 2016]. 28. Appleby J, Devlin N.

Measuring NHS success. The

King’s Fund January 2005. Available at:

ISSUE 5, SEPTEMBER 2017

https://www.kingsfund.org.uk/

sites/files/kf/field/field_publica

tion_file/measuring-nhs-

success-patients-views-health-

outcomes-help-manage-

performance-john-appleby-

nancy-devlin-kings-fund-1-

january-2005.pdf [Accessed November 26, 2016]. 29. Campbell D, Watt N. NHS

comes top in healthcare

survey. The Guardian June 17, 2014. Available at:

https://www.theguardian.com/

society/2014/jun/17/nhs-

health[Accessed November 26,

2016].

ST OLAVE’S ACADEMIC JOURNAL

ISSUE 5, SEPTEMBER 2017

How was French Literature used as Propaganda during the Occupation?

Alex Bull

1. Abstract

In this essay I will answer the question of: ‘How was French literature used as propaganda during the occupation?’ by splitting this question into smaller sub-topics, which I will address individually. These will include the censorship regulations in place, the role of the collaborationist press, publishing houses and their importance in literature during the occupation, the clandestine, resistance press, the role of authors in the occupation, the role of poets in the occupation and finally the role of theatre in the occupation. In conclusion I will summarise my key findings and give a concrete answer to the question that I am addressing, which will have been reinforced by the arguments made throughout this dissertation. However before I begin I need to firstly address an integral point revolving around the word ‘literature’. When I use this word in my dissertation I am using it in its broadest definition, that is including not only novels and poems but also newspapers and plays. I believe it is important to view the artistic, intellectual and literary scene as a whole during the Occupation. Additionally I also found it incredibly interesting to research and write about how different forms of ‘literature’ were affected differently by the extraordinary nature of the Occupation and to

discover which forms were more popular and which were more useful as propaganda.

2. Introduction

The Second World War is an undeniably fascinating and disastrous period of history for mankind, where mass atrocities of proportions never seen before were carried out with incredible efficiency, like a well oiled machine. At schools, at home and on the television information is readily available about the Second World War, yet surprisingly a topic which is often hard to discover is the role of literature during this period. Therefore the aim of this dissertation is to explore in depth the effects of the occupation of France by the Nazis on French literature and see how literature was used both by the Nazis and by French intellectuals during the occupation. This topic came naturally to me as a student of both French and German at A-Level, because I will have the ability to expand my knowledge of contemporary French literature, culture, and also modern European history whilst researching and writing this dissertation.

French literature and literature in general is always evolving with the times. The many ways that literature adapts and changes are fascinating, for example between 1800 and 1850 romanticism was at

ST OLAVE’S ACADEMIC JOURNAL

its height. Great French novelists and poets such as Alphonse de Lamartine and Victor Hugo wrote at length about the perfect life of the peasant and the beauty of nature, placing much emphasis on the glory of the past and emotion. It is clear to see that this romantic movement was a reaction to the industrial revolution that was occurring at the same time, and that in idealising the peasant, countryside life these literary giants were using their works to convey multiple messages to their readers about the industrial revolution. For example that man must not forget to enjoy nature, that we must not let machines destroy nature and also expressing general fears surrounding the new advances of machinery that were felt in that era. Therefore one area I want to address in this dissertation is the main themes of war-time French literature, and, similarly to how the industrial revolution was a cause for romanticism, I want to see what caused writers to discuss their chosen themes. I also want to see what messages were conveyed to readers during the occupation. No doubt there will be many contrasting ones from different authors, some supporting the Nazis, perhaps some calling the French to join the Resistance. However I am not limiting my EPQ to just books and authors. When I use the term literature in my title, it is in a broad sense, including poems, the press and the theatre as well as traditional novels. Consequently one of my primary aims is to see if intellectuals and authors used all these ‘forms’ of literature to convey messages to the public and I want to explore the ways all these different manifestations of literature were

ISSUE 5, SEPTEMBER 2017

used by the Nazis and by the Resistance during the occupation to achieve their goals. I find this aspect of using literature as propaganda with a definitive political message (either pro or anti German in this case) to be incredibly fascinating as it highlights the power of literature.

My second aim to understand the implications that Nazi rule had on French literature, as there was a lot of censorship on what writers and poets were able to publish at this time. I will research the effects of the Nazi regime on the French publishing houses and consequently try to work out the knock on effect that this had on French literature. I will also research the different methods authors employed in order to avoid these regulations, or comply with them, whilst still conveying their true messages via the use of literary techniques or undertones in their works.

Thirdly I will detail the ways that literature was used as a weapon; that is as a tool to try and combat the Nazi and Vichy regime. This particularly interests me as I am fascinated by how French writers were able to use newspapers, poems, books and plays, things which seem absolutely harmless, as powerful and harmful weapons which weakened the Nazis. I will research the different ways various authors attempted to do just this and also explore their different roles in the whole resistance movement in Paris and the rest of France.