Duk abin da kuke Bukatar Ku sani Game da Rikici na Sha'awa

Lura: Wannan shine kashi na farko na rubutun blog na kashi 3 akan rikice-rikicen sha'awa da son zuciya a cikin magunguna da kimiyya. Wannan shigarwar galibi game da rikice -rikicen kuɗi ne na sha'awa. Shigarwa ta biyu shine game da wasu nau'ikan ɓoyayyun ɓoyayyu waɗanda ke damun masana kimiyya da likitoci, kuma na uku zai ba da shawarwari game da abin da masu amfani da masana kimiyya za su iya yi don magance waɗannan matsalolin.

A watan Satumba na 2016, wani abin ban tsoro ya fallasa Jaridar New York Times ya bayyana cewa duk abin da muke tsammanin mun sani game da sukari, mai, da cututtukan zuciya ba daidai ba ne. Kuma ba wai kawai ba daidai ba ne, amma an yi amfani da bayanan da muke amfani da su don jagorantar shawararmu game da abin da za mu ci da abin da za mu ciyar da yaranmu a cikin abin da kawai za a iya kwatanta shi a matsayin makirci tsakanin masana kimiyya da masana'antar sukari.

Ba sai an faɗi ba, mutane sun fusata. A matsayin mai karatu daya Jaridar New York Times labarin yayi sharhi, “Wannan makirci ne na MAGANAR kimiyya. Kamfanonin sukari da suka aikata wannan yakamata a gurfanar da su akan $ BILLIONS saboda cutarwar da suka haifar. ” Ba da daɗewa ba aka fara kwatanta masana'antar sigari: “Sugar shine sabon taba kuma ya ɗan daɗe. Labarin shine kawai dusar ƙanƙara, ”wani mai karanta NYT yayi sharhi.

Sannan, a tsakiyar lokacin zaɓe, ra'ayoyin maƙarƙashiya sun zo: “FYI .. Hillary ta Big Sugar ta ba da kuɗi sosai don ku iya cin amana ba abin da zai faru sakamakon waɗannan binciken. Tare da Hillary a Fadar White House, duk za mu ci kek ko ta yaya- Nasarar nasara ce ga kowa! ”

Wannan labarin ba shakka ya tayar da hankali. A cikin zamani na ƙara nuna gaskiya da wadatar bayanai, yana da wahala a yi tunanin cewa har yanzu muna iya yanke shawara mai mahimmanci game da abincin mu dangane da shaidar da ta samo asali daga rikice -rikicen sha'awa. Kuma yayin da takardar Harvard da aka ambata a cikin wannan binciken na New York Times ya bayyana a gaban dokokin zamani game da fallasa rikice -rikicen sha'awa a binciken kimiyya, wani binciken da aka buga a wannan shekarar yana tuhumar sahihancin sabbin jagororin sukari na WHO suma an gano cewa sun sami kuɗaɗe sosai. masana'antar sukari, da masana kimiyyar da abin ya shafa basu cika fitowa gaba ɗaya game da yadda wannan tallafin zai iya shafar ra'ayinsu.

Dangane da tabarbarewar sukari, ya zama a bayyane cewa muna buƙatar komawa baya da sake nazarin tsarin mu na yanzu na magance rikice-rikice na sha'awar kimiyya da magani. Yana aiki? Da kyau, mun sami mafi girman matakan nuna gaskiya game da tallafin masana'antu na kimiyya da magani. Amma nuna gaskiya a kanta da alama bai isa ba.

Ya zama ƙara bayyana a cikin 'yan shekarun da suka gabata tun bayan binciken sukari na Harvard cewa masana kimiyya da likitoci suna fuskantar son zuciya dangane da tallafin kuɗi da tallafawa masana'antu. Waɗannan bayanan sun bayyana a sarari kuma ba sa buƙatar maimaitawa anan. Daidaitaccen martani ga wannan matsalar shine kawai ya haɗa da bayanan bayyanawa a ƙarshen takaddun kimiyya.

Amma karanta kalmomin: “Kraft Foods ne ya ɗauki nauyin wannan binciken a sashi” a zahiri yana taimaka wa editocin mujallar, masu bita, ‘yan jaridar kimiyya, da babban mai karatu su fahimci ko kuma yadda binciken zai iya nuna son kai?

Amsar ita ce ... Wataƙila ba.

Domin da kansa, nuna gaskiya baya taimaka mana sosai. A zahirin gaskiya, zamba ta gaskiya kamar yadda muka gani a cikin binciken sukari abu ne da ba a saba gani ba, amma son kai wanda ke shafar karatun kimiyya a sarari ya zama ruwan dare. Tabbas, ire -iren waɗannan tasirin tasiri da son kai sun fi wahalar ganowa, musamman ga matsakaicin mai amfani da karatun kimiyya da labarai. Ba tare da ambaton cewa waɗannan bayanan suna mai da hankali kan rikice-rikicen kuɗi na maslahohi ba, yana barin mai amfani da damar da ba za ta iya fahimtar waɗanne irin ƙaƙƙarfan son zuciya da ba na kuɗi ba na iya shafar sakamakon binciken.

Don haka muna matukar bukatar amsoshin tambayoyin guda biyu masu alaƙa da juna:

1. Ta yaya yakamata a sanar da jama'a masu son zuciya ta hanyar da za ta ƙara wayar da kan masu amfani amma ta rage damar samun mugun zato wanda a ƙarshe zai haifar da ƙin kimiyya?

2. Ta yaya muke lissafin rikice-rikicen da ba na kuɗi ba na sha'awar kimiyya da magani?

Menene rikici na sha'awa?

Da farko, muna buƙatar fahimtar abin da ake nufi da “rikice -rikicen sha'awa” da yadda zai iya bambanta da tuhumar zamba. "Rikici na sha'awa" yana da alaƙa da shiga mutum tare da wani mahaluƙi wanda zai iya lalata yanke shawara ko hukunci game da batun da ke hannu.

Komawa ga misalin sukari, idan da kawai an ba da kuɗin marubutan Harvard don gudanar da binciken kimanta alaƙar da ke tsakanin sukari da cututtukan zuciya ta masana'antar sukari amma babu wata hujja ta ƙarin shigar da masana'antar a cikin binciken kanta, to mu zai iya cewa rikici na sha'awa yana iya kasancewa.

Rikici na sha'awa shine dabi'a hasashe. Lokacin da marubutan suka ba da sanarwar “muradun gasa” ga mujallar likitanci, ba sa yarda da wani irin laifi. Suna bayyana gaskiyar cewa wasu buƙatu na iya yin tasiri ga karatun su.

A fagen kiwon lafiya, waɗannan “sauran buƙatu” suna da faɗi sosai. Suna nufin ainihin wani abu banda sha'awa don inganta lafiyar jama'a ta hanyar binciken "tsarkakakke" na kimiyya.

A ka'idar, zamu iya tunanin yanayin da babban binciken mai binciken sabon maganin cutar kansa ya nuna son kai saboda mahaifiyarsa tana da cutar kansa kuma yana matukar neman samun sabon magani wanda zai iya ƙara tsawon rayuwa. Tabbas, wannan ba shine irin “rikici” da aka nemi masana kimiyya su ba da rahoto ga mujallu na kimiyya da na likita ba. Maimakon haka an mai da hankali kan bayar da rahoto na gaskiya game da alaƙar kuɗi wanda a zahiri zai iya haifar da sakamakon binciken son zuciya.

Shin nuna gaskiya da tona asirin su ne kawai amsoshin rikice -rikicen sha'awar magani da kimiyya?

A matakin ilhama, wannan yana da ma'ana kuma ba shakka nuna gaskiya koyaushe abu ne mai kyau. Amma lokacin da aka bankado wani abu kamar sukari "makirci", zai zama a bayyane nan gaba cewa yawancin mutane suna rikicewa gabaɗaya game da abin da tallafin masana'antar bincike na kimiyya yake nufi, menene ainihin barazanar kimiyya mara ma'ana, da kuma yadda ake fassara bayanai game da yuwuwar " rikice -rikice na sha'awa ”lokacin da ake kimanta shaidar kimiyya.

Lokacin da NYT ta karya labarin game da sukari a watan Satumba, fitowar jama'a ya bayyana cewa, a zahiri, bambanci tsakanin "rikici na sha'awa" da "zamba" wani lokaci yana rikicewa. Ya kasance kamar mutane suna ɗauka cewa kowace harka ta tallafa wa masana'antar dole ne ta zama daidai da misalin sukari - cewa ɗaukar nauyin masana'antar a ciki da kanta koyaushe zai haifar da zamba.

Gaskiyar cewa masana'antar sukari ta ɗauki nauyin karatun Harvard a ciki da kanta na iya ko ba ta kasance matsalar ba.Abin da ya nuna masana'antar da masana kimiyya a wannan yanayin shine wasiƙar da ta bayyana cewa masu gudanar da sukari sun nemi masu ilimin kimiyyar da su yi amfani da bayanan su don fifita ƙarshen kamfani.

Wannan a bayyane babban misali ne kuma abin godiya ne wanda ba a saba gani ba. Sau da yawa muna fuskantar yanayi wanda tallafin masana'antar kimiyya ke kasancewa kuma tallafin yana da ikon yin tasiri da tasiri ga ra'ayoyi da halayen masana kimiyya da ƙwararrun masana kiwon lafiya.

Me muka sani game da yadda kuɗi ke shafar masana kimiyya da likitoci? A takaice, shin kuɗi ko kyaututtuka daga wani masana'anta da gaske masu ilimin kimiyya da likitoci na iya nuna bambanci, koda kuwa babu buƙatun kai tsaye waɗanda karatun da masana'antun ke tallafawa suna nuna sakamako mai kyau, kamar yadda muka gani tare da misalin sukari?

Amsar wannan tambayar ita ce eh. Tuni akwai yalwar karatu da ke nuna cewa kuɗi daga masana'antu - har ma da ƙaramin adadi - yana tasiri ga ƙarshen kimiyya da likitan da ke rubutawa. Wannan fahimta ta haifar da ƙara yin tsauraran rahotanni da manufofin fallasa a cikin kimiyya da magani.

Shin kuɗin masana'antu ne kawai abin da zai iya nuna son kai ga masana kimiyya da likitoci?

A cikin shekaru 30 da suka gabata ko makamancin haka, mun ga ba kawai dokoki da yawa game da tonawa ba har ma da roƙon ƙarin tallafin sashin jama'a don bincike na kimiyya don guje wa tasirin masana'antar da bai dace ba na iya samun ilimin kimiyya da magani.

Amma da gaske waɗannan mafita suna magance matsalar? Mataki ne a kan hanya madaidaiciya. Amma ba su ne cikakkiyar amsar wannan matsalar ba. Me ya sa? Domin “tasiri” a zahiri abu ne mai rikitarwa kuma mai ban mamaki.

Abin ban sha'awa, ɗayan manyan masu ba da amsa ga wani ɓarna na sukari a wannan shekara shine Dean Schillinger, wanda ya rubuta edita yana sukar tsarin da aka yi amfani da shi a cikin labarin bita da aka tallafa wa masana'antu game da sabbin jagororin sukari na WHO a cikin Annals of Medicine na ciki. A cikin martanin da ya bayar game da wannan labarin na bita, a zahiri ya bayyana cewa ya kasance ƙwararren masanin shaidu na birnin San Francisco a cikin karar da masana'antar abin sha ta kawo a shekarar da ta gabata lokacin da garin ya ba da umarnin alamun gargadi kan abin sha. Tallafin da gwamnati ke bayarwa na binciken kimiyya na iya zama mafi ƙanƙanta fiye da tallafawa masana'antu, amma bai kamata mu yi imani na minti ɗaya cewa wannan hanyar ta kawar da son kai gaba ɗaya.

Kuma a zahiri, akwai hanyoyi da yawa na son zuciya waɗanda ba a bayyana su a ƙarƙashin manufofin nuna gaskiya na yanzu don kimiyya da magani. Misali, menene idan babban likita ya rubuta sanannen littafi game da mahimmancin fara bincike akai -akai don cutar kansa? Mene ne idan an san wannan likitan don matsayinta cewa mammogram na shekara -shekara yana da mahimmanci? Lokacin da wannan likitan ya buga takarda da ke nuna cewa mammogram na shekara -shekara yana haifar da raguwar ƙimar cutar sankarar nono, shin ba zai yiwu cewa ƙiyayya mai mahimmanci ta iya kutsawa a nan ba? Tabbas, ana iya kallon wannan son zuciya a matsayin na kuɗi, tunda wataƙila waɗannan ingantattun binciken na iya fassara zuwa ƙara yawan siyar da littafin ga likitan. Amma irin wannan son zuciya ba zai buƙaci a bayyana a cikin takarda ba.

Ko, don ɗaukar wani misali, menene idan likitan mahaukaci yana da babban aikin zaman kansa wanda ya danganta da wani nau'in magani, in ji fahimi-halayyar motsa jiki (CBT)? Shin hakan na iya zama tushen rikice -rikicen sha'awa a cikin sabon binciken likitan akan fifikon CBT idan aka kwatanta da maganin miyagun ƙwayoyi? Shin yakamata a yi wa wanda ya yi tiyata na baya da yawa ya rubuta takarda wanda aka kwatanta aikin tiyata a baya da ilimin motsa jiki? Waɗannan son zuciya a zahiri duk a ƙarshe an haɗa su da ribar kuɗi, amma ba a bayyana su a cikin takardu. Kuma wannan ba a ambaci dukkan nau'ikan nau'ikan son zuciya waɗanda gaba ɗaya ba na kuɗi bane amma suna da tasiri sosai.

Don haka me za mu iya yi don fahimtar duk masu yuwuwar rikice -rikice na son rai da son zuciya a cikin magunguna da kimiyya? Ta yaya kwararrun masana kiwon lafiya da masana kimiyya za su iya sa ido sosai kan son zuciyarsu? Kuma ta yaya masu sanar da masu amfani za su iya tantance ko kuma yadda rikice -rikicen sha'awa da son zuciya za su taka rawa a ilimin da suke ci da kuma kulawar da suke samu?

Waɗannan ba tambayoyi ne masu sauƙin amsawa ba, amma za mu yi ƙoƙarin ɗaukar su a wata mai zuwa a Sashe na II na wannan jerin kan rikice -rikice na sha'awar kimiyya da magani. Kasance damu. A halin yanzu, idan kuna son ƙarin bayani, muna ba da shawarar bin ingantattun shafuka guda biyu waɗanda aka sadaukar da su ga batutuwan da suka shafi nuna gaskiya, zamba, da kimiyya ba daidai ba gaba ɗaya, Sauraron Saurara da Kimiyya mara kyau.

http://www.nytimes.com/2016/09/13/well/eat/how-the-sugar-industry-shifted-blame-to-fat.html

http://jama.jamanetwork.com/article.aspx?articleid=202867

http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2520680

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0040005

http://www.nytimes.com/2016/12/19/well/eat/a-food-industry-study-tries-to-discredit-advice-about-sugar.html