Wandering Primate

Jus' Sayin'

2009-12-02T10:51:00.007-07:00

When medicine -in this day & age- has to deal with a pile of "medical" garbage magically transmuted into "real" medicine in the mind of a political hack...

it's no wonder that real scientists and researchers who spend endless hours, blood, sweat and tears at work...that are hit again and again with the cold whip of comunal criticism, sometimes dispair...

Especially, when all you need to "educate" the masses is to claim to see the "answer"...and if your bullshit is good enough, fanning the flames of madness can be had with but the conjured image of an idea...

Noble reflection of reality and inner knowledge....an intimate connection to THE answer for us all?...

uh....you be the judge....

Types of Truth...

2009-07-15T14:40:00.009-07:00

In a strange way, the truth or "Truth" can have a degree of fuzziness depending on ones perspective. It comes in and out of focus based on the lens one chooses to view it through. In other words, some things are truer than others.

The evolving mind has come up with an intriguing description of this phenomenon and -if nothing else- helps structure this concept so that certain beliefs and philosophies can be categorized more clearly. For example reagrding reality, some points of view concentrate on a tree, others embrace the forest, while others don't even look at trees and concetrate on the "idea" of a tree and still others distill their observations to the worship of scratches and scribbles with no trees in sight.

1. personal truth

A personal truth is what is true for an individual. Personal truths reflect physiological attributes, psychological tendencies and the learning and experiences of an individual.

2. social truth

A social truth is what a distinct group perceives to “be so.” Social truths reflect group history, customs, and values.

3. human truth

A human truth reflects and pertains to the universal dispositions and abilities of our species, Homo sapiens.

Many things that we consider to be inherently true probably reflect distinctive features of human psychology. For instance, because human beings are primates that readily establish and acknowledge dominance hierarchies, the human individual may be predisposed to feeling that there is or could be some entity “greater than me,” whether or not that happens to be true.

4. universal truth
A universal truth is one that all sufficiently intelligent and educated observers, from this planet or any other (should they exist), would conclude to “be so.” For instance, the proportion of a circle’s circumference to its diameter is 3.141592 ( . . . ). This is a universal truth. Any capable, unbiased individual could verify that truth.

A universal truth is the only type of truth that is not relative to the person or group making the claim. Science, by and large, provides us with universal truths. Or it at least aspires to.
Religion, no doubt, reflects social truths, and perhaps, in some regards, human truths as well.

So, this doesn't validate in and of themselves the "new age" philosophies, religions nor postmodernism for example as reality. These edifices are mostly human constructs:

What believers in a religion frequently fail to do is to place possible human truths and their own social truths into a wider perspective.

Good or bad, they are chained and bound well within the subjective bounds of humanity whereas reality expands beyond this realm. Obviously, there may be utility in some of these perspectives, but always if their limitations are acknowledged.

These perspectives or tools work better -if they work at all- at a different level and may or may not reflect reality in a hit or miss sort of way. On the other hand, from a humanistic perspective many of these constructs can serve as useful bridges between us and reality -but again with the caveat that they need to be kept in check.

Reality itself -to an extent- may always be beyond our reach, but there are ways to embrace its essence and approximate an understanding of how things truly are. Here is where the self effacing and correcting community based methodology -science- has proven its worth. It has proven to date to be the most objective human tool available to consistently touch "her" true face.

Acknowledging our humanity in the light of whatever wonders we discover keeps us humbly grounded to ourselves and who we are - just highly social primates on a tiny pale blue dot.

That Mitchell and Webb Look: Homeopathic A&E

2009-07-14T06:28:00.005-07:00

Just wanted to add a link to this hilarious sketch.
Sadly, it does have a morbid side to it as the last post demonstrates.

Homeopathy: What's the harm?

2009-07-13T07:47:00.004-07:00

So, inert placebo based ritualistic practices are harmless and should be tolerated as innocent and benign ?

In context, belief based medicine does a lot more harm than one would guess - but you know that. In a modern, fairly stable society these practices may cause less obvious impacts but -even here- if they hold more sway on every day reality than Bugs Bunny, the Simpsons and flying tea kettles we've got problems.

Imagine then, the consternation of those doctors in the trenches working in parts of the world where anarchy, lawlessness, illiteracy and corruption drip from every pore of society when homeopathy is promulgated as a reality.

Here's hoping the WHO will support their very reasonable and humanitarian plea for support.

"Many people in developing countries urgently need access to evidence-based medical information and to the most effective means of treating these dangerous diseases. The promotion of homeopathy as effective or cheaper makes this difficult task even harder. It puts lives at risk, undermines conventional medicine and spreads misinformation.

We are sure that you will recognise these dangers and ask that you issue a clear international communication condemning the promotion of homeopathy for treating TB, infant diarrhoea, influenza, malaria and HIV. We are sure, too, that you will recognise the urgency of our request, and look forward to your response."

Spreading the word...

2009-06-11T07:56:00.008-07:00

New science based veterinary blog promoting critical thinking!

Though I've been temporarily distracted from my little blog posting hobby, I continue to enjoy the wonderful and thoughtful writings of so many excellent thinkers.

As the scourges of psuedoscience, dogma and crankery continue their assault on reason and so many seem to trod a stuporous mindless path, it's very gratifying to note that there are many knowledgeable folks out there willing to take the time and energy to be "candles in the dark"...beacons of intellectual honesty and authentic reason.

In that vein, I am pleased to bring to your attention a new veterinary medicine site and its associated blog of note chalk full of critical thinking and reasoned posts. Please add The Skeptvet.com and The Skepvet blog to your links and enjoy some great reading!

Keep up the great work, we need it... !!

Acupuncture: forget the qi & meridians...AND any strong placebo effect

2009-01-29T13:46:00.014-07:00

...even more dead in the water than thought.

There is an interesting research study published January 2009 regarding acupuncture treatment for pain. The most interesting thing about it is that it seems acupuncture isn't even much of a placebo, let alone anything else related to real healng. The second most interesting development as a result of this study is the almost comical cognitive dissonance from several media players as well as acupuncture apologists.

DC's improbable science has the goods and excellent discussion regarding the study and some of the sadly predictable -albeit quite athletic- false positive mental "spin" on the obviously negative implications for the institution that is acupuncture itself.

Dr Colquhoun notes in the comments section that even "modern" acupuncture denuded of the archaic and imaginative sophistry of "qi", points or meridians is dealt what could be a fatal blow:

"It’s true that the Medical acupuncture people, Adrian White et al. have abandoned the hocus pocus, and seem happy to admit that it doesn’t matter where the needles go. But that was already well-established before these last lot of reviews.

It was also quite well established already that in a non-blind comparison of acupuncture versus no acupuncture, the acupuncture wins.

The really new thing in the Madsen paper is that although acupuncture still beats no acupuncture, the advantage is too small to be much use to patients. So it may be a theatrical placebo, but the placebo effect isn’t big enough to matter in real life.

If this conclusion is confirmed by others, then acupuncture is dead. You can’t even make the (morally-dubious) argument that it’s a good placebo."

(my bold)

It's important to note that non-blind studies severely limit the quality of interpretations, especially for elucidating any effects beyond a placebo. Other superior studies clearly reveal no putative acupuncture effects beyond chance or placebo. In essence, as the study design improves acupuncture effects disappear.

Remember, this particular study relates to the very nebulous, variable and personal concept of pain- a realm fraught with confounding factors. Many studies regarding acupuncture effects deal with these rather subjective areas because that's pretty much what is left as the search for bigger effects has proven fruitless. If it is this hard to tease out any real acupuncture effect here from the a back ground noise of probability, acupuncture -as a legitimate medical modality- has a big, big problem.

Yet some people just don't get it...and the credulous will likely still drink deep from the twisted rhetorical kool aid and "feel" good.

Trusting the medical literature

2009-01-29T10:46:00.008-07:00

really nothing new...as always... just take it with a grain of salt
Dr RW has an interesting post where he responds to Dr Marcia Angells JAMA commentary where she questions the ability to practice evidence based medicine noting that "Physicians can no longer rely on the medical literature for valid and reliable information".

Though, as pointed out by Dr RW, there are prescient challenges and significant problems reagrding industry and non-industry supported research, Dr Angells assertion -reminiscent of the "pharma is all evil" canard- indeed seems far too simplistic.

Unfortunately, her opinion -though important and worth measured consideration- may be taken as fact and used by the ideological or the less scientifically literate to distract from a more balanced approach to considering a litany of real problems. Indeed, the research landscape is far from the useless state Dr Angell seems to claim.

As Dr RW notes:
"What then are practicing doctors to do? Angell’s statement above suggests that in the current environment the practice of evidence based medicine and science based medicine are impossible. Nonsense. EBM is premised on the fact that all research reports have weaknesses and are to be viewed with skepticism. SBM, recognizing that EBM lacks the tools to examine all claims, goes a step further by evaluating reports in light of prior research and scientific plausibility. In short, doctors have the tools to critically appraise the medical literature. It’s hard to believe Dr. Angell wants to abandon EBM altogether."
(My bold)

Hopefully that is not her intent. Dr Angell does seem to favor an "independent body" to serve as overseer and provider of clinical trails...an option fraught with many of the same problems beguiling the present research environment.

In the end, as these issues are -hopefully- objectively and pragmatically addressed, Dr RWs' call to using evidence and science based approaches and tools when evaluating data will continue to serve practitioners and their patients well.

"Storm" live by Tim Minchin

2009-01-29T09:36:00.006-07:00

Just too good to let slip by....

Tim Minchin graciously provided for purview a wonderful live version of STORM

(lyrics posted here).

Enjoy....

Case studies in debunking fallacious thinking: anti-vaccine apologists and acupuncture "effects"considered

2009-01-29T07:22:00.009-07:00

Here are three fabulous examples of lucid and clear analysis in action against the dogma and fallacy of ideological thought - critical thinking at it's best.

Respectful Insolence: Can we finally just say that acupuncture is nothing more than an elaborate placebo? Can we?

Heal Spiel: Response to antivaccination parent

Neurologica: Some follow up on migraines

These excellent fellow bloggers confront psuedo-science with clear, referenced, factual and reality based discussion cooly eviscerating delusional thinking; whether confronting antivaccine supporter claims or analyzing putative acupuncture "effects".

Very refreshing and stimulating...think I'll do a post on an animal related psuedo-science issue soon.

Cectic on skepticism

2009-01-28T10:16:00.003-07:00

WildEarth

2009-01-28T09:17:00.003-07:00

....live and close up

The WildEarth.TV site is a great way to experience the fascinating world of the African wild in an intimate and interactive way.

"LIVE wildlife broadcasting is set to become an important part of natural history TV, why not join the experts and help make the revolution a reality ... it's in your nature."

Very cool!

Elevating Science, Elevating Democracy

2009-01-28T07:13:00.003-07:00

Very nice and well written piece in the New York Times.

"The knock on science from its cultural and religious critics is that it is arrogant and materialistic...So the story goes...But this is balderdash. Science is not a monument of received Truth but something that people do to look for truth."

Statistical Literacy Guide

2009-01-26T09:29:00.006-07:00

DC's Improbable Science has an interesting link -the Statistical Literacy Guide- located in the UK commons library archive regarding the oft misunderstood and abused science of statistics.

This is a great read and introduces the reader to many of the nuances of statistical analysis and how these important tools can be inappropriately spun "a la politico" into down right meaningless and vacuous interpretations.

A very helpful piece for those of us trying to tease out real meaning from a sea of confusion regarding "new" (or old) research purported to "prove" or support grandiose claims that pop up from most every sector in the medical and -especially- the psuedo-medical world.

Medicines that contain no medicine and other follies

2009-01-22T12:41:00.008-07:00

David Colquhoun wrote a very nice article regarding the blurring between "alternative medicine" and outright quackery and self delusion. This is an important statement in the struggle to redirect all too limited funds towards more appropriate areas of medical research.

It also brings to the fore a telling problem for Complementary and Alternative supporters. They just don't know when to call off or discontinue a modality when there is little or no supporting evidence of efficacy.

Some of the commentators I read on this humble blog seem to exude a mix of active denialism, ignorance or mistrust of scientific methodology and a curious rigid undergirding of belief based opinions not very amenable to objectivity.

Indeed, many in the CAM field defend their particular fixations (be it acupuncture, homeopathy, nutritional supplement...etc.) claiming "more studies are needed"ad infinitum, that you just can't properly test it -when you can if it's real, that it's "complicated" (appeal to complexity) or "you do it too" accusations (Tu Quoque).

They very commonly support demands and claims with an astounding quagmire of classical fallacious reasoning (dare I say mental masturbation) and resist reality and science based information - especially if it is unsupportive of their cause.

Dr Colquhoun nicely sums up some CAM modalities as follows (I'm sure to the shagrin of beleivers) thusly:

"Homeopathy: giving patients medicines that contain no medicine whatsoever.

Herbal medicine: giving patients an unknown dose of a medicine, of unknown effectiveness and unknown safety.

Acupuncture: a rather theatrical placebo, with no real therapeutic benefit in most if not all cases.

Chiropractic: an invention of a 19 th century salesmen, based on nonsensical principles, and shown to be no more effective than other manipulative therapies, but less safe.

Reflexology: plain old foot massage, overlaid with utter nonsense about non-existent connections between your feet and your thyroid gland.

Nutritional therapy: self-styled ‘nutritionists’ making unjustified claims about diet to sell unnecessary supplements."

At any rate, read the article when you can.

How can you recognize pseudoscience?

2009-01-06T17:33:00.004-07:00

What is it?....How can I recognize it?

From the Pseudoscience blog:

"A pseudoscience is a belief or process which masquerades as science in an attempt to claim a legitimacy which it would not otherwise be able to achieve on its own terms; it is often known as fringe- or alternative science. The most important of its defects is usually the lack of the carefully controlled and thoughtfully interpreted experiments which provide the foundation of the natural sciences and which contribute to their advancement.

Of course, the pursuit of scientific knowledge usually involves elements of intuition and guesswork; experiments do not always test a theory adequately, and experimental results can be incorrectly interpreted or even wrong. In legitimate science, however, these problems tend to be self-correcting, if not by the original researchers themselves, then through the critical scrutiny of the greater scientific community. Critical thinking is an essential element of science -----------------------------------------

science	pseudoscience	comment
The primary goal of science is to achieve a more complete and more unified understanding of the physical world.	Pseudosciences are more likely to be driven by ideological, cultural, or commercial goals.	Some examples: astrology (from ancient Babylonian culture,) UFO-ology (popular culture and mistrust of government), Creation Science (attempt to justify a literal interpretation of the Bible), "structure-altered" waters (commercial quackery.)
Most scientific fields are the subjects of intense research which result in the continual expansion of knowledge in the discipline.	The field has evolved very little since it was first established. The small amount of research and experimentation that is carried out is generally done more to justify the belief than to extend it.	The search for new knowledge is the driving force behind the evolution of any scientific field. Nearly every new finding raises new questions that beg exploration. There is little evidence of this in the pseudosciences.
Workers in the field commonly seek out counterexamples or findings that appear to be inconsistent with accepted theories.	In the pseudosciences, a challenge to accepted dogma is often considered a hostile act if not heresy, and leads to bitter disputes or even schisms.	Sciences advance by accommodating themselves to change as new information is obtained. In science, the person who shows that a generally accepted belief is wrong or incomplete is more likely to be considered a hero than a heretic.
Observations or data that are not consistent with current scientific understanding, once shown to be credible, generate intense interest among scientists and stimulate additional studies.	Observations or data that are not consistent with established beliefs tend to be ignored or actively suppressed.	Have you noticed how self-styled psychics always seem eager to announce their predictions for the new year, but never like to talk about how many of last years' predictions were correct?
Science is a process in which each principle must be tested in the crucible of experience and remains subject to being questioned or rejected at any time.	The major tenets and principles of the field are often not falsifiable, and are unlikely ever to be altered or shown to be wrong.	Enthusiasts incorrectly take the logical impossibility of disproving a pseudoscientific priniciple as evidence of its validity.
Scientific ideas and concepts must stand or fall on their own merits, based on existing knowledge and on evidence.	Pseudoscientific concepts tend to be shaped by individual egos and personalities, almost always by individuals who are not in contact with mainstream science. They often invoke authority (a famous name, for example) for support.	Have you ever noticed how proponents of pseudoscientific ideas are more likely to list all of the degrees they have?
Scientific explanations must be stated in clear, unambigous terms.	Pseudoscientific explanations tend to be vague and ambiguous, often invoking scientific terms in dubious contexts.	Phrases such as "energy vibrations" or "subtle energy fields" may sound impressive, but they are essentially meaningless.

Chiropractic wishfull thinking...

2009-01-06T12:16:00.005-07:00

...pediatric specialty???

The chirotak discussion forum has a very enlightening thread regarding chiropractic perdiatric specialty training.

Really, no surprises.

Pediatrics: DC vs. MD Training« Thread Started on Dec 6, 2007, 10:34pm »

I have been looking through websites of various "Pediatric" Chiropractors and most seem to be very proud that they obtained their "Pediatric Certification" by completing a 300 hour course.

Let's compare the number of hours of training in Pediatrics:

DC= 300 hours at the Holiday Inn

MDPediatrician= 80 hrs/week X 50 weeks X 3 years= 12,000 hrs

Now how about those who treat childhood asthma and allergy:

DC= 300 hours at the Holiday Inn

MD Pediatric Allergist :-----12,000 hrs for basic Pediatric Residency------8,000 hrs for Pediatric Allergy Fellowship GRAND TOTAL= 20,000 hrs of training

QUESTIONS:

1) Do they bring newborn babies to the Holiday Inn so the DCs can practice adjustment?

A. Yes

B. No

2) If not, where do the DCs get their clinical practice on newborns?

A. Motel 6

B. Airport Best Western

C. Days Inn

D. They get no clinical practice

3) How delusional must one be to adjust a newborn or treat childhood asthma or epilepsy with some bogus nonsense?

A. Very

B. Very, very

4) What in chiropractic "philosophy" allows a DC to be an expert in vaccination and infectious disease?

A. Sid said so

B. It has to do with nerve energy

C. C3 is pressing on the pituitary

D. Nothing.....nothing at all

5) Is the infectious disease seminar always held at the Holiday Inn or can it sometimes be at the Ramada?

A. Always at the Holiday Inn

B. Sometimes at the Ramada

C. Holiday Inn on South Cobb Parkway only

D. Holiday Inn off of Delk Road and I-75 only

Detoxin' your wallet dry!

2009-01-06T09:57:00.007-07:00

...on todays snake oils
Steven Novella at Nuerologica blog has -as usual- an excellent take down of some really juicy pseudoscience and related hubris that can only be described as classic scam artistry.

He notes "There is a cycle to the snake oil market - like the fashion industry. Words and claims come in and out of fashion, used for marketing impact rather than scientific accuracy. Some words, like “natural” and “energy” have staying power, while others last for a time and then may fade, but can come back into fashion like wide ties.... Recently “detox” is all the rage."

Dr Novella notes that the Sense about Science group is in the forefront of taking down the ridiculous and spurious claims purveyors of "detox" nostrums blantantly trumpet to a sadly creduluos populace.

As their Debunking Detox pamphlet puts it:

" The multi million pound detox industry sells products with little evidence to support their use. These products trade on claims about the body which are often wrong and can be dangerous."

Dr Novella concludes his post noting that "What the marketers of detox products have done is made the term “detox” meaningless - actually the term now is nothing but a red flag for snake oil."

On a related note, I was recently introduced to a "super juice" supplement product called Goji juice. Of course it's supposed to be nothing short of some miraculous nectar from the gods.

Not!

Under closer scrutiny, other than being made from dehydrated goji berrys from China, this product does not live up to the rather outlandish claims of many of its distributors (looks like fodder for a future investigative post!).

In fact, these wild statements are reminsent of the false hype and hyperbole from the Mangosteen crowd. It's the same old pimping up of some "exotic" special elixir....basically fruit juice in a golden wrapper. An interesting skeptical blog seeks to take this issue head on. I wish them well!

The Emperor’s postmodern clothes

2009-01-05T14:53:00.005-07:00

The often over the top relativism in much of today’s academic environment (perhaps with emphasis in the humanities) is an increasingly frustrating phenomenon. The seemingly stunning disregard for evidential empiricism and apathy towards observable reality has resulted, for example, in the metastasis of un-proven and dubious medical modalities into the very institutions charged to protect reason and critical thought.

Here is a humorous comparative list translating some “politically correct” phrases into what is really meant when they are uttered. Postmodernism is an interesting philosophical exercise with respect to human social interactions, but it does have one major drawback if extended beyond the realm of the mind – reality.

A brief guide to deconstructing academically fashionable phrases for the uninitiated (partial exerpt)

David A. Levy

All points of view are equally valid

…….I am willing to abandon all logic and evidence just to maintain the illusion that I am being open-minded and fair.

There is no objective reality

…….except for what I’m saying right now.

In our culture, empiricism is over-privileged

…….I don’t have any facts to back up my argument.

I’m not saying better,I’m saying different

…..I’m saying better.

Let us start a dialogue

….Let me start a monologue.

This warrants more conversation

…I can’t believe that you have the temerity not to agree with me.

Don’t you think that sounds kind of racist?

….good luck disagreeing with me now.

One can prove anything with statistics

…I should have paid more attention in stats class.

The interreferential nature of our phenomenological field can be neither deconstructed nor decontextualized from our ontological meta-narrative

…Don’t I sound really intellectual and hip?

Science is merely one more opinion

…My Uncle Bill told me so.

Ref: Skeptical Inquirer Vol32, No. 6 Nov/Dec 2008

An acupuncture fallacy in action

2009-01-04T19:27:00.004-07:00

...confusing correlation with causation (among other things…)

For the last 6 weeks, Sam the dog had been seen and treated with acupuncture for an undetermined lameness by a local “natural” veterinarian who specializes in Chinese Medicine and Acupuncture therapy. Sam was being seen by a conventional vet and wasn’t responding typically to palliative treatment. That is, he would get better and then get worse intermittently.

After declining, for the moment, further diagnostics this veterinarian grudgingly ceded to the clients wishes to pursue alternative treatments making clear –to her credit- the difference between science and non-science based modalities. This is an unfortunate, yet fairly common scenario among a percentage of many a veterinarians client roster. The ever present, albeit usually tiny, clad of holistically oriented people who innocently –and sometimes tragically- muffle and slow the course of getting to the bottom of a case like Sam.

On the other hand, this is fairly familiar territory and many veterinarians will attempt to establish some kind of continued interaction with these folks in the interest of their patients. In fact, to some alternative veterinarians’ credit there are those who insist on some type of interaction with science based practice and require that a “conventional” diagnosis be given.

That most of these cases are either chronically or terminally ill patients undergoing a constellation of naturally occurring waxing & waning cycles of disease seems to be overlooked –especially when they are experiencing a usually quite temporary upswing. Anything good is ultimately and erroneously attributed to whatever strange concoction or instrument is used.

Because Sam wasn’t responding “as expected” it was determined -quite correctly by the attending alternative vet- that a clearer diagnosis was needed. The regular conventional veterinarian was called on to now pursue a diagnosis after the clients’ discussion with their alternative vet. Yes, the irony is duly noted.

However, by claiming that the acupuncture treatment wasn’t working and actually making the problem worse he used the wrong reasons. Whether an animal is getting better or worse, without a profound knowledge base of the natural history of disease and a good dollop of solid science based studies and data supporting the therapy being used, you really can’t claim anything –good or bad.

It turns out Sam the dog was dying from a severely malignant form of spinal bone cancer. He was basically terminal from day one and is now under focused conventional and humane end of life care…and Chinese herbs for cancer. Any improvement quite possibly will be attributed to the herbs.

The main point of this tale is that when something bad happens in the realm of alternative medicine, the problem is often attributed to an equivocal diagnosis, or that the alternative treatment was started too late, or that some diseases are made worse by one alternative modality…all mostly claims made without any solid evidence (including -on balance- acupuncture studies).

…and here’s one of the big problems. There is always something else to try or mix with the science…often without really knowing what’s going on. This brings all involved dangerously close to the edge of a dark abyss.

Without the proper tools -the light of reason- we're destined to stumble through interminable blind alleys and false hopes...armed with little more than hat tricks to bide the time.

World of the small

2009-01-04T09:00:00.009-07:00

Every now and again, the MSN home site presents some interesting stuff that's relatively free of the medias general tendency to -all too commonly- report sciency things in a short sighted dim witted sort of way.

Here is a fascinating exposition of winning images from Nikons annual small world phot0micrography competition. Check it out!

Some of my favorites:

Artists rendering of an alien cyborg? Actually a chicken embryo photographed at 6X. ( by Tomas Pais de Azevedo of Lisbon, Portugal, using stereomicroscopy.)

A Borg mother ship? Really, a 14x image of rare mineral called arsenuranospathite. (It was submitted by Stephan Wolfsried of Germany.)

Rows of towels hanging in the midst of some Florence neighborhood? No, this beauty is a 100x magnification of scales on the wing of Urania riphaeus, the sunset moth. (The fiber-optic illumination was submitted by Charles Krebs from Issaquah, Wash.)

A myth busters' obsession

2009-01-03T13:55:00.006-07:00

Adam Savage of “Myth Busters” fame demonstrates, in this talk, some of the qualities that define the essence of human inquiry and discovery so crucial to authentic enlightenment. Could this be called a healthy obsession? Yep…and the type of focus and energy needed to look under the mask of mystery to reveal untold riches of knowledge.

Tim Minchin asks at the end of his beautifully brutal deconstruction of credulity in his poem “Storm”,

“ Isn't this enough? Just, this world? Just this Beautiful, Complex, Wonderfully Unfathomable, Natural, World? How does it so fail to hold our attention that we have to diminish it with the invention of cheap man-made myths and monsters?”

Indeed. One wonders if the opiate of the masses –credulous belief- will ever be put back on the shelf of human character quirks’. Perhaps still vital to a degree, but best taken off the pedestal it’s on.

(hat tip Bad Astronomy)

Understanding Chopra woo

2009-01-02T12:01:00.009-07:00

Another reason to support separation of "church" and medicine...

Being that there are a lot of folks who think Dr. Chopra has unique qualifications and solidly researched support for his quest to "integrate" scientific medicine with whispy shades of a strange belief based system -religion- here are two well put together posts regarding Deepak Chopras modus operandi.

Pharyngula 2006:

"Chopra is a doctor, supposedly, but every time I read something by him that touches on biology, he sounds as ignorant as your average creationist. He also writes incredibly poorly, bumbling his way forward with a succession of unlikely and indefensible claims. "

Skeptico 2005
"Skepticism has become a legitimate form of inquiry that Deepak parenthetically acknowledges (in a left-handed sort of way) as occasionally laudable, another refrain we often hear in the form of “I’m a skeptic too, but…,” where skepticism is fine as long as it is someone else’s codswallop under the microscope."

It is important to note that Chopra, over the years, has developed whole made up world views from stunningly naive, flimsy and often outright wrong assumptions about the actual nature of phenomena around him.

Mind you he has said some pretty interesting things regarding human wisdom and how we can all get along but this guy is just as fallible and screwed up as any of us. He really needs to get off that high horse and admit it though.

If Chopra wants to promulgate a belief system, that's fine. What he can't -or at least shouldn't be aloud to do- is force this system on everybody else. This is exactly what he would like to do imposing "magic" based medicine onto science based medicine.

He should just get real, put on a priest robe, stick to teaching ancient Hindu wisdom and call it good.

Deepak Chopra does it again...

2009-01-02T08:14:00.007-07:00

...or on being an uncritical CAM apologist
...or how to insert foot in mouth

Orac has a nice response to Chopras most recent "rebutal" against reason which just so happens to be related to yesterdays post about Steve Salernos very fine take down of the "Integrative" medicine movement. For good measure, Chopra calls on the "authority" of alternative medicine experts Andrew Weil and Rustum Roy to shore up his vain effort to claim scientific legitimacy -failing miserably.

As Orac notes "... Basically, the argument being made by the Woo-meisters Three boils down to an attack on evidence-based medicine based on exaggeration and cherry picking, topped off with a huge dollop of conspiracy-mongering and playing the victim. There is not a single positive, science-based argument that Chopra's woo or Andrew Weil's "integration" of the dubious with the evidence-based produces better health outcomes than the evidence-based medicine they attack..."

Yep...you can dress it up with the finest of imaginary cloth...but it still comes down to one simple fact...the emporers' still butt naked!

The bigger problem though, as Salerno points out so eloquently, is that in spite of the fact that most of the alternative movement is more illusion than real...more belief based than fact based...more bullshit and sofist rhetoric than a real reflection of reality...it is poised to adversely influence and contaminate an already severely strained health system.

The Chinese did something like this decades ago. They dressed up -made up- a scam health system to "appease" the populace who were devoid of access to science based medicine. It was called Traditional Chinese Medicine.

Orac nails it with this ominous warning:

"...Chopra's article demonstrates beyond a shadow of a doubt is that advocates of unscientific medicine and quackery apologists are a potent political force, and their new strategy has become clear. With the impending inauguration of Barack Obama as the President of the United States, they see a huge opportunity in his plans to overhaul the government health care system to insert into legislation provisions that will pay for unproven and pseudoscientific CAM/IM modalities. They will sell these provisions as "reform" and as "health maintenance," when they represent neither."

It is my hope his voice and the many others calling for reason be heard.

-adendum-

It appears Dr. Chopra has earned an additional well deserved laser guided intellectual thumping from Skeptico:

"Chopra’s piece is just one logical fallacy after another. This is Chopra's article, summarized:
Ad hominem
Appeal to authority
Red herring
Science was wrong before
Appeal to other ways of knowing
Straw man

Add claims of “concerted research and clinical practice” that his woo works, without one shred of evidence that his woo works, and you have Chopra’s entire article. (He should employ me as his editor.)"

"Alternative" Medicine and Bullshit

2009-01-01T09:48:00.013-07:00

...either way, the stink still comes through

"The Touch That Doesn't Heal" is a very insightful article regarding the rather sad tale of the insiduous and undeserved penetration of unproven...and disproven (within the realm of reason) "alternative' or "integrative" therapies into more mainstream medicine.

Steve Salerno nicely articulates the problem of incorporating therapuetic modalities built on smoke and mirror "logic" into the real world of disease, limited funds and the false assumptions of efficacy proffered by CAM (Complementary and Alternative Medicine) to a credulous population (many doctors included).

"...A survey of 32,000 Americans by the National Center for Health Statistics, released earlier this month, suggests that 38% of adults use some form of "complementary and alternative medicine," or CAM -- now aggressively promoted for everything from Attention Deficit Disorder to the Zoster virus. The survey polled consumers on 10 provider-based therapies -- for example, acupuncture -- and 26 home remedies, such as herbal supplements.

On the other hand, it should be noted that all is not lost. The reality of CAMs inroads may not be as entrenched as appears as suggested by Mark Crislips excellent post at the Science Based Medicine Blog . Still, there is a critical disconnect -a collective cognitve dissonence- opening a "back door" and for non-science based practices to garner a legitamacy that doesn't exist. You can use all the perfume you'd like...but bullshit is bullshit and that ol' smell eventually comes through!

Salerno continues "...This should be a laughing matter, but it isn't -- not with the Obama administration about to confront the snarling colossus of healtallowing h-care reform. Today's ubiquitous celebration of "empowerment," combined with disenchantment over the cost, bureaucracy and possible side effects of conventional care, has spurred an exodus from medical orthodoxy. As a result, what was once a ragtag assortment of New Age nostrums has metastasized into a multibillion-dollar industry championed by dozens of lobbyists and their congressional sympathizers..."

"Indeed, one of the great ironies of modern health care is that many of the august medical centers that once went to great lengths to vilify nontraditional methods as quackery now have brought those regimens in-house. "We're all channeling East Indian healers along with doing gall-bladder removal," says Arthur Caplan, director of the University of Pennsylvania's Center for Bioethics. Mr. Caplan harbors no illusions about what's behind the trend: "It's not as noble as, 'I want to be respectful to Chinese healing arts.' It's more, 'People are spending a fortune on this stuff! We could do this plus our regular stuff and bill 'em for all of it!'..."

"...Meanwhile, CAM has secured its own beachhead within the National Institutes of Health in the form of the National Center for Complementary and Alternative Medicine (NCCAM). "Special commercial interests and irrational, wishful thinking created NCCAM," writes Wallace Sampson, a medical doctor and director of the National Council Against Health Fraud, on the Web site Quackwatch.com. And Sen. Tom Harkin (D., Iowa), who credited bee pollen with quelling his allergies, was single-handedly responsible for the $2 million earmark that provided seed money for NCCAM, chartered in 1992 as the Office of Alternative Medicine. Despite the $1 billion spent in the interim, the center has failed to affirm a single therapy that can withstand the rigors of science..."

This article is well worth reading. One take away is that the battle for reason goes on...and on. Here's to a great year of critical thinking!

STORM by Tim Minchin, 2008

2008-12-30T10:30:00.007-07:00

An instant classic........Tim Minchins' masterfull performance "Storm" can be heard on his latest DVD... well worth ordering if you are a fan of sublime musicality and awe inspiring comedic irreverence.

Though not doing it justice, here is the transcript of this wonderfully sharp and witty poem....enjoy!

--------------------------------------------------------------------------

Storm

Tim Minchin

In a North London top floor flat,
All white walls, white carpet, white cat.
Rice paper partition, Modern art And Ambition

The host's a physician,
Lovely bloke,
Has his own practice,
His girlfriend's an actress -
An old mate of ours from home,
And they're always great fun,
So to dinner we've come -

The fifth guest is an unknown,
The hosts have just thrown us
together for a favour.
The girl's just arrived from Australia,
And she's moved to North London,
And she's a sister of someone.
Or has - some connection.

As we make introductions,
I'm struck by her beauty,
She's irrefutably fair,
With dark eyes and dark hair.
But as she sits, I admit:
I'm a little bit wary,
As I notice the tip,
Of the wing of a fairy,
Tattooed on that popular area,
Just above the derrière,
And when she says "I'm Sagittarius!"

I confess, a pigeonhole starts to form,
And is immediately filled with pigeon,
When she says her name is *Storm*

Conversation is initially bright and light-hearted,
But it's not long before Storm gets started.

"You can't know anything.
Knowledge is merely opinion."

She opines over her Cabernet Sauvignon
Vis-à-vis,
Some unhappily empirical comment made by me.
Not a good start I think,
We're only on pre-dinner drinks,
And across the room my wife widens her eyes,
Silently begging me "Be nice!"

A matrimonial warning,
Not worth ignoring.
So,

I resist the urge to ask Storm,
Whether knowledge is so loose weave,
Of a morning, when deciding whether to leave,
Her apartment by the front door,
Or the window on the second floor.

The food is delicious,
And Storm whilst avoiding all meat,
Happily sits and eats,
As the good doctor slightly pissedly holds court on some anachronistic aspect of medical history.

When Storm suddenly insists:
"But the human body is a mystery
Science just falls in a hole
When it tries to explain the nature of the soul."

My hostess throws me a glance,
She, like my wife, knows there's a chance,
I'll be off on one of my rare, but fun, rants.
But I shan't, My lips are sealed,
I just want to enjoy the meal.

And although Storm is starting to get my goat,
I have no intention of rocking the boat,
Although it's becoming a bit of a wrestle,
Because, like her meteorological namesake,
Storm has no such concerns for our vessel.

Pharmaceutical companies are the enemy,
They promote drug dependency,
At the cost of the natural remedies,
That are all our bodies need,
They're immoral and driven by greed,
Why take drugs when herbs can solve it?
Why do chemicals when
Homeopathic solvents can resolve it?
I think it's time we all return to live,
With natural medical alternatives.

And try as I like,
A small crack appears in my diplomacy dyke.

By definition, (I begin)
Alternative medicine, (I continue)
Is either not been proved to work,
Or been proved, not to work.
Do you know what they call
'Alternative Medicine'
That's been proved to work?

-- Medicine

So you don't believe in any natural remedies?
On the contrary, Storm, actually,
Before we came to tea,
I took a natural remedy,
Derived from the bark of a willow tree.
It's a painkiller, virtually side-effect free.
It's got a, a weird name,
Darling, what was it again?
Maspirin?
Baspirin? Oh, yeah -
Aspirin!
Which I paid about a buck for,
Down at the local drugstore.

The debate briefly abates,
As my hosts collect plates.
But as they return with dessert,
Storm pertly asserts,
Shakespeare said it first:
There are more things in
Heaven and Earth,
Than exist in your philosophy
Science is just how we're trained, to look at reality,
It doesn't explain, Love or spirituality.
How does Science explain
Psychics, auras, the afterlife,
The power of prayer?

I'm becoming aware,
That I'm staring,
I'm like a rabbit suddenly trapped,
In the blinding headlights of vacuous crap.
Maybe it's the Hamlet,
She just misquoted,
Or the fifth glass of wine I just quaffed.
But my diplomacy dyke groans,
And the arsehole held back by its stones.
Could be held back no more.

Look up, Storm, So I don't need to bore ya,
But there's no such thing as an aura,
Reading auras is like reading minds,
Or tea leaves, or star-signs,
Or meridian lines.
These people aren't plying a skill,
They're either lying, or mentally ill.
Same goes for people who claim
To hear God's demands,
Spiritual healers who think
They've got magic hands.
By the way, why do we think it's okay,
For people to pretend they can talk to the dead?
Isn't that totally fucked in the head?
Lying to some crying woman whose child has died,
And telling me you're in touch with the other side?
I think that's fundamentally sick.
Do I need to clairify here,
That there's no such thing as a psychic?

What are we - fucking two?
Do we actually think that
Horton heard a Who?
Do we still believe that Santa brings us gifts,
That Michael Jackson didn't have facelifts?
Or are you still so stunned
by circus tricks,
That we think the dead would,
Wanna talk to pricks like John Edward?

Storm, to her credit,
Despite my derision
Keeps firing off cliches
With startling precision
Like a sniper using
Bollocks for ammunition.

You're so sure of your position,
But you're just close-minded,
I think you'll find that
Your FAITH in science and tests,
Is just as blind as the
faith of any fundamentalists,

Wow, that's a good point,
Let me think for a bit.
Oh wait, my mistake,
That's absolute bullshit.
Science adjusts its views
Based on what's observed.
Faith is the denial of observation,
so that belief can be preserved.

If you show me that, say,
Homeopathy works,
I will change my mind,
I will spin on a fucking dime.
I'll be as embarassed as hell,
Yet I will run through the streets yelling,
It's a MIRACLE!
Take physics and bin it!
Water has memory!
And whilst its memory
Of a long lost drop of onion juice is infinite,
It somehow forgets all the poo it's had in it.

You show me that it works,
And how it works,
and when I've recovered,
from the shock,
I will take a compass and carve
'Fancy That',
On the side of my cock.

Everyone's just staring now,
But I'm pretty pissed and I've dug this far down.
So I figure.. In for a penny, in for a pound!

Life is full of mystery, yeah,
but,
there are answers out there.
And they won't be found,
By people sitting around,
Looking serious,
And saying: Isn't life mysterious,
Let's sit here and hope,
Let's call up the fucking Pope,
Let's go on Oprah,
And Interview Deepak Chopra.

If you must watch telly,
you should watch Scooby-Doo,
That show was so cool!
Because every time
There was a church with a ghoul,
Or a ghost in a school,
They looked beneath the mask.
And what was inside?
The fucking janitor,
or the dude who ran the water slide!
Because,
throughout history,
every mystery
ever solved,
Has turned out to be -
Not Magic!

Does the idea that
there might be knowledge frighten you?
Does the idea that
one afternoon on Wiki-fucking-pedia
Might enlighten you,
Frighten you?
Does the notion that there might not be a supernatural,
so blow your hippy noodle,
that you'd rather just stand in the fog of your
Inability to google?

Isn't this enough?
Just,
this world?

Just this,
Beautiful,
Complex,
Wonderfully Unfathomable,
Natural World?

How does it so fail to hold our attention
That we have to diminish it
with the invention
of cheap man-made
myths and monsters?
If you're so into your Shakespeare,
Lend me your ear
To gild refined gold,
To paint the lily,
To throw perfume on the violet,
Is just fucking silly
Or something like that.
Or what about Satchmo?
I see trees of green,
Red roses too...

And fine, if you wish to,
Glorify Krishna and Vishnu,
In a post-colonial,
Condescending,
Bottled-up-and-labeled
kind of way,
Whatever, That's okay.

But, here's what gives me a hard-on,
I'm a tiny, insignificant
Ignorant bit of carbon.
I have one life,
And it is short and unimportant,
But thanks to recent scientific advances...

I get to live twice as long,
As my great-great-great-great
uncleses and auntses.

Twice as long!
To live this life of mine,
Twice as long,
To love this wife of mine.
Twice as many years,
Of friends, of wine,
Of sharing curries and getting shitty,
At good looking hippies,
With fairies on their spines,
And butterflies on their titties.

And if perchance, I have offended,
Think but this, and all is mended,

We'd as well be ten minutes back in time
For all the chance you'll change your mind.

On the critical need for an educated populace and transparent government

2008-11-04T08:52:00.001-07:00

"A popular government without popular information or the means of acquiring it, is but a Prologue to Farce, or a Tragedy, or perhaps both. Knowledge will forever govern ignorance. And a people who mean to be their own Governors, must arm themselves with the power which knowledge gives."

-James Madison

Vote

2008-11-04T07:45:00.000-07:00

Here in colorado we were able to cast our vote a while ago and many of us did.

For those who haven't or couldn't today is THE day. It looks like the country is in for a big turn out and history is in the making whatever your choice.

Hopefully you've considered the issues through all the sophistry and rhetoric.

Hopefully reason, inclusion and clear thinking surface as the new focus for national governance.

Hopefully most of us will excersize our basic civic duty and VOTE.

Treating evidence with contempt

2008-10-20T08:33:00.001-07:00

Sad commentary regarding the use of critical thinking by many complemenary and alternative proponents:

"For 15 years I have studied the effectiveness and safety of treatments such as acupuncture and homeopathy. Often, the results were not what the proponents ofthese treatments had hoped for. One would have thought that this might lead to debate, further research, or even health policy changes. Sometimes it has, but recently we have witnessed a new phenomenon.

People or organisations promoting highly questionable treatments are treating the evidence with contempt and flex their legal muscle to have it their way. The New Zealand Journal of Medicine recently published an article showing that most chiropractors use the title "doctor." The argument was that this might mislead patients and cause harm. As a consequence, the chiropractors sought to silence the journal by threatening legal action. (1) Fortunately the attempt failed.

The Guardian was sued for libel by Matthias Rath. The paper had exposed Rath’s strategyof convincing South Africa’s government that his vitamin pills were more effective than antiretroviral drugs for treating AIDS. The Guardian put up a fight, and eventually Rath dropped the libel action and was ordered to pay costs. (2) An editorial in the Guardian (http://www.guardian.co.uk/commentisfree/2008/sep/13/matthiasrath.aids noted that Rath’s activity in South Africa "provides a terrible illustration of thepotential consequences of treating the evidence with contempt."

Science journalist Simon Singh recently condemned the British Chiropractic Association for advocating chiropractic care as a treatment for childhood asthma and a rangeof other paediatric conditions. Instead of arguing their corner publicly, the association filed a libel action against Singh (www.telegraph.co.uk/news/newstopics/mandrake/2570744/Doctors-take-Simon-Singh-to-court.html). The case is likely to come before the courts soon.

When I critically commented on a report that Prince Charles had commissioned on the cost effectiveness of alternative medicine, (3) my university received a letter from the prince’s first private secretary, Sir Michael Peat, to "draw attention"to what he perceived as a "breach of confidence" on my behalf. It took a gruelling 13 months of an internal inquiry at Exeter University to clear my name.

Since I published a book with Simon Singh that evaluated the evidence for or against homoeopathy and other alternative treatments, (4) UK homoeopaths have been engaging in an elaborate campaign of multiple letter writing, repeatedly invoking the Freedom of Information Act to harass and silence me. This letter shows that they have failed. All of this "is not just unpleasant, it is also unhealthy," commented Ben Goldacre. (5)

I would add that the frequency of these events in recent months is downright scary. People who use legal muscle and power, rather than reason and debate, are a danger to reason and progress. What is at stake here is our right, I would argue our duty, to speak out against misleading claims and dangerous concepts. We should find ways of protecting ourselves against such enemies of reason. "

Cite this as: BMJ 2008;337:a2063 Edzard Ernst, Laing chair of complementary medicine"

Gilbey A. Use of inappropriate titles by New Zealand practitioners of acupuncture,chiropractic, and osteopathy.

N Z Med J 2008;121(1278):15-20Boseley S. Matthias Rath drops libel action against Guardian.

BMJ 2008;337:a1710(18 September.)Henderson M. Prince plots alternative treatments for the NHS.

Times 2005 Aug 24:1.Singh S, Ernst E. Trick or treatment? Alternative medicine on trial. London: BantamPress, 2008. Goldacre B. With their money, myopia and abuses, these pill makers match big pharma.Guardian 2008 Sep 13:34.

The science of economy

2008-08-14T14:56:00.004-07:00

The process of learning necessarily implies that any held opinions and concepts need to be continually examined, re-examined and -in light of new information- often modified or expanded upon to better fit a larger picture of understanding. This takes time, leads to many twists & turns and can frustrate a lot of people!

For example, it can put one at complete odds with a "faction" of people and yet alternatively, at other times, in solid agreement with that same crowd. This goes for a plethora of 'categorized' groups- many of whom are polar opposites of each other! Granted, there are always those folks with whom the only thing you ever find in common with is the air that’s breathed!

On the one hand, we need to acknowledge and consider solid reasoning while, on the other hand, take issue with hubris & bullshit no matter the origin- be they liberals, conservatives, independents....neocons, neosocialists, neoluddites, isolationists, consumerists, comunalists,...theocons, fundies, dogmatists, apologists... bioluddites, nihilists, primitivists, anarchists, globalists, anti-globalists, corporatists, anti-corporates...yadda… yadda…

Obviously, categorizing ourselves in these ways is quite arbitrary anyway and is really only marginally useful if you think about it a while. In fact, I find even the most stalwart extremists I know succeed only in fooling themselves much of the time.

The reality is we are quite schizophrenic when it comes down to it and can be described -at one moment or another in varying degrees- with any of the spectrum of descriptive adjectives we've come up with so far. We are Narcissus and Goldmund blended -a bizarre fusion of tangled humanity. On the other hand, many of us strive to reach out for that “candle in the night” in a search for the truer nature of things.

In that vein, I've been following a variety of economic topic threads with the goal of trying to understand the bigger economics conversation a little better…Short take so far is nothing new. That is, 'purism' of any sort doesn't work and striving for a smeared and messy, yet transparent and educated participatory "middle" seems most realistic -even with its concurrent complexities. Here the gorilla in the room -whatever it is for you- becomes a more benign presence and allows for more 'humane' versions of free market (& capitalist) economies of scale.

Anyway, thought you might be intrigued with this economics book list I'm building up. It's proving useful as a data base for the so called "dismal science" and offers tools to differentiate between the "wheat & the chaff" and what's already right & what's not.

Though my keenest interests lie elsewhere -actually waaaay elsewhere- I guess it's important to have some working awareness of a topic that so affects us all. If you have any favorite economy book, lectures, or other suggestions, please send them along!

Economics book list (partial):

Game Theory: Analysis of Conflict

Economics and the Theory of Games

The Worldly Philosophers

Nudge

New Ideas from Dead Economists

Naked Economics: Undressing the Dismal Science

The Undercover Economist

The Race Between Education and Technology

The Mind of the Market

Poverty Traps

Inequality in America

Social Movements: Identity, Culture and the State

Astronomy lectures and climate change

2008-08-13T16:52:00.001-07:00

From the Silicon Valley Astronomy Lectures...a very interesting talk:

Take an entertaining and enlighting journey with astronomer and popular author Dr. David Grinspoon through the history of our solar system, discovering run away greenhouses and snowball planets. Compare the evolution of Venus, Earth, and Mars over the years and learn how studying the evolution of other planets can help us understand and predict climate change on Earth.

Labrador love

2008-08-13T06:30:00.000-07:00

Doesn't get much better...

2008-08-12T20:40:00.001-07:00

On occasion, I will be passing previous posts relating to evidence and science based veterinary medicine, complementary and alternative veterinary medicine and other pertinent skeptical issues to the Vetskeptics blog.

This is an attempt at consolidating veterinary & other medical information relating to skeptical information about CAM/CAVM that may prove useful and interesting in a more focused venue. Time permitting, some of these posts will be expanded upon. As always, posts from anyone interested in contributing (see vetskeptic blog) are welcome.

The Beyond the illusion post touches on some of the factors that confound and fool practitioners and others into thinking ineffective therapies work when they really don't.

End of life: Jasper and Karen

2008-08-12T10:06:00.002-07:00

How does one walk in a world where joy and pain are inseparable...where fullfillment and utter despair embrace in an impossible trist...and where saying goodbye becomes confused with saying hello...?

The relationship between Jasper (the dog) and Karen (the human) reflects an authenticity and profound acknowledgement of life as it is....brief, harsh, contradicting, brief, beautiful, resonant, incredible, brief.

For a veterinarian, walking down the path between life and death with a person and their beloved companion is always different. Jasper had an untreatable malignancy (throat cancer) that was literally and quickly choking away his life...what he needed and what I could give him was a good death...

....this is a part of our world.

Never let them see your fear...

2008-08-12T08:48:00.001-07:00

A tale -in some version or another- most veterinarians have lived through...

Integrative medicine and hat tricks

2008-08-12T06:31:00.004-07:00

So many times the devil really is in the details. So it seems, time after time,
I and many others find ourselves confronted with the same tired and increasingly tenuous arguments from Complementary and Alternative Medicine proponents.

Sadly, it doesn't seem to slow the creep of medicine back towards a far more
dangerous era -one of "curative anarchy"- that society wisely decided
to collectively walk away from a hundred years ago.

How quickly we forget...

These modalities continue to find fertile ground with the credulous by insiduously blanketing and confounding themselves with a false legitimacy. By appropriating and altering innocuous sounding concepts such as 'freedom of choice', 'teaching the controversy' and having a 'balanced' discussion (where none exists) -all for the sake of an ideology- many CAM supporters succeed only in weakening and degrading the pillars of reason and critical thought.

A colleague, Dr. Novella writes a sharp and clear post regarding one of CAMs
more succesful hat tricks...the bait & switch.

Excellent reading.

Carl Sagan: A thousand years of darkness

2008-08-12T06:20:00.001-07:00

The importance of questioning not just the permanence of the stars, but also the justice of slavery can not be overstated...

...only then will history not -once again- be damned to repeat itself.

Carl at his best.

on choosing humanity over magic

2008-08-11T15:14:00.001-07:00

Good article on how taking into account 'provenance' helps us ellucidate -even with our limited capacity - truer realities. Though we can never completely escape our biases nor should we (pattern seeking social primates that we are), we can sure strive for balance between -not magic and reality- but humanity and reality.

The article talks about 'woo' which is a catch phrase -as most of you are aware- for a broad collection of credulous mind sets. Here is a brief primer of what 'woo' is (thanks Orac):

Beliefs that clearly demonstrate magical thinking, uncritical acceptance of things for which no good evidence exists. This includes, but is not limited to, psychic phenomenon, ghosts, the paranormal, "energy healing" and a wide variety of other mystical and pseudoscientific beliefs.

Woo is resistant to reason. Indeed, woo has a double standard when it comes to what it considers to be good evidence. It is very accepting of a wide variety of fuzzy, mystical ideas, but is often incredibly distrustful and skeptical of anything having to do with "conventional" science or "conventional" medicine. Woos tend to be very quick to react to defend their particular brand of woo and very unforgiving of its being questioned.

StevenPinker: on the decline of violence

2008-08-11T10:47:00.001-07:00

....or it helps to continually learn, listen & understand -as best we can- when trying to affect change in the ways of the world.

In that regard here is an interesting review of Steven Pinkers lecture (& upcoming book) with respect to the study of human violence from a historical perspective...important to "consider as one considers".

Of course regarding violence, things can easily go to hell in a hand basket -and often do- for a variety of reasons...still, teasing out these observable phenomena can prove very useful in understanding human collaboration.

Steven Pinker on the decline of violence

"Steven Pinker, a professor of psychology at Harvard, begins his presentation with an image of corpses on a truck, being taken from Auschwitz concentration camp. The image is one of many characteristic of the 20th century, a century that included brutality under Stalin, Hitler, Pol Pot and the genocide in Rwanda. The 21st century, which has barely started, already includes the brutality of Darfur and the daily destruction in Iraq.

These sorts of images can lead us to thinking that modernity brings terrible violence. Perhaps native people lived in a state of harmony that we’ve departed from.

This, Pinker tells us, is bullshit. “Our ancestors were far more violent than we are.” We’re probably living in the most peaceful time of our species’s existence, a statement that seems almost obscene in light of Darfur and Iraq.

The decline of violence, he tells us, is a fractal phenomenon - we see it over the centuries, the decades and the years. That said, we see a tipping point in the 16th century - the age of reason - particularly in England and Holland.

Until 10,000 years ago, all humans were hunter gatherers. This is the group that some believe lived in primordial harmony - there’s no evidence of this. Studying current hunter-gatherer tribes, the percent of male adults who die in violence is extraordinary - from 20 to 60% of all males. Even during the violent 20th century, with two world wars, less than 2% of males worldwide died in warfare.

Moving slightly further forward, we can see that violent punishment was common in the Bible - Moses tells his followers to kill all the men and married women of a village and rape the virgins. The death penalty was used for murder, idolatry, disrespecting your parents and “collecting sticks on the sabbath”.

The Middle Ages were filled with mutilation and torture as routine punishments for trangressions we’d punish with fines today. This was merely another charming feature of a time that featured passtimes like “cat burning”, dropping cats into a fire for entertainment puposes… Some of the most creative inventions of the Middle Ages were fantastically cruel forms of corporal punishment.

One on one death has plummeted through the middle ages, with an “elbow” of the curve in the 16th century. Despite a slight uptick in the 1960s - “perhaps those who thought that rock and roll would lead to a decline in moral values had it right” (joking) - we’ve seen two orders of magnitude fall in one on one violence from the middle ages to today. State sponsored violence has also fallen sharply - we’ve seen a 90% reduction in genocide since the end of the cold war. State on state conflicts are dropping every decade.

So why do we so mispercieve the violence of our society? For one thing, our reporting is better. AP is more likely to cover a war somewhere on the planet than a 16th century monk. We’re subject to a cognitive illusion - memorable events (brutal murder) are judged to be more probable than they actually are. Finally, our standards tend to change faster than our behavior. We may be offended by capital punishment today because it no longer fits with our vision of ourselves, but it’s worth remembering that not long ago, that sort of punishment was exceedingly common and there wasn’t strong protection of rights in the courts to prevent it from taking place.

So why is violence becoming less common? He offers four explanations:

1) Hobbes got it right. “Life in the state of nature is solitary, poor, nasty, brutish and short.” In anarchy, there’s a temptation towards pre-emptive violence, hurting the other guy before he hurts you. But with the rise of the Leviathan - the State - there’s a monopoly on violence. This helps explain why we still see violence in the absence of the state - zones of anarchy, failed states, street gangs.

2) In the past, we had a widespread sentiment that life was cheap. As we’ve gotten better at prolonging life, we take life more seriously and are more reluctant to take life.

3) We’re seeing more non-zero sum games, as people discover forms of cooperation that can benefit both parties, like trade and shared peace dividends. These zero-sum games come with technology, because it allows us to trade with more people. People become more valuable live than dead - “We shouldn’t bomb the Japanese because they built my minivan.”

4) Finally, Pinker leans on Peter Singer to speculate about “the expanding circle”. By default, we empathize with a small group of people, our friends and family. Everyone else is subhuman. But over time, we’ve seen this circle expand, from village to clan to tribe to nation to other races, both sexes and eventually other species. As we learn to expand our circles wider and wider, perhaps violence becomes increasingly unacceptable."

A non-zero sum game of human to human interaction makes the most intuitive sense to me and is reminiscent of aspects of evolutionary game theory, though the "expanding circles" notion is intriguing. However, Peter Singer goes way too far in other writings where he or at least some of his readers manage to confound unrelated ideas into a bizzaro house of cards version of 'animal rights' mindlessly parroted, overused and abused by 'animal rights' activists.

It’s likely, that a combination of Pinkers’ hypotheticals blend together –possibly along with other intangibles- to affect this fascinating fractal phenomenon observed as a general reduction in human on human violence.

What is going on that is right is as important to know as all that is going wrong. All in all this presentation offers some interesting food for thought.

Acupuncture: still no point to the point...

2008-08-09T16:03:00.007-07:00

This has been a summer full of distractions and challenges needing a lot of attention. Add to that a touch of blog writer “blues” and you get a dry spell regarding postings. Consequently, this blog –not to mention the new blog baby - has been neglected and hungry for forward movement and novel discussion.

Hopefully, this little post will get things going again. All in all, this is a fun and gratifying way of expressing ideas and thoughts and helps to keep the mind sharp and attentive.

The following is a comment on my “Veterinary acupuncture” post that, although friendly and thoughtful, latches on to a few canards and fallacies in order to defend the concept of acupuncture as a viable medical therapy. Obviously, I disagree and felt compelled to write a quick response which follows the commentators blurb.

"Unfortunately there are far too many veterinarians, physicians and researchers who dismiss acupuncture as a hoax or as in this case lacking adequate scientific and clinical proof to warrant its use. Clearly the problem has been that clinical and scientific studies of acupuncture have lacked adequate controls. Without proper controls study results are nothing more than hearsay. However more recent scientifically controlled studies would argue that perhaps acupuncture therapy has merit. In this regard recent studies using microarray technology to examine acupuncture effects on gene expression in peripheral blood are no less than fascinating. For example Shiue et al (2008) have shown that acupuncture therapy significantly reduced allergic rhinitis symptoms, including nasal symptoms, non-hay fever symptoms, and sleep in human patients and this was accompanied by and alteration in the balance between T-helper 1 and T-helper 2 cell-derived proinflammatory versus anti-inflammatory cytokines in the blood. Such studies are paving the way for a more scientific explanation of acupuncture's effects. One only has to examine the recent fMRI studies of acupuncture effects on brain activity in humans and animals to conclude that acupuncture point stimulation has remarkable effects on brain activity compared to non-acupoint stimulation (see for example Napadow et al., Hum Brain Mapp, 2005). These are real effects and whether they underlie the ability of acupuncture to alter pain sensation in humans and animals remains to be proven with certainty, but nonetheless acupuncture has the capability to change brain activity. In our own studies we have found that acupuncture can prevent tumor growth if given at the very early stages of tumor cell proliferation. Conversely if acupuncture is applied later on after a tumor begins to grow, it significantly enhances tumor growth, which is why acupuncture is typically not recommended as a treatment for cancer. On the other hand acupuncture provides clear relief of pain in animal models of neuropathic pain and inflammatory pain. These effects are real folks and I have seen them first hand, so I refuse to believe that acupuncture is of no value in the medical community, be it veterinary or human medicine. There is evidence that acupuncture does not work in certain individuals and works well in others, so there is clearly individual variation in the ability of acupuncture therapy to work effectively. Taking all of this into account, I would argue that you shouldn't dismiss acupuncture until you have tried it!”

The real unfortunate issue is not that acupuncture is dismissed as a hoax, but that – even with a preponderance of disappointing evidence- this modality continues to expect unearned acceptance.

Though plagued with poorly designed studies that are often replete with equivocal results or laced with regional geographic bias, better designed acupuncture studies are out there. However, the news is not good for any real acupuncture effect. The infamous placebo –among other problems (i.e.; expectation, suggestion, counter-irritation, operant conditioning, and other psychological mechanisms) - continue to confound even “modern” acupuncture technique (that is to say; those acupuncture practices that use needling and claim no association with the ‘elam vital’, points, or meridians).

The studies you mention do not address a critical issue with respect to acupuncture- whether or not its putative effects exist. The attempt to correlate a claimed acupuncture effect to epigenetic influence puts the cart before the horse (and is reminiscent of what ‘nutritional supplement support’ advocates claim for a favorite herb, vitamin, or tonic du jour) and purported brain responses apparently observed by fMRI are interesting but it seems apparent that any mechanical puncturing of the dermis –on points or no points, shallow or deep- will effect changes.

There is little or no evidence that acupuncture is effective for any real medical disease (i.e.; neoplasm) nor, for that matter, for less well defined symptoms (including chronic pain, depression, allergies, asthma, arthritis, bladder and kidney problems, constipation, diarrhea, colds, flu, bronchitis, dizziness, smoking, fatigue, gynecologic disorders, headaches, migraines, paralysis, high blood pressure, PMS, sciatica, sexual dysfunction, stress, stroke, tendonitis and vision problems). Interestingly, promising and plausible mechanisms –if any- seem associated with completely different modalities that are confused with acupuncture (i.e.; TENS, psychosomatic, placebo).

Seeing acupuncture effects “first hand”, no matter how impressive, is simply anecdotal testimony and adds nothing to a scant evidence and science based foundation supporting acupuncture. In short, the accumulating evidence suggests most of the perceived beneficial effects of acupuncture are probably due to the power of suggestion and forms of the ‘placebo effect’.

Whether or not acupuncture is of any value to the medical community might be better discussed in a philosophy of science course. For example, acupunctures place might be better off in the realm of personal belief or preference (i.e.; priest or shaman) and well outside of medicine (If you believe in it, it will make you think you feel better – that’s your business).

As for having tried acupuncture…been there done that. I’ve also extensively observed its use in animals by certified veterinary acupuncturists.

Not impressed.

Science

2008-05-29T06:43:00.000-07:00

(hat tip to Orac)

leading forward

2008-05-15T20:45:00.004-07:00

One of the goals when teaching is to "lead forward'; that is create an
environment that sparks interest and wonder. If a teacher can manage to provide
a glimpse into the breathtaking world of life long learnig they are doing their
job.

The "thousand year model" is a great way to introduce astronomy to just
about any one and is an especially good "mini" field trip set up for school
kids. It creates an experiential excersize of our own solar system that seems to
stick with them.

Maybe you know some teachers who might be interested in it if they aren't already aware of it, but try it yourselves if you ever have some time to take a long walk -it's amazing!

non sequitor

2008-05-15T19:33:00.001-07:00

A nice statement ...

2008-03-07T09:35:00.001-07:00

No matter where one stands on the spectrum of perception and worldviews…the “state of being” these words reflect serve as a sound guide...they fly sound and true.

I believe in time,
matter, and energy,
which make up the whole of the world.

I believe in reason, evidence and the human mind,
the only tools we have;
they are the product of natural forces
in a majestic but impersonal universe,
grander and richer than we can imagine,
a source of endless opportunities for discovery.

I believe in the power of doubt;
I do not seek out reassurances,
but embrace the question,
and strive to challenge my own beliefs.

I accept human mortality.

We have but one life,
brief and full of struggle,
leavened with love and community,
learning and exploration,
beauty and the creation of
new life, new art, and new ideas.

I rejoice in this life that I have,
and in the grandeur of a world that preceded me,
and an earth that will abide without me.

(hat tip to Pharyngula)

Vetskeptics blog

2008-03-05T16:23:00.000-07:00

A blog baby!
This little blog project at wanderingprimate has always been about pondering on a rather wide breath of topics. Hopefully regular readers- if any- have enjoyed some of these posts as I have meandered- or wandered- about from topics in physics, medicine and other science related themes that have caught my fancy. As long as it is enjoyable, I plan to continue writing and perhaps broaden the scope a bit- touching more on other sciences and philosophy from time to time.

Along the way, I have managed to build up a fairly significant body of veterinary posts that have proven useful and may be of some use to others. With that in mind, I’ve decided to create a new veterinary specific blog site -Vetskeptics- with the goal of collecting these posts into an easier to access format and, at the same time, initiate a veterinary specific site that promotes critical thinking and skepticism.

My goal is to add to the scarce resources on the "ether" net for veterinary skeptics, or any animal lover tired of the pseudo-scientific blather out there. I hope to improve on some of the old posts and have new authors send in their own quality posts in an effort to put together a more collaborative site of like minded veterinarians, veterinary technicians, animal care-givers or any animal lover interested in sharing their thoughts.

If nothing else, it will be a nice skeptical reference blog. If you are interested in helping out, please have a gander at the site and drop me a line at (drg at vetskeptics dot com).

It could be a lot of fun!

Prions: mysterious shape shifters

2008-03-04T13:28:00.003-07:00

Everywhere and nowhere

It is the strangest thing to see a vibrant and healthy Colorado bred elk begin to shrivel and waste away before your eyes. It is even more frustrating to feel that old familiar tinge of complete helplessness when the realization comes to you that chronic wasting disease has taken (CWD) hold of another victim. No matter how aggressive and careful you are there is literally nothing that can be done once this mysterious disease takes hold.

Thankfully, the incidence of this prion based sickness is relatively rare and slow to ravage whole herds. This is good as the best we can do to control CWD is to monitor it by testing the tissues of captive adult animals that have died or researching “test and cull” methods for eradicating it from wild herds.

The mechanisms that make this disease so bizarre and counter intuitive starts with the causative agent – a prion- a small protein structure without any nucleic acid. They are described as “small proteinaceous infectious particles which resist inactivation by procedures that modify nucleic acids.”

This is indeed beyond strange. The idea that a protein structure by itself can cause disease defied a lot of what was known about infectious disease. The infected animals are usually neurological and the disease is now classified into a family of “spongiform encephalopathies” based on the post mortem lesions found in affected mammals¹- of which most seem to have some version of this thing (table 1). They are all characterized by varying degrees of loss of motor control, dementia, wasting (paralysis) and eventually death.

Table 1 some prion diseases:

Scrapie: sheep
TME (transmissible mink encephalopathy): mink
CWD (chronic wasting disease): muledeer, elk
BSE (bovine spongiform encephalopathy): cows
CJD: Creutzfeld-Jacob Disease: human
GSS: Gerstmann-Straussler-Scheinker syndrome: human
FFI: Fatal familial Insomnia: human
Kuru : human
Alpers Syndrome: human

An interesting historical anecdote regarding early prion research is touched on by Dr Shaun Heaphy lecturer at the University of Leicester “Kuru is the condition which first brought prion diseases to prominence in the 1950s. Found in geographically isolated tribes in the Fore highlands of New Guinea. Established that ingesting brain tissue of dead relatives for religious reasons was likely to be the route of transmission. They ground up the brain into a pale grey soup, heated it and ate it. Clinically, the disease resembles CJD. Other tribes in the vicinity with same religious habit did not develop the disease. It is speculated that at some point in the past a tribe member developed CJD, and as brain tissue is highly infectious this allowed the disease to spread. Afflicted tribes were encouraged not to ingest brain tissue and the incidence of disease rapidly declined and is now almost unknown.” This rather macabre custom did illustrate how this strange infection behaved and how it might work through a population of people.

Even more intriguing, these prions seem to be related to a normal and abundant cellular protein (PrPc) located on the membrane on run of the mill neural cells. These prion like structures have a different structural shape than infectious prions and are perhaps functionally linked with normal neural transmission, though no one really knows for sure.

Prions and these PrPc proteins seem to have species specific structures but these configurations are fairly similar across the board. This species specificity dramatically slows down cross species infections and makes such jumps far less probable, but not impossible- especially if there is a susceptible individual on the other end.

The prion varies in its structural three dimensional forms from the normal PrPc protein and it’s this structural difference that seems to make them so insidiously pathological. To make matters worse, it seems there may be genetically susceptible individuals that are more prone to having their own PrPc proteins “shape shift” into the pathological infectious prion by coming into contact with a prion (by the way, not all shape shifted prions are lethal).

Interestingly, that it is possible to eventually “transform” an infectious prion from one species to another susceptible species is a prime example of witnessing evolution “unplugged” right before our eyes. The ability of these prions to evolve structurally and in time come up with the right configuration to cross species without any genetic elements is remarkable.

As ERV puts it “How does something with the same amino acid sequence evolve??”. With respect to prion research being done by Dr Bartz she adds “The idea I pitched to Dr. Bartz (the idea he was already planning on pitching to the scientific community hehe, I iz smrt) is that prions operate like HIV-1. But instead of exploring sequence space like my HIV, his prions explore structure space. One protein exploring all possible structural configurations. It has an optimal configuration for minks, but needs to explore and find a more optimal configuration for ferrets.” Amazing stuff!

What does a normal PrPc do? What makes its shapeshifted version so lethal? According to the Prion Institute “Studying how and why proteins misfold and the genetics, diagnoses and treatments of prion diseases will have positive implications for both animal and human health issues.”

Indeed, the possible breakthroughs for understanding the prion phenomenon may have staggering implications towards not just understanding the spongiform encephalopathies, but other degenerative neural diseases (i.e.; Alzheimer) as well as shed light on normal brain physiology. All this from a tiny inert blob of protein- reality is indeed far stranger than fiction.

------------------------------------------------------------

1) Visible end results at post-mortem are non-inflammatory lesions, vacuoles, amyloid protein deposits and astrogliosis.

Killing fields of Darfur, Chad and beyond

2008-03-03T22:05:00.004-07:00

From people to endangered species: the travesty grows

The unending specters of misery and death so ubiquitous to the killing fields of Darfur have set their gaze to distant riches beyond the borders of Sudan. They have stirred and moved in the name of money on easy prey and this time it is the animals that suffer. According to Sharon Begley of Newsweek, the sad tale of this human travesty has now reached the world of Africa’s endangered species- and it’s killing them at near industrial scales.

As if a child’s dying cry wasn’t enough for the hungry hordes of the Janjaweed (nomadic proxies in a terrible struggle between Sudanese powers that be), they now spread their bloody reach into Chad’s Zakouma National park ; a refuge of endangered species and a tantalizing source of blood money for these killers. However, they aren’t the only "armies" in need of Chad’s treasures in a continent choked by desperation and greed. The endless quest to feed bloody struggles for power and domination can be seen in ever more brazen poacher raids like those supported by Somali warlords and demonstrate the perils of trying to defend the defenseless.

Once rebounding populations of elephants and rhinos among many other endangered species are now being decimated to fuel the ongoing human tragedy in Darfur, Somalia, and who knows where else. Begley notes that this “signals a terrifying turn in the world's efforts to save vanishing species. The battle is no longer just about the elephant's trumpet never again echoing over the African savanna, or the Bengal tiger's roar being heard only in memory. The threat posed by the contraband wildlife trade is now also about the money it generates—wave upon wave of it—that is being used by very bad people to do very bad things.”

Chadian park rangers are caught in the middle of a newer more vicious illegal animal trade whose endgame appears to be the very extinction of the animals they defend. The problem of course extends far beyond the borders of Sudan or Chad and reaches into the depths of India, Asia and North America. Part of the problem is the shear idiocy and ignorance of people who create a market demand for these animals in pieces and parts that end up as ivory statues or in "magical" aphrodisiac powders. By doing so, whether they know it or not, these buyers aid and abet in an unfolding human tragedy.

Begley concludes her article noting "that as the ultimate blame for drug lords who murder the innocent lies with users, so the blame for a wildlife trade that sustains organized crime and genocidal militias lies with the buyers. "There is a vague awareness in America that some things, they shouldn't be buying," says McMurray. "But the psychology seems to be that if it's in a store [or online] it must be OK." Americans who buy ivory carvings (easily available online), Japanese who collect the ivory signature seals called hankos and Chinese who clamor for "medicines" made from tiger bone are not supporting some lone poacher who's trying to feed his family. They're putting money into the coffers of the Janjaweed, warlords and possibly even worse actors. With the new wildlife traffickers, it's not only animals whose lives are at stake.”

Cry the children... and the animals….

Combating Malaria with mosquitoes

2008-03-01T13:14:00.003-07:00

A possible novel strategy

There have been a lot of mixed results on the malaria control front. Simple and effective measures such as executing public malaria prevention campaigns, spraying against mosquito larvae, disseminating anti-malarial medications and mosquito netting have been slow to take hold due to a constellation of frustrating problems. The sad scourge of political corruption, extreme poverty and socio-cultural prejudice are but a few of the barriers that impede progress towards bringing down the death toll of this ancient protozoal disease that kills in the area of one million people a year.

This is why it is still worth perusing alternative strategies against the malaria parasite. Any measure that can help impact the effects of this disease should be considered and if found to be effective, added to the existing known strategies. This doesn’t include opening ones mind until your brains fall out and embracing implausible measures that just don’t work such as homeopathy and nutritional supplement “treatments”. Alternative efforts like these reflect -at best- a stunning dissonance between reality and belief or -at worst- complete and utter stupidity and a morbid disregard for human life.

However, among the more interesting possible anti-malarial strategies that might bypass some of the problems of other programs are biological approaches for combating malaria. For example, approaches that could cut its life cycle could dramatically reduce the prevalence of this parasite using a completely novel angle.

Actually, the idea itself isn't really new. Scientists have been trying for years to develop a malaria resistant mosquito that could survive in the wild. Until recently, the idea of combating malaria through biological mechanisms involving its life cycle has been a nice but impractical theory. It made sense but has been very difficult to make work- the devils been in the details. The good news is that recent developments in this area might breathe new life to this approach making it, at the very least, a promising avenue worth pursuing.

An interesting article in the January 2008 issue of Scientific American touches on some of the hopeful developments in this field. In summary, it mentions various lines of research on the malarial parasite life cycle, genetically engineered mosquitoes (Anopheles) and their capacity to survive in the wild that are coming together to perhaps create an viable and effective instrument for combating the malaria organism (Plasmodium falciparum).

In 2007, researchers found that the midgut environment of the anopheline mosquito, where the malaria parasite is transported and becomes infectious, plays an important role in the development of the malaria parasite. By genetically manipulating the mosquito to produce a substance found in Sea Cucmbers (CEL-111) in this midgut region, these researcher have been able to significantly inhibit the sporogenic development of Plasmodium falciparum.

The authors in this study note that “To our knowledge, this is the first demonstration of stably engineered anophelines that affect the Plasmodium transmission dynamics of human malaria. Although our laboratory-based research does not have immediate applications to block natural malaria transmission, these findings have significant implications for the generation of refractory mosquitoes.” These researchers basically have managed to create a viable mosquito resilient to the malaria parasite- an important piece of the puzzle.

Other threads of research are probing alternative mechanisms that alter the parasite life cycle within the mosquito and offer intriguing bits of information adding to the development of a robust data base for discovering more anti-malarial bio-mechanisms. For example, in the same year it was discovered that a capsule protein PbCap380 an ingredient of the malarial oocyst outer wall was critical for malarial survival inside the mosquito. The oocyst stage of the malarial life cycle is key to this parasites ability to infect humans and without this particular protein component the parasites were gradually eliminated from the mosquitoes reducing their capacity to transmit the disease.

Another study found they were able to reduce the adherence of the ookinate stage of the parasite to the lining of the mosquito midgut; an important part of eventual oocyst development by RNA interference. In essence they were able to reduce the level of a “ligand” – a glycoaminoglycans structure on the gut lining- that acts like Velcro.

Having a mechanism or mechanisms to inhibit plasmodium inside altered mosquitoes and maintaining a viable population of these insects are crucial steps toward a larger active bio-engineered anti-malarial program. However, one of the biggest steps in this area is to translate these successes to the field. If one or more of these mechanisms can be spread throughout the wild gene pool of mosquitoes then a whole new front against malaria could be established.

In fact, another recent study offers tantalizing evidence that transgenic malaria resistant mosquitoes can in fact survive in the wild. These authors note that “The introduction of genes that impair Plasmodium development into mosquito populations is a strategy being considered for malaria control. The effect of the transgene on mosquito fitness is a crucial parameter influencing the success of this approach.”

The study found that transgenicaly altered mosquitoes actually had a survival advantage in the lab when compared to non- transgenically altered mosquitoes. The authors conclude that the result of their findings “suggest that when feeding on Plasmodium-infected blood, transgenic malaria-resistant mosquitoes have a selective advantage over non-transgenic mosquitoes. This fitness advantage has important implications for devising malaria control strategies by means of genetic modification of mosquitoes.” On a related note, another important study in fruit flies reveals that it is possible to spread genetically modified insect genes in the wild.

Taken as a whole, one begins to see that several vital steps are being made to close the circle on a novel biological mechanism that can be used to reduce malaria in its natural environment. Each of these studies provides a brick of knowledge that begin to form a wall against malaria transmission. This fascinating activity may indeed be the genesis of a true “bio-weapon” against malaria and add to the greater effort in combating a deadly human disease.

81st Skeptics' Circle

2008-02-29T10:53:00.003-07:00

A leap year....at the Conspiracy factory. Get your skeptic fix today.

“Big” Pharma Marketing

2008-02-28T22:08:00.006-07:00

Doctors need to navigate with care

Much of alternative medicine makes dubious assumptions about the world of healing that set it apart from the real world. In essence, this makes it an untenable world view- at least scientifically speaking- and simply a non-starter. On the other hand, that’s not to say these methods have nothing to offer or teach us. Many of these modalities claim to “reach” people because they tend to cater to clients needs. Though, they often go too far, there is a germ of truth to these claims. By attempting to co-opt very real human social needs –empathy for example- they have in some way helped direct attention to important social aspects of human interaction.

The previous post touched on some of the more nuanced qualities of the “human” side of medicine and how important it is to understand and be aware of the complexities of social interactions –networking- and how it can impact health. It plays into the “art and science” of medicine and reminds us that it is a uniquely human endeavor.

Though it is difficult to wrestle with these issues, it is just as important to consider them as it is to debunk the non-science and falsehoods of alternative methods. This brings us to a related theme regarding the effect of networking.

It’s not a stretch to note that the state of medicine today is full of structural and foundational problems (i.e.; health care distribution, client/doctor relations). For example, pharmaceutical companies can make practicing science and evidence based medicine more challenging than it should be. Market pressures, commercial demands, and fierce competition within the industry create a need to vie for each and every costumer -in this case doctor- and can drive their therapeutic choices to some degree.

Here is where ugly “big pharma” conspiratorial accusations begins to bubble up out of the woodwork and out of many peoples mouths. Indeed there may be shades of this occuring. However, this probably gives the industry too much credit as any business works this way at some level –at least in a capitalistic society. On the other hand, an awareness of these forces (of the market) and how they work is crucial for doctors and patients (especially in this age of direct advertising) so that they can better navigate these sometimes muddy waters.

It needs to be made clear that market pressures drive the alternative medicine market in the same way –perhaps more so- as they do the pharmaceutical industry (sometimes they are one and the same!). In addition, the alternative industry (i.e.; supplements, homeopathic products, Chinese herbs) is not nearly as tightly regulated or policed as their “counterpart” is, making arguments against “big pharma” sound a bit hollow.

The science based medicine blog has a very interesting post “A foolish consistency” by Mark Crislip that discusses the undo influence of industry over the practices of medical doctors. As mentioned, topics like these need to be targeted and discussed openly and honestly. This is the best way to identify real problems and find solutions in a complex world.

By the way, veterinary medicine doesn’t seem -for the most part- to suffer near the pressure our counterparts in human medicine do. It seems easier to stand back and assess a particular drug or machine without some type of “market loyalty” ploy (i.e.; fancy gifts, free good or trips to wherever) getting in the way.

In the world of marketing and consumer “wooing” a saving grace, at least to some degree, with pharmaceutical companies is that they are tightly controlled and claims about their products need to be substantiated. Even with the biases often inherent in substantiating a product, it is still possible to evaluate them critically. That said there is still a question of whether pharmaceutical marketing is always a bad thing.

As noted by Crislip: “Does this marketing lead to worse outcomes? Or just more expensive treatment. I don’t have data. I will note that one of the driving forces of antibiotic resistance in bacteria is the overuse of broad spectrum antibiotics and choice of antibiotics is more often driven by marketing rather than science. Association or causality? ” This is definitely food for thought.

Crislip ends the post with the following quote: “In the interests of patients, physicians must reject the false friendship provided by reps. Physicians must rely on information on drugs from unconflicted sources, and seek friends among those who are not paid to be friends” http://medicine.plosjournals.org/perlserv?request=get-document&doi=10.1371/journal.pmed.0040150

At least one commentator, Dr RW gives doctors a bit more credit in their ability to discern the difference between market pressures and good medicine and find a balance between them.

He notes that “Many physicians I’ve discussed this issue with are aware that they are influenced by pharmaceutical company promotions. There is no reason to think there is massive self deception in the ranks of physicians. On the other hand many physicians would dispute any claim that industry promotions impact negatively on patient outcomes. As you acknowledged, there’s not a shred of evidence that they do. It is equally plausible that industry promotions (and their influence on doctors’ prescribing habits) are beneficial to patient outcomes…”

With respect to doctors applying evidence to practicing medicine as opposed to uncritically following “the market” there probably is some problem. However as Dr RW notes “I suspect many physicians do apply it (evidence). I certainly do. How? By being aware of the bias inherent in industry promotions. By applying appropriate analysis to the claims (e.g. looking not only at relative risk but also absolute risk) and by checking any such claims.”

It bears repeating that evaluating and studying issues like these dynamic market pressures which can impact social networks (doctors and patients) allows for a better understanding of real problems and opens the doors for meaningful improvements. These positive attributes; that of being self critical and self correcting, are part of what makes science based medicine –on balance- such an effective and successful practice as it thrives even in the buffeting winds of demanding special interests.

The power of social networking: medicine with meaning

2008-02-26T20:42:00.006-07:00

Shredding a paper tiger

Carl Sagan once noted that pursuing the truth no matter where it took you is far more enriching and fulfilling than believing in fantasies and made up realities. No matter how harsh, if you acknowledge your limitations- your humanity- nothing trumps the search for truth.

This is a premise for many who chase down and expose false and deceptive lines of reasoning in human society in an unending search for those gems that shine true. This is why complementary and alternative medicine (CAM) sometimes sticks out like a sore thumb. It pretends to dress itself in a robe of legitimacy and reality claiming actual therapeutic abilities for many of the maladies of society. Yet most of its most basic tenets disintegrate like sand between your fingers if you stop to examine them closely.

Because CAM is so replete with falsehoods peeling away at the facade is an important exercise because it sheds light on what not to do as a client or doctor. In this way much of CAM can be seen for what it is; a non-falsifiable belief system. The doctors’ stethoscope gets replaced with a sorcerer’s wand, and the lab coat with a priests robe.

Critical thinking can also help clarify many problems and pitfalls of the relationship and bond between modern medicine and society. Though there are plenty of issues on the table here, a crucial point to remember is something Carl Sagan alluded to. We need to acknowledge our humanity as it is. In other words, no matter how close to the truth we might get, we are necessarily driven to live with some form of "human" meaning (i.e.; awe, spirituality, inspiration).

But what is it that breathes life and meaning into our everyday lives? This core question has been an insufferable bane to philosophers and the opium of the masses for innumerable religions. It’s likely it has no one real answer.

We have made tremendous inroads -in spite of our limitations- towards a better understanding of reality. At the same time though, certain human qualities such as esthetics, art, and “value” still belong to a hazy area within the spectrum of human society. Somewhere in this realm CAM has created its own meaning with powers it doesn’t have as it stakes claim to things it doesn’t own – namely human “bonds”.

Human qualities (i.e.; fear, anger, happiness, love) form an integral part of the human condition and who we are. Though they may be as hard to pin down as an electron orbit, they contribute to how humanity relates to the world as well as how one individual relates to another. What has all this discussion got to do with social networking?

The importance of interconnections

Richard Dawkins in “An Ancestors Tale” noted that -to some degree- evolution rhymes, patterns repeat themselves. From the gene to the cell and beyond, there is a thread of constant interplay occurring that allows for differing levels of connection. This can be observed throughout the interdependent ecological scheme of life on this planet.

Zoologically speaking, one of its most elaborate versions seems to come in the form of multicellular animals. Here the tightness of interaction (along with the need for a nervous system) seems to have produced a unique form of interconnection. This is a pattern that can be loosely followed from cells that make up organisms to organisms that make up larger groups, herds, to even human societies.

It seems that this repeating phenomenon of networking gives rise to many of the emergent qualities resulting from interconnectedness in humans. For example, phenomena such as consciousness, art and “morality” may be some of the hard to quantify byproducts of networking that are tied to clearer evolutionary mechanisms (i.e.; kin selection, altruism). That these qualities are hard to pin down doesn’t make them less important- especially when we try to understand what it is to be “human”.

The implications for gaining insight into the fuzzy realm of human interactions can have huge payoffs in medicine. For instance, much of what may be attributed to the placebo actually has to do with some of the spin off effects of social networking. This person to person interaction can have a significant influence on the quality of the human experience in medical interactions which can -in turn- positively impact health.

Much of the force and claimed power of CAM actually stems from these networking effects and not at all from the CAM method itself. If doctors better understand how these interactions occur and who they affect, perhaps many CAM modalities would atrophy and be thrown into histories trash bin- at least as medical therapies.

The always interesting Edge web site has a video of Dr Nicholas Christakis Professor of Medical Sociology at Harvard and Attending Physician at Mt. Auburn Hospital in Cambridge, Mass., discussing the remarkable properties of social networks, how they obey certain deep biological-like rules and the amazing capacity they have to spread many qualities including altruism, happiness, and even loneliness. These qualities seem to propagate in a way similar to “biological contagions” yet they are social aspects of human interactions.

This research takes the potential for social networks in medicine to new levels. According to his web site “This work takes seriously the contention that because people are inter-connected, their health is inter-connected. This work explores two aspects of social networks: the process by which they form ("connection") and the way they operate to influence behavior ("contagion"). Related work examines the health benefits of marriage and the consequences of spousal illness and widowhood. Other ongoing investigations consider the effects of neighborhoods on people's health, the biodemographic determinants of longevity, and the genetic bases for human behaviors. His past work has examined the accuracy and role of prognosis in medicine and ways of improving end-of-life care.”

Unlike the false magical claims of CAMs “humanity”, this research is based on solid research and science. If these properties are better understood, they could expand our ability to positively impact social networks. We inherently know that illness can indirectly impact others in addition to the ill individual -but we don’t know all the details and potentially miss out on an opportunity to effectively help a broader circle of affected people.

For example, Christakis evaluated how the illness of a spouse affected the healthy partner in the marriage and found that it is possible to identify individuals at greater risk for emotional stress and diseases of their own (mental health and substance abuse). This could allow for specific interventions depending on the circumstance that relieves the caregiver and minimizes the propagation of the negative social effects of what was originally a real organic medical disease in somebody else. This might seem like common sense, but studying its effects brings home the importance that medicine take social networks very seriously.

Part of what we understand as a “good bedside manner” has roots in being aware of these issues. By expanding our body of knowledge, it may be possible to formalize clear and effective approaches to the client/doctor relationship and teach aspiring students solid techniques that seam the “human condition” more intimately into the tapestry of medical practice. That way, these important social interactions would be less prone to false hopes and empty promises common in CAM while softening some of the “sharp edges” of modern medicine.

Christakis describes his research as follows “it is critical when you think of networks to think about their dynamics. A lot of times, people fail to understand networks because they focus on the statistics. They think about topology; they think about the architecture of the network. They think about how people are connected, which is of course incredibly important and not easy to understand either. While on the one hand the topology can be understood or seen as fixed or existing, on the other hand this topology is itself mutable and changing and intriguing, and the origin of this topology and its change is itself a difficult thing.

But here is something else: Once you have recognized that there is a topology, the next thing you must understand is that there can be a contagion as well — a kind of process of flow through the network. Things move through it, and this has a different set of scientific underpinnings altogether. Understanding how things flow through the network is a different challenge from understanding how networks form or evolve. It is the difference between the formation and the operation of the network, or the difference between its structure and its function. Or, if you see the network as a kind of super-organism, it is the difference between the anatomy and the physiology of the super-organism, of the network. You need to understand both. And they both interconnect and affect each other, just as in our bodies our anatomy and our physiology are interrelated.”

The implications of his work are somewhat reminiscent of the social “meme” concept that Dawkins originated and Blackmore is trying to legitimize. Whether these particular ideas reflect reality remains to be seen. The social networking scheme of Dr Christakis work though does appear promising. The potential benefits to understanding how social systems network and function in medicine can positively impact health on a broader more human scale (without CAM help). This is a good thing.

Vaccinations and “herd immunity”

2008-02-24T19:21:00.004-07:00

Cooperating to save lives

One of the more interesting phenomena in the realm of epidemiology is how infectious disease affects large populations. Though the patterns of morbidity and mortality will fluctuate, taken as a whole they tend to adversely impact certain subpopulations more than others. For example, the very young and very old can have higher rates of illness and death from many infectious disease.

The obvious benefit of vaccinating against certain diseases in all types of animals has been nothing less than spectacular and revolutionary. From human Small Pox to Canine Rabies, the resulting eradication or reduction of disease exemplifies the power it has had to positively impact health- especially in many of the most susceptible groups. In addition to the obvious effects of protecting an individual from a disease, vaccinating whole populations has another powerful effect.

By preventing the spread of infection, vaccination can reduce and sometimes eliminate the risk of disease transmission in general -otherwise known as herd immunity. Dr Panagiotopolulos of the Institute of Child Health in Athens (Egypt) defines herd immunity as “The indirect protection from infection of susceptible members of a population, and the protection as a whole, which is brought about by the presence of immune individuals.” This means that, for example, in addition to having the ability to protect individuals from a certain disease, vaccinating a population incurs another level of protection -like an umbrella- and blunts the propagation of the disease. Many people are vaguely aware of this property, but don’t realize just how crucial it is in any cases for providing optimal protection.

This phenomenon can be described mathematically and provides the theoretical foundation for many of the herd immunity effects observed in real vaccination programs. An infection will usually spread via the “mass action principle” and is a function of the number of susceptible individuals. The equation is described as follows:

C_t+1/C_t = f (S_t), where C is the number of infected cases, S the number of susceptibles, t a given time period, t+1 the next time period. (This can also be expressed as: C_t+1 = S_t C_t r, where r is a transmission parameter¹).

What is so interesting about this equation is that it can help describe the dynamics of how infections spread throughout populations. Dr. Panagiotopulos notes “ It was introduced in the 1900’s and helped understand the dynamics of epidemics of diseases like measles: as the infection spreads during an epidemic, the number of infected cases in each successive time period initially increases while the number of susceptibles in the population decreases; therefore, there will be a point when susceptibles become sparse and the number of new cases in each successive time period decreases; and, finally, susceptibles are so scarce that there is no more than one new case for each case in the previous time period, and the epidemic fades out although a number of susceptibles have not been infected.”

Several potential effects can be gleaned from the movement of diseases through these populations and are usually related to the beneficial effects of vaccination. In general, the propagation of diseases are either blunted or even stopped, especially if a large part of the population is protected (herd immunity). However, there can be adverse effects (“perverse effects”) in some cases and these are dependent on the specific disease in question and the level of protected vaccinates.

For example Rinderpest in Africian cattle, Chicken Pox and Rubella in humans have peculiar characteristics that require special consideration. Rinderpest vaccination can be more targeted to focal outbreaks due to a synergistic herd immunity that makes immunizing the hold population less beneficial. Rubella, if vaccination campaigns are less than ideal, has the unfortunate characteristic of protecting one group while actually placing another at higher risk than before.

In these cases, it is vital that other factors are taken into account before implementing broader vaccination campaigns. Of course, this is a point that anti-vaccination advocates get spectacularly wrong as they misrepresent this particular form of herd immunity (i.e.; claiming that all vaccines do this, or taking it out of context) and use this false knowledge to decry vaccinations in general.

One of the most important points to consider is that vaccination protocols need to cover a high percentage of populations to reduce complications in disease dynamics –especially in these special instances- to optimize the herd effect. In other words, a significant number of unvaccinates can put a larger population at risk². In the cases where it really matters, the selfishness of anti-vaccine advocates can directly cause harm to others.

The bottom line is that herd immunity is an extremely potent natural phenomenon that provides effective protection –sometimes even the eradication- of many diseases. The implementation of vaccination campaigns need to be realized with care and preparations made so that the threshold of proper herd immunization levels can be reached. Vaccines protocols can be modified as other factors might present themselves (synergistic immunity as in the Rinderpest case).

With people, the best results seem to come with cooperative efforts (there may be -though a very touchy subject- a place for obligatory vaccines in some cases). Depending on the country, different educational and culturally sensitive strategies may improve the initial conditions for starting vaccination programs. Perhaps similar strategies may appease some in the anti-vaccine crowd in the US, though many in this group seem heavily biased against science and reason- at least when it comes to vaccines.

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(1) Dr. Panagiotopulos adds "The latter expression explains the name of the "mass action principle", which was given by analogy to the "law of mass action" in chemistry, according to which the velocity of a chemical reaction is a function of the concentrations of the initial reagents."

(2) Those small number of individuals who can not be vaccinated for whatever reason (i.e.; illness, immune compromise) would be theoretically protected indirectly through the herd effect but this is not meant for other wise healthy groups that refuse vaccinations (i.e.; for cultural or belief related reasons) and this can be a big obstacle.

Cats, toxoplasma and shizophrenia

2008-02-22T20:05:00.007-07:00

On biological complexity

A recent article in the February publication of DVM news magazine (a veterinary multimedia news source) discusses a study that linked a cat parasite; toxoplasma gondii, to the risk of schizophrenia in humans (affects about two million individuals a year or 1% of the US population).

This story is interesting because it illustrates just how interrelated and messy the world of life can be. It also exemplifies just how deeply a parasitic organism can penetrate into a larger ecosystem. By utilizing differing mechanisms to weave a tangled web toxoplasma gondii has become so enmeshed with warm-blooded animals and their environment that it would be extremely difficult or next to impossible to eradicate- and you thought politicians were bad!

The study the article refers to is discussed in the American Journal of Psychiatry and is titled “Selected infectious agents and risk of schizophrenia among US military personnel.” It forms part of an increasing number of studies that seem to be finding a possible association between people exposed to toxoplasma gondii (based on collected serum samples) and an increased risk for developing schizophrenia.

This particular study stands out in that it is larger than most, serum samples were collected in many cases before a diagnosis of schizophrenia was given and the subjects (military personnel) could be clearly compared with non-schizophrenic subjects from the same population. Though the link was small and there are some important confounding factors, combined with other studies these results shed some light on one possible infectious trigger to schizophrenia in predisposed (genetically?) individuals.

Notes on T gondii

Toxoplasma gondii is a well known ubiquitous intracellular parasite that has a rather complex and fascinating life cycle involving a variety of intermediary hosts (i.e.; pigs, goats, insects, humans, and chickens) as well as the environment (i.e.; water and soil). Felines are definitive hosts, which mean this is where toxoplasma will eventually sexually reproduce and form the oocysts that can infect other organisms on a journey that eventually takes some back to infect other cats.

In humans the CDC notes that it is known as one of the most common human infections in the world affecting over 500 million people. In the US it is the third leading cause of death related to food borne illness. Though about 60 million people in the US carry the parasite, most healthy individuals have no symptoms although pregnant women and imuno-compromised people are at higher risk for problems.

Infected cats usually shed oocysts soon after weaning and only for a short time. Though oocysts shed from infected cats spread the illness, the most common form of exposure in humans is through the ingestion of raw or undercooked meat (usually pork, goat, and lamb). Interestingly, there is no correlation between increased toxoplasmosis and cat ownership (there are a couple of studies that seem to relate adult schizophrenia and childhood exposure to cats in the household- not enough epidemiological power to make anything out though).

Because this organism is so common and the infection to humans is usually between intermediaries and not cats, it turns out that simple hygienic measures do the most to minimize problems. Feeding cats cooked food, cleaning there litters every day, reducing stray populations are some effective measures to reduce infection and environmental contamination. In humans eating cooked meats (and pasteurizing goats milk), cleaning ones hands after outdoor activities such as gardening, covering children’s sandboxes and controlling insect mechanical vectors (i.e.; houseflies, cockroaches). It should be noted that the biggest risk of oocysts exposure is in warm, moist, or tropical climates and lower in arid and frigid areas of the world.

The bigger picture

The January 2008 American Journal of Psychiatry editorial Alan Brown MD, MPH suggests that the idea parasitic infections can play some role in psychological diseases is not as strange as it sounds and does have parallels with other infectious disease processes.

Dr Brown notes that “Authorities from several diverse disciplines, including infectious disease, neonatlogy, pediatrics, neurology, and obstetrics and gynecology have long known that infections during prenatal and postnatal life have many neuropsychiatric sequelae, including behavioral problems, mental retardation, learning disabilities, and mood alterations.”

Improved data bases are allowing for more refined statistical analysis and seem to be finding associations between “prenatal exposure to influenza, toxoplasma gondii, genital/reproductive pathogens, and immunologic disturbances with an increased risk of schizophrenia.” Though still in its infancy, there are animal model studies that also support a link between behavioral anomalies consistent with what is seen in schizophrenia and “anti-viral like” inflammatory responses. So, the association with infectious disease and schizophrenia, if it exists, is not due just to a feline linked parasite.

If the body of evidence eventually indicates that infections do in fact impact schizophrenia in some cases then preventative measures as well as different treatment approaches could be used to reduce this mental illness in some people. Dr. Brown notes that “several infections that have been associated with this disorder can be effectively treated with antibiotics and prevented by vaccination and by minimizing the occurrence of risk factors for these infections.” That is the good news.

This is only a small part of the picture as further epidemiological, molecular genetics, genomics, brain imaging and human developmental (looking for precursors) studies expand researchers’ ability to discover new factors involved with schizophrenia risk as well as enhance their search for new treatments.

Though informative, these findings could easily be misconstrued by many who don’t have a biological background as an indictment against our beloved pet cats. It doesn’t emphasize that though toxoplasma has “chosen” felines as its definitive host where it reproduces sexually and sheds its oocysts, it is in fact an organism that takes advantage of many other animals and environmental factors –as intermediary hosts- in an elaborate “macro- bio-ecological” parasitic relationship.

These overlapping characteristics are the M.O. of innumerable organisms from viruses to larger organisms and illustrate how some of them don’t work under our taxonomic classifications- species are more blended from their viewpoint. Therefore it behooves people to take the bigger picture into account, use common sense –to have a “situational” awareness of the world around us- and most important remember that cats still rule!

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Ref:

Greene E Craig. Infectious disease of the dog and cat (3^rd edition). WB Saunders. Philadelphia, Pennsylvania. 2007

Niebuhr, D.W., Millikan, A.M., Cowan, D.N., Yolken, R., Li, Y., Weber, N.S. (2007). Selected Infectious Agents and Risk of Schizophrenia Among U.S. Military Personnel. American Journal of Psychiatry, 165(1), 99-106. DOI: 10.1176/appi.ajp.2007.06081254

Transforming Data

2008-02-20T11:37:00.001-07:00

glimpes of evolution in the information age

Hans Rosling is founder and director of Gapminder, an interesting non-profit venture that promotes sustainable global development. He has breathed life into the world of numbers and managed to do what many thought impossible.

By developing a software program named Trendalyser he was able to “unveil the beauty of statistical time series by converting boring numbers into enjoyable, animated and interactive graphics.” The ultimate goal is to access all of the existing and accumulating informational data bases of the world – which are critically important yet often stored in archaic and difficult to reach places- and transform them into large interactive pools of information that display in incredibly useful formats.

The ability to get more out of the data is truly astounding and has global implications in developmental, economic, health, environmental and social sectors just to name a few. An example of what this technology offers can be seen in Roslings 2006 discussion “debunking the myths of the world.”

The potential for evaluating, examining, and understanding statistical information is staggering. In this way, better decisions and more effective solutions could be implemented. For example, trends in medicine could be tracked and correlations made that favor optimal health thereby improving our understanding of what does and doesn’t work.

These trends could be noticed quicker and targeted more precisely with much more nuance (i.e.; what subpopulations respond to what therapies). This could have a significant impact in science and evidenced based medicine in the near future and promises to make life easier for practitioners striving for the best medicine.

On a related note, there is a bourgeoning new generation of web based services in human medicine that promises to revolutionize how medicine is practiced. The ScienceRoll site has an excellent review of the possibilities.

Should Complementary and Alternative (aka Integrative) Veterinary Medicine be taught in vet schools?

2008-02-19T14:24:00.011-07:00

The short answer is NO.

The core of today’s veterinary education has, for good reason, been built upon a vast web of interconnected and established science. With this in mind, the belief in the need to teach Complementary and Alternative Veterinary Medicine (CAVM) at veterinary schools immediately brings to the fore a looming dilemma.

Science is a powerful filter and provides a foundation from where medicine has discovered truly effective therapies. It has proven an excellent tool for excising the useful from the useless (i.e.; statistical significance vs. fanciful testimony and tenuous beliefs). To date, science is the only way to assure that medicine stays on the straight and narrow and optimizes its effectiveness. Without it, no matter how well intentioned, the practice of medicine falls prey to a world of delusion and fairy tales.

Medicine develops and refines innumerable modalities and therapies based on accumulating evidence. Though this evidence may vary in robustness and quality it is always grounded in science. In general, you can’t skip over this basic filter and practice any kind of “medicine” that suits your fancy- that usually leads to the realms of metaphysics and belief.

The machinery for seeking and establishing effectiveness in medicine assumes the plausibility of what is being studied. If it is not a plausible modality the best the research can offer is often just garbled noise -equivocal statistical data- that is neither here nor there. This is something novice students are not being taught and herein lays the problem.

Medical education needs to emphasize critical thinking tools and teach aspiring doctors how to navigate within the depth of established science based medicine before tackling fringe areas such as alternative medicine.

If a student sees a CAVM modality as part of the curriculum of veterinary education the assumption is made –whether these young minds know it or not- that there must be something to this particular practice. It falls under the rubric of an accepted standard of practice and therefore is a part of general practice. This simply is not the case because if it were there would be no “alternative” in alternative medicine.

When it is implicit to students that academia tolerates alternative medicine as “just another way” you compromise these students science based education. Dr. Colquhoun points out that “Once any treatment is shown beyond doubt to be effective, it ceases to be ‘alternative’ and becomes just like any other part of medical knowledge. That means that ‘alternative medicine’ must consist of unproven treatments.” It is not the domain of academia to be teaching unproven treatments to young students.

Introducing unsubstatntiated non science based modalities and therapies that might have some plausible basis (acupuncture), no matter how scientific they might appear, to these aspiring professionals before they are ready to critically evaluate them is a bad idea. It opens the doors to a Pandora’s Box as other alternative medical paradigms (i.e.; homeopathy, energy medicine) will inevitably also demand a place in academia.

This is reminiscent of “teaching the controversy” of evolution that intelligent design advocates support so vehemently. This red herring demonstrates an alarming lack of actual scientific knowledge regarding proper methodology and smacks of dogma and pseudoscience.

Dr. Colquhoun points out an interesting observation with respect to the curious confounding of pseudoscience and science ("quackademics") in medical schools. He states that “All these outfits have two things in common. They all claim to be scientific and evidence- based, and none has produced any real evidence that any of their treatments work.”

This is one of the weaknesses to claiming that the CAVM offered in veterinary schools is being scrutinized under the framework of science. If they were, they would be pulled out of the cirriculum or possibly relegated to research. As noted though, you can't use evidence-based research very well when the underlying science is suspect.

In addition, the fact that CAVM has become a fairly popular practice among some people and practitioners outside academia is not an excuse to teach it in school. This is an appeal to popularity and gets medicine no-where.

It has been noted that veterinarians need to be more non-judgmental and not stigmatize CAVM; implying a rush to judgment and a bias against CAVM. In some cases, the implication goes; this may threaten a client/doctor relationship and could lead to the loss of clients who might move entirely to alternative medicine. Medicine needs to “adapt to changes brought about by societal influence” and the popularity of CAVM –another effective way of doing medicine- needs to be accepted, embraced, and taught in school. This is threading misrepresentation with populism- a dangerous mix.

Fallacious reasoning like this creates false realities and gives little credence to the ability of a skilled practitioner and the influence they can have on client/doctor relationships. The opportunity to communicate and teach science based medicine is taken seriously my many practitioners.

They feel obligated to create a comforting, supportive, and trusting bond that openly and honestly approaches the situation at hand. Practicing the best science and evidence based medicine they can goes hand in glove with this bond and most clients will respect that.¹

Though, there may be emotionally charged biases against CAVM at times, the fact remains that -for the most part- it is not science and it is definitely not a substantiated medical modality. Disregarding or not recommending CAVM if it does not fulfill the requirements of science and evidence based medicine is not being biased.

Learning how to communicate and interact empathetically with people is by far one of the most important skills a veterinary student can learn. This is what should be stressed more in university curriculums than teaching pseudo-science. On the other hand, future practitioners need the critical thinking tools and knowledge to clearly and dispassionately discuss why a given CAVM modality may not be the most ideal approach to a given problem. This can be done without creating the impression that CAVM is or should be an accepted part of scientific medicine.

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1. If a client elects to proceed with a CAVM modality then it’s their decision, and though sometimes difficult, practitioners should strive to continue working with these clients if possible and promote what is in the animal’s best interests.

Pet Foods: notes from the experts

2008-02-17T15:02:00.002-07:00

Towards a greater understanding (part 3)

The idea of government oversight has always been a bit of a touchy subject in the United States; a country known for an independent citizenry strong on "freedom of choice". This admirable quality though can sometimes create a lot of tension. The struggle to balance between allowing an indiscriminate free flow of goods and the need to protect the public has been the source of many regulatory headaches. Depending on the subject in question, there are varying degrees of expected government intervention the public expects.

For example, entertainment is one thing and medical care another. The intensity of control between the two is very different. Since the early nineteenth century society decided to filter a haphazard and dangerous quackery filled world of medicine through the tried and proven framework of science. Those practices that couldn’t pass muster (i.e.; homeopathy and bloodletting) fell out of favor or were disregarded. Though, unfortunately today there is a resurgence of non-science in medicine, this framework has worked extremely well in disseminating effective medicine to many more people than would otherwise have been possible.

This basic concept (though not nearly as tight as in medicine) is also utilized in the oversight of food safety for animals in the United States, but the current regulatory system is probably not what most people imagine.

Last years pet food recall illustrates some of the strengths and weaknesses of the US regulatory and inspection system for pet food ingredients. Laflamme notes that “There are issues at all levels: USDA issues in terms of guidelines and inspections, import issues, domestic issues, and, of course, pet food companies have their own standards for determining the nutritional value of the ingredients and tests for known contaminants...What happened in the 2007 recall was deliberate contamination of an ingredient from something that we wouldn’t even think to look for. There’s little that can be done if somebody wants to deliberately put toxins into a food, whether it’s for humans or pets.”

In other words, the current regulatory model was not looking for what McChensey described as a “strictly economic adulteration of a product.” He adds “The other thing is that pet food and animal feed are regulated under the adulteration provision of the Food, Drug, and Cosmetic Act. So, the presumption is that a company will make a product that is not adulterated or unsafe.” Though most companies will operate under these constraints there are no set regulations that require them to follow quality practices for “non-medicated feeds” which comprises almost all of the pet foods. So if there is a problem its “difficult to take action against someone because of a problem.”

On the other hand, regulatory agencies and regulations have a two pronged strategy. They are there not only to protect the consumer but as Roudebush notes “are there to protect the companies too.” He states that industry plays a critical role in helping to set up standards that protect them as well as the public. He uses the aircraft industry as an example; “every 5 years, a group that represents industry- airplane manufacturers, the government, academics- comes up with standards for lubricants that are used on commercial and private aircraft. Industry is important. Companies have the technological know-how and share that information, allowing industry as a whole to come up with the regulations that protect the users and also the companies.”

On a related note it is important to realize that neither the AAFCO nor the Pet Food Institute are regulatory bodies nor have they been created by the pet food industry. The AAFCO for example, is composed of regulatory people from all 50 states that among other things facilitate interstate commerce. Though they may contribute opinions about regulations they don’t have the ability to establish regulations.

The USDA is charged with regulating many food related products. For example, they have a person assigned to all slaughter plants that are making a USDA-regulated product. On the other hand, it’s the FDA- under the Food, Drug, and Cosmetic Act- that is ultimately charged with the oversight of the safety of imported ingredients into the US. McChensey notes that “The FDA does look at about 1% of the products crossing the borders...ultimately it falls to the company to make a safe product.”

Daritotle adds that “Most of the major pet food companies have been fairly vocal about the quality control in place and have quality-assurance programs accordingly.” And as Roudebush states “the reality is that most of us think if the company is reputable, then it is assumed that quality-control procedures are in place.” For the most part, this is true and a part of the combined effort it takes to produce a generally safe product.

But there are still plenty of holes and inefficiencies, especially in this era of increasing globalization, and it behooves the veterinarian and pet owners to be vigilant. Having a better idea of how things are set up helps us to perhaps find other more constructive solutions.

As we struggle to balance a full plate of sometimes contradicting issues (i.e.; the need to protect ourselves vs cost of that protection, freedom of choice vs limiting that freedom to choosing among safe products, cheaper vs expensive food ingredients) it all comes down to being well informed and finding ways to cooperate together.

Taken as a whole, cats and dogs in this country have the opportunity to be healthier and live longer than ever before. By working as a team, pet owners, veterinarians and others can successfully navigate these challenges and come up with excellent nutritional solutions for our beloved pets.

Cectic- The Comic

2008-02-16T20:27:00.000-07:00

Pet Foods: notes from the experts

2008-02-16T18:40:00.013-07:00

Towards a greater understanding (part 2)

There are many variables that go into making informed decisions regarding what to feed a healthy dog or cat. Having a solid veterinary/ client relationship forms the foundation from where information can be sifted taking into account each pets unique circumstance in order to come up with a reasonable dietary plan.

Among the most important issues with respect to pet food is that we have to make dietary choices based on the best science and evidence available and avoid the allure of unsubstantiated claims. The big challenge here is that things aren't always clear cut. For example dog food companies, whole food advocates, and purported alternative nutritionists all -in one form or another- fall under the sway of faddism, premature nutrient recomendations, consumer driven demands, and market pressures.

The more informed we are the better. If our information is balanced, dispassionate and accurate then picking a path through this quagmire is easier. With that in mind, we can go back to the Veterinary Forum nutritional expert panel for more interesting discussion regarding pet food and the state of the industry.

On ingredients

This appears to be one of the most pressing issues when it comes to some of the common general misunderstandings. Part of the problem stems from a general lack of basic skills in science and general nutrition which can impede a more nuanced perpective of this complex issue.

At least some of the details regarding food ingredients, preservatives, additives, and other constituents need to be understood enough so that prudent choices can be made by veterinarians and pet owners. For example, a pet food company might cut corners too much, or someone may claim a certain chemical additive is just poison. Armed with the right tools, a person could effectively analyze the issue at hand and make a rational more balanced determination of the problem or claim and what to do about it.

One of the interesting points mentioned in the discussion was that people in general seem to lose sight of the fact in spite of the huge number of available foods products on the market, animal needs have not changed too dramatically. Delaney notes “the nutritional needs of dogs and cats really haven’t changed. Yet, so many new products are being introduced. Veterinarians need to start by understanding the nutritional needs of dogs and cats and the individual factors that affect those needs.”

A rough analogy is that a shirt and jeans are always the basic and essential part of a teen’s attire. You can dress it up, loosen the pants, change the colors, add jewelry, or add whatever puffery the teen demands; but in the end the jean and t-shirt never goes away.

A detailed discussion of all the common components of food such as micro and macronutrients is beyond the scope if this post. However, we will touch on one topic mentioned by the experts on the panel as an example of some of the issues involved with food sources and pet food ingredients.

There is a lot of misunderstanding regarding the meaning of macronutrients in pet food. These are the main components of a diet and comprise the bulk of for example proteins, fats, and carbohydrates. Freeman notes “There’s so much misinformation about ingredients on the list. For example, lamb listed as the first ingredients is sometimes perceived as better than a by-product, which has become a frightening term to some people. Yet, some labeling might list the first ingredients as beef heart, beef liver, or beef lung without the word by-product.” This belies a very basic problem with the attitude and general perception of what an acceptable macronutrient might be. Daristole adds that “Consumers may not understand that most of the macro-ingredients in commercial pet foods are indeed by-products of the human food industry, not because they are bad for anyone but because of food preferences.”

If one stands back and thinks for a moment, it becomes evident that these are big issues and could be barriers towards comprehending nutrition at the most basic levels. Roudebush very eloquently reminds the panel that “My grandfather and father grew up on farms, and when an animal was slaughtered, all of it was used. There were no by-products. We have gotten away from that practice. People who are entering veterinary medicine today have less of that background. Then, so much of it is cultural in the United States, where people are less accustomed to having contact with where our food comes from and how it is used.” This is not really a yearning call for days of old. It is an important observation that requires our attention as we try to navigate through the issues of pet food ingredients.

On the other hand, a promising and positive development has been the increasing consumer awareness of “greener” and more wholesome (organic) food ingredients as well as concern for how our food sources are handled and treated. This opens the doors to perhaps a more balanced approach to a host of agricultural practices and animal husbandry techniques.

Roudebush states that “The AAFCO manual defines organic as a formula feed or a specific ingredient within a formula feed that has been produced and handled in compliance with the requirements of the USDA natural organic program.”

The problem seems to be, that due in part to a “disconnected” consumer, terms and descriptions like “organic”, “nature”, and “human grade”(1) that supposedly denote some type of superiority either in production methods or nutritive value over “conventional” methods turn out to be more semantics than anything real.

In other words, we shouldn’t throw the baby out with the bath water when it comes to evaluating the pet (or human) food industry. Though a laudable ideal, the organic industry has its own “foot print” to contend with. The book “An Omnivores Dilemma” is a good introduction to the realm of food production and the challenges of feeding the masses well while balancing food gathering and distribution.

Raw, commercial, and homemade pet food

In and of itself, the concept of raw food diets is simply another way of delivering food to pets. The problem is when people claim that it is a superior method for feeding dogs and cats. Though still a fairly rare practice in the US (more common in Australia) it is on the rise and there are several companies that distribute different types of commercial raw food mixes.

According to Freeman “ there are no proven benefits linked to raw diets, yet there are multiple studies showing nutritional imbalances, both in commercial and homemade raw diets, and multiple studies showing contamination in the vast majority of raw diets. There is a risk for the people in the household but also for the pets themselves. So, in terms of raw-food diets the risks far outweigh any potential benefits.”

Freeman, Curchill, Laflamme and Tefend note that there are more reports of nutritional deficiencies and excesses with raw and homemade diets than with many commercial diets. Roudebush notes that no AAFCO maintenance feeding trials have been done on any homemade prepared diets and this is a problem when looking for evidence.

Laflamme mentioned that there have been two independent studies that “compared dogs fed commercial pet food with dogs fed homemade diets. The study (1999) I’m most familiar with involved 1,000 dogs in three different groups…There were significant differences in terms of health problems being greatly reduced by the feeding of commercial pet foods.”(2)

On the other hand, this is not to say that home made foods in general don’t have a place “on the table” and indeed can often be a critical part of the nutritional puzzle for some pets and for any owner willing to put in the effort needed to do it right.

However, they need to be complete and balanced and Churchill cautions that “I frequently see well meaning owners make substitutions to the recipe, until over time, ‘diet drift’ occurs, and the diet may no longer resemble the original formulation.”

McChesney and Churchill also add that salmonella risk is higher when dealing with the day in/ day out processing of homemade and especially raw diets and extra care needs to be given for maintaining routine hygienic standards. Cooking homemade food does not significantly diminish its dietary quality (problems with heat labile substances can be corrected) and reduces the risk of food borne disease.

Again, it is more advantageous to take note of the evidence, science, and -to a degree- the opinions of experts in the field. No, it’s not perfect and problems abound, but the ability to make the best decisions regarding what to feed our pets lies here and not on assumption, hearsay, what we’d like to believe.

(Part 3 touches very briefly on the recall and regulatory issues)

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1) Roudebush notes “According to AAFCO the term human grade cannot be used anymore. However the term continues to be used on websites, in brochures and on some labeling.”

2) Interestingly, there is an often repeated study alternative veterinary nutritionists fondly allude to that claims to support raw foods or the broad use of nutritional supplements. It is an old 1940’s report known as “Pottingers cats” that seemed to evidence multi-generational deficiencies in cats with cooked or “processed” foods. The more likely reality was that the affected cats suffered from other confounding issues such as a species specific sensitivity to taurine deficiency, a heat labile protein, that when added to a cooked diet corrects this problem.

Pet Foods: notes from the experts

2008-02-15T16:33:00.007-07:00

Towards a greater understanding (part 1)

There is a huge body of information regarding pet nutrition that plays loose and fast with the facts. With so much misrepresentation floating around out there, getting a clear understanding of an already complex issue becomes nearly impossible. This rather confused state of affairs has to do with a whole assortment of issues some relating to pet food sourcing, preparation, and quality control, others to changing consumer expectations. These are not necessarily all bad things; especially when it comes to owners who want to feed their pets the best food they can get and afford.

The pet food industry is an extremely competitive and active field. For example, in the past three or four years 1,000 pet food products have been introduced into the US market.This has resulted in a dizzying surge of pet food nutritional claims, a plethora of new ingredients, and advertising gimmicks that cater to an increasingly discriminating pet owner.

Trying to evaluate all these pet foods is indeed a formidable task for veterinarians and pet owners alike. This is made even harder when many people lack the knowledge or tools to navigate all the crazy details in the constantly changing world of nutrition. Though it is hard to select a pet food with all these choices (including home-made), the bottom line is that veterinarians and pet owners really want to select the most appropriate dog or cat food for their own individual pets.

The good news is that it can be done- at least reasonably well. It all comes down to education, education, education. For example learning how to read labels, understanding ingredients, where they come from, why they’re used, and how pet food is regulated would go a long way towards getting the most out of this experience.

A discussion

A recent round table discussion among several veterinary nutritional experts sponsored by Veterinary Learning Systems Veterinary Forum discusses many of these concerns. These specialists offer up an interesting glimpse into many of the challenges clients and veterinarians face when trying to make sense of the confusing world of pet food and offer up some sound advice regarding pet foods.

One of the most important issues they note is that there needs to be a solid foundational client/doctor relationship from where –as a team- the best science and evidence based choices for a particular pet can be considered and actually implemented. With respect to food choices the matter might actually be a bit easier with a sick animal than a healthy one. There are often clear therapeutic choices and perhaps a better idea of a pets’ nutritional needs in the case of illness.

On the other hand, a healthy animal poses a problem because of the hundreds of choices out there. In this case, a routine healthy visit can become a frustrating experience when it comes to recommendations. Both doctor and client need to be invested and interested in focusing on these nutritional issues because it can vary from pet to pet, region to region, and pet food to pet food. A place to start is to check the label and make sure the pet food in question was subjected to AAFCO feeding trials (and not approved only through its nutritional profile).

According to Dorothy Laflamme, DVM, Phd, DACVN “Animal feeding tests, according to AAFCO, are certainly a greater level of assurance , but even that , in my opinion, is probably a minimum level. Those studies will identify gross nutritional deficiencies. But we’re formulating diets that we anticipate to be fed for years- sometimes the lifetime of a pet- and you have to look at an AAFCO feeding trial as an important component, but only one component. You also have to look at the history of the company, and the research it does. Veterinarians need to complete diet histories for all their patients to establish a pattern of diets that are associated with healthy pets and diets that are associated with pets that aren’t doing quite so well.”

This is where the doctor/patient team becomes a vital clearing house for the the endless streams of a veritable media and propaganda blitz from pet food companies, tips from some misguided pet shop clerks (most do their objective best), and alternative nutritional “experts” (veterinarian or otherwise) pushing unsubstantiated theories. Add to that a plethora of self prescribed nutritional supplement gurus ready and willing to steer the topic of nutrition into a world of conspiratorial accusations (of “the man” – big industry- big pharma) against the pet food industry proselytizing about unproven claims of superiority for their “pet feeding paradigm” and you just want to pull your hairs out! That said there are many people out there genuinely interested in the pets’ health and act as objective support to the client doctor team.

Even without the confusing blather of misrepresentation regarding pet food, it can still be really difficult to hone in on the “ideal” diet for a pet. Each animal has general as well as unique requirements that play into the equation. For example, some pets are over-weight, others extremely active, and yet even others prone to food intolerances.

Labels can be difficult to read and do not say much about actual nutrient levels. They do give a general idea of the list of ingredients (ordered by weight), crude protein, and crude fat percentages for example, but they don’t give other important details. For example Sean Delaney, DVM, MS, DACVN notes “I would provide the proximate analysis, meaning the protein levels and then, by difference, the carbohydrate level. Being able to calculate and compare that information can be useful…My favorite example is Fancy Feast- the fat level among different flavors can range from 25% up to 55%. That’s a huge difference from a physiological point of view.”

Another example is that reduced calorie diets are often based on a particular original formulation and may not be what you think. Daniel McChesney, Phd adds “if product X started with 2,000 calories, a reduced-calorie diet must be less than 2,000 calories. However, if another brand also claims to be a reduced- calorie but started with 3,000 calories, the calorie intake would be substantially higher than that found in product X.” Though not the norm for now, adding some calorie information to the label would help the doctor and client along with their decision.

Keeping an inventory of the available pet foods in the area help veterinarians establish a solid baseline from where to establish recommendations with their clients. Laflamme states that “By completing dietary histories on all patients and then considering additional pertinent information from pet food manufacturers, veterinarians can identify a number of different foods they can feel confident recommending in different price categories to meet the financial capabilities of all their clients.”

Fortunately, there is usually a range of acceptable products (and recipes) to choose from. Pets today can be offered very good and balanced diets with the help of their concerned owners and veterinary care givers. In the end, it goes back to a good doctor/client relationship and old fashion education.

(Part2 touches on ingredients, raw food diets, home prepared diets, last years recall, and regulatory issues)

80th Skeptics' Circle: Valentine Edition

2008-02-14T12:08:00.001-07:00

Check out Bug Girl's Blog for your skeptic fix....

Magnetic therapy update (static)

2008-02-13T16:07:00.014-07:00

in people and animals: still a bust

A recent 2008 article in Livescience discusses the apparently promising outcome of a new study on static magnetic therapy in rats. The author notes that “Thomas Skalak of the University of Virginia found that static magnets reduced swelling by up to 50 percent in the tiny hind paws of rats. Skalak published his results in the November issue of the American Journal of Physiology.”

The actual study “Chronic static magnetic field exposure alters microvessel enlargement resulting from surgical intervention” used neodymium static magnetic field (SMF) magnets or weight-matched shams that were affixed to murine skin fold chambers on rats and observed the adaptive microvascular response over seven days. Neodymium (NeFeB) rare earth magnets are the strongest static magnets available and seem to be the favored magnet type in much of the research.

According to Skalak using static magnets (these had a strength of 700 gauss -“10 times stronger than a refrigerator magnet”) he was able to observe a significant reduction in “bee sting or sprain level” swellings. The impact was strongest when the magnets were applied immediately to the affected area.

Among the possible mechanisms for the observed results, Skalak mentions was the possibility that these magnets may alter calcium channels in muscle cells thereby modulating arterial dilation; an in vogue theory in magnetic theory circles. The study states that “These results suggest that chronicSMF exposure can alter the adaptive microvascular remodelingresponse to mechanical injury, thus supporting the further studyof chronic application of SMFs for the treatment of vascularpathologies involving the dysregulation of microvascular structure.”

This study may or may not yield interesting information as it is analiyzed in more detail, but even added to the paucity of positive studies that have evaluated magnetic therapies (including static as well as other magnetic configurations and field strengths) it still leaves room for serious doubt on whether magnets in general really work for these applications.

To his credit, Skalak notes that this study only looked at one specific field strength for a specific swelling at a specific distance below the skin therefore any implications for the efficacy of the plethora of magnetic products on the market should be discouraged.

Other studies seem add to the confusion. For example, a 2006 study looked at the effect of SMF magnets on healing rat colons. These magnets were made of NeFeB and with between 390-420 gauss in strength and the shams were non-magnetized NeFeB bars similar in weight and size. The authors found no difference in effect and that “The study results suggest that static EMF has no effect on experimental colonic wound healing in the rat.”

Interestingly, a critical review was published a little before Skalaks' study in the Evidence-based Complementary and Alternative Medicine Journal. It found that the existing studies on SMF could not be reasonably tied together due to a number of confounding variables including differing magnetic field strengths, magnet dimensions, durations of application, and distances from target tissue. They conclude “Our findings highlight theneed to optimize SMF dosing parameters for individual clinicalconditions before proceeding to a full-scale clinical trial.” In essence, there is too much fog in the research; it is not clear exactly what is being done to what tissue and with what magnets to even establish whether these things even work on humans- and this from a CAM journal no less (however nice the title sounds).

This is consistent with the NCCAM “Research Report” that states "Scientific research so far does not firmly support a conclusion that magnets of any type can relieve pain. However, some people do experience some relief. Various theories have been proposed as to why, but none has been scientifically provem." Though this equivocation is typical for NCCAM ( a never admit defeat line) they finally acknowledge that the "results of many trials may not be truly meaningful. Most reviews stated that more and better quality research is needed before magnets' effectiveness can be adequately judged." And even add that "The U.S. Food and Drug Administration (FDA) has not approved the marketing of magnets with claims of benefits to health (such as "releives arthritis pain"). The FDA and the Federal trade Commission (FTC) have taken action against many manufacturers, distributors, and web sites that make claims not supported scientifically about the health benefits of magnets."

So what are we to make of all the activity and discussion over static magnetic field magnets? For now, nothing at all- there is no compelling evidence that SMF magnetic therapies work in the clinical setting. Even the supposedly intriguing microvascular rat studies are too far removed and too specific to give any support to current SMF magnet therapies or justify the billion dollars spent worldwide by the public on magnets that don’t help heal anything.

On plausibility

In spite of some vaguely promising results in some studies using certain magnets, just how plausible is this whole magnet idea?

In a January, 2006 editorial comment in the BMJ professor of physics Leonard Finegold sums up things pretty well stating that “Extraordinary claims demand extraordinary evidence. If thereis any healing effect of magnets, it is apparently small sincepublished research, both theoretical and experimental, is weightedheavily against any therapeutic benefit. Patients should beadvised that magnet therapy has no proved benefits. If theyinsist on using a magnetic device they could be advised to buythe cheapest—this will at least alleviate the pain intheir wallet.”(1)

On that note, it behooves us to briefly look into some of the physics involved with magnets. Living bodies are basically made up of inert materials and are described as diamagnetic meaning they are not only un-attracted to magnetic fields, they are actually weakly repelled by them. This physical phenomenon does not seem have any obvious tissue effects with respect to the supposed clinical effects of SMF magnets in spite of the number of theories that claim they do.

The earths' magnetic field is at the strength of just less than half a gauss whereas most magnetic therapy magnets usually have a field strength of several hundred gauss. The magnetic filed strength of a standard MRI of around 10,000 gauss (one tesla) causes no obvious changes to people or animals- nobody explodes or is shot through the air as you might expect if that were so.

By the way, it takes powerful electromagnets of around 160,000 gauss (16 telsa) to see magnetic effects begin to counter balance some modest gravitational forces². At this level, if you put small objects such as water droplets, flowers, and little frogs within this type of magnetic coil you can actually “levitate” them (you need a lot more power than 16 telsa to make a human float)! This interesting information shows how small the effect therapeutic magnets are compared to other devices (some used routinely) where one would expect to observe the same or related effects as those claimed to occur with SMF magnets.

It seems the researchers hopes are pinned on some as yet undiscovered effect for example such as those mentioned to purportedly effect ions or channels that may influence such larger events as inflammation or vascular function. The problem though is no real and repeatable clinical effect has been either demonstrated or established!

More problems for magnets

Medical researcher Bruce Flamm comments on he and professor Finegolds 2006 BMJ review of magnetic literature which found little supporting evidence for magnetic efficacy. He notes that though the human body might be affected by electromagnetic fields of electromagnets (due to the generated electricity- known to affect tissue) it does not seem to be affected by magnetic fields per se. For example, the iron in blood is not composed of ferromagnetic iron and is not affected by a magnet. In addition, in spite of the above mentioned rat study and calcium channels; several other studies show no effects on blood flow from static magnetic fields.

Flamm notes the bottom line is that even if “for the sake of argument, what if some effect of magnets on human tissue could be demonstrated? What is the likelihood that it would be a therapeutic or healing effect? Probably slim to nil. By analogy, consider chemical compounds. The number of known chemical compounds is on the order of ten million. However, only a handful have ever been shown to have any therapeutic effects. Yet millions are toxic. It would be most unwise to eat or drink anything found on the shelves of a typical chemistry lab. If a magnet had an effect on human tissue, there is no reason to believe that it would necessarily be a healing effect.”

Veterinary medicine is replete with its own assortment of mostly SMF magnetic paraphernalia. They come in a variety of forms such as blankets, pads, bandages, and bedding to fit and “treat” all animals large and small. Depending on the company, these magnets are constructed to have alternating numbers of poles (Some claim the more alternating north and south poles the stronger the effect. In reality though this magnifies a magnets stick power it shortens an already short range).

Some alternative medicine (CAVM) veterinarians extol the possible benefits of magnetic therapy either by itself or as an “integrated” modality with other medicine even if they are not sure how they work.Others seem to support their use while attempting to distinguish between "good and bad" magnets and discuss differences in static versus pulsed electromagnetic field therapies (PEMF- breifly touched on in the footnote below) .

The problem is static magnetic therapy is an implausible modality and as far as we know doesn't work. Researchers are not even sure they can find a way to make it work! This is another CAM modality where the claims and beliefs in “healing” powers have far outstripped any of the evidence that it actually does anything but make people poorer.

This wise old piece of advice goes a long way: Its a good thing to keep an open mind…but not so open that your brains fall out.

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(1) On the other hand, that same month a research fellow named James Teo noted "Not all magnetic devices are equally non-efficacious. Magnetic fields from bracelets and such may have little effect on human tissue, but it would be wrong to discount all effect on human tissue...There is a strong research literature using transcranial magnetic stimulation (TMS) to induce neuronal firing in the brain and spinal cord.. while no large clinical trials have been done yet, it is crucial that not all magnetic therapy should be discounted."

This comment alludes to another form of magnetic devices used described as pulsed electromagnetic field (PEMF) therapy (worth a future post). Though still questionable, these magnetic devices use electromagnetic pulses of varying telsa strengths to generate electrical fields. The effect, if any, probably has to do with the electrical feilds and not magnetism. Some people use pulsing electromagnetic fields in people, horses, and other animals applying varying frequencies and pulses- the exact intensities of which are determined by blind intuition rather than hard facts.

Though there may be some merit to this unproven theory, it is important to remember that cells and tissues seem to respond to a variety of different electrical stimuli implying that specific impulses, sequence, and cell types might play into any real response and what might work one place won’t somewhere else. Many proponents of PEMF consider it a promising future modality- time will tell.

2) http://csicop.org/si/9807/magnet.html

Other Ref:

Ramey D, Rollin, B. Complementary and alternative veterinary medicine considered.Iowa State Press.Ames, Iowa. 2004

neodyme

Magnetic therapy in vet practice

For the love of animals…for the love of us

2008-02-12T15:19:00.001-07:00

understanding the nature of things

One of the greatest lessons Charles Darwin left us was that, as life goes, we are not the center of the universe. He taught us to take a step back from our busy lives and open our eyes to a reality staring us in the face. The message was –and is- breathtakingly simple: Humanity is not the pinnacle of the biological world; it is only a small part of a vast living landscape. Never before, or since has such a powerful lesson in humility been given to us as a species.

This is a lesson that many seem to be forgetting today; an age where there is an increasing disconnect with nature. It may be that we are letting slip from our grasp the very thing that might save us. Here in the “greatest” democracy the very concept of an educated citizen is fading (at a time when we need him/her the most) in an era of dogmatic beliefs, inflexible attitudes, and myopic compassion

Children are graduating from schools with minimal science knowledge, weak critical thinking tools and their hiking shoes rot in the closet as a virtual world increasingly clamors for attention. Not that it is all bad. Fantastic new and novel horizons are opening up before us. It could be that this is just the way of things as humanity stumbles along, but this schism between us and the rest of the real world is not healthy.

The fact is, our stumbling should be done with a little more balance. For example we could be better connected to our origins, our history, and our environment. There is something to be said for the outdoors - “rolling” in the dirt, smelling the smells, watching the ways of plants and animals. We hear this call all the time but it is more urgent now than ever before.

Dr Miller, a veterinarian and horse trainer, in a poignant article “And they call us horse lovers” laments a loss of genuine connection with animals and nature- even with the ones we live with. He notes “How many people who sincerely consider themselves to be "horse lovers" wean foals at three months of age, or even earlier, which nature never intended? How many horses, a gregarious species, spend their lives locked in box stalls? How many horses in the U.S.A, like so much of our human population, are damaged healthwise by excessive nutrition? Such abuses exist in every breed, every discipline, in every equine sport. We need to step back and analyze what we are doing.”

This is a call for a gentler approach to animal husbandry that goes back to, in this case, observing and emulating a little more closely a horse’s natural behavior. It is a train of thought can be extended out to many other human and animal relationships.

The problem though is that many people are increasingly losing their grip on the reality of nature that Darwin unfolded before us. There are those that proselytize with imagined righteousness and confound and confuse the rest of us with self aggrandized claims of “the truth.” For example, animal activist groups that pretend to offer salvation to “enslaved” animals really don’t. They only manage to threaten the very lives of genuine researchers like Dr London. * Whatever legitimate concerns and credibility these groups might have had has long ago washed away along with their blind runs at home grown terrorism.

This sad example, though extreme, reflects a disconnect between many people and the world around them. They might go too far; seeing animals through a narrow filter that mixes human traits, emotions, and belief into an unnatural vision that completely misses the point. Granted we all do this but taking it too far becomes destructive.

It is said, that to truly understand ones connection to the world, you need to gather your own food from the source at least once, rear an orphaned animal, and grow a plant from seed. In this way, the connection between sacrificing and sustenance is seared into memory. This creates a powerful bond to the world around us and makes navigating the present sea of dogma a bit easier and our relationship with the life around us clearer.

The world continues to move on and -one way or another- history will inevitably unfold. Whether or not humanity can achieve any level of sustainability has a lot to do with understanding and accepting our place here. Whether this happens or not is up to all of us.

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* Dr. London eloquently defends her work towards understanding addiction.

Happy Darwin Day

2008-02-12T06:42:00.000-07:00

He opened our eyes to the world as it is...

...this is indeed a gift among gifts...Thank you Charles Darwin