Week in review 13/11/2012

Here it is guys, some more tidbits from the world of science and skepticism;

More Than a Quarter of St. Louis EMTs Don’t Get Flu Vaccines, Saint Louis University Study Finds

http://www.newswise.com/articles/more-than-a-quarter-of-st-louis-emts-don-t-get-flu-vaccines-saint-louis-university-study-finds

A Saint Louis University study reveals that more than 25 percent of St. Louis area Emergency Medical Technicians (EMTs) do not get vaccinated against the flu.
Published in the American Journal of Infection Control, the study indicates that the seasonal influenza vaccine compliance for St. Louis EMTs still remains far below the 90 percent target outlined by the U.S. Department of Health and Human Services’ Healthy People 2020 program…

…The study, funded by the Saint Louis County Department of Health, gauged the seasonal and H1N1 influenza vaccine compliance and whether or not St. Louis EMTs planned to get vaccinated. It also measured the attitudes and beliefs of EMTs about the seasonal influenza vaccine. Sixty percent of EMTs who did not get vaccinated said they do not trust the public health authorities when they say the influenza vaccine is safe, and about a third said that flu vaccine has a lot of side effects and reported being afraid of them. More than half in this group also said they do not believe they can play a role in transmitting influenza to their patients if they are not vaccinated.

There are a few points from this that are very worrying indeed. I don’t think it would be speculating too wildly to think that you could generalise from this study to other regions, and nations. EMTs are on the front line and as such interact with more patients than nearly any other health professional, especially the elderly who are most at risk from influenza. For health professionals the flu vaccine is not just to protect the immunised, but also to protect the people they come into contact with. Previous studies have shown that at risk groups like the elderly are not nearly as likely to receive the flu vaccine than is necessary, which means the will be depending on the vaccination status of others to prevent catching the flu, which can be fatal. Which is why it’s all the more important that healthcare professionals get the vaccinations they require, vaccines like the flu and whooping cough boosters.
What is more surprising to me is the distrust that 60% of the non-vaccinated have for their own profession. It really demonstrates the up-hill battle we are facing as skeptics and activists to prove that modern medical establishments aren’t part of some money making conspiracy, with peoples lives caught in the middle. The fact of the matter is that pharmaceutical companies are already hesitant to produce vaccine due to the risk of legal action over vaccine injury, vaccines aren’t hugely profitable either.
Perhaps the most disappointing finding though is the clear lack of education that lead more than half of the non-vaccinated to believe that they were not capable of transmitting the flu to their patients. Working in the health industry myself I have all too often been witness to shocking gaps in what should be common knowledge to any health professional, especially in matter where patients lives are literally on the line. Clearly more resources are needed to keep members of our healthcare systems up to date.

Mike Lacelle Passed Away

http://www.facebook.com/theskepticsguide

Last night around midnight our friend Mike Lacelle passed away. We will be talking about him on the next show and his silent contributions to skepticism.

The sad news came last week that friend and contributor to the podcast Skeptics Guide to the Universe Mike Lacelle passed away. This is the second death to rock the show after the great Perry DeAngelis passed away several years ago. Mike was an enthusiastic fan of the show creating the SGU fan site as well as countless hours of behind the scenes contributions to skepticism’s most popular podcast; The Skeptics Guide to the Universe. His work ethic was a real inspiration to me, he showed that we can all make a difference, even if we don’t get the glory we feel we might deserve. Condolences to Mike’s family and friends, he will be missed but not forgotten.

New Study Updates Statistics on CAM use in Autism

http://pediatrics.aappublications.org/content/130/Supplement_2/S77.full.pdf+html

Children with ASD use more CAM when they have coexisting

gastrointestinal symptoms, seizure disorders, and behavior

problems. This study suggests the importance of asking about CAM

use in children with ASD, especially those with complex symptoms.

The journal Pediatrics recently published a study about complementary and alternative medicine use in paediatric patients with autism with some interesting results. 28% of the 3173 patients sample reported use of CAM therapies. For all the publicity CAM gets, especially with autism this result is actually surprisingly low, though admittedly still too high. There was a correlation between increasing severity of disease and increased likelihood to use CAM therapies. There was also a correlation between increased wealth and increased likelihood to use CAM. This is not really that surprising, I would speculate that the more severe the disease, the more distressing for the parents and therefore the more likely the parents would be to seek alternative therapies and wealthier parents are more likely to be able to afford the sometimes expensive CAM treatments.

In the good news category Chelation therapy, a dangerous and thoroughly unsupported treatment according to the evidence was reported by only 0.6% of the 3173 respondents, this is down from as much as 7% in previous studies. Perhaps all the work of skeptics and scientists has been paying off when it comes to these kinds of treatments?

For more information the original article is available in full for free and doesn’t contain too much scientific jargon.

http://pediatrics.aappublications.org/content/130/Supplement_2/S77.full.pdf+html

For a great review of CAM therapies used by autism patients and the evidence behind the claims I highly recommend this article.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2597185/

Natural is not the same as safe

Herbal remedies linked to drug side effects

http://www.telegraph.co.uk/health/healthnews/9636982/Herbal-remedies-linked-to-drug-side-effects.html

Interactions between prescription drugs and herbal or dietary supplements can cause complications including heart problems, chest and abdominal pain and headache, according to a review of existing evidence.

Remedies and supplements including ingredients like St John’s wort, magnesium, calcium, iron and ginkgo caused the greatest issues, researchers reported in the International Journal of Clinical Practice.

Experts from the China Medical School in Taiwan studied data from 54 review articles and 31 independent studies involving 213 herbal and dietary supplements and 509 prescribed drugs.

A total of 882 linked effects were observed, with warfarin, insulin, aspirin digoxin and ticlopidine among the drugs which were most affected.

Flaxseed, echinacea and yohimbe, a stimulant and aphrodisiac found in Africa, were the herbal ingredients which were found to cause the greatest number of drug interactions.

It seems these days that one of the most common logical pitfalls I come across is the naturalistic fallacy. It’s everywhere you go, from those natural herbal supplements, natural milk, pretty much everything is marketed as natural at the moment, it’s the big buzz word, probably surpassing organic.

For those that aren’t aware of the naturalistic fallacy it is the flaw in logic that describes that because something is natural it must be beneficial, or at least not harmful. It doesn’t take much to dispel this particular fallacy. I like to point out that arsenic, cyanide, snake venom and crude oil are natural, and I sure wouldn’t want to ingest those.

So let’s talk about this recent literature review, it highlights what the medical profession and Skeptics have been trying to put across for years. News Flash! Herbs are drugs! That’s right folks, they are not inert, and they actually have physiological effects on your body. Unfortunately they are not normally the effects that are claimed on the bottle.

The biggest problem is that patients rarely report to their doctors what supplements they are taking because they don’t consider them to be drugs, it doesn’t even occur to most people. The fact is that most of our potent pharmaceuticals were found in nature, the difference between a pharma drug and a “natural” remedy is that pharmaceuticals are refined and defined. This means you take a pure form of the drug and you know how much you are taking. The same cannot be said for herbal remedies.

Why is this an issue? It’s because of the aforementioned non inertness of herbal remedies. While a lot of herbal remedies don’t really have a big effect by themselves (with the exception of some quite toxic remedies) they can react with real drugs that you are taking at the time. St Johns Wart is just one example, and probably the most well-known, this study also identified flaxseed and Echinacea. These are all commonly taken supplements that could be harming unknowing patients who are taking prescription meds. Heart problems are serious and potentially life threatening, whilst headaches, chest and abdominal pain are nothing to be sniffed at.

The moral to this story is that tell you doctor EVERYTHING, honestly you just don’t know how useful and even potentially lifesaving this could turn out to be.

Week In Review 06/11/2012

So throughout the week I found a few news items that peaked my interest a little and wrote a few words about them, hopefully this will be a weekly occurrence, now that I contribute to the DoubtfulNews.com feed a lot of my better stories will end up there but the rest will go here if you feel like absorbing more of my thoughts.

http://www.klewtv.com/news/local/Clairvoyant-Spiritual-Counselor-Louise-Hauck-173722521.html

LEWISTON, ID – Lewis-Clark State College is offering a continuing education class that may have some skeptics wondering what to believe.

“I’m able to access this flow of information that’s really infinite and unlimited,” said Intuitive Spiritual Counselor Louise Hauck.

This kind of thing is a continuation of a disappointing and worrying trend in which academic institutions are cashing in and offering pseudoscientific courses. Not only does it provide practitioners with buzz words to use in marketing but (even if the course is not credited) it lends the practice with a false sense of legitimacy in the eyes of the public

Well they say a skeptic really isn’t a skeptic or they wouldn’t be asking questions,” said Hauck.

I just couldn’t let this quote go by without comment… I rather think Ms Hauck has missed the point of being a skeptic with this statement.

 

(From Natural News link not provided)

 In the aftermath of superstorm Sandy, which has devastated many parts of the East coast, we’ve been receiving a flood of calls and emails asking about emergency preparedness items for first aid and natural medicine.

Here, I’ve put together a quick checklist of things you’ll want to acquire (or grow) to add to your emergency medicine collection.

It looks like everyone is getting in on the act exploiting hurricane Sandy, and well, no body will be surprised to see Natural News entering the fray too. As expected there are a number of egregious articles to choose from, but natural first aid? Conveniently Natural News have a natural first aid kit available to purchase.

Just some of the things on the list;

• Aloe Vera – Can be used as a topical antibiotic as well as a treatment for burns and skin issues. Can be consumed internally (the gel only) for digestive support and to help eliminate intestinal issues.
• Activated charcoal – As a dietary supplement, activated charcoal can be a true lifesaver. It absorbs poisons! It’s the primary ingredient in the poison treatment liquids used in emergency rooms.
• Baking soda – This simple but miraculous substance has a multitude of uses in personal health and even treatment of many conditions including gout, arthritis, and even some cancer tumors.
• Wound clotting products such as Quik Clot. Available at:
• Cayenne Pepper Tincture – An amazing first aid substance with applications for boosting circulation and even helping heart attack victims.
• Gauze and bandages: You can never have too many, it seems. Available everywhere.
• Rubbing alcohol and hydrogen peroxide: Both are super cheap to acquire and have very long shelf life. Both can help clean first aid tools or even light wounds.

The list goes on including things like colloidal silver. It’s one thing to recommend some kind of natural remedy for the sniffles that will go away on it’s own but people in need of first aid can have some serious injuries that need proper medical treatment and medicines that actually work such as say, I don’t know, antibiotics?

At least the list does contain some actual potentially life saving pieces of kit. Nice to know that common sense isn’t completely missing from the good folks at Natural News.

 

Best of the Rest

http://www.9news.com/news/local/article/297924/222/School-community-fooled-by-leukemia-hoax

This one is a sad reminder that we need to apply skepticism to all areas of our lives.

http://www.rrobserver.com/news/local/article_84c6ac2c-2537-11e2-8842-0019bb2963f4.html

More acupuncture madness, (jn the ear! seriously!), funny how they always seem to say, “when used with conventional treatment” how do they know that the acupuncture works?

The Shonky

The Shonky for
Woo water goes to… Nature’s Way Kids Smart Natural Medicines

http://www.choice.com.au/reviews-and-tests/awards/shonky-awards/shonkys/the-2012-shonky-awards.aspx

http://www.choice.com.au/reviews-and-tests/awards/shonky-awards/shonkys/the-2012-shonky-awards/page/natures-way-kid-smart-range.aspx

Shonky loves homeopathy. The idea of selling water for upwards of $1000 per litre and claiming it’s medicine represents the very essence of shonkiness. But convincing anxious or desperate parents they can use it to treat their children’s ailments takes it to a whole new level. Introducing the Nature’s Way Kids Smart Natural Medicine range, with variants for colds and flu, hay fever and runny nose, pain and fever, and for calming kids down. Already feather-whipped by the TGA for making unsubstantiated claims about the uses and effectiveness of the products, the company has done nothing to temper its assertions the products might actually do something.”

Every year the Australian consumer watchdog group; Choice, releases its “Shonky Awards”. For the non-Australians among us shonky means dodgy, suspect, misleading or fraudulent. Each year the Shonky Awards highlight the most inefficient, poor value for money and sometimes outright dangerous products or services making their rounds in Australia.

Well the results are in… amongst the usual suspects of ineffective cleaning products, inefficient washing machines and disproportionate service fees is Nature’s Way. As you may have already guessed from the name Nature’s Way is a brand of alternative “natural” medicine products. They earned their Shonky this year for their range of Kids Smart homeopathic remedies. That’s right folks, a range of homeopathy targeted at children!

While homeopathy can be considered a sham at the best of times, targeting worried parents with sick children must surely be considered a new low. Dr Ken Harvey sums up his thoughts on the matter;

Symptoms like ‘restlessness, anxiety, irritability and agitation’ the ‘Calm’ claims to treat can be the symptoms of potentially serious childhood infectious diseases for which a homeopathic remedy is entirely inappropriate, and such misguided treatment might make a parent postpone seeking more appropriate medical advice to the child’s detriment.

In a welcome development the claims of this company have been referred to the Australian Competition and Consumer Commission (ACCC) and the New South Wales Fair Trading commission has written to the ACCC and offered their assistance.

Acupuncture and poor science… again.

A study published in the Journal of Clinical Oncology this week has concluded that acupuncture can decrease cancer related fatigue in breast cancer patients. However concluding something and finding something are two separate beasts.

In this study, 227 breast cancer patients were treated with acupuncture alongside the usual care they receive, 75 patients did not receive acupuncture but continued to receive their normal care. In order to asses fatigue levels, anxiety, depression and quality of life, established 20 point scales determined by questionnaires were performed and the results show that on average the acupuncture patients improved on all assessments compared to the non-acupuncture group.

That sounds promising doesn’t it? Surely the only thing you might conclude from this study is that acupuncture can reduce fatigue in breast cancer patients? Well not exactly no; what we can conclude from these results is that acupuncture might reduce fatigue in breast cancer patients and here’s why.

Clinical science is a funny old thing, this is mostly because human beings are a fairly odd sort with complicated psychology and what some may call intelligence. This means that studying the effects of health care interventions is a lot different from studying say physics. The laws of physics are immutable and constant, if you were to drop a ball with the exact same weight and dimensions from the same height with the same force and the exact same environmental conditions, the ball would take exactly the same amount of time to hit the ground, every time. Humans though, not so much.

How do you feel right now? It seems like an easy question but I’m willing to bet that you had to think quite hard about it, chances are if I asked you tomorrow you might not give me the same response, even though little will have changed. This is because human emotions and perception is affected by the experiences and expectations you gain from your existence. This is what makes clinical trials quite tricky, if you are told that you are getting a treatment, you might expect to get better, then when you are asked if you feel better you think that you do, because it’s what you expect. This is called the placebo effect.

So let’s get back to why the conclusion from this study is not congruent with the results they obtained. The author described this study as a “Pragmatic Study”, what this means is that is a real world study. Usually a pragmatic study is used to make an observation and then form a hypothesis. In order to reach a conclusion you must do a controlled trial that accounts for all the variables that are reasonable to control. Concluding that an effect exists from a pragmatic study is just plain poor science.

In the study there were two groups, one that did not receive acupuncture and a group that did. As stated earlier the group that received acupuncture improved on all measured levels of wellbeing by a small amount, which might suggest that acupuncture is useful as a treatment, however that is all you can surmise from those results, it might be useful. This is because the study did not control for the other variables that might account for these results.

Let’s talk about blinding, this is a tool used by scientists to remove variables such as the placebo effect. Blinding means that the patients do not know whether they are receiving the treatment or not. This is important because if the patient doesn’t receive a treatment but still reports an improvement the effect can’t be due to the treatment, but more likely because they expected to improve. If the effect from the treatment group isn’t stronger than the placebo group, it is safe to assume that the treatment is no more effective than no treatment at all.

What this trial needed then was a third group, this group would have received a placebo type of treatment, this involves using fake needles that retract rather like a stage knife, or the acupuncture is done in none-acupuncture points (although this makes the assumption acupuncture must be done on certain points on the body and isn’t just the process of inserting the needles) my preference would be the fake needles because these don’t actually pierce the skin. Importantly the subjects would not know whether they were receiving “real” acupuncture or the placebo acupuncture.

If the results of this trial had then shown that the real acupuncture group had a bigger effect than both the non-treatment and placebo acupuncture group, that would have been more interesting and the conclusion that acupuncture is effective rather than might be effective is much more valid.

At the least this trial should have included a group that received another form of alternative treatment such as massage or aroma therapy. While this still doesn’t allow us to make firm conclusions about the effectiveness of acupuncture it would at least indicate whether the effect was specific to acupuncture or not.

The fact is that a non-blinded, non-placebo controlled study is almost worthless to our understanding of whether something works or not. For the author of this study to make such a definitive conclusion shows a poor lack of knowledge about the scientific method and at worst an agenda to promote acupuncture. That this article was published in a reputable journal is all the more disappointing.

doi:10.1200/JCO.2012.41.6222

Bones in Bulgaria may be of John the Baptist: study

http://phys.org/news/2012-06-bones-bulgaria-john-baptist.html

It seems that every few months some one claims to have found body parts, shrouds or other artefacts of biblical figures. The problem is: with modern scientific techniques, people who read about such finds are over generous with their certainty and credulity than is due. The fact is that these finds can scarcely be considered more authentic or certain now than they were 50 or even 100 years ago.

I’ll give you an example, for some time now archaeologists and other bone experts have had the ability to fairly well describe the ethnic origin of bone remains. Now with DNA analysis technology being faster and cheaper we are able to very accurately define the ethnic origin of bone. This is a great thing, especially when we discover a species of hominid. What does it tell us about these kinds of finds though? It tells us exactly what it would tell us about any other archeological find. Where the person was from. Unless John the Baptist is the only middle-eastern man known to have existed at the time this means very little.

The dating of the bone is faced with a similar problem, just because the bone can be dated to when a person was alleged to be alive does not make it a compelling case for the bone belonging to that person, as there were a lot of other males from the middle-east alive at that time also.

What is more slightly more compelling is the box that was found near the sarcophagus. The box had inscriptions that referenced John the Baptist as well as the date of his birth which is celebrated by Christians. This piece of evidence is also not without it’s problems though. Firstly the box was found near the sarcophagus, the body parts weren’t inside of it. Also the inscription itself is somewhat suspicious to me, the exact birthdate of people from those times was seldom known and was often arbitrarily assigned at a later date, so for the box to bear that date rings alarm bells for me. Finally the inscription itself has not been dated. It’s not too long ago that a certain documentary claimed to have found the body of Jesus only for real scientists to discover the inscription was a fake.

This brings me nicely to my final point. Always be suspicious of anything when the results are presented first by the media, especially in a high-profile documentary. Peer review of evidence by other experts in your field is the best validation you can get. So many claims fall by the way side after rigorous scrutiny from well-trained and experienced contemporaries. I highly expect this case to be no different.