Thursday, May 28, 2009

"As part of our commitment to transparency, we are becoming less transparent" - Ofquack

This is how the CNHC website looked on May 21st 2009 and here's how it looks now - see the difference?

I had previously written to Ben Bradshaw MP regarding CNHC, got a largely unsatisfactory reply and have to-ed and fro-ed again since then.

One of my main issues was that the quack health lobby group, Prince Charles' Foundation for Integrated Health, had received £900,000 of Dept of Health funding (my and your taxes) to set up CNHC and yet, they were being opaque as to their operations. Seemingly by mistake, a CNHC staff member put the minutes of the Nov 08 meeting on the web, which contained discussions about 'misinformation on a blog' and infiltrating websites to promote CNHC. I should point out that the CNHC have stated the minutes were not OK-ed by the board and contained inaccuracies. At the time of writing, those minutes are still available on the CNHC website here(.doc file).

The website (shown above) continued to state until May 21st 09 that
In order to meet our commitment to transparency, CNHC will make the minutes of board meetings appear here.
Rubbish. The Nov 08 minutes (and previous) never 'officially' appeared, nor did the Feb 09. From a letter I've seen from the Dept of Health, it appears that at the Feb 09 meeting, a decision was made not to put the minutes on the website, but instead
a synopsis of items for discussion and decision would be put on the website.
Seemingly, no need to update the website though.

It's also interesting to note how many therapists are registered. Or it would be, if you could find out. Ever since a public spat (pdf) with the General Regulatory Council of Complimetary Therapies (splitters....), even the potential number of sign-ups was always going to be difficult to establish. The CNHC also seem unable to provide an answer because they allow industry bodies to upload blocks of therapists - despite an FoI request response from the Dept of Health, which stated
the [Professional Associations]cannot register their members with the CNHC. Rather, individual practitioners have to apply to the CNHC if they wish to be admitted to the
register.
More muddle and confusion. One of the CNHC key objectives is to register 10,000 therapists by end of 2009, although I'm lead to believe the number is currently around 2,000.

So it seems the commitment to transparency has been discreetly removed - the new webpage on the CNHC website has dropped its 'commitment to transparency' tag (along with the word 'minutes') and replaced it with heavily edited meeting notes which contain such salacious gems as
Various amendments and changes were agreed.
How useful.

I never did find out what they did with that £900,000.


BPSDB

Wednesday, May 27, 2009

The Guardian brings all the nerds to the Yard, and they're like "it's quackery, yeah?"

With apologies to Kelis, and it doesn't even scan.

Anyway, not even a badly constructed blog title could take away from a funny little PR-disaster which happened today to Neal's Yard, courtesy of the Guardian and an internetful of geeks (that's the collective noun, surely? - feel free to provide suggestions below).

Neal's Yard Remedies, the super-ethical, eco-aware health and cosmetics company, had agreed to take part in a Guardian series called "You ask, they answer". In this feature, in the Ethical Living section of the Guardian, internetians were offered the chance to ask Neal's Yard Remedies any question they wanted, although they were generally supposed to be regarding organics and beauty.

By finishing the article with the comment
This is your chance to grill them: from the controversy surrounding the chain's removal of a homeopathic malaria remedy to the benefits and reasons to switch to organic beauty products.
it nicely teed up a complete pwning of Neal's Yards' quackery division.

Now perhaps you haven't been taking your Co-Enzyme Q10 pills (this link may be more useful) or your 100% Organic Pre-Sprouted Aktivated Barley Powder so perhaps you've forgotten that Neal's Yard was the subject of a BBC documentary, investigating the sale of homeopathic prophylaxis for malaria. Unsurprisingly, they were concerned that Neal's Yard were selling an evidence-free sugar pill to protect people from a potentially fatal disease (doesn't seem very ethical to me). There is a transcript of the article here and the YouTube version of it is here. It includes the bit where Susan Curtis, Neal's Yard's Medicines Director storms off in a huff after being made to look extremely foolish. The BBC investigation reported Neal's Yard to the regulatory authorities (MHRA), who promptly spanked their bottoms and forced them to remove the product from sale.

When it came to the Guardian article, the Nerds did not disappoint - after 5 pages of questions along the lines of
Do you see no problem with trying to be 'ethical' while at the same time selling snake oil for a living? (SaltyCDogg)
Surely you don't view it as ethical to sell products which are of unproven benefit and which you don't even know are safe? (Puzzlebobble)
I'll buy the relief of stress and tension, especially if combined with massage, but what evidence is there for the elimination of toxins held in the body? What evidence is there that these toxins exist in the first place?(Peter Sterling)
what is "healing energy"? What units is it measured in and where does it come from?(Tristanod)
Adam Vaughan from the Guardian came on to say
have just had a chat with [Neal's Yard Remedies].

Unfortunately, despite previous assurances that they would be participating in this blog post, I've now been told they 'will not be taking part in the debate'.

So yes, as several people have pointed out, this has become something of 'You Ask', rather than a 'You Ask, They Answer'. I'm still hoping NYR will reconsider.
(They have a habit of pulling out of PR events - apparently they were supposed to be sponsoring a garden at Chelsea Flower Show). An hour later, James Randerson from the Guardian stated that
We have tried again to convince NYR to respond to your comments but they have reiterated their position that they do not wish to enter the debate.

We will keep trying to change their mind, but if they stick to that we will be closing this thread in a hour at 15.00 BST.
Which they did.

Neal's Yard have scored a massive own goal - an epic fail and a prime case study for "How Not To Do PR". They've cried off, seemingly unable to salvage anything from the situation and deciding the bunker was the best place to be. HolfordWatch is contacting Neal's Yard to see if they would like to continue the conversation there - seems unlikely, but we'll see.

I wouldn't like to be the one explaining this cock-up to the Neal's Yard board.......

BPSDB

Tuesday, May 26, 2009

Chiropractic for menstrual pains? No evidence. Period.

I'll hopefully convince you by the end of this blogpost, that there are bogus chiropractors in the UK.

Menstrual pain (or to give it its posh name, dysmenorrhoea) is estimated to affect between 45 - 95% of women at some point. (Bit of a rubbish estimation, if you ask me, but it gives an idea of its occurrence).

Here we have a condition which is widespread, can be debilitating, can be chronic, and the main respite from which is through painkillers. A perfect combination for a theatrical placebo. (And a cynic would add it was a regular monthly income).

It takes a leap and jump in the logic to imagineer how chiropractic could assist in the alleviation of dysmenorrhoeaic pain, but it goes something like this, courtesy of Pringle Chiropractic, Belfast:
[Pringle Chiropractic] are aware that many women who suffer from menstrual cramps also experience frequent back pain. Is there a connection? Both may be related to subluxation in the lower spine that affects the nerves that serve the female anatomy.
More hand waving than the Queen on a walkabout. Subluxations are interesting little chaps - it seems they are impossible to x-ray, and the definition of what they are has changed over time - they used to be a considered a disruption in innate intelligence but that has been dropped for obvious reasons and replaced with something along the woolly lines of
a loss of function in the spine and nervous system due to a reduction in its normal motion or alignment.
- from Pringle Chiropractic, Belfast again. And what, amongst other things do Pringle recommend for menstrual pain?
Good, old fashioned chiropractic adjustments.
Glasgow Chiropractic also are keen to espouse the amazing ability of chiropractic to deal with menstrual pain, by starting off by talking about chiropractic for menopausal symptoms, using this paper from Obstetrics and Gynaecology. Which is interesting because dysmenorrhoea and menopause are completely different beasties. I guess Glasgow Chiro just lumped them together in a sort of hand-wavy "women's problems"-type way. In fact, according to Latthe et al., the predisposition factors for dysmenorrhoea are as follows:
Age < 30 years, low body mass index, smoking, earlier menarche (< 12 years), longer cycles, heavy menstrual flow, nulliparity, premenstrual syndrome, sterilisation, clinically suspected pelvic inflammatory disease, sexual abuse, and psychological symptoms.

Glasgow Chiro claim:
Chiropractic provides the mechanisms through which dysmenorrheic women can be relieved of their pain in a drug-free environment and even go on to live a life free of period pain.
which is pretty much a statement of cure.

It's a fairly widespread chiropractic claim to be able to assist in menstrual pain - a quick squizz on Google shows that alongside Pringle Chiropractic, Belfast and Glasgow Chiropractic, Tooting Chiropractic, Townhill Total Health, Bank Chambers Clinic in Chipping Sodbury and Newcastle Chiropractic to name a few, also insist that chiropractic can assist in some way with menstrual pain.

So, given that there is a widespread belief within chiropractic circles that it can cure or relieve dysmenorrhoea, what decent evidence exists to back this up?

It should come as no surprise to anyone who knows anything about chiropractic that the answer is "not a jot".

A Cochrane Review in 2006 titled Spinal manipulation for primary and secondary dysmenorrhoea concluded that:
Overall there is no evidence to suggest that spinal manipulation is effective in the treatment of primary and secondary dysmenorrhoea. There is no greater risk of adverse effects with spinal manipulation than there is with sham manipulation.

The Clinical Evidence section of the BMJ places Chiropractic in the "Unlikely to be beneficial" category for dysmenorrhoea.

BUPA's page on chiropractic categorically states
Currently, there is no evidence that spinal manipulation helps to relieve period pain.

The NHS page quotes the Cochrane review above and follows its conclusion.

What about the General Chiropractic Council? Does it recommend chiropractic for menstrual pain?


It used to. In this letter (.doc) written in 2004 to the GCC on behalf of Actions for Victims of Chiropractic, Frances Denoon happens to quote from the GCC's document "What Can I Expect When I See A Chiropractor?" which states:
benefit may also be seen for some types of asthma, digestive disorders, migraine, infant colic and menstrual pains.
The current version of this document can be found on the GCC website here (.pdf), dated Sept 2007, and the same passage now reads:
You may also see an improvement in some types of asthma headaches (including migraine) and infant colic.
It seems clear that following the publishing of the Cochrane Review, in 2006 showing that chiropractic had no demonstrable effect on menstrual pain, the GCC (in an attempt to show it was evidence-based) removed menstrual pain from its list of treatable disorders.

That means the GCC, the UK regulator of chiropractics, is fully aware that dysmenorrhoea cannot be treated successfully with chiropractic. No doubt it will have made every effort to communicate this to its members and ensure that no-one was claiming otherwise. I'll be arranging for complaints to be made to the GCC regarding the above chiropractor's claims.

I now suggest to you that, given the evidence above, any chiropractor that suggests that chiropractic is a worthwhile therapy for menstrual pain is bogus. Period.

BPSDB

Tuesday, May 19, 2009

Chiropractic - totally bogus, dude?


The word 'bogus' is back in vogue - and not before time. It's been 18 years since Bill & Ted's Bogus Journey hit the big screen and had all teh kidz talking like west coast surfer dudes.

The word 'bogus' has been thrust back into the limelight for a much more serious reason - just over a year ago, Simon Singh wrote a piece for the Guardian entitled "Beware of the Spinal Trap" (you can read the full article on Gimpy's excellent website here) which contained the line:
The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.
In the usual manner of Complementary & Alternative Medicine, the BCA decided to sue for libel rather than entering into a rational discourse regarding evidence or the lack thereof. At the time, it wasn't apparent what the offending part of the article was, just that it was happening, hot on the heels of another legal chill from New Zealand Chiropractors to David Colquhoun.

Blogger and legal eagle, Jack of Kent has been following this story meticulously - his round up of the preliminary hearing (which was on 7th May 2009) can be found here. From Jack of Kent's site:
[The Judge continued that] The word "bogus" meant deliberate and targeted dishonesty. So it did not mean that chiropractic for the six named children's ailments (including asthma) was simply wrong, or that it was contrary to established medical practice or research, or even that it completely lacked evidence. "Bogus" meant a lot more. The judge held that by the mere use of the word "bogus" Simon Singh was stating that, as a matter of fact, the BCA were being consciously dishonest in promoting chiropractic for those children's ailments.
[...]The ruling means that, as it stands, Simon Singh would have to prove at full trial that the BCA were being deliberately dishonest. This is not only extremely difficult but it was undoubtedly not Simon Singh's view in the first place. The BCA, as with many CAM practitioners, may well be deluded, irresponsible, and sometimes rather dangerous; but calling their promoted treatments "bogus" was not an express statement of their conscious dishonesty.
(My bold).

A Facebook site has been set up and on Monday 18th May in London, there was a collective show of support for Simon Singh, with Dave Gorman, Evan Harris MP, Nick Cohen and Brian Cox all speaking, as well as Simon himself. The Quackometer is setting up a Carnival of Bogus* Chiropractic to promote the fact that there really is little evidence for chiropractic at all, never mind the more exotic claims of colic, athsma and others.

So then, are chiropractics claiming all manner of curatives without the evidence to back it up? If so, then it's difficult to see how they aren't being consciously dishonest. Gimpy has already shown that the General Chiropractic Council appear to admit there may be bogus chiropractors. I suppose chiros could be deluded, well-meaning, possibly ignorant of the evidence, but I'm not sure how likely that is. I looked at one in the Wiltshire area at random to see what came up:

Step up Healthcare 2000 in Trowbridge and Chippenham - this is a one-stop shop for alternative quack-like things - clicking on the 'Select Treatment' icon downloads a pdf document which states the following:
This section lists alphabetically a number of conditions that may be alleviated by the therapeutic specialities shown. Many complementary therapies are not condition specific but treat the “whole person”, making it difficult to accurately list conditions alongside a therapeutic approach in this way.
Fairly weaselly - could be written as "by claiming a holistic approach, we can claim to help any disease in the whole wide world". And here is a list of the ones they claim chiropractic can 'alleviate' (I've put beside a few of them a link to a relevant Cochrane review if available and the conclusion from that review.)

Asthma - Various therapists use [...] chiropractic. The review found there is not enough evidence from trials to show whether any of these therapies can improve asthma symptoms, and more research is needed.
Bedwetting (childhood) - Complementary treatments such [...]chiropractic may help, but the evidence was weak.
Hypertension
Cancer (with a disclaimer that it may ease symptoms and enhance well-being)
Catarrh
Chronic Colds
Colic in infants - still at Protocol stage
Constipation
Digestion
Emphysema
Glue Ear
Hay Fever
Infertility
IBS
Osteoporosis
Pregancy (well being during)
Rheumatism
Sinusitis
Stress
Tinnitus.

Remember this is chiropractic - mainly spine manipulation. Despite claiming all these diseases can be alleviated with chiropractic, there are few Cochrane reviews to confirm their claims and the ones that are available are not very positive.

How can Healthcare 2000 claim this? They must have some idea of evidence to show efficacy, I mean they wouldn't just make it up, not knowingly anyway, because that would mean their claims are bogus (according to Justice Eady).

This business with the BCA will undoubtedly have the same effect (known as the Streisand Effect) which is to blast the news round the world via the internets that BCA want to silence dissent about chiropractic. This will in turn shine a skeptic-ninja searchlight on the chiropractic industry and show that the evidence for any of it is weak to non-existant.

Roll on the Carnival!

* - deliberate deception not implied.
BPSDB

Monday, May 18, 2009

Honey, I shrunk the cold (and the evidence)

I love honey.

In fact, I love it so much, I became a beekeeper (which, even when things go wrong and honey levels are low, is still an amazing, rewarding and worthwhile pursuit). I met the Honey Monster once, but it turned out to be an actor in a honey monster outfit. Gutted.

Nonetheless, honey ticks all the boxes for being hijacked by quacks as a cure-all - it is natural, available and has historical & religious provenance;
And thy LORD taught the bee to build its cells in hills, on tree and in men’s habitations, then to eat of all the produce of the earth and find with skill the spacious paths of its LORD, there issues from within their bodies a drink of varying colors, wherein is healing for men, verily in this is a sign for those who give thought
(Qu'ran Surat Al-Nahl, The Bees, Aya 69)
Some time later, when [Sampson] went back to marry her, he turned aside to look at the lion's carcass. In it was a swarm of bees and some honey, which he scooped out with his hands and ate as he went along. When he rejoined his parents, he gave them some, and they too ate it. But he did not tell them that he had taken the honey from the lion's carcass.
(Bible, Judges 14, NIV)
Leaving aside the bee-zarre story of Sampson (he murders 30 people and gives his wife to his best mate a week after the wedding), honey has been used for squillions of years as an antiseptic - most micro-organisms are unable to survive in such a sugar-rich, water-poor environment. Hence, it never goes mouldy in your cupboard.

(One important exception is clostridium botulinum whose spores can survive in honey, meaning that it shouldn't be given to infants, although there have been no cases in UK since 2001. Of course, there will be people telling you that feeding honey to a 6 month old baby is fine, such as Unhindered Living, but then they are also anti-vaccination so I guess the stupid goes with the territory.)

So history, religion, antiseptic qualities and naturalness are all part of the honey story. (Naturalness may not be a real word). Throw into the mix the intriguing biology and evolution of bees (matriarchal society, highly beneficial to flowering plants, pheromone behaviour, relaying of information through the medium of dance, to name a few) and you have a perfect background for flogging honey as a natural panacea. (Although let's not forget the tragic case of Russell Jenkins who died after trying unsuccessfully to treat gangrene with honey).

Obviously, not any old honey will work to cure every disease in the world ever, it has to be special expensive branded honey, like Life Mel (still no follow up trial?) or Manuka Honey.

A story promoting the health benefits of honey is always going to make certain sections of the media. The fawning, uncritical, regurgitating cut-and-pasters at the Daily Mail will always print your honey story - no questions asked. It'll cure cancer, kill superbugs, fight heart disease and counter ageing.

The most recent story to be CtrlC/CtrlV-ed into the People's Journal of Science (Daily Mail) is that
Eating honey shortens colds by two days

The first line of copy tempers this a bit (naughty attention-grabbing sub-ed - so out of character) by saying it 'can help' reduce the duration of colds. 'Can help' is one of those weaselly marketing phrases like 'may', 'reduce' and 'up to' which allows them to infer much more than they *actually* can. Still, it's possibly worth further investigation. Like all dead-tree media, the reference to the original paper is never given (no idea why not) so after a brief hunt, I found the paper here. (Unfortunately, it's paywalled, but this is only one of a number of minor hurdles presented to the modern bloggist.)

If you click on the link to the paper, something very obvious and quite odd should become apparent. A cheeky tactic employed by some researchers is to write to the editor of a journal, have your letter printed, and then by neatly side-stepping peer-review and due process claim you have 'published' a paper. And so it is in this case - not actual published research, just a letter to the editor - how nice. Never mind, let's perservere.

The trial involved 60 people, who had developed cold symptoms within the previous 24h. They were divided into two groups of 30, with the first group getting paracetomol, naproxen and chlorpheniramine (Piriton) and the second group getting the same drugs, but with 50g of natural honey per day as well. So, poor randomisation, no blinding and a small sample - the results are already next to worthless. They were visited by researchers every day to examine the symptoms (rhinitis, muscle pain, fever, throat congestion, cough and sneezing), and these researchers were unaware of which group the patients were in.

The only result the paper gives is that
In the group given honey, duration of signs and symptoms was 1-2 days less than control group.
And how long was the duration of symptoms in the control group? Doesn't say - which is mighty important if the results are to be put into context - was it 4 days in which the honey group halved the time of recouperation or was it 14 days in which the honey (along with all the flaws in the methodology) did almost nothing?

Now don't get me wrong, this mightn't be useless research - it could be what some people call 'skunk' work - a little trial on the side just to see if it's worth investigating further under more suitable conditions (possibly for funding reasons). However, it's important to look at it for what it is - a correspondence to the editor of a journal, not peer reviewed, not blinded, not placebo-controlled, not randomised, lacking in detail and information, and hence completely unreliable.

What it does not show is the remotest glint of reliable evidence that demonstrates that honey is any good for colds - I hope I have persuaded you of that. Compare this again to the headline "Eating honey shortens colds by two days" - not only is it bollocks, but the Daily Fail have overegged the pudding by using the '2 days' rather than the woolly and meaningless '1-2 days' that was in the not peer-reviewed, not blinded, not placebo-controlled, not randomised, lacking in detail and information, and hence completely unreliable letter.

The article goes on to describe
a recent trial at the Dubai Medical Centre, [involving] 16 adults with a history of recurrent cold sores.
After a hunt, I think I found the paper - if you call 2004 recent, and if by cold sores you mean "labial and genital herpes lesions". Still they got the Dubai bit right. A unblinded, unrandomised, non-placebo controlled trial of 16 people is, yet again, not worth a jot.

This is the state of UK media science journalism. If this is the level of effort being put in by the hacks at the Daily Mail for their science stories, what does that say about the level of truth, fact and effort in the rest of the paper?

I think it needs some honey.
Many thanks to Samuel Eaton.BPSDB

Wednesday, May 13, 2009

Homeopathic Protection Against ChemTrails or Fun with Freedom of Information.

This is just a bit of pointing and laughing really - childish, puerile and enjoyable.

I was reading the People's Journal of Science (PJS or Daily Mail as it's known) and how they even-handed and non-sensationally reported CHEMtrust's commissioned report on Male Reproductive Health Disorders and the Potential Role of Exposure to Environmental Chemicals (pdf). The Daily Mail screamed
Gender-bending chemical timebomb fear for boys' fertility
and followed it up with hardhitting quotes like
Exposure to environmental chemicals slightly increases the risks of undescended testes and hypospadia - malformed genitalia - in boys, the report found
'Slightly increased'? That's a world away from 'timebomb fear', no? Anyway, I haven't fully read the report and only laugh at the Daily Mail's reporting rather than the report itself.

However something in the comments reminded me of a bizarre Freedom of Information request I saw about a year ago on the fantastic WhatDoTheyKnow website. The comments section of any Daily Mail story range from the weird to the scary and have every veiw point in between. e.g.
[Soy] will turn a boy less masculin and reduce his chances of having children,"birth control". This is all part of population reduction by the elite, not so many slaves are required for their New World Order. - peter neilson, wigan england
Righty-oh, pretty resonable point of view...... but it was Anne Palk-Smith who really made me snigger:
In the article Professor Sharpe is quoted as saying 'you can'y do anything about chemicals in the environment...'
Perhaps it would be a start for us to ask goverment who is ordering the polution of the skies by pumping out toxins from planes under the guise of contrails. For anyone not familiar with this issue do a search on internet for 'chemtrails'. - anne palk-smith
So what are Chemtrails? Wiki has the following to say:
The chemtrail conspiracy theory holds that some contrails are actually chemicals or biological agents deliberately sprayed at high altitudes for a purpose undisclosed to the general public. Versions of the chemtrail conspiracy theory circulating on the internet and radio talk shows theorize that the activity is directed by government officials.[1] As a result, federal agencies have received thousands of complaints from people who have demanded an explanation.[2] The existence of chemtrails has been repeatedly denied by government agencies and scientists around the world
So why doesn't someone ask the government what's going on?

And they did. Step up Veronica Chapman - no stranger to conspiracy theories. (She has also a FoI request for "Is income tax legal?"

I'm going to reproduce an slightly edited version of the mail discussion between Ms Chapman various government bods. It's really worth perservering with.....

Dear Sir or Madam,

I make the following request for information under the Freedom of
Information Act.

For sometime now I, and many others, have observed trails left by
low-ish flying aircraft. These trails do not disperse rapidly as do
those ice-crystal vapour trails from high-flying jets.

Will you please be so kind as to tell me:

1) The chemical composition of these slowly-dispersing trails.

2) Who authorises them.

3) What know effects they may have on the population of the United
Kingdom.

Thank you in anticipation.

Veronica Chapman

Dear Veronica

Thank you for your email. Unfortunately Defra does not hold this
information. We believe it is an issue for the Department for Transport.


Dear Helpline, Defra (CCU),

Thank you for your response.

Are you suggesting that the environment is not affected? That
whatever is in these trails does not fall to the ground and enter
the food/water chains?

I will, of course, contact the Department of Transport as you
suggest, and pose the same questions to them.

But would still like to know your reasoning as to how something
man-made, that is falling from the sky, has been given the
all-clear as far as earthbound living organism is concerned. (As
far as the environment is concerned, if you wish to put it like
that).

Is the air we breathe being continually monitored?

If so, what are the results? Do the air, water, and food supplies
contain any unusual substances, referenced back (say) to 30 years
ago.

I think, with respect, these are fair questions to ask, based on
what many of us have observed.

Yours sincerely,

Veronica

In response to your recent enquiry concerning emissions from airplanes and air quality, this is a matter for the Department for Transport, but I can confirm that we monitor and assess air quality throughout the UK in accordance with EU air quality legislation. For further information, please see: http://ec.europa.eu/environment/air/quality/index.htm

Dear Snary, Chris (AQIP),

Thank you for your response, and for answering ONE of my questions
- i.e. to the effect that you are responsible for monitoring our
AIR, and that is to EU quality standards.

May I therefore please have answers to my remaining questions,
which I will repeat (slightly rephrased) for your guidance:

1) Do you monitor the water supply (as well as the air)?

2) Who monitors the food chain (if not yourselves)?

3) Can you positively confirm that these unusual sky markings have
absolutely no effect whatsoever on the environment and, in
particular human and animal life?

4) Can you positively confirm that the air, water, and food
supplies contain no unusual substances, referenced back (say) to 30
years ago

Yours sincerely,
Veronica

Dear Ms Chapman

Thank you for your e-mail of 7 July to Chris Snary about unusual markings in
the UK skies. I have been asked to reply. To respond to your questions in
turn:

1) Do you monitor the water supply (as well as the air)?

The quality and safety of drinking water is monitored by water companies and
is regulated by the Drinking Water Inspectorate. The quality of natural
bodies of water is monitored by the Environment Agency.

2) Who monitors the food chain (if not yourselves)?

The Food Standards Agency regulates the safety of food products.

3) Can you positively confirm that these unusual sky markings have
absolutely no effect whatsoever on the environment and, in particular human
and animal life?

As Mr Snary has previously advised, the Department for Transport is best
placed to advise on matters relating to emissions from aircraft.
4) Can you positively confirm that the air, water, and food supplies contain
no unusual substances, referenced back (say) to 30 years ago[?]

There are public regulatory processes in place to manage all environmental
risks that have been identified as potentially significant.

Contact details for the organisations listed above can be found at:

Drinking Water Inspectorate:
[1]www.dwi.gov.uk/contact.shtm

Environment Agency:
[2]www.environment-agency.gov.uk/contactus

Food Standards Agency:
[3]www.food.gov.uk/aboutus/contactus

Department for Transport:
[4]www.dft.gov.uk/contact

Yours sincerely


Dear Defra UnHelp Line,

Thank you very much for your stone-walling, and attempts to divert
this FoI request.

However I have (in the meanwhile) had the good fortune to be told,
via a friend, to check up on "Chemtrails". When I did that I saw
many, many pictures, from all over the world, looking exactly like
the sky markings I tried to describe.

And, guess what! The answers to my questions are already known!

These 'trails' contain such substances as barium (radio-active?
Barium Meal given to X-Ray patients?), and aluminium.

I'm breathing, eating, and drinking barium & aluminium?

And the Department of the Environment doesn't mind?

This is within 'EU guidelines'?

Well, I certainly mind, even if you & the EU don't.

But then apparently, it gets worse. This chemtrail soup also
contains nano-technology-sized pathogens …

(pathogen: noun: any micro-organism, especially a bacterium or
virus, that causes disease in a living organism)

… and that these can accumulate, and link together to destroy the
electro-chemical balance of any living creature.

Or, to put it another way "they are *very* not nice at all".

All this information comes from:

http://www.curezone.org/forums/fm.asp?i=...

… which includes a test to see if you are affected (you will be),
and various detox methods.

Or, to put this another way "The EU Guidelines are obviously a very
sick joke, devised by some very sick people"

Defra: You and your EU have been absolutely no help whatsoever. In
fact 'deliberate hindrance' would be a far more apposite
description.

Yours sincerely,
Veronica

Dear Ms Chapman,
Thank you for your email of 12 July regarding unusual markingsin the UK
skies. I have been asked to respond.
I am unable to add anything further to the previous response from my
colleague Christopher Conder.

I hope this is helpful.

Dear Sir or Madam,

The information you have supplied has not been helpful in the
slightest. (So ... well done! You are doing your job!). Fortunately
I found the information elsewhere.

Along with the information I received from elsewhere, came a
homeopathic detoxification method designed to kill (without any
side-effects) any parasitic activity that I may very well have
inadvertently breathed in (under your EU Guidelines).

Since you, presumably, breathe the same EU-Guidelined air as I do,
all I can do is to wish you good luck, in the long term, with skin
lesions that 'just don't seem to want heal, no matter what you do'.

Yours sincerely,

Veronica Chapman

Dear Ms Chapman,
Please see our response on aviation contrails here

Dear Roger Worth,

Than you for the documentation on Contrails, which is totally
irrelevant because my question was about CHEMTRAILS ... which have
been analysed to contain barium and aluminium, etc, and also some
for of nano-particles which (possibly) create Morgellon's disease.

On re-reading your response, and my original request, it seems
clear to me that you did not read my original request.

So, in order to clarify the situation please be so kind as to read
this.

I am not in the slightest bit interested in Contrails left by
high-flying aircraft … even where these ice crystals may contain a
small amount of unburned kerosene (paraffin).

The 'unusual markings' of this FoI request relate to CHEMTRAILS
(Google it!) left by LOW-FLYING aircraft, in various shapes … such
as "V"s and "X"s, parallel lines, etc. Sometimes these cover the
entire sky as they spread out.

According to independent Analysts these CHEMTRAILS comprise such
substances as barium (which is, of course, radio-active),
aluminium, and other materials. There is good information on the
Internet to state that these CHEMTRAILS also contain nano-particles
(Google it!) which cause Morgellon's Disease (Google it!).

CHEMTRAILS are what forms the subject of this FoI request.

I would like confirmation of the EXACT chemical composition.

I would like confirmation of exactly how long this has been going
on. (Some have said "two decades")

I would like to know who authorises this, and WHY.

Since I breathe the air, eat the food from the food chain, and
drink the water, I think I have the right to know. Don't you?

Yours sincerely,
Veronica

I am not aware of any scientific work by credible scientists that supports the existence of chemtrails. Limited analysis has been undertaken to analyse contrails but you are not interested in them.

I would be interested in seeing the source that you refer to so that I can consider circulating it amongst our scientific advisors.

I've done a quick search of the internet on Morgellon's disease and it appears more closely related to soil than to anything else.

Sorry I can't offer you anything more substantive
Roger Worth

Dear Roger Worth,

You said: "I am not aware of any scientific work by credible
scientists that supports the existence of chemtrails".

You don't need Scientists. All you need is to *open your own eyes,
and look upwards*

Or Google "Chemtrails"

The distinction between "Contrails" and "Chemtrails" is totally and
blindingly OBVIOUS to anyone with open eyes and a functioning
brain.

Your statement indicates you (presumably) possess neither of these
essential organs which, with the greatest respect, renders your
statement utterly crass. Are you actually PAID to write such purile
rubbish?

Yours sincerely,

Veronica Chapman


Sadly, the conversation ends. Veronica has her homeopathic detoxification method (whatever that is) and poor Roger Worth had to write with patience to a crank - I would love to know what he 'wanted' to write.

Freedom of Information is a fantastic resource and is an excellent step towards open government, I suppose the downside is something like the above. It's all a government conspiracy, if you ask me ;)

Monday, May 11, 2009

Swine Flu: What's the difference between US pill peddlers and UK ones?

Interesting little comparison this.

According to the Natural Products Insider,
The American Herbal Products Association (AHPA), the Consumer Healthcare Products Association (CHPA), the Council for Responsible Nutrition (CRN), the Natural Products Association (NPA) and the United Natural Products Alliance (UNPA) are endorsing the following unified advisory for marketers and retailers of dietary supplements:

* Marketers and retailers of dietary supplements are urged to refuse to stock or sell any supplements that are presented as treating or curing swine flu, and
* Marketers and retailers should refrain from promoting any dietary supplement as a cure or treatment for swine flu.
* Anyone who believes they may have swine flu or may have come in contact with the virus should contact a healthcare professional. More information on swine flu and the proper actions to take if you suspect you are ill is available on the Centers for Disease Control Web site.

“There are dietary supplements that have much to offer in terms of enhancing general immune function,” the released statement said. “However, therapies for the treatment of swine flu should only be recommended by qualified healthcare professionals or public health authorities.”


"Marketers and retailers should refrain from promoting any dietary supplement as a cure or treatment for swine flu" - pretty admirable, in my opinion.

How does that compare with the UK stance?

Everyone's favourite science-mangler, Patrick Holford starts with a informercial entitled "Can Vitamin C kill swine flu?". A lovely little example of Dr*T's First Theory, amended to include Patrick Holford articles (we'll leave aside the long time debate about whether it's possible to 'kill' a virus). The article is sharply fisked on the tireless HolfordWatch site.

Mind you, Holford has form when it comes to Vitamin C - he has previously claimed that AZT (an anti-HIV drug) is more harmful and less effective than Vitamin C.

AZT is more harmful and less effective than Vitamin C.

I thought it deserved repeating. So Vitamin C is more effective at combatting AIDS than an anti-HIV drug - which is something his old buddy Matthias Rath thought as well. In fact, those of you who have been stocking up on brain-boosting fish-oils will no doubt remember that Rath bought full page adverts denouncing Aids drugs in South Africa while promoting his vitamin pills. Whenever Guardian columnist Ben Goldacre said as much, Rath sued - and subsequently dropped the case incurring 'alf a million nicker in costs.

It's also a striking coincidence that Rath and Holford are again buddies-in-arms with regards to swine flu - Rath (a la Holford) has published an infomercial on his site and expounds the benefits of....? anyone? anyone? Bewler? Correct - Vitamin C (amongst some other oh-so-scientific micronutrients).

Helios Homeopathy have followed a similar "Here is some information on Swine Flu and what you should do (oh, and buy some homeopathic products)"-infomercial pattern, including this Arthur Weasley McWeasle wording
Homoeopathy has a long history in the treatment and prevention of epidemic diseases. However it must be stressed that there is at present only anecdotal and bibliographical evidence that homoeopathic prophylaxis works
The Irish Homoepathy Society are joining a Swine Flu Taskforce, which will be extremely helpful -
The [homeopathic] organisations are being urged to exchange validated information and details to determine the most effective remedies to be used in the treatment of the condition.
I wonder will they only concentrate on homeopathic remedies or actually look at effective ones?

Holland & Barrett wouldn't do anything as clumsy as advertise swine flu products. No. They just put a big banner saying "SWINE FLU WATCH" and then list some completely unconnected products underneath it (including Vitamin C) and in no way are they saying that these products are for swine flu - definately not. No sir. The banner is just there to fill space.

The Alliance for Natural Health hasn't succumbed to selling or advertising pills for the pig flu, though - there's no point because swine flu "looks to be massively overblown by the media, by governments and by the drug companies."

Perhaps a hint of a Swine Flu conspiracy theory there?


BPSDB

Thursday, May 7, 2009

Homeopathy, regulation and MHRA

What an exciting title, eh?

It's always fun wading through UK and EU legislation, and many happy hours can be wiled away reading the Shakesperean prose of statutes.

This posting is brought to you by Nelson's Arnica ClikPak, the first homeopathic product to receive approval by the MHRA to be labelled with therapeutic indications (i.e. is allowed to put on the labelling the symptoms that the sugar pill is supposedly to aid). It really is *that* exciting.

Let me give a potted history of homeopathic labelling:

1971: The Medicines Act (1968) comes into force, issuing a Product Right of License (PLR) to all medicines (inc. Homeopathics) on the market. These allowed labelling of therapeutic indications.

1992: The Simplified Registration Scheme (Directive 92/73/EC) came into operation, which did not permit therapeutic indications on the labelling, because of the 'difficulty in demonstrating efficacy in clinical trials'.

2001: DIRECTIVE 2001/83/EC is published, which amends Dir 92/73/EC - the full text of it can be found here (pdf). The important bits (Article 68 & 69) are reprinted here for your nigh-orgasmic delight.

Article 68: Without prejudice to the provisions of Article 69,homeopathic medicinal products shall be labelled in accordance with the provisions of this title and shall be identified by a reference on their labels, in clear and legible form, to their homeopathic nature.

Article 69
1. In addition to the clear mention of the words homeopathic medicinal product’, the labelling and, where appropriate, the package insert for the medicinal products referred to in Article 14(1) shall bear the following, and no other, information: the scientific name of the stock or stocks followed by the degree of dilution, making use of the symbols of the pharmacopoeia used in accordance with Article 1(5), name and address of the registration holder and, where appropriate, of the manufacturer, method of administration and, if necessary, route, expiry date, in clear terms (month, year), pharmaceutical form, contents of the sales presentation, special storage precautions, if any, a special warning if necessary for the medicinal product, manufacturer's batch number, registration number,homeopathic medicinal product without approved therapeutic indications’,a warning advising the user to consult a doctor if the symptoms persist during the use of the medicinal product.


2006: Following consultation MLX 312 (pdf here), the National Rules Scheme was introduced in Sept 06 by the MHRA. According to the MHRA website:
The purpose of the Scheme is to enable homoeopathic medicinal products to be registered with indications for the relief or treatment of minor symptoms and conditions (those that can ordinarily be relieved or treated without the supervision or intervention of a doctor).
The main changes were that homeopathic products should be allowed to label therapeutic indications, but more importantly, would not have to demonstrate efficacy - due to the difficulty in getting clinical trial success. (In my humble opinion, it shows that the clinical trial system was working, but in good government style it's best to change the system until it gives the answer you want). In this case, the 'efficacy' charge was relegated from clinical trial success to:
provide suitable evidence that the product has been used as a homeopathic treatment in the indications sought.
Information provided should be in the form of provings, excerpts from homeopathic materia medica or other
bibliographic data and should be sufficient to demonstrate that homeopathic
practitioners would accept the efficacy of the product for those indications.
In fairness, that's pretty bonkers. Just so as you know, a 'proving' is when you take a new homeopathic remedy (30c is the concentration normally used, which means there is no possibility of there being a single molecule of the original tincture left in the remedy) and give it to healthy people who then are asked to describe what symptoms it gives. These symptoms are then the symptoms homeopaths use to proscribe this new remedy against. The Materia Medica is the collection of these provings. As I say, it's pretty bonkers - BUT - it's good enough for the UK's Medicines and Healthcare Products Regulatory Agency.

OK, due to no real efficacy needing to be demonstrated, the therapeutic indications are limited to self-limiting problems that normally wouldn't require medical intervention, but this is certainly a start at legitimising quackery. (But thankfuly, due to this clause, provings such as the ones for HIV/AIDS (I can't believe it either) cannot be used to make homeopathic products with therapeutic indications for AIDS.

[Just to spell it out, I, Dr* T, think that it is disgusting, immmoral, unethical and disgraceful for anyone to try and give a sugar pill to someone with AIDS and telling them they will be cured. In fact, it's difficult to believe anyone would do it. Step up, Jeremy Sherr. He's also alleged to have recommended people come off the ARV AIDS treatments as part of his trial, but his blog containing the statement was removed. This is the closest I've come to using the c-word on my blog]

When the MHRA announced in 2006 that homeopathic products were going to be issued with approvals for therapeutic indications without having to give any (non-bonkers) evidence of efficacy, understandably there was an outcry from rationalists and skeptics across the land. Sense About Science put out a statement , DC Science had quite a bit to say, amongst others (pdf).

The finalised Homeopathic National Rules Scheme is summed up here (pdf) in this Brief Guidance for Manufacturers and Suppliers.

From that, here is a list of examples of indications that would not be acceptable on a homeopathic product:
Bone diseases
Cardiovascular diseases
Chronic insomnia
Diabetes and other metabolic diseases
Diseases of the liver, biliary system and pancreas
Endocrine diseases
Genetic disorders
Joint, rheumatic and collagen diseases
Malignant diseases
Psychiatric conditions
Serious disorders of the eye and ear
Serious gastrointestinal diseases
Serious infectious diseases including HIV-related diseases and tuberculosis
Serious neurological and muscular diseases including epilepsy
Serious renal diseases
Serious respiratory diseases
Serious skin disorders
Sexually transmitted diseases
Treatment and Prevention of malaria
and some that would:
Indigestion, heart burn, hyperacidity, dyspepsia, halitosis (bad breath) or
flatulence
Colicky pain, stomach ache or nausea, occasional or non-persistent diarrhoea or
constipation
Travel sickness or related symptoms
Minor skin infections, relief of pruritus or exanthematous rashes of childhood
infection and boils, athlete’s foot
Common colds, coughs, conditions commonly referred to as influenza and similar
upper respiratory tract infections
Minor acute inflammatory conditions of the buccal cavity and pharynx including
sore throats
Muscular pain and stiffness including backache, sciatica, lumbago, fibrositis,
rheumatic pain and cramp.
Hay fever, rhinitis and catarrh.
Blocked-up sinuses.
Headache including migrainous headache
Neuralgia
Difficulties falling asleep
Agitation, anxiety, irritability, nervous tension, stresses, strains, tenseness

All pretty classic alternative medicine claims - i.e. minor ailments that will get better on their own, and excellently suited to a placebo response.

Next, the labelling. How do you ensure that people know that it is a homeopathic product and not anything that will actually do anything? According to the MHRA,
The labelling should also refer, in clear and legible form, to the homoeopathic nature of the product (article 68 of the 2001 Directive).
Nelosn's Arnica ClikPak states it is:
a homeopathic medicinal product used within the homeopathic tradition for the symptomatic relief of sprains, muscular aches and bruising and swelling after contusions
which as far as I can see, is the standard phraseology that all homeopathic medicines will be required to contain.

[I asked MHRA for a document relating to this, and they sent me one from 2004, which stated that the homeopathic product wasn't allowed to show therapeutic indications! Do try to keep up with your own meddlings, MHRA].

The full dossier for Nelson's Arnica ClikPak has yet to appear on the MHRA website for public assessment reports which means I guess they can't actually put the therapuetic indications on the label and sell them yet, but will do soon. When it arrives, I'll let you.

So that's about it. You can wake up now. Tha's quite enough legislative bodice-ripping for one afternoon.

BPSDB

Tuesday, May 5, 2009

On cam lesions, arthritis and the bizarre world of homeopathy

So I haven't been blogging as much recently, give a guy a break.

As it happens, I've been back on the slab having an open hip debridement to remove 'cam' lesions - basically opening up the hip, dislocating the femur, and removing all the osteophytes (bony growths) on it that were causing pain and restricted movement. Hopefully this will greatly slow the progression of osteoarthritis already apparent in the hip joint.

All of which means I have plenty of blogging time to make up for the past month or so, as well as an extremely bruised arse. A friend wryly offered me some arnica ("everyone knows that arnica heals bruising") so I sent her an (admittedly small) placebo controlled trial comparing metronidazole with arnica and placebo in the prevention of post-surgical complications. The trial showed the metronidazole did what it was supposed to, but more interestingly, the arnica gave rise to more pain and increased swelling compared to placebo.

Homeopaths have an odd relationship with arthritis in general. The reasons for getting osteoarthritis are not at clear - there appears to be a large element of heredity involved, with obesity and previous joint injury also playing an important part. There is plenty of research going in to finding out why it happens, because the truth is, we don't completely know.

Or perhaps I should qualify that statement - 'we' includes the medical establishment and arthritis charities, but doesn't include homeopaths.

The College of Practical Homeopathy in London would rather have you believe that:
Poor nutrition, allergies, infections and food sensitivities can lead to [arthritis] problems. Overuse and dietary imbalance can lead to a breakdown of cartilage.
More bizarrely, arthritic conditions are linked to
the underlying emotional states of resentment, feeling victimized, bitterness and lacking in love.
That's right, your arthritis will get worse unless you get yourself some good ol' loving and stop being such a sourpuss.

Of course, I'm trapped in the modern medical paradigm of wanting my disease cured, or failing that, having the symptoms managed so that I can live with the problem, unlike the complementary therapists who look at you holistically:
Our practically trained Homeopaths will establish the causes of your symptoms. If they can see clear causes (physical traumas or emotional shock etc), in your time line, they may treat these first before going on to a detox program.
You see, if people come to a homeopath regarding arthritis, they'll already know the causes of the symptoms - it's the arthritis. You can tell them that it's because they are unloved or that they don't eat enough goji berries, but that would be bollocks. And a 'detox' (a crock of nonsense in itself) will do nothing for arthritis.
They will take into consideration your nutritional states, and support you in developing a healthier approach to your nutritional needs and in taking action to achieve a healthy lifestyle.
More confusion - what are they going to do for the arthritis? And why are they calling themselves homeopaths? There's nothing homeopathic in their plan. In summary, they are incorrect in the causes, they are bizarre in their understanding of disease progression, and they are clueless about their own ability. They'll happily take your your money of course, caveat emptor but, as long they don't do anything inappropriate, Ofquack, the 'regulator', is happy.

Even Dr Peter Fisher, homeopath to the Royal Family is confused:
Osteoarthritis ... is basically 'wear and tear' of the joints.
Whoops, wrong again. So give us an example, Dr Fisher, of a cause of arthritis. No seriously. The article is here.
For instance, a woman came to consult me with extra-articular manifestations of rheumatoid arthritis...when I enquired into the social background it turned out she had been through a messy divorce, including a court battle for custody of the children, which she eventually won. The onset of her illness coincided almost to the day with the end of the custody case. I was amazed that she did not make the connection.
Ah yes, causes of arthritis include joint injury, obesity, heredity and custody battles? This is the royal physician, remember.

In the last part of this fun rant, I'd like to direct you to an article written on the National Rheumatoid Arthritis Society Website, titled "Homeopathy in Rheumatoid Arthritis". The article was written by Professor David L Scott of King's College, London and near the end, discusses a small clinical trial (58 people) of rheumatoid arthritis that was 15 years in the preparation:
During the 6 months of treatment the pain scores fell by 18%, their tender joint counts fell by 24% and their and ESRs fell by 11%. However these improvements were unrelated to homeopathic treatment. They reflected the fact that only patients with improving disease could remain on this type of therapy. Not only were there no benefits from homeopathic treatment but the placebo-treated cases actually showed greater improvements in pain scores. Mean pain scores were significantly lower after 3 months' placebo therapy than 3 months' active homeopathic therapy.
I'm not sure if this was ever published - PUBMed draws a blank - but Prof Scott is 'unclear how to interpret the negative results', concerning more with the question of
is it cost-effective to complement conventional therapy in patients requesting homeopathy? It seems more important to define if homeopathists can genuinely control patients' symptoms and less relevant to have concerns about whether this is due to a ‘genuine’ effect or to influencing the placebo response.
I disagree with this completely - and so should every self-respecting homeopath, but for different reasons. Surely homeopaths don't look at symptoms, they look at the whole person? Surely, any self-respecting homeopath with belief in the religion of dilution would be looking to reestablish the 'natural curing abilities of the body' and remove the rheumatoid arthritis completely? Surely only nasty 'conventional' medicine treats only the symptoms?

It's pretty clear to me from the homeopaths themselves they are clueless about arthritis - it's cause, it's progression and most importantly, it's alleviation and cure.

And that's without having to mention that homeopathy itself is drivel.

BPSDB

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