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The Society of Homeopaths: failing to make the case for homeopathy
Homeopaths publish ten studies they claim affirm the 'potential benefits of homeopathy for a range of health problems', but do they withstand scrutiny?
Homeopathy is under severe pressure in the UK with what little credibility it had, destroyed. The ending of referrals from GPs in Liverpool and the Wirral over the last year or so and consultations on the future of homeopathy in Clinical Commissioning Groups in Bristol and Enfield, and more recently by NHS England, have piled on top of the decline by 96% of NHS prescriptions for homeopathy in England in the past 20 years.
We have also seen the recent announcement that Weleda (a supplier of homeopathic and anthroposophic products to the NHS) is ending the production of their 'bespoke' homeopathic products. The pending outcome of a consultation by the Charity Commission on CAM charities could add yet more woe.
We could be seeing the final death throes of homeopathy on the NHS with possible knock-on effects on the businesses of lay homeopaths: many relying on the false imprimatur leant to it by the NHS.
In November, the Council of the Royal College of Veterinary Surgeons (RCVS) issued a position statement including 'Homeopathy exists without a recognised body of evidence for its use. Furthermore, it is not based on sound scientific principles.'
This followed a statement in September 2017 from the European Association of Science Advisory Councils, which represents the national science academies of 27 countries, concluding that homeopathy 'can actually be harmful: by delaying or deterring a patient from seeking appropriate, evidence-based, medical attention and by undermining patient and public confidence in scientific evidence.'
Homeopaths are also under pressure from the Advertising Standards Authority to make sure their advertising is 'legal, decent, honest and truthful', but many still seem to have difficulty with those principles. To protect the public from misleading claims, the ASA rightly sets a high standard of evidence — one clearly too high for homeopaths. But the ASA make it easy for homeopathy advertisers, stating: "Practitioners should therefore avoid making direct or implied claims that homeopathy can treat medical conditions." Crystal clear.
Whether it concerns human or animal health, the debate is clearly about the consideration of the best available scientific evidence; to that battle, homeopaths come unarmed. Continue reading
The Scotland College of Chiropractic: out of kilter with science?
Guest post by Blue Wode
What have the Scots ever done for us? The answer is a candid 'quite a lot'. Over the last few centuries we have been indebted to many remarkable, but often unsung, Scottish scientists and innovators for improving the quality of our lives.
By comparison, what have chiropractors ever done for us? Perhaps not surprisingly, they have failed to offer anything of unique value to science. Indeed, much of chiropractic involves blatant quackery, including a strong belief in the bogus notion of vitalism (an immeasurable and un-observable force), and cult-like references to chiropracTIC and vitalisTIC, which refer to the philosophy of chiropractic that has at its centre the principle that life is intelligent. Moreover, increasingly the effects of chiropractic's main intervention, spinal manipulation, are being shown to be non-specific and not without risks.
However, despite such unfavourable evidence emerging over the last decade or so, the chiropractic profession in the UK continues to enjoy the automatic respect and benefits lent to it by statutory regulation and a Royal Charter that was awarded to its foremost professional membership body despite that body failing to fully comply with the requirements set out by the UK Government's Privy Council. As if such spurious legitimacy wasn't enough, it now looks like a further storey is about to be added to this healthcare house-of-cards in the form of the 'Scotland College of Chiropractic'.
Life University
Unlike all the other UK chiropractic colleges — the Anglo European College of Chiropractic (AECC), the Welsh Institute of Chiropractic (see also here) — and the McTimoney College of Chiropractic, the Scotland College of Chiropractic does not hold a .ac.uk domain. In fact, it has two domains, the other being Life Scotland, a name that indicates that it has a strong affiliation with the controversial 'Life University' in Marietta, Georgia, USA.
The Italian Job
Life University has already been negotiating a partnership with the Italian Chiropractic Association in Rome, Italy, with the purpose of offering a Doctor of Chiropractic degree. As a branch campus of Life University in Italy, offering an identical curriculum, its accreditation (recognition) would be through the U.S. Council of Chiropractic Education and the Southern Association of Colleges and Schools. This set up would allow Life University students to study for their degrees in Italy while continuing to have access to US federal financial benefits. According to the 2015 Fall edition of Life University's Your Extraordinary LIFE magazine, the Italian campus is scheduled to open in 2018. In the interim, having confessed that it is "barely graduating enough DCs (Doctors of Chiropractic) to replace those retiring or passing away", Life University is busy forging other partnerships which, like the new campus in Italy, appear to fall under its Global Initiatives programme, which harvests educational institutions "that recognize the value and vision of building sustainable partnerships around the world". These partnerships are based "on the Vitalistic paradigm that drives the entire University", and will benefit from 'Presidential International Initiative Scholarships' that are "awarded in key areas of the world where recipients must return to their home country to further develop our partnership goals in order to promote chiropractic philosophy internationally". Notably, a trade body, the Scottish Chiropractic Association, already offers Life University scholarships, no doubt in full knowledge that chiropractors who have graduated from Life University who wish to work as chiropractors in the UK need only pass a Test of Competence to achieve registration with the UK statutory regulatory body, the General Chiropractic Council. But more about the Test of Competence later.
The General Chiropractic Council
As the statutory body for chiropractors in the UK, the General Chiropractic Council (GCC) is responsible for setting the standards of any educational organisation in the UK that trains anyone who wants to be called a chiropractor. Essentially, it decides whether these establishments are entitled to issue chiropractic degrees (see Section 14.—(1) of the Chiropractors Act 1994). On page 19 of the GCC's current Degree Recognition criteria (up for review this year) it says that "the course must be at the minimum at the level of an honours degree or integrated masters degree validated by a UK-recognised higher education institution". Currently, the GCC accredits (recognises) the Chiropractic Degree Program at the University of South Wales (the first university in the UK to offer a fully integrated undergraduate Masters chiropractic degree), the academic programmes at the AECC (validated by Bournemouth University), and the McTimoney College of Chiropractic, which has its Integrated Masters in Chiropractic (MChiro) programme, and its postgraduate programmes, validated by the BPP University (which is a private university, owned by the U.S. Apollo Global Education Network). This raises the question, how will the Scotland College of Chiropractic, with its vitalistic Life University tie-in, meet the GCC's accreditation standards? Perhaps more to the point is, will it need to?
Scenario 1: Escaping UK jurisdiction?
It could be that the Scotland College of Chiropractic is hoping to circumvent the need for GCC accreditation via its association with Life University. This is because, in the UK, if a course is not validated by any recognised body, it can be offered by a foreign university:
Foreign universities may offer degrees in the UK provided they make it clear that they are not UK degrees. The UK authorities cannot advise on the quality of these courses. It is up to you to check what recognition arrangements exist in the country of origin for any degree course you undertake in the UK.
However, it carries this caveat:
It is an offence in the UK for any organisation to offer a degree qualification which could be taken to be that of a UK institution unless the body making the offer is recognised by the UK authorities. The relevant legislation in this area is section 214 of the Education Reform Act 1988. Organisations suspected of committing an offence under this Act will be reported to the appropriate local Trading Standards Department for investigation. This could lead to prosecution.
It is not an offence for overseas organisations to offer their own awards in the UK, as long as they make it clear that they are not qualifications from a UK institution and that accreditation is from overseas. However, the UK authorities are unable to vouch for the quality of these qualifications, many of which may involve no formal study. UK employers are familiar with bona fide UK universities and colleges and will easily detect a bogus degree.
As with the SCA scholarships mentioned above, it's likely that if the Scotland College of Chiropractic graduated students from the UK (as well as US students), they would only have to pass the GCC's Test of Competence if they wished to work in the UK. (Looking further to the future, if Scotland eventually voted for independence it's very possible that Scottish chiropractors would lobby the Scottish Government to create a sympathetic Scottish chiropractic regulatory body, the foundations for which may have been laid already.)
Scenario 2: Recognising nonsense?
But what if it isn't permissible for the Scotland College of Chiropractic to be validated by Life University? As we already know, a UK chiropractic educational body awarding a qualification must have its programmes validated by a UK-recognised higher education institution, and then have the GCC accredit it. In this scenario, would there be a UK university prepared to validate an educational establishment with such unscientific leanings? The answer seems to be yes. Using its current Degree Recognition Criteria,the GCC has seen fit to accredit the controversial, BPP University validated McTimoney College of Chiropractic, even although the college is far from science-friendly.
Conflicting views on chiropractic standards in Europe
Ironically, however, one chiropractic standard-setting organisation, the European Council on Chiropractic Education (ECCE), an autonomous organisation established by chiropractors and with no statutory powers, has been hesitant to accept the philosophy-based chiropractic element into its ranks. In 2015, it refused a request for accreditation from the McTimoney College of Chiropractic, condemning the college's philosophical orientation and questionable techniques and approaches to evidence in a 39-page report. McTimoney students fired back with a 17-page open letter to the ECCE in which they:
- questioned "the role of any organisation that singles out philosophies, techniques and/or approaches"
- questioned "the right of the ECCE to exclude accreditation based on philosophical preference" especially when its legal accreditor, the GCC, had approved them "with high levels of commendation" in its 2013 inspection
- questioned the rationale behind the ECCE's comment (see 4.2.2a of the ECCE report) that the 'scientific level of staff does not appear to be at an appropriate level for the school to teach the principles of logic (biological plausibility) and evidence of clinical practice'
- freely admitted that the McTimoney College of Chiropractic was set up "to teach traditional (Palmer style) chiropractic with a more traditional style philosophy", with an approach "developed organically…in the belief that more specific adjustments…enabled the practitioner to use less force to achieve similar goals", although it remained "something that is considered fluid, even if it taught with a degree of ordering"
- declared that "a weakness based on our philosophy is hugely disrespectful"
- stated that the ECCE appeared "to be questioning the authority of statutory powers"
The fear behind the McTimoney students' defensive response almost certainly originates in well-founded suspicions that the ECCE wants to have chiropractic fully accepted by conventional medicine by outlawing (arguably less arduous) pseudoscientific practices.
Around the same time that the ECCE refused to accredit the McTimoney College of Chiropractic, it also denied accreditation to the Barcelona College of Chiropractic. Once again, this was due to issues regarding lack of adherence to evidence-based practice, as well as because it referred to its patients as "practice members". However, unlike the McTimoney College of Chiropractic, the Barcelona College of Chiropractic, on reflection, accepted that its programme of study would "benefit from being more evidence-based". This is quite a volte-face considering that, in the past, the Barcelona College of Chiropractic has been accused of "taking five years of time and a substantial financial investment from students, promising them chiropractic wings, lying to them about their chiropractic futures…taking their fledglings to a literal cliff edge and yelling, "jump"."(It's also worth mentioning here that there is a new private chiropractic school with a vitalistic approach being secretly developed in South Australia by a handful of well-organised mavericks. They have put their faith in a chiropractor called Marc Hudson who is a self-proclaimed Shaman, chiropractic coach and 'ingenious gentleman fundraiser of Barcelona' who has odd beliefs about chiropractors being Shamen and Shawomen.)
Bringing the above ECCE accreditation issues up to date, in December 2015 the McTimoney College of Chiropractic learned that an appeal that it had launched against the ECCE's refusal to accredit it had been successful on the grounds of:
- failure to be fair and accurate
- failure to be objective; and bias or apparent bias
The Appeal Panel's report has now been sent to the ECCE's Commission on Accreditation for them to review their decision in the light of the Appeal Panel's findings. If the ECCE's accreditation commission does ultimately approve accreditation for the McTimoney College of Chiropractic, it will serve to further condone chiropractic quackery that is already rife in Europe. It remains to be seen if the ECCE will accredit the Scotland College of Chiropractic, but the current ECCE status of the McTimoney College of Chiropractic and the Barcelona College of Chiropractic can be monitored here.
Registered UK chiropractors, vested interests, and influencing an amenable regulator
Returning to the subject of the GCC and its apparent leniency in recognising the education standards of a chiropractic college with a traditional 'philosophical preference', why might this be? Evidently, it's because it doesn't have a sound knowledge of chiropractic — ie its early history, chronic in-fighting, and very shaky evidence base. For instance, its legislative framework doesn't cover the scope of chiropractic practice and, in 2015, it admitted to having no detailed information (p.14) about the make up of the UK chiropractic profession and its registrant base. Due to this ignorance, it would seem that UK chiropractors have managed, entirely unimpeded, to always elect a good proportion of subluxationist chiropractors (i.e. chiropractors who don't seem to have a problem with vitalistic dogma) as serving members on the GCC's committees. The most prominent of these chiropractors has been Christina Cunliffe, a graduate of the McTimoney College of Chiropractic, who is now Principal of it, and who has served on the GCC's Education Committee. You can learn more about her style of chiropractic here where, in an unflattering investigation, it is described as 'a cult within a cult'.
Holding similar philosophies to Christina Cunliffe is the founder of the Scotland College of Chiropractic, Ross McDonald, who graduated from this UK chiropractic college, and who appears to have been influencing the GCC for some time through a variety of channels:
- He and his chiropractor wife own a family 'wellness' practice in Edinburgh, Scotland, and together they founded The Edinburgh Lectures, "a vitalistic conference designed to educate, empower and inspire chiropractors and their staff". In the past, the lectures have featured anti-vaccination speakers .
- He has been President of the subluxation-based Scottish Chiropractic Association since 2007.
- He was Chair and co-author of the dossier, The Vertebral Subluxation Complex – The History, Science, Evolution and Current Quantum Thinking on a Chiropractic Tenet, which, in August 2010, resulted in the withdrawal of GCC legislative guidance that had previously forbidden chiropractic 'subluxations' to be linked to health concerns. The GCC's public explanation for this was that it had decided to do so after 'a Council meeting' and 'on reflection'.
- He is one of the leaders of the several hundred-strong Alliance of UK Chiropractors (AUKC), the largest vitalistic body of chiropractors in the UK, comprising members of the McTimoney Chiropractic Association, the Scottish Chiropractic Association, and the United Chiropractic Association.
Talking the ToC
As an executive of the AUKC, one of Ross McDonald's most recent attempts to influence the GCC was in a letter to it from the AUKC (see pages 11-15) that he co-signed. The letter informed the GCC of the AUKC's vote of no-confidence in its new Test of Competence (ToC) process which, as previously mentioned, is the route to GCC registration for chiropractors who haven't been trained via a GCC-accredited establishment in the UK. Indeed, the letter clearly shows the AUKC to be deeply agitated about the new ToC's evidence-based line of questioning. But that's understandable, not least because Ross McDonald might want to lessen the need for his future students to swot up on non-vitalistic educational materials in order to pass the ToC. Of particular concern is item 7 in the AUKC's letter that takes exception to the GCC examining panel's cautious views on taking x-rays in clinical practice. The AUKC claim:
One of the indications for requiring radiographic examination is the presence of neurological signs or symptoms. A subluxation (or any other name they wish to call it) by nature has a neurological component. Presence is an indication for x-rays (amongst other reasons).
In response to the AUKC's letter (see C-180615-4, page 5), the Chair of the GCC's Education Committee said that the Committee was "of the view that the new ToC system was proportionate and reflective of other regulators' approaches", and confirmed that there would be an internal review of the ToC at the end of one year, and an external review at the end of three years. Unfortunately, the Chair made no reference to chiropractic 'subluxations', which, as we already know, the GCC links to 'health concerns' (albeit indirectly). With this in mind, the outcome of the internal and external reviews of the GCC's ToC will make for interesting reading. (NB. In 2007, the GCC reported (p.13) that one of its expert witnesses claimed that chiropractic 'subluxations' were "commonplace to the point of universality in patients".)
Bumbling bureaucrats and bogus treatments
With the GCC taking an apologist stance on the subject of chiropractic subluxations, it should come as no surprise that its Chief Executive Officer and Registrar, David Howell, seems to have been caught up in the vitalistic chiropractic agenda that's gathering steam in Scotland. For instance, he attended the Scottish Chiropractic Association's AGM in October 2015. Ostensibly, his presence there was to update the Scottish Chiropractic Association's members on the General Chiropractic Council's activities. However, a 'Dr' Tim O'Shea, one of two American vitalistic chiropractors who were guest presenters at the event, blogged enthusiastically about his thoughts on it, revealing that it descended into a late night, whisky-fuelled affair in which David Howell's loquaciousness had left him with the distinct impression that the GCC's highest office "did not require a detailed knowledge of the profession that it regulated". Others feel much the same.
In view of Scotland's fine reputation for medical advancement, it's disappointing that the Scotland College of Chiropractic seems intent on helping to compromise those hard-won achievements by dragging healthcare back to a time when, in a hopeless attempt to resolve health problems, superstition and religious ritual were the order of the day. Only robust regulation can stop a pernicious slide towards a culture that's indifferent to quackery. It will mean ensuring that relevant legislators are thoroughly acquainted with The Scientific Method. Most crucially, in order for patients and the public to be truly protected, not only will transparency have to be paramount, but the inevitable backlash from chiropractors whose livelihoods will have to be earned under a defined, evidence-based scope of practice will have to be met with a persistent and conscionable resistance that firmly conveys an intolerance of double standards.
Meanwhile, the Scotland College of Chiropractic, a registered charity whose statement of purpose is "the advancement of education", continues to evolve. Its Trust was signed recently, with its Official Witness, Michael B. Dibley, declaring that
The VitalisTIC ChiropracTIC Movement is NOW bigger than ever. Get on The Quantum Train or Hang out at the Educated Station.
There is, of course, not a jot of scientific evidence for chiropracTIC, but no doubt chiropractors who aren't dedicated to the realities of science will be more than happy to place their trust in the Scotland College of Chiropractic and its associates. However, potential students should seriously consider doing the exact opposite. They need to ask themselves if there's a good chance that they would be wasting their time and money, and risking harm to themselves, and others, in pursuing a career in which they could find out too late that spines aren't the only things that can be manipulated for a fee.
Another homeopathy fail
Prof Ernst has covered the details of the Judicial Review brought by homeopathy user Honor Watt against NHS Lothian after their decision to withdraw funding for homeopathy referrals to the Glasgow Homeopathic Hospital: Homeopathy: another day in court + another defeat.
The judgement, published yesterday, names the three products she was prescribed and calls them 'homeopathic medicines': Agaricus and Rockrose for anxiety and Bovista for arthritis.
Ignoring the fact that many homeopaths would baulk at the notion of prescribing a homeopathic potion for a particular medical condition rather than treating her 'holistically', it's interesting to look at these in a bit more detail.
We know that the Glasgow Homeopathic Hospital buys most or all of its supplies of homeopathy products from Freemans Homeopathic Pharmacy in the village of Busby, just south of Glasgow.
Agaricus and Bovista (puffball) are both genuses of mushroom and Freemans list four different Agaricus products: Agaricus Bulb, Agaricus Emet, Agaricus Muscarius and Agaricus Stercorarius, and one Bovista product: Bovista (Lycoperdon Gigan). It could well be these that Watt was prescribed.
Flower power
RockRose isn't listed as a homeopathic product, but Rock Rose is one of the 38 Bach Flower products and Freemans do sell these — genuine Bach Centre products, apparently — so it could be this she was prescribed for her anxiety.
Homeopath Dr Edward Bach described Rock Rose thus:
The rescue remedy. The remedy of emergency for cases where there even appears no hope. In accident or sudden illness, or when the patient is very frightened or terrified or if the condition is serious enough to cause great fear to those around. If the patient is not conscious the lips may be moistened with the remedy.
Bach Flower products are not homeopathic, of course: they are very dilute herbal products, usually diluted to around 1 part in 100,000 using brandy and grape alcohol. And there is not a jot of good evidence to support any notion that it can do what Bach supposed it could.
But then, Bach Flower Remedies are foods, not medicines and have been that way since the medicines regulator, the MHRA, cancelled the Product Licences of Right (which they had held for the past 40-odd years) in January 2014. Because of this, they are now classified as foods and have to abide by the rules laid down by the EU Register of authorised health and nutrition claims. In the UK, advertising claims for food supplements fall within the remit of the Advertising Standards Authority. The rules do allow some health claims to be made, but only ones authorised as shown in the register. However, because Bach products are mostly alcohol, the rules rightly prohibit any health claims.
The Bach Centre sells Rock Rose in the usual 10 ml bottle for £5.99 to the general public. I wonder how much NHS Lothian were paying?
Only by the label
Of course, the two mushroom products are unlicensed medicines and as such, should not be advertised, sold or supplied to the general public, but we know that Freemans have sold other unlicensed medicines to the public, including homeopathic owl.
We also know that, once in their bottles, it's a bit difficult to tell which is which. Giving evidence to the House of Lords Science and Technology Committee in 2007, Kate Chatfield. representing the Society of Homeopaths and a senior lecturer in homeopathy at the University of Central Lancashire was asked:
Lord Broers: I have a simple, technical question about homeopathy and drugs. Is it possible to distinguish between homeopathic drugs after they have been diluted? Is there any means of distinguishing one from the other?
Ms Chatfield: Only by the label.
Prof Ernst was also present, but Hansard doesn't record whether he chuckled at that admission.
Too many Cooks?
John Cook of North West Friends of Homeopathy and director of the British Homeopathic Association (BHA) gets a mention in the judgement as having been specially invited by Lothian Health Board during their consultation and the judgement mentions that the Board's submission says:
The real force behind the petition [to the Court of Session] was a charity, not the petitioner. [Honor Watt]
The Judge says no more about this — presumably because it was irrelevant to the case as presented — but the BHA is mentioned in relation to its position on the evidence for homeopathy.
We know the BHA — and John Cook in particular — are staunch defenders of homeopathy and they are one of only of several homeopathy charities, but it does seem a fair assumption that it was the BHA that was behind this — they are a charity, after all. Perhaps they were funding it as well. It could have been another homeopathy charity, Homeopathy: Medicine for the 21st Century [sic]. Who knows? If you do, please let me know.
I was checking the documents of the BHA that are filed at Companies House and noticed that two documents were filed on 20 August:
Termination of appointment of John Kenneth Halesworth Cook as a director on 15 April 2015
Termination of appointment of Francis Samuel Treuherz as a director on 3 August 2015
The BHA's website still shows Treuherz (who also runs the website Homeopathy Helpline [sic]) as a trustee, but not Cook. Cook is shown as a Trustee in archive.org's cache of that page on 16 March 2015.
The Charity Commission also shows the Treuherz as a trustee, but not Cook but their 2013–2014 report (filed on 15 May 2015) states (bizarrely):
Mr John K H Cook (retired 15 April 2015)
Interestingly, their area of operation as noted on the Charities Commission website is 'Throughout England and Wales'. If it really was them behind the JR in Scotland, might the Charities Commission be interested (although given recent events it seems unlikely)?
It could be Cook was due to stand down (he was 68 in April) anyway… but is it a coincidence these documents were filed just seven days before the judgement was handed down?
Whatever has been going on, the fact remains that homeopathy on the NHS is becoming increasingly marginalised, adding to the other recent signs that homeopathy is in its death throes on the NHS:
The (further) decline of homeopathy on the NHS
NHS Lanarkshire to end referrals to Glasgow Homeopathic Hospital
More misleading claims at NHS Homeopathic Hospitals
NHS Homeopathy Legal Challenge
And what better excuse is needed to again highlight this, showing the decline in the number of NHS homeopathy prescriptions fulfilled in community pharmacies in England: a drop of 94% in the past 17 years.
The evidence for David Tredinnick MP
Last month, the following exchange took place in the House of Commons during Health Questions, supposedly about the Government's revised adult Autism strategy:
David Tredinnick (Bosworth) (Con): Is my right hon. Friend aware that there is clear evidence that homeopathy is effective in treating autism, especially when doctors have not found a solution? Now that the Society of Homeopaths is regulated by the Professional Standards Authority, will he make more use of homeopathy in the health service generally, and in this particular instance?
Mr Speaker: The hon. Gentleman's question is quite a long way from the statutory guidance, but it can be given a brief reply.
Norman Lamb: I have to say that I was not aware of the information provided by the hon. Gentleman. I should be happy for him to send me more information, but I make the general point that it is always important for us to base our decisions and expenditure on evidence.
We know Tredinnick is a True Believer in homeopathy and all thing quackish, but here is a definitive claim that "there is clear evidence that homeopathy is effective in treating autism".
There is, of course, no good evidence homeopathy can effectively treat any condition whatsoever other than HWS (Heavy Wallet Syndrome), but it would certainly be interesting to see what evidence Tredinnick thought substantiated such a bold claim.
Since Normal Lamb (Minister of State for Care and Support at the Department of Health) asked Tredinnick to send him that information, I submitted a Freedom of Information Act request to the DoH to get hold of that 'clear evidence'.
The information provided consisted of a letter from Tredinnick, an article from the magazine Homeopathy in practice from 2010 titled Saving a lost generation: Autism and homeopathy and a screenshot of the home page of the website CEASE Therapy, originally created by the late homeopath and MD Tinus Smits:
See also Lee Turnpenny's take on this FOIA response: 'MINISTER FOR QUACKERY': TREDINNICK'S CONTINUING FOLLY
The letter
Tredinnick told Lamb:
As you will be aware, in the past 20 years there has been a dramatic rise in neurological and developmental disorders in children, particularly Autism Spectrum Disorder (ASD). Conventional medicine considers ASD incurable, and offers powerful pharmaceutical medication to deal with the most difficult behaviour, often with serious side effects.
However, there is ongoing work in this area by homeopaths in various places around the world including the Netherlands, United States and Australia, which suggests that homeopathy could be effective in tackling the possible underlying causes behind autism. I attach an article and information on this for your information.
Whilst the evidence on autism could be described as anecdotal, there were, up to the end of 2013, a total of 188 RCT papers in homeopathy (on 100 different medical conditions) which have been published in good quality scientific journals. 44% of the RCTs have a balance of positive evidence and only 5% are negative. The remainder were inconclusive which does not mean they are negative.
In light of the large number of conditions that conventional medicine finds difficult to treat, including autism, this is an area which does warrant further research.
Where to start with this…
Tredinnick regurgitates the same old zombie arguments and fallacious nonsense homeopaths and their supporters are wont to do.
But remember Tredinnick proclaimed in the House that "there is clear evidence that homeopathy is effective in treating autism", so it's surprising that he didn't bother to provide any…
But at least he now says:
Whilst the evidence on autism could be described as anecdotal…
Is this his 'clear evidence'? Is he now saying that anecdotal evidence is 'clear evidence' or has he realised that anecdotes are not 'clear evidence' and shifted his position? I doubt he has any clue.
Imaginary numbers
He has clearly taken what the British Homeopathic Association have published as gospel, but he's quoted what they said last year:
The BHA's current page has slightly different numbers, but let's take Tredinnick's outdated numbers to show how he misrepresents the balance of evidence.
He states that only 5% are negative and that 44% are positive. But what of the remaining 51%? Tredinnick tells us these are 'inconclusive' and implies that these should just be ignored.
But that's not how it works.
Prof Edzard Ernst deals with this very problem in his blog post: The alchemists of alternative medicine – part 3: the 'NON-CONCLUSIVE' method:
A clinical trial is a research tool for testing hypotheses; strictly speaking, it tests the 'null-hypothesis': "the experimental treatment generates the same outcomes as the treatment of the control group". If the trial shows no difference between the outcomes of the two groups, the null-hypothesis is confirmed. In this case, we commonly speak of a negative result. If the experimental treatment was better than the control treatment, the null-hypothesis is rejected, and we commonly speak of a positive result. In other words, clinical trials can only generate positive or negative results, because the null-hypothesis must either be confirmed or rejected – there are no grey tones between the black of a negative and the white of a positive study.
Homeopaths don't like the way this turns out: it would mean that there were more negative trials than positive and that wouldn't look too good in their advertising. It's bad for business.
So, how could they spin this to make it look good for homeopathy?
Prof Ernst nails it:
One fairly obvious way of achieving this aim is to simply re-categorise the results. What, if we invented a new category? What, if we called some of the negative studies by a different name? What about NON-CONCLUSIVE?
How exactly do we do this? We continue to call positive studies POSITIVE; we then call studies where the experimental treatment generated worst results than the control treatment (usually a placebo) NEGATIVE; and finally we call those studies where the experimental treatment created outcomes which were not different from placebo NON-CONCLUSIVE.
Genius! (And it's not often that can be said about homeopaths!)
The trick that Tredinnick uses makes it look as if the balance of evidence for homeopathy is overwhelmingly in its favour (44% to 5%), but the correct way to state his numbers is: 44% are positive and 56% are negative. Remember Tredinnick said "The remainder were inconclusive which does not mean they are negative", but oh yes, it does mean they are negative — they do not refute the null hypotheses: they are therefore negative.
But even then it's still not that simple.
All trials are equal, but some are more equal than others
There is no doubt that some of these 44% trials will be of a higher quality than others and what's important is which of them are the better ones and what do the results of those show. Creating a trial that gives positive results for homeopathy is easy, but we should not be swayed by any trial without looking closely at how robust it is. If it is a trial that was not robust methodologically, we should view it with suspicion and treat its results with extreme caution. What we need to do — assuming what we're trying to achieve is not to confirm preconceived beliefs but to genuinely look to see what the best, most robust, most independent, least biased evidence tell us — is to tentatively acknowledge those better results until such time as even better evidence comes along.
This isn't the place to go through all the trials making up the 44%, but it's useful to remind ourselves of the time when the Society of Homeopaths were investigated by the Advertising Standards Authority over claims they made. Their evidence was demolished by the ASA as not being up to the standard required to substantiate the claims they made. Although the ASA don't identify the evidence the SoH provided, Cool Hard Logic on YouTube has had a very good go at identifying most of the papers. His demolition of them is a joy to watch. Click here to watch the video
But as Linde et al. noted after examining 89 placebo-controlled trials of homeopathy:
We conclude that in the study set investigated, there was clear evidence that studies with better methodological quality tended to yield less positive results.
Of course, looking at all the best evidence leads to just one conclusion:
It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.
That'll be a negative, then.
Why does Tredinnick believe otherwise?
The magazine article
Next up is the magazine article Tredinnick sent to Lamb. Perhaps it has that elusive evidence?
It's not really worth demolishing all the tropes spewed out in it by homeopath Carol Boyce MCH CCH RSHom(NA), but the flavour of it can be got from just a couple of quotes:
Under the guise of 'protecting' children from the 'scourge' of childhood diseases, known to kill or maim just a handful of (already sick) children every year in the West, the push for enforced mass vaccination may be trading our children's entire futures and with them the very future of society itself. (For more information on this see: http://www.ageofautism.com.)
The link to the notorious anti-vax site Age of Autism is very telling.
But, of course, homeopathy comes to the rescue:
Treating a case of ASD [Autism Spectrum Disorder] should be no different for the homeopath than any other case, although the options for success seem to be increased when the homeopath is familiar with the specific symptomatology of ASD, in order to identify the strange, rare, peculiar and characteristic symptoms of the case and not confuse them with those that belong to the diagnosis.
We can initially take the pressure off the system by removing the maintaining causes — gluten and casein — from the diet and supplementation to address the nutritional deficiencies that impact the ability to synthesise, catabolise and excrete.
Ultimately, though, the body must be able to complete these processes independently in order to sustain health in the absence of supplementation. Once these metabolic processes are reset and working efficiently, it stands to reason that external supplementation is no longer required and has the potential to overload the system, especially a system that has already had problems with excretion and subsequent toxicity.
There you have it in all it's sciencey-sounding jargon finery, the simple solution to treating ASD.
If only someone would tell the doctors.
At least the article doesn't fall into the usual referenciness trope and lists just:
Baron-Cohen S et al (2009) 'Prevalence of autism-spectrum conditions: UK school-based population study.' The British Journal of Psychiatry 194, 500-509 http://www.cdc.gov/vaccinesafety/Activities/vsd/priority_studies.html#3
Knapp M, Romeo R, Beecham J (2007) Economic Consequences of Autism in the UK. Foundation for People with Learning Disabilities
Boyce C (2007) 'Magnus Pharma and the Golden Goose — The case of allopathy and the implications for homeopathy.' Similia Vol 19 No 1 June 2007
Klein L (2010) http://www.narayana-verlag.com/spectrum-homeopathy/louis-klein-the-orchid-project?fromOverview=spectrum-homeopathy-012010
Scholren J (2009) http://www.interhomeopathy.org/lanthanides_in_pdd_nos
Shang A (2005) http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)67177-2/abstract
None of those, however, provide Tredinnick's 'clear evidence that homeopathy is effective in treating autism'.
Just stop it
And finally, CEASE Therapy.
Standing for Complete Elimination of Autistic Spectrum Expression, this has also been well covered elsewhere: here by Orac:
Apparently Tinus Smits was no different. I'll give him credit, though. If you're a homeopath and believe that autism is caused by vaccines, toxic medicine, other toxic substances and "some diseases," what would you treat autistic children with? If you know the Law of Similars, you know the answer. The Law of Similars states that the way to treat a symptom is to use a diluted substance that causes the symptoms. So, if you're a homeopath, it's rather obvious. If you believe, against all science, against all reason, against all medicine that vaccines, "toxic medicine" and other "toxic substances" cause autism, then there's only one thing to do, isn't there. Yes, that's right:
The treatment of autistic children and even adults has matured through 300 cases over the last three years and is called CEASE Therapy, which stands for Complete Elimination of Autistic Spectrum Expression. Step by step all causative factors (vaccines, regular medication, environmental toxic exposures, effects of illness, etc.) are detoxified with the homeopathically prepared, that is diluted and potentized substances that caused the autism. Currently we use the 30C, 200C, 1M and 10M potencies to clear out the energetic field of the patient from the imprint of toxic substances or diseases.
Yep. Unadulterated pseudo scientific nonsense.
CEASE Therapy is frequently advertised on the websites of homeopaths and the notion that vaccines are the cause of just about everything is well ingrained in the homeopathic psyche.
But still no 'clear evidence'. Perhaps there isn't any after all.
Coincidentally, Tredinnick is hosting an event at Westminster this evening that promises to be, erm, interesting. As announced on the website of the Confederation of Healing Organisations:
An email sent out by a PR company (whose website doesn't even appear to work) gave more details:
The evening, co-hosted by David Tredinnick and the Parliamentary Group for Integrated Healthcare, will begin with Professor Chris A. Roe (University of Northampton) presenting the positive results arising from the most comprehensive meta-analysis to date into the scientific evidence for the efficacy of healing as a complementary therapy. Immediately following this there will be a unique opportunity to question several of the lead researchers about the research and also the results. There will then be a wider discussion with the researches [sic] and a variety of representatives within the healing community about the implications of these results and what this means for healing as a complementary therapy within and alongside the NHS.
Forget homeopathy. Move aside chiropractic. Ignore acupuncture. We appear to have good positive evidence for Healing!
But what is 'Healing'? Even the Complementary and Natural Healthcare Council, which 'regulates' Healers, isn't very clear on what it actually is, saying simply:
The history of Healing stretches back for thousands of years. Nowadays most Healers view their work as a natural and purposeful energy based process which, from mostly anecdotal evidence, is believed to help relieve everyday stress, provide a sense of physical and emotional revitalisation and on some occasions bring about a deep sense of peace.
If you're none the wiser, you're not alone.
Anyway, this new evidence is being presented by Chris Roe, professor of psychology at the University of Northampton. His list of current research projects includes:
To conduct an analytical review of the published empirical studies on healing to date to determine whether it is tenable to claim that directed intention can have a measurable effect on another living system and to identify best practice to maximise effect sizes in future research (Confederation of Healing Organisations)
…so it looks like he's presenting the results of this research.
It'll be interesting to see what this meta-analysis is and how it stands up to scrutiny. Will it be 'clear evidence' as Tredinnick might think, or just 'homeopathic' levels of evidence?
If I get any information on it, I'll let you know.
Oh my God — it's full of stars!
While we're talking about Tredinnick, the Good Thinking Society is still waiting to hear from him after they asked him to help them test astrology.
Tredinnick certainly seems to believe in it. In the House of Commons in 2009, he declared:
In 2001 I raised in the House the influence of the moon, on the basis of the evidence then that at certain phases of the moon there are more accidents. Surgeons will not operate because blood clotting is not effective and the police have to put more people on the street.
It would be easy, you would have thought, to provide evidence for clear claims such as those.
Evidence, for David Tredinnick, is nebulous, variable and malleable to suit whatever hobby-horse he is currently promoting.
How on earth did he get on both the Health and Science and Technology Select Committees if he is so clueless about evidence?
An idiot's guide to understanding NHS homeopathy prescription data
A guide for the clueless
When writing Nightingale Collaboration newsletters, I presume readers have some basic science, search, maths and critical thinking skills. I'm sure this covers a good proportion of readers, but there seem to be some who are somewhat more challenged in these areas.
Some homeopathy supporters seem particularly inept when it comes to verifying evidence, data, facts and generally looking stuff up. Proper research seems well beyond their abilities.
In the newsletter The decline of homeopathy on the NHS, I gave links to the original Government sources for the data I used. This is certainly more than sufficient for any reasonably capable reader to use to verify the figures and charts I had created, but not, it seems for some.
So, to show how I arrived at the charts that shows the decline of homeopathy on the NHS, this is an appropriately named idiot's guide to accessing and extracting the data from the original Government source and checking the charts.
Here's one of the charts that some homeopathy supporters didn't seem to like.
I can understand why homeopaths might not like it, but letting their beliefs get in the way of reality is their problem.
One particular homeopathy supporter apparently believed that searching the HSCIC website using the words I used in the title of the chart and getting no results was sufficient 'research' to proclaim triumphantly:
(Click on the image to see a larger HSCIC search page screenshot.)
That would appear to be the limit of her 'research' abilities.
Curiosity is what makes a scientist: not being satisfied with not knowing, not understanding; being inquisitive; not giving up at the first hurdle; pushing on and on…
Homeopaths on the other hand seem content with anything that confirms their beliefs — particularly if it saves them having to think for themselves.
Data extraction and analysis
So, for those unable to do see how to do it for themselves, here's where the data come from and how they were extracted to form the charts.
As I said in the newsletter, there are two websites for the data: the HSCIC website for data since 2004 and the National Archives for older data. The HSCIC is the Health and Social Care Information Centre, the Government body that collects these data — and much more besides — and is the official source for all NHS data.
The data I used are the Prescription Cost Analysis (PCA) data. This gives data on all English NHS prescriptions fulfilled in community pharmacies. The HSCIC website search for these data returns links to pages for each year. This is published in April of each year, so the latest is the data for 2013.
Let's take the data for 2013 as an example, but this applies to all years.
Clicking on the page for that year gives Prescription Cost Analysis, England – 2013.
The source data are listed at the bottom under the heading Resources. The one of interest here is the zip file that contains all the original data rather than the other files, which are just summaries, etc. So, in this case, the file required is Prescription Cost Analysis, England – 2013: Tables [.zip]. This file is 2.3 MB.
This is a zip file, but most computers should be able to open it. In the zip file is an Excel spreadsheet, pres-cost-anal-eng-2013-tab.xls. This file is over 7 MB. Opening this in Excel gives a work book with seven tabs. The lowest level source data is the tab called 'Individual Preparations'. This spreadsheet has over 23,000 rows and 17 columns of data, giving nearly 400,000 cells of data.
Some familiarity with Excel has to be assumed here. If anyone doesn't know what Excel is, doesn't have it or can't competently use it, then that's not my problem. If your computer can't handle large spreadsheets, that's your problem too.
These data are identified by the type of prescription according to the classes in the British National Formulary (BNF). Prescriptions for homeopathy products are categorised under the single class of Chapter 2, Section 3, Paragraph 3, Sub Paragraph 0, ie BNF 126.96.36.199.
We only need one row: the one for homeopathic prescriptions. In this file, it is row 12,331. It can also be found by searching for 'homeopathy': this is worth doing anyway to check there are no other rows for homeopathy. This row has the correct BNF class as given above. The BNF SUB PARAGRAPH NAME is 'Homeopathic Preparations'.
The columns of interest are the ones headed 'Items (thousands)' and 'NIC £ (thousands)'. 'Items' is the number of prescription items and NIC is the Net Ingredient Cost, the basic cost per item, before discounts and does not include any dispensing costs or fees. These terms are defined in the Glossary.
From the 2013 data for Homeopathic Preparations, the figures are:
- Items (thousands): 13.001
- NIC £ (thousands): 137.298
This is 13,001 prescription items at a total cost of £137,298.
These figures can be checked by looking at the tab called 'Totals for BNF Sub Paragraphs'. This totals all the data by BNF sub paragraphs and row 336 confirms the above figures and that we have not missed any data in the 'Individual Preparations' tab.
The charts I created use these data and the data obtained in exactly the same manner for the other years. Collating the data for each year from 1995 to 2013 from the respective spreadsheets and putting them into a table gives:
Prescription Items
Net Ingredient Cost
Charting these data gives the charts here and in the newsletter.
The third chart, the average cost per prescription item, is simply the total cost per annum divided by the number of prescription items and can be checked with a calculator.
For anyone who's interested, the above is more than sufficient to check each chart back to the original, authoritative source data to ensure the charts are accurate.
These data clearly demonstrate to all but the most clueless that homeopathy on the NHS has declined drastically over the last 18 years. For those less numerate, the pictures show this even more clearly.
The skills required are basic: there's no multi-variant analysis, no calculation of a p-value, no calculating the skew or kurtosis of a distribution. It's all very simple and straightforward data extraction, basic computer literacy, Excel skills and simple arithmetic.
It is all basic stuff; something that scientists and skeptics do all the time to check their facts, figures and data, but, it seems, something that homeopaths and homeopathy supporters are incapable of.
Falling trust in homeopathy
There's an un-written rule — or at least there should be — that anything said in support of homeopathy cited by a homeopath or supporter should be taken with a large pinch of natrium muriaticum.
That's not to say homeopaths will always be wrong or there won't be some grain of truth in what they say, of course, but it will always bear a bit of investigation. There will frequently be more to it than meets the eye.
Take for example, a homeopath citing the meta-analysis Clinical trials of homoeopathy by Kleijnen et al. (1991). Nancy Malik summarises this paper thus:
Clinical Trials of Homeopathy (1991) FULL TEXT // 81 (77%) out of 105 RCT (1943-1990) shows statistically significant result for homeopathy and 15 out of 22 best quality studies are also statistically significant.
Out of 81, 5 out of 5 of the clinical trials for hay fever showed a positive result and 8 out of 10 trials looking at mental or emotional problems showed a beneficial effect, while 6 out of 7 trials for infection showed that homeopathy could effectively relieve the problem.
"Based on this evidence we would be ready to accept that homoeopathy can be efficacious, if only the mechanism of action were more plausible" and "the evidence presented in this review would probably be sufficient for establishing homoeopathy as a regular treatment for certain indications……..a conventional method would have been acknowledged with this amount of evidence", the results are mostly favourable for homeopathy regarding the quality of trials."
Glowing praise for homeopathy it would seem, but what she fails to mention is the conclusion the authors reached, quoted here in full:
Conclusions At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials.
Spot the difference. Malik does try to link to the paper (but not to an accessible copy of it), but how many will click on her link to check the veracity of what she says? Some other examples of conclusions homeopaths would rather you didn't read can be found on the Discover Homeopathy website.
Anyway, the point is made: always check original sources to make sure claims made by homeopaths for homeopathy are complete and accurate.
How much do people trust homeopathy? That's difficult to know unless a survey is done asking that specific question. We could perhaps use the sales of homeopathic products as a proxy, but market surveys are complex things to do and tend to cost a lot on money. Mintel, for example, will sell you their market survey on homeopathic and herbal products in the US for a mere £2,466.89 (Excl.Tax), or their report Complementary Medicines – UK – December 2009 for just £1,750. Well beyond the reach of many, including me.
But the teaser for that last report does tell us:
Growth in the UK's £213 million complementary medicines market [note: not specifically homeopathy] has gathered pace in the last two years. It is estimated to have grown in value by some 18% between 2007 and 2009 when Mintel last reviewed the industry.
We also know that the market for homeopathic and anthroposophic medicinal products in the EU exceeded €1 billion for third year in a row in 2011. It doesn't tell us anything about the sales in the UK, but it's still an interesting figure. Whither the cries of homeopaths that they have no money for decent trials? And we know there is plenty of scope to raise the money for trials if they really, really wanted to.
But homeopaths frequently like to use increasing sales figures in the mistaken belief that this somehow correlates with efficacy. Equally, sales figures are not a measure of trust: they tell only about the success of marketing and PR that they do about whether homeopathy works or whether people trust it.
But fortunately, there are some limited data available that answers that question about trust.
In a recent Tweet, a dedicated homeopathy supporter claimed:
60% growth h'pathy mkt in Europe 1995-2005 Mintel est sales in UK to reach 46M pds 2012
When asked for a source of those figures, she replied:
Mintel, Global Global TGI Barometer — look them up
I did.
As I said, Mintel reports cost a lot of money, but I thought it would be interesting to see if I could find the Global TGI Barometer source.
A search shows that the one Global TGI (Target Group Index) Barometer that pops up regularly on homeopaths' websites is the Global TGI Barometer, January 2008, Issue 33: The lure of alternative medicine. It's this article that is cited frequently in support of homeopathy, eg:
British Homeopathic Association: The growing demand for homeopathy
A survey conducted by Global TGI in 2008 found 15% of the population of Britain trusted homeopathy.
Homeopathy manufacturer, Nelsons: 150 Facts About Homeopathy
57. In India, alternative treatments, including homeopathy, are well established and integrated into the healthcare system, with 94 per cent of people saying that they have faith in alternative remedies.[8] [8] Global TGI Barometer, January 2008; Issue 33.
Dr Brian Kaplan: Homeopathy in perspective:
Homeopathy has never been so popular; currently 15% of the population of Britain trust it.1 Homeopathy is the fastest-growing form of complementary medicine and has experienced a growth of 44% since 2004.1 1. Global TGI Barometer, January 2008; Issue 33.
Homeopath, Paula Yates:
It is estimated that between 6 and 9 million people in the UK choose to use homeopathy (Source: Global TGI Barometer, issue 33 – Jan 2008).
Homeopath, Gill Marshall:
It is used by 15% of people in the UK, 27% of Germans and 40% of French people. (2)
(2) Global TGI Barometer January 2008 Issue 33: The lure of alternative medicine.
There are a couple of websites that seem to give most of the text of the article (eg here and here, but the links to the original source are broken), but none looked like the full article, so I asked the publishers, Kantar Media. Although the document is some six years old, they were kind enough to send me the full, original article: The lure of alternative medicine.
This was about a survey of 13 countries, finding out what proportion of people agree with the statement 'I trust homeopathic medicine': This puts a rather dramatic perspective on the 15% figure for Great Britain.
Additionally, it's clear that many of the statements made by homeopaths about this article are not supported by what the article actually says! I have to wonder if any of them actually read the article — it is only three-and-a-half pages long — or whether they were just parroting what others had said.
The article also says:
In many countries, particularly in Europe, consumers are less convinced. At 15% agreement, Britons are the least trusting of homeopathy, and only 1 in 10 say that they prefer alternative medicine. Even in Germany, the birth place of homeopathy, just 27% of people trust this kind of treatment. France is the European market in which people are most trusting of homeopathy.
Unfortunately, we can only speculate about the historical, cultural and political reasons for these marked differences, but maybe the reason for the figure for France is more obvious?
But now we know that one of the sources the homeopathy supporter cited did not substantiate the claims she made for the growth in homeopathy. No surprise there. Copying and pasting without engaging brain is an all too familiar gambit of homeopathy supporters — perhaps through ignorance or in the desperate hope that no one will bother to check… More likely, though, it can be attributed to a complete lack of curiosity on their part.
In decline
We already know that homeopathy in the NHS has been in steep decline for the last few decades: This could well indicate that homeopathy isn't as unthinkingly accepted as it once was.
But the Global TGI Barometer data was from some six years ago — what about trust in homeopathy now? Although Kantar Media haven't publicly published such a comprehensive survey since 2008, in 2013 they published a Factiod, a single page document Headache Remedies: East vs. West. In it, they were able to say:
TGI data shows that 43% of people in China agree with the statement 'I trust homeopathic medicine' compared to just 20% in the USA and 12% in GB.
It would have been good to see up-to-date figures for the other countries, but this does show that trust in homeopathy products in Great Britain has dropped by a fifth, from 15% in 2008 to just 12% in 2013.
As more people find out what homeopathy is and how homeopathy works, we should not be surprised to see this figure drop even more.
Paying the price of homeopathic research
Do homeopaths' claims that trials are too expensive and that they can't afford them hold water?
Science is simply a systematic way for carefully and thoroughly observing nature and using consistent logic to evaluate results. Which part of that exactly do you disagree with?
— Dr Steven Novella
But homeopaths have a problem: all advertising in the UK has to comply with the Advertising Standards Authority's CAP Code and this rightly demands a high standard of evidence for any claim, regardless of whether it's about how clean a soap powder makes your whites, how efficient double-glazed windows are or how much a skin cream reduces the appearance of wrinkles. So it is with homeopathy: high quality evidence is required. Continue reading
WDDTY: Waging war on "doctor-induced disease"
What does the two-decade-old 'endorsement' by The Times really say?
Any reader not aware of the current fuss and bother over the What Doctors Don't Tell You magazine can find a comprehensive list of blog posts, etc curated by Josephine Jones: WDDTY: My Master List.
In a recent spat — after The Times published an article by Tom Whipple (Call to ban magazine for scaremongering) — WDDTY posted a scan of part of a 1989 Times article that appeared to praise their original (online subscription) publication of the same name, saying it was "A voice in the silence".
WDDTY use this same endorsement 24 years later on their main website, the WDDTY subscription website for their latest glossy, supermarket edition (although they get the quote mixed up with others) and in the glossy magazine itself.
Despite calls for them to publish the complete article, its editor, Lynne McTaggart, has not obliged, so I will. Continue reading
Beware the spinal spin
Finding a document on the website of the British Chiropractic Association titled "CONFIDENTIAL FOR BCA MEMBERS ONLY" is an open invitation…
Perusing the BCA's website usually finds extremely useful advice on schoolbags, gardening, bras, shopping, Bank Holidays, baking, gadgets, sitting and, of course, Christmas.
This time, however, I was bravely looking for what they said about the differences between chiropractic and osteopathy after a comment by a chiro on Prof Edzard Ernst's blog:
Chiropractic and osteopathy have different origins. They are separate forms of spinal manip. Typically osteopaths use long level techniques, chiros use short lever. Both aim to achieve the same thing – spinal health.
This highlights a frequent question asked by skeptics: Are chiropractic and osteopathy substantially or even significantly different forms of healthcare?
Stop this unscientific meddling
The exposé by Prof David Colquhoun of the interference by the Department of Health — at the behest of homeopathy promoters — in the publication of impartial, scientifically-based information about homeopathy on the NHS Choices website has been covered by the Guardian and the Daily Mail this past week.
Damned by their own words, the DoH said in response to the draft submitted by the editors of NHS Choices that mentioned the House of Commons Science and Technology Committee's comprehensive Evidence Check report on homeopathy:
Can we remove this statement? This report is really quite contentious and we may well be subject to quite a lot of challenge from the Homeopathic community if published.
The statement was removed. What NHS Choices were eventually told to publish was a biased sop to homeopathy, including a list of the main homeopathy trade bodies and a list of medical conditions homeopathy could, apparently, treat.
Andy Lewis, on his excellent website, The Quackometer, asked that we contact our MP over this to demand NHS Choices be allowed to replace this biased page with one that properly reflects the scientific consensus on homeopathy so that the public can make properly informed choices in their health care.
Below is our email to our MP. We urge all those concerned about the public being given unbiased information to write to your own MP — please feel free to use whatever you feel useful.
We are concerned to read that the Department of Health has been interfering with the content of the NHS Choices website to the detriment of the public's ability to make informed choices about health care.
It was reported in the Guardian on 13 February (Prince's charity lobbied government to water down homeopathy criticism) and in the Daily Mail on 15 February (Homeopathy charity run by Charles 'cowed civil servants' into supporting the therapy) that the NHS Choices website editor had been prevented from stating the lack of scientific evidence for homeopathy for fear of lobbying from the 'homeopathy community'. This debacle came to light after a Freedom of Information request by Professor David Colquhoun.
As a result of this interference, the page on homeopathy as it stands now is in danger of misleading the public into thinking that homeopathy may be able to treat potentially serious medical conditions such as asthma, ear infections, high blood pressure and depression when there is no scientific evidence to suggest this is the case.
In his response to the House of Commons Science and Technology Committee's Evidence Check report on homeopathy (which recommended removal of all NHS funding for homeopathy because of the complete lack of scientific evidence), the Secretary of State for Health stated:
10. In order for the public to make informed choices, it is therefore vitally important that the scientific evidence base for homeopathy is clearly explained and available. He will therefore engage further with the Department of Health to ensure communication to the public is addressed. His position remains that the evidence of efficacy and the scientific basis of homeopathy is highly questionable.
He also stated:
14. The Government agrees that, when looking at the evidence base for efficacy, it is important to focus on the most scientifically robust studies and evidence.
It is therefore incomprehensible and deplorable that the Department of Health believes it now acceptable to tell the public that homeopathy can be used to treat the following:
- asthma
- depression
- ear infections
- hay fever
- other mental health conditions, such as stress and anxiety
- allergies, such as food allergies
- dermatitis (an allergic skin condition)
- arthritis
- high blood pressure
For such a highly respected, informative and authoritative source of sound medical information such as NHS Choices to have been forced by the DoH into publishing such erroneous information on homeopathy is disgraceful and unacceptable.
This can only lead to the public being mislead and potentially making ill-advised and dangerous health care decisions.
As we are sure you are aware, the Chief Medical Officer, Professor Dame Sally Davies, has recently made clear that homeopathy is 'rubbish'. The DoH needs to heed this advice and allow NHS Choices to completely re-write the page on sound scientific and evidence-based principles.
We also note that Anna Soubry recently stated to the House:
The Department [of Health] does not maintain a position on any particular complementary or alternative medicine treatments including homeopathy.
We therefore ask you to request that the Secretary of State for Health explain these actions and that he allow NHS Choices the freedom to ensure that the public can make the informed choice that are entitled to make based on sound scientific evidence and principles and not to have that distorted by vested interests.
We look forward to receiving your reply.
Thanks and best regards.
I'll let you know what response we get.


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subset: commoncrawl


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• High quality components, professional assembly, great value.
• High quality black crystal glass top, durable heat resistant to withstand long hours of cooking.
• Easy to operate, easy to clean ,just need to wipe lightly; time-saving,high efficiency, energy saving and environmental protection advantages.
• overheating and boiling dry protection.
• No fume, no gaseous waste, no danger of explosion and anti-magnetic well.
• Great performance, passed strictly QC test system, ensuring the safety and healthy.
OEM and ODM service is available!
• Your inquiry will be replied within 24 hours
• Sample is available before place an order
• OEM and ODM are warmly welcomed
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If you are interested in our products can contact us through the following e-mail.
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Company Information
1. With the steel ring / No the steel ring
The effect that the hot pot induction cooker insets the tabletop
Product size: 196mm×70mm
The effect that the hot pot induction cooker with the steel
Open pore size: 200mm
2. Optional power cable
American Standard (the United States, Canada, Japan, Brazil, the Philippines, Thailand and other countries and Taiwan use is characterized in that a circular flat.)
European standards (country, France, Holland, Denmark, Finland, Norway, Poland, Portugal, Austria, Belgium, Spain, Sweden and other EU countries and South Korea, Russia and other countries use)
The comparison of our hot pot induction cooker and others:
Entirety comparison:
Main board comparison:
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Winpai Electric Technology Co., Ltd. focus on the production of pot induction cooker, hot pot table, hot pot accessories and other equipment, is a set design, custom, sales as one of the Professional Company. We were founded in 1998, covers an area of about 5000 square meters, the number of employees for 200-300 people, there are 5 production lines. In the professional commercial electromagnetic furnace production, we have more than 10 years of experience and professional R&D department, after years of steady development, we have gradually become one of the largest manufacturers of electromagnetic furnace, the monthly output of 100000 units.
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text:
Contact Supplier
Mr. Watson LinLeave a message
|Payment Type:
|L/C,T/T,D/P,Paypal,Money Gram,Western Union
|Min. Order:
|1 Piece/Pieces
|Delivery Time:
|15 Days
Basic Info
Model No.: AC-141
Type: Plate
Material: Clay, Alumina Ceramic
Style: Western
Usage: Wedding, Business Gift, Daily Use, Garden Decoration, Home Decoration
Feature: Chinese
Processing: Casting
Color: White, White/Ivory
Shape: Round
Age: Modern
Surface Decoration: Glazed
Application: Machinery, Industry, Medical, Aerospace Etc.
Additional Info
Packaging: Customized
Brand: Hard
Transportation: Ocean,Land,Air
Place of Origin: Guangdong,China
Supply Ability: 1,000,000 pcs/Month
Certificate: SGS
Port: Shenzhen
Product Description
high temperature Alumina Zirconia ceramic tube pipe
Reputation depends on quality, quality comes from Hard!
Alumina ceramic dry press forming technology is limited to articles with a simple shape and an inner wall thickness of more than 1 mm and a length to diameter ratio of not more than 4:1. The forming method is uniaxial or bidirectional. The press is available in hydraulic or mechanical form and can be semi-automatic or fully automatic. The maximum pressure of the press is 200Mpa. The output can reach 15 to 50 pieces per minute. Since the hydraulic press has a uniform stroke pressure, the height of the pressed parts is different when there is a difference in the filling of the powder.properties:
High hardness, high strength, wear resistance, corrosion resistance, high temperacture (1600°), good thermal diffusivity, good insulativity, low cost etc.
Data Sheet↓Color: White/Ivory
Thermal Shock Resistance: 200 △T°C
Maximum use temperature 1650°C
Dielectric Strength: >10 KV/mm
Dielectric Constant: 9.1er
Dielectric Loss Angle(1MHz): 0.0002-0.0003
Volume Resistivity(20°C): >1014Ω.cm
Company Information:
Shenzhen Hard Precision Ceramic CO.,Ltd founded in 2007, located in Shenzhen of China. We are a company that integrates development, design, molding, sintering, production and sales of precision ceramic products. After 10 years of development, we have cooperated with more than 2000 customers and 60 universities; Our factory covers an area of 2000 square meters, 50 employees, and annual production value of nearly 20 million. We have a higher visibility and better reputation in the same industry.Our products include ceramic rods, tubes, plates, blocks and precision parts for industrial. We have all-line high precision equipments from ceramic forming, sintering to precision machining. Hope for a wide range of sincere cooperation with customers at home and abroad.
7.MOQ is not limited, small quantity is welcome.
8.Vigorous team and good after-sales service
Products Show
Factory Show
Our Team
Q: Are you trading company or manufacturer ?
A: We are factory.
Q: How long is your delivery time?
A: Generally it is 5-10 days if the goods are in stock. or it is 15-30 days if the goods are not in stock, it is according to quantity.
Q: Do you provide samples ? is it free or extra ?
A: Yes, we could offer the sample for free charge but do not pay the cost of freight.
Q: What is your terms of payment ?
A: Payment<=1000USD, 100% in advance. Payment>=1000USD, 50% T/T in advance ,balance before shippment.
Product Categories : Alumina Ceramics > Alumina Ceramic Disc
Hot Products


text:
Women's Rowing Wraps Up First Season At Dad Vail Regatta
By ODU Athletics
May 6, 2009
PHILADELPHIA, Pa. -- The Old Dominion women's rowing team wraps up its inaugural season this weekend at the prestigious Dad Vail Regatta. The Lady Monarchs will be among the more than 100 colleges and universities from the United States and Canada participating in the largest collegiate regatta in the United States.
The regatta starts Friday morning, May 8th, on Philadelphia's Schuykill River with qualifying heats. Semi-final events start Saturday morning, May 9th, ending around 1 p.m. followed by the finals.
"We're all very excited to get to race this weekend," said head coach Heather Weisel. "The team is feeling prepared and is anxious to get started."
The Dad Vail is named for Harry Emerson "Dad" Vail the coach at Wisconsin in the 1920's. Two officials with ties to crew at the University of Pennsylvania started the Dad Vail naming it for their friend Harry Vail.


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Palm Tree Muslin Wrap
Regular price $35.95
or make 4 interest-free payments of $8.99 AUD fortnightly with More info
Muslin Wrap made from a deliciously soft, 100% cotton fabric. Measuring approximately 1m x 1m, our wraps are light weight and versatile. The perfect baby shower gift.
Washing Instructions
Gentle hand wash only. Do not tumble dry. Iron on low heat.
Turn Around
Current turn around time for play mats is 2-3 weeks plus postage. If you require a rushed order, please let us know.
Selecting EXPRESS POST at the checkout means that your order will be posted express after our 2 - 3 week turn around time.
Supervision is always recommended when in use.


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|Quantity Per Pack
|Primary Brand
|S&S Worldwide
|Allergen - Latex
|Instructions Included
|Youngest Recommended Age
|5 years
Reviewed by 1 customers
Sort by
Displaying reviews 1-1
Best Uses
Comments about Go Green Sayings Silicone Bracelets (Pack of 24):
Love the product. Well worth the money and the student thought they were great.
Displaying reviews 1-1
Customer Service: [email protected]
Webmaster: [email protected] (Problems or suggestions related to the site only.)
Toll-free phone: (800) 288-9941
Monday through Friday, 8:00am to 7:00pm, EST
Representatives who speak Spanish are available
Monday to Friday 9 AM to 6 PM EST
Representantes que hablan Español están disponibles
Lunes a Viernes 9 AM to 6 PM EST
24-Hour toll-free fax: (800) 566-6678
S&S® Worldwide
PO Box 513
75 Mill Street
Colchester, CT 06415


text:
Address: 39 Elliott St, Auckland City
Ph: (09) 303 0217
Amanda and Mark leave shortly to join their yacht in Panama and continue their round-the-world voyage. Honestly, the lives some people lead. What could be more appropriate, then, but to meet at a restaurant that bills itself as the first Latin American gourmet restaurant in New Zealand? And a chance, of course, for Amanda to polish her conversational Spanish.
Besos Latinos (besos translates as kisses) is tucked away in a quiet back corner of the Elliott Stables compound in the CBD. The exposed brickwork that characterises this complex lends a warm ambience and the presumably native Central American banners and pictures add to the joyous atmosphere.
Alonso, our Chilean waiter, showed us to our table, introduced himself (a gracious but infrequent touch), brought water and menus, and generally made himself useful. Amanda and I ordered the Peruvian ceviche, which was excellent.
The fish was almost raw but very fresh, and the marinade of lime juice, chilli and ginger held interest until the last mouthful.
Mark loved the chilli hit in the butter of his street-style grilled corn, while the beef in Bill's empanadas was lean and pleasantly spicy, with no chewy bits and not overloaded
with vegetables.
Bill and I both went for the Argentinian asadito, grilled skirt steak (a cut of beef I have never been brave enough to cook in this manner) with chimichurri salsa, an artisanal pork sausage, traditional egg and potato salad and a tomato and onion salad. The steak was tender and flavourful and the sausage soft and tasty, although the egg and potato salad was a little insipid.
Amanda and Mark shared an El Che platter, named for Che Guevara's route around Latin America. It held a selection of entrees, empanadas and corn tamales or humitas, as well as tiger prawns with beans, rice and salsa. Plenty for two and well-presented.
With room remaining, Mark managed the rice pudding with prunes, coconut and port; an unlikely combination he swore worked very well. Cuban coffee to finish, made with cane sugar and cinnamon (a little bitter for our taste), and we were done.
Besos Latinos, under the control of head chef Luis Cabrera, produces unusual and interesting flavours and combinations that are seldom found in this country. Long may he prosper.
Rating out of 10
Food: 8
Service: 8
Value: 7
Ambience: 8
Our meal: $260.60 for four starters, two mains plus a shared platter, one dessert, eight glasses of wine and one very expensive beer ($18 for half a litre), and one coffee.
Wine list: Predominantly Chilean and Argentinian, which made for an interesting time, as they are mostly unknown to us. Our Chilean Millaman sauvignon blancs and chardonnays were excellent, although they could have been chilled a little longer.
Verdict: An exciting and unusual menu, which made for a highly entertaining meal. Recommended.


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Contains indexing for over 8,000 publications, many of them peer-reviewed journals. Full text is available for more than 4,450 of these titles in subjects such as biology, chemistry, engineering, physics, psychology, religion & theology, and more.
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Explore and stay informed on local and national topics, people and events in areas such as business, health, education, jobs and careers, political and social issues and more. Features a wide variety of credible, vetted news sources spanning the U.S., including the Providence Journal, The Independent and Standard-Times. Also available remotely 24/7 on any device.
The North Kingstown Free Library has aquired an institutional membership to the New England Historic Genealogical Society. This comes with access to their databases at AmercanAncestors.org. Commonly used resources such as the NEGHS Register, RI Roots, and Arnold's Vital Statistics are included in this database.
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Ancestry from Home Please use Firefox. Discover your unique family history! This resource includes billions of records from around the world, including U.S., U.K., and Canadian census and vital records, immigration and passport records, periodicals and books, photos, and more.
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Provides access to biographies, bibliographies, and critical analysis of authors from every age and literary discipline. The foundation of Literature Resource Center is Gale Group's three well-known author databases: Contemporary Authors, Contemporary Literary Criticism Select, and Dictionary of Literary Biography. Gale's Literature Criticism, and For Students series are also included.
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Designed specifically for public libraries, this multidisciplinary database provides full text for nearly 1,700 general reference publications with full text information dating as far back as 1975. Covering virtually every subject area of general interest, MasterFILE Premier also contains full text for nearly 500 reference books and over 164,400 primary source documents, as well as an Image Collection of over 502,000 photos, maps & flags. This database is updated daily via EBSCOhost.
MEDLINE provides authoritative medical information on medicine, nursing, dentistry, veterinary medicine, the health care system, pre-clinical sciences, and much more. Created by the National Library of Medicine, MEDLINE uses MeSH (Medical Subject Headings) indexing with tree, tree hierarchy, subheadings and explosion capabilities to search citations from over 4,800 current biomedical journals.
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Find comprehensive financial information on thousands of mutual funds, including the Morningstar star rating. Get comprehensive financial information on New York Stock Exchange, American Stock Exchange, and NASDAQ stocks. Get return information on various investment indexes, types, sectors, and styles. Test drive our robust yet easy-to-use portfolio tools and calculators to determine what your asset mix should be, how your investments are working together, and more.
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My good friend, Jyl Riendeau, was quick to send in some of her recipes. She combines creativity with great cooking so I'm sure you'll enjoy her contributions.
4 firm, mild white fish fillets, such as grouper, sea bass, flounder, cod, halibut or tilapia, each about 6 oz.
Sea salt or kosher salt, to taste
1 small yellow onion, diced
1 walnut-sized piece of fresh ginger, peeled and
thinly sliced
1 small bunch fresh cilantro, chopped
1 tablespoon chopped garlic
2 teaspoon minced jalapeño chili
2 teaspoon grated lime zest
1 teaspoon freshly ground pepper
1/4 cup lime juice
1/4 cup olive oil
1 lime, quartered (optional)
Place the fish fillets in a nonreactive container and season lightly with salt. In a food processor, combine the onion, ginger, cilantro, garlic, chili, lime zest, pepper, lime juice and olive oil. Using on-off pulses, pulse until a paste forms. Rub the paste evenly over both sides of each fish fillet. Cover and marinate in the refrigerator for up to 2 hours.
Prepare a fire in a charcoal grill or preheat a grill pan over medium-high heat.
Season the fish fillets with salt again. Lightly oil the grill or grill pan. Grill the fish, turning once, until opaque throughout when pierced with a knife, 3 to 4 minutes per side.
Transfer the fish to warmed individual plates. Serve immediately with lime wedges. Serves 4.


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Sleep Matters
[ Read More ]
The region's children aren't getting enough of it. BY Dr. Arif khan Shakespeare referred to sleep as "nature's soft nurse." But in today's world, many of us have moved away from appreciating the goodness of sleep to regarding it as a deterrent and a waste of time. Perhaps it is best manifested in Thomas Alva Edison's own