Oh, loneliness and cheeseburgers are a dangerous mix.
– Comic Book Guy
Same can be said of viral syndromes and Thanksgiving. My brain has been in an interferon-induced haze for the last week that is not lifting anytime soon. Tell me about the rabbits, George. But no excuses. I have been reading the works of Chuck Wendig over at Terrible Minds. (Really, really like the Miriam Black books). Writers write and finish what they start and only posers use excuses for not completing their work.
Recently I attended an excellent Grand Rounds on some of the reasons doctors do what they do. Partly it is habit. We learn to a certain way of practice early in our training and it carries on into practice and it is not always best practice. Patients also learn from us and have expectations on what diagnostics or treatments they should receive, and that too it is not always the best practice.
So to educate physicians and patients, the American Board of Internal Medicine (ABIM) started the Choosing Wisely initiative. (more…)
Steve is off today, so I thought it would be a good idea to use this slot for a little shameless self-promotion (of Science-Based Medicine and the Society for Science-Based Medicine, of course).
The Northeast Conference on Science & Skepticism (April 9-12, 2015 in New York City) will be bigger than ever in 2015 with fabulous presenters, exciting panels, and engaging workshops.
We’re thrilled to announce that NECSS 2015 will be co-sponsored by the Society for Science-Based Medicine and will expand to include a third full day of programming! Friday’s schedule will be curated by the team at SfSBM and features content available exclusively at NECSS 2015. Saturday and Sunday schedules will once again feature the best of science and skepticism.
NECSS weekend also includes a special evening performance on Friday, two workshop tracks on Thursday for the early-birds, our popular “Drinking Skeptically” socializers, and more!
The full NECSS speaker line up will be announced shortly, but, as always, Rationally Speaking and the Skeptics’ Guide to the Universe will record live podcasts during the conference.
We have secured discounted room rates at the Hilton Fashion District, located one block from the main conference hall. These rates are available exclusively to NECSS attendees and we will be available shortly.
Conference registration will open in December, but you can like the NECSS Facebook page or follow us on Twitter for updates.
See you in April!
(Editor’s note: I was away at Skepticon over the weekend, where I gave a talk entitled “The Central Dogma of Alternative Medicine”. (When the talk’s up on YouTube, I’ll provide a link, of course.) Because of all the fun and travel delays I didn’t get a chance to turn my slides and notes into a blog post yet. Also, I’m on vacation this week. However, this gives me the opportunity to resurrect a blog post from 2007 on my not-so-super-secret other blog, because I think the concept is interesting. I even use it in a slide that shows up in many of my talks (above). I’ve updated dead links and added some text to include relevant links to posts written since. Enjoy, and I’ll definitely be back next week with original material, if not sooner, given that there are others here who might have the temerity to take part or all of this week off.)
I wish I had thought of this one, but I didn’t. However, I never let a little thing like not having thought of an idea first to stop me from discussing it (even if Steve Novella’s also discussed it), and this particular idea is definitely worth expanding upon because (1) it’s interesting and (2) it combines two of my interests, alternative medicine and evolution. I agree with parts of the idea, but it’s not without its shortcomings. Indeed, I’d very much welcome any of the evolutionary biologists who read this blog to chime in with their own ideas.
A colleague of mine, Martin Rundkvist over at Aardvarchaeology, has proposed a rather fascinating idea regarding the evolution of alternative medicine in which he argues that alternative medicine evolves according to certain selective pressures. As you may or may not know, evolution is not just for biology, but has been proposed as a mechanism in cultural memes, for example. Since alternative medicine is a cultural phenomenon, it is not unreasonable to look at such non-evidence-based medicine and hypothesize what might be the selective pressures that shape its popularity and evolution. After all, if we’re going to discourage the use of non-evidence-based medicine or even quackery, it’s helpful to understand it. We already know that alt-med terminology has evolved considerably into the current preferred term, “integrative medicine.” (See also the image above and my blog posts on this evolution here and here.)
This is not for kids?
Last month I wrote a post on the causes of poor sleep in adolescents, as well as the myriad problems that can result in this high-risk population. Fortunately there is a system-wide public health measure proven to work, and now groups like the American Academy of Pediatrics are fully endorsing it. In that post, I briefly mentioned the increasing popularity of energy drinks and shots as caffeine delivery devices, and their role as both a potential cause of sleep deprivation and a means of temporarily ameliorating the effects.
I have been planning on addressing in greater detail the intentional, and unfortunately often accidental, ingestion of energy drinks in the pediatric population and the various associated risks for quite a while. What finally motivated me to get to work on this topic was the recent spate of media coverage regarding the results of a study presented this week at the American Heart Association’s Scientific Sessions 2014. The research, which involved the analysis of data obtained from the National Poison Data System for October 2010 through September 2013, supports concerns that pediatricians and other pediatric healthcare professionals have had for a very long time. Energy drinks are dangerous, particularly in young children, and a large part of the blame falls on the shoulders of manufacturers as well as the 1994 Dietary Supplement Health and Education Act (DSHEA) so frequently discussed on SBM.
Before I break down the scary numbers from the study, first a little background on energy drinks. (more…)
One of my early forays into the world of pseudoscience was an investigation of “Vitamin O” (the O stands for oxygen). The story is hilarious; please click and read; I guarantee you won’t be able to read it without at least a chuckle. Vitamin O is still for sale; it’s even available on Amazon.com. You can read the manufacturer’s ridiculous rationalizations about the FTC’s and FDA’s regulatory actions against them and their bogus “research” here. In my article, I mentioned oxygen bars, which were popular at the time. I was under the impression that they had gone out of fashion since then. Alas, no.
Dr. Stephen Barrett of Quackwatch e-mailed me to suggest that I might want to write about the O2 Planet website. It calls itself “the largest oxygen bar and oxygen spa source on the planet.” I can’t decide whether to thank Dr. Barrett for steering me to a source of entertainment and making me laugh or curse him for making me suffer through a disgusting collection of pseudoscientific rubbish. Some of the company’s claims are listed on the graphic above. (more…)
Low body temperature! Do you have Wilson’s Temperature Syndrome?
This is another in an irregular series of posts that puts the statements of naturopaths up against the scientific evidence
How are you feeling today? Tired? Lethargic? Chilled? Lacking energy? Is it the nature of life – or is it something more serious? If you consult with a naturopath, you could walk out diagnosed with something called Wilson’s Temperature Syndrome. But the naturopath would be wrong, because Wilson’s Temperature Syndrome is a fake disease.
One of the hallmarks of alternative medicine is the “fake disease”. Fake diseases don’t actually exist – they are invented without any objective evidence showing that they are real. Fake diseases tend to emerge from vague symptoms which can’t be attributed to a specific medical diagnosis. This is not to say what patients are experiencing isn’t real – the issue is the diagnosis, and the practitioner making the call. As has been pointed out by other SBM contributors, it’s understandable to want reasons and answers when you have debilitating symptoms. But symptoms need to be studied in rational and objective ways in order to understand the underlying illness – call it the “root cause” if you prefer. The diagnosis guides the treatment plan, so getting a diagnosis right is essential. While a group of vague symptoms might lead a medical doctor to run tests to rule out serious illness, alternative medicine providers already know the underlying problem. It’s your Chi. Your energy fields. Your diet. Whatever it is, it’s usually your fault. Adrenal fatigue is a fake disease. So is multiple chemical sensitivity, and Morgellons (delusional parsitosis). “Chronic” Lyme disease is another fake disease. Rather than offer a guide to proper care, a fake disease is a distraction from the truth. (more…)
One of the most interesting aspects of living through the second half of the 20th century and into the first half of the 21st century is the profound change in access to information. I remember in the 1980s there was a buzz (at least among technophiles and science fiction nerds) about how computers were going to be connected in a worldwide network and it would transform the way we access information and communicate. The reality we are living in now exceeds even the most fevered predictions being made at that time.
What was difficult to anticipate was how rapid access to almost any information would affect our day-to-day lives. Now, during a discussion, if a fact is in dispute we can simply look it up and resolve the dispute. I can no longer imagine doing research in a pre-internet age, promoting science-based medicine without social media, or collaborating without the virtual-time communication of e-mail.
The internet is rapidly becoming humanity’s collective culture and body of knowledge. For that reason it is important to nurture that body of knowledge to ensure that it is complete, accurate, and fair. That goal is frustrated, however, by the fact that the World Wide Web is not simply being used for scholarly information. It is also a tool to promote ideology and commercial interests. Therefore any efforts to provide scientifically accurate and unbiased information are likely to be swamped by well-funded and highly-motivated misinformation. Search on any medical topic and you will quickly see what I mean.
I have a new term to add to the English language, ebolasmacked, a derivative of the British term gobsmacked. Ebolasmacked defines my life the last few weeks since Ebola, or at last preparations for Ebola, have taken a huge bite out of my time with many interesting twists and turns. I think this is maybe the 9th outbreak (HIV, MERS, SARS, Legionella, H1N1, Avian flu, West Nile, MRSA) of my career and it has certainly generated more hysteria relative to the risk than any to date. Many of my usual pastimes, like SBM (as this essay will no doubt demonstrate), have had to take a back seat to preparing for what should be a very unlikely, but very disruptive, event. We do not want to get caught with our hazmats down should a case of Ebola come through the door.
What makes life interesting, among other things, is the constant realization that the more you know the more there is to know. I like Richard Dawkins’ metaphor in Climbing Mount Improbable where he pictures scientific progress as a series of false summits extending into infinity. It sure seems that way. Every time I think I understand a topic, I find there is still more to learn.
My Dad told me when I graduated from medical school that half of everything I had just learned was probably not true, the only problem is that you didn’t know which half. It was partially true. There have been ideas that have been abandoned since I was an intern, the most famous being that ulcers were due to stress and diet. But a new paradigm has been the exception, not the rule.
The last thirty years have been more about refining knowledge about the complexity of disease and its treatment and, perhaps equally importantly, having a better understanding of the all slings and arrows of outrageous fortune that can make the results of a clinical trial suspect. (more…)
In August of this year, a new policy statement from the American Academy of Pediatrics was published which tackled the widespread problem of insufficient sleep in our adolescent population. They even went so far as to label insufficient sleep as “one of the most common, important, and potentially remediable health risks in children.” The statement, which gave a number of recommendations on how to address the problem, made the news rounds primarily because of the call for schools to delay start times until at least 8:30 AM.
I wrote about pediatric sleep in March for a post on the potential link between some sleep disorders in children, specifically nightmares and night terrors, and the development of psychosis. Those claims are suspect but please read that post for a review of what sleep is, why we need it, and what can go wrong with it in children of all ages. For this post, my focus will be on adolescent sleep specifically, and on the role of delaying school start times in improving a variety of health parameters.
What are the common adolescent sleep challenges?
The typical modern teenager faces a variety of challenges to consistently obtaining a full night’s sleep, which is considered by most sleep experts to be in the 8.5 to 9.5 hours per night range. This doesn’t mean that every teenager will fall apart if they only get 7 hours of sleep each night, but sub-optimal sleep can adversely affect school performance in many, and even lead to long-term health problems in some children who establish such a pattern during these pivotal years. Hold that thought for now, however.
One obvious reason for insufficient sleep in teenagers, at least it is likely obvious if you have one of your own or have ever spent more than two minutes near one, is technology. Most older children have electronic media in their rooms, if not attached to their bodies in the form of a smart phone. 24-7 access to the internet and social media is a commonly-cited impediment to sleep onset. The increasing availability and popularity of energy drinks containing absurd amounts of caffeine among adolescents likely also plays a role as both a coping strategy for daytime fatigue resulting from insufficient sleep, and as a cause of it. In fact, I think I’ve just come up with the topic for my next post.