Shoulder Subluxation

As a student Occupational Therapist, I had a patient with a subluxation of the shoulder. This is a relatively common side effect for people who have had a stroke, as this person had, because essentially the weight of the arm is hanging without muscular support. When the shoulder muscles lack tone, the arm is held by flaccid tissue that has the ability to stretch out, allowing the shoulder to displace downward from the socket.

In my treatment of this patient, I did some research on shoulder subluxation, as you do when you are an evidence-based practitioner. A Google search of “treatment shoulder subluxation” found me this as the first entry.

CPSO Extends Public Commentary Regarding Bizarre Health Policy Proposal

As was reported by David Gorski (surgical oncologist), Scott Gavura (pharmacist), the CFI Committee for the Advancement of Scientific Skepticism, Larry Moran (biochemistry professor), and others a bit more colorfully, the College of Physicians and Surgeons of Ontario (CPSO) has drafted an appalling (and at times simply confusing) policy regarding alternative medicine as it relates to general medical practice. Originally, the policy had been open for public commentary until 1 September, but after an overwhelming response the CPSO has extended the deadline to 16 September.

CBS Fail

The skepticism website Skepchick has alerted the masses that CBS is airing a joint venture by Joe Mercola and NVIC (two hefty sources of anti-vaccination nonsense) alerting people to the “risks” of vaccines and their “choice” of whether or not to get them. Though by highlighting risk, it’s clear what choice they want people to make.

There’s a petition to sign. I’m not really partial to those, however there is also information on how to contact CBS directly and through Twitter with the hashtag #VaxCBS.

Are Psychics the New Therapists?

Short answer: No.

Longer answer:

Psychics/mediums are people who claim to predict the future and/or talk to the dead using paranormal powers. There is no evidence (despite years of investigation) that people have these abilities. There is evidence that psychics/mediums use a technique called “cold reading” – even when they aren’t aware of it - which is a technique that allows psychics to gather information from their client/mark using body language, other cues, and a clever tongue. This allows the psychic to appear very accurate in their information, requiring no supernatural ability. Anyone can learn to do this.

People’s self-ignorance of using a trick may seem odd, but most people haven’t tested their “abilities” under controlled conditions. This allows them to legitimately believe that they have supernatural powers through thinking errors, like one called confirmation bias (remembering hits more than misses). Unfortunately, as with most things, there are also people who are downright frauds, using cold reading with intentionally-practiced skill. They may even go so far as to use “hot reading”, where the psychic cheats by surreptitiously gathering information about their mark before their reading. Examples of psychics and their techniques can be seen in Penn and Teller’s Bullshit! episode about psychics here.

Psychics operate on a scale from small local shops to vast phone networks to a much grander scale: national TV. One example of the latter is John Edward (previously busted using both cold and hot reading techniques on his former show Crossing Over), who was recently featured on the Dr. Oz show in a segment entitled “Are Psychics the New Therapists?“, hence this topic coming to the attention of a  health blog.

Edwards and Oz essentially present the argument that grief is like a cancer that, if left “untreated”, will metastasize, and psychics/mediums are helpful in this regard. But even this one claim contains several assumptions:

• First, as discussed above, there is no respectable evidence that psychics can talk to the dead.
• Second, even if we assume that psychics abilities are real (or at least non-harmful), there is no evidence that they are helpful.
• Third, in relation to the segment title, can psychics be so helpful as to replace professionally-trained therapists with evidence-based skills in grief counseling?
• Fourth, even if psychics are real, can John Edwards – specifically – really talk to the dead? Does he deserve to be featured on this show given his history using (intentionally or not) known reading tricks?

Their “yes” arguments are less than compelling, with Dr. Oz stating:

“as a heart surgeon I have seen things about life and death that I just cannot explain and that science can’t study.”

And later:

“I can’t make up an explanation for what John Edward does. And, again, what was most eerie was his level of detail, the concreteness of it all.”

In other words, “I’ve never heard of cold reading and I assume science can’t study some things, therefore I assume psychics are real/helpful.” Dr. Oz’s ignorance about the topic and his allowance that psychics abilities “can’t be studied” (they have – psychics just don’t like the results) allows him to imply to his trusting audience that psychics are a valid form of grief treatment.

So put down your psychology textbooks and peer-reviewed clinical research, young health students, the “new therapists” are helpful because we can’t explain how it might work. ???

Forget your degree, learn cold/hot reading.

The position of critical thinkers, as with anything, is that evidence comes first. There’s no evidence that John Edward or any other psychic/medium has the capability to provide consistent therapeutic benefit for grief, let alone as much benefit as a trained professional.

Psychics/mediums are not a health profession, they have no standards of practice or code of ethics (which are required of any legitimate health provider to protect people), and they have no oversight to ensure their customers that they are legitimate (which is impossible, due to lack of supporting evidence) or that they are effective in providing their services. They likely have no training in psychology and therefore no appreciation for the harm that may be done by (intentionally or not) implanting false memories or altering existing memories of dead loved ones with their claims.

It’s unfortunate that a doctor, particularly one with such a large reach, would devalue therapeutic professions and lend authoritative “legitimacy” to the claims of unproven psychics/mediums, particularly when actual people’s lives, emotions, and personal well-being are on the line. It just goes to show how easily anyone can buy into unproven claims, no matter what their degree, if they do not practice critical thinking.

CBC Marketplace Investigates Homeopathy: A Review

Benefiting from the Atlantic Time Zone, I got to be one of the first to watch CBC Marketplace on Friday night (darn you, Newfoundland!) where they covered the topic of homeopathy. Here are my impressions.

First, I want to praise Marketplace for not offering false balance on the issue. Homeopathy is not something about which there is any serious scientific debate. The evidence is clear that homeopathy is not physiologically/chemically/physically possible, has no defined mechanism of action, and does not work beyond a placebo effect. It would be wonderful if it did work, but it doesn’t.

After Wakefield: Undoing a decade of damaging debate

It's said that you can't unring a bell

This article was co-written by Scott Gavura, Pharmacist. Cross-posted at his blog, Science-Based Pharmacy.

Immunization has transformed our lives. This single invention has prevented more Canadian deaths in the past 50 years than any other health intervention. Our parents and grandparents accepted illness and death from diseases like smallpox, diptheria, and polio as a fact of life. Mass vaccination completely eradicated smallpox, which had been killing one in seven children. Public health campaigns have also eliminated diptheria, and reduced the incidence of pertussis, tetanus, measles, rubella and mumps to near zero.

“Good” vs. “Less Bad”

People are more aware of healthy eating these days (whether they’re successful at putting awareness into practice is another story) and marketers have gained another angle from which to sell products.

Enter the “less bad = good” ad/product label.

This is where companies frame their product as better than other products, or better than a previous version of their own product because, for example, the new/improved product might have less fat, sugar, or calories, and more nutrients. The trouble is, often the food is still appallingly unhealthy. Don’t even get me started on fruit juice.

Mayo

I saw a TV ad for Hellmann’s, made with “real ingredients like whole eggs and oil”, now with half the fat. Their slogan is “It’s time for real.” and they boast that their product, Hellmann’s Real Mayonnaise, is:

Made with high quality ingredients, including whole eggs, [...] low in saturated fat, contains no trans fat, and is low in cholesterol.

Mayo is not healthy no matter how it’s packaged, yet they try to convince us otherwise by virtue of it being less bad than regular mayo. But a one-tablespoon serving of this product has 100 calories. Put in perspective, an equal amount of mustard has almost no calories; cream cheese — about 30 calories. Though Hellman’s tries to sell us on the benefits of “healthy fats”, that doesn’t change the fact that mayo is basically processed eggs and oil whipped into submission. Consumers concerned with healthy choices shouldn’t have mayo anywhere on the radar.

Here are some other examples I noticed during a recent trip to the grocery store:

Chips

First, Multigrain Doritos. Now to be fair, the bag doesn’t boast any health claims, but they are certainly banking on the multigrain moniker to sell products. People might be surprised to learn that these chips have 12 grams of fat and 260 calories per 50 gram serving. Multigrain fibre is a tad less healthy when it’s covered in salt and fat…

Another guilty party is baked chips, such as Baked Lays, which have 120 calories and 2 grams of saturated fat per 1 ounce serving — by the way, who eats one ounce of chips (28 grams)? Chips are bad for you, baked or not. Yet the “low in fat” marketing of baked chips seems to comfort people into thinking they are healthier than regular chips. Are they, though? Baked chips do have less fat than regular chips, but they have as much salt (note the serving size when comparing) and about the same amount of calories.

Bread

Another trendy grocery store item are those flattened hamburger buns that are supposedly healthier because… um… they’re flat, I guess. The idea is that they are supposed to have fewer carbs. But they actually have more fat, more calories, and more sugar than regular hamburger buns, despite the “healthy choice” label on the in-store brand. I guess I should point out that if the regular hamburger bun brands bothered to boast about their “nutritional content”, they’d win the fake healthy choice contest hands down.

Cereal

The worst product that I noticed though, is the new Kellogg’s Fruit Loops and Corn Pops. Now with fibre! Super, so they added fibre to their 24 grams of sugar and over 200 calories per cup, boldly stating that “Kellogg’s makes fibre fun” in an ad campaign that is clearly geared toward children (adults generally don’t care if fibre is made fun for them).

If adults are having such a hard time making appropriate food decisions against the onslaught of misleading advertising, what chance do children have? Rather than decreasing the absurd amounts of sugar in their children-aimed breakfast cereal, they’ve added fibre as if this nutrient is a magic shield against diabetes.

Conclusion

I don’t believe there’s anything inherently wrong with the concept of cooking pre-made or packaged food, nor is there anything inherently wrong with having a treat every now and then. But we can’t fool ourselves into thinking that sugar, salt, and fat is healthy or invisible as long as one other unhealthy ingredient has been reduced or some arbitrary nutrient is promoted on the package.

Until companies change the way these foods are produced and packaged, we’re all better off with fresh food. Nutrients don’t necessarily mean healthy, especially when they are foremost a marketing tool.

On Disability …and Penn and Teller

On the show Bullshit, by magicians Penn & Teller (P&T), various topics (such as UFOs, 9/11, bottled water, recycling, etc) are discussed from their unique point of view. I enjoy this show for its spectacle and the topics they discuss, even though they are biased (though they fully admit it). They have even admitted to mistakes, such as their stance on second hand smoke, so props to them for that. However, in my opinion, sometimes their politics interferes with their common sense and detracts from the overall quality of their arguments.

In the episode “Disability” (Season 5, Episode 7), they really screwed up big time.

The Efficacy of Stress Relief Techniques

I often hear about relaxation techniques in pop psychology. We also discussed them in the mental health section of our Occupational Therapy (OT) curriculum when we explored anxiety. But are they effective and science-based?

Scott Gavura: Why we Make Bad Health Care Decisions

Date: Friday, May 28, 2010
Time: 7:00 pm – 9:00 pm
Location: Centre for Inquiry Ontario, 216 Beverley Street (Just South of College and St. George Street)

Despite the dramatic improvements in the extent and quality of our lives, largely owing to modern medicine, our current health care system has fostered a backlash, manifested in part by the emergence of non-science-based “alternative” health care practices . This trend has driven a need for dialogue on how best we should balance evidence-based decisions against demands for consumer choice – regardless of the science. In this presentation, Scott Gavura will discuss how health care decision-making differs from all other goods and services, and how this impacts on the choices we make, both as individuals, and in aggregate. Through an interactive discussion, he will facilitate a dialogue on the opportunities for science advocates to effect positive change in health at the patient- and population-level.

$5, $4 for students, FREE for CFI Members.

See the Facebook Event for this talk.