Tag Archives: health

Infections of the mind: why anti-vaxxers just ‘know’ they’re right

The Conversation

Thom Scott-Phillips, Durham University

Anti-vaccination beliefs can cause real, substantive harm, as shown by the recent outbreak of measles in the US. These developments are as shocking and distressing as their consequences are predictable. But if the consequences are so predictable, why do the beliefs persist?

It is not simply that anti-vaxxers don’t understand how vaccines work (some of them may not, but not all of them). Neither are anti-vaxxers simply resistant to all of modern medicine (I’m sure that many of them still take pain killers when they need to). So the matter is not as simple as plain stupidity. Some anti-vaxxers are not that stupid, and some stupid people are not anti-vaxxers. There is something more subtle going on.

Naïve theories

We all have what psychologists call “folk” theories, or “naïve” theories, of how the world works. You do not need to learn Newton’s laws to believe that an object will fall to the floor if there is nothing to support it. This is just something you “know” by virtue of being human. It is part of our naïve physics, and it gives us good predictions of what will happen to medium-sized objects on planet earth.

Naïve physics is not such a good guide outside of this environment. Academic physics, which deals with very large and very small objects, and with the universe beyond our own planet, often produces findings that are an affront to common sense.

A life force. Food by Shutterstock

As well as physics, we also have naïve theories about the natural world (naïve biology) and the social world (naïve psychology). An example of naïve biology is “vitalistic causality” – the intuitive belief that a vital power or life force, acquired from food and water, is what makes humans active, prevents them from being taken ill, and enables them to grow. Children have this belief from a very young age.

Naïve theories of all kinds tend to persist even in the face of contradictory arguments and evidence. Interestingly, they persist even in the minds of those who, at a more reflexive level of understanding, know them to be false.

In one study, adults were asked to determine, as quickly as possible, whether a statement was scientifically true or false. These statements were either scientifically true and naïvely true (“A moving bullet loses speed”), scientifically true but naïvely false (“A moving bullet loses height”), scientifically false but naïvely true (“A moving bullet loses force”), or scientifically false and naïvely false (“A moving bullet loses weight”).

Adults with a high degree of science education got the questions right, but were significantly slower to answer when the naïve theory contradicted their scientific understanding. Scientific understanding does not replace naïve theories, it just suppresses them.

Sticky ideas

As ideas spread through a population, some stick and become common, while others do not. The science of how and why ideas spread through populations is called cultural epidemiology. More and more results in this area are showing how naïve theories play a major role in making some ideas stickier than others. Just as we have a natural biological vulnerability to some bacteria and not others, we have a natural psychological vulnerability to some ideas and not others. Some beliefs, good and bad, are just plain infectious.

Here is an example. Bloodletting persisted in the West for centuries, even though it was more often than not harmful to the patient. A recent survey of the ethnographic data showed that bloodletting has been practiced in one form or another in many unrelated cultures, across the whole world.

Paraphernalia. (Source: Peter Merholz, CC BY-SA)

A follow-up experiment showed how stories that do not originally have any mention of bloodletting (for instance, about an accidental cut) can, when repeated over and over again, become stories about bloodletting, even among individuals with no cultural experience of bloodletting.

These results cannot be explained by bloodletting’s medical efficiency (since it is harmful), or by the perceived prestige of western physicians (since many of the populations surveyed had no exposure to them). Instead, the cultural success of bloodletting is due to the fact that it chimes with our naïve biology, and in particular with our intuitive ideas of vitalistic causality.

Bloodletting is a natural response to a naïve belief that the individual’s life force has been polluted in some way, and that this pollution must be removed. Anti-vaccination beliefs are a natural complement to this: vaccinations are a potential poison that must be kept from the body at all costs.

At an intuitive, naïve level we can all identify with these beliefs. That is why they can satirised in mainstream entertainment.

In Stanley Kubrick’s great comedy Dr. Strangelove, the American general Jack D. Ripper explains to Lionel Mandrake, a group captain in the Royal Air Force, that he only drinks “distilled water, or rainwater, and only pure grain alcohol”, because, he believes, tap water is being deliberately infected by Communists to “sap and impurify all of our precious bodily fluids”. The joke works because Ripper’s paranoia is directed at something we all recognise: the need to keep our bodies free from harmful, alien substances. Anti-vaxxers think they are doing the same.

The ConversationThis article was originally published on The Conversation. (Reblogged by permission). Read the original article.


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The 2015 flu vaccine – what’s new, who should get it and why

The Conversation

Aeron Hurt, WHO Collaborating Centre for Reference and Research on Influenza

It’s that time of year again when scientists and doctors make predictions about the impending influenza (flu) season and we must decide whether to go out and get the flu vaccine.

The government-funded flu vaccine will be available from 20 April, a month later than most years, as the vaccine has been reformulated to cover a new strain. But some GPs may offer the vaccine privately before then.

So, who should consider getting the vaccine and who gets it for free? And are we really in for a bad flu season in Australia?

How does the vaccine work?

The flu vaccine helps prevent us from getting the flu each season. It contains dead, broken-up bits of flu viruses that are expected to circulate during the upcoming season.

Once injected into our arms, the pieces of dead virus stimulate our body’s immune response to produce antibodies, which act as a defence that can rapidly swing into action when a live flu virus infects our nose and throat.

Because the viruses in the vaccine are dead, they can’t give us flu.

What’s new about flu vaccines in 2015?

For the first time, Indigenous children are able to access free flu vaccine in Australia.

This is important because Aboriginal and Torres Strait Islander children are five times more likely to be hospitalised with flu and pneumonia than non-Indigenous children. Indigenous children are also 17 times more likely to die from flu or pneumonia than non-Indigenous children.

Australia’s vaccine has been updated to protect against the harmful new A(H3N2) viruses. (Source: El Alvi/Flickr, CC BY)

This year a new flu vaccine, known as “quadrivalent”, will be available. This type of vaccine contains four flu viruses compared with three in the normal trivalent vaccine. The additional flu strain provides extra insurance that may be useful if unexpected viruses begin to circulate.

However, it’s likely that the standard trivalent vaccine will cover the great majority of the flu A and B strains expected to circulate in Australia this winter.

The quadrivalent vaccine won’t be available via the government’s free flu vaccine program and will be more expensive than the standard trivalent vaccine if purchasing it privately.

Who should get the flu vaccine?

For certain members of the community, catching flu can lead to severe illness or death. It is these “high-risk” groups (listed below) that should actively avoid catching it. Getting the flu vaccine is a major step towards achieving protection from flu.

Certain groups of individuals at high risk of developing severe illness or complications if infected with flu are eligible for free flu vaccine via the federal government. These are:

  • Anyone aged 65 years or over
  • Aboriginal and Torres Strait Islander people aged 15 years or over
  • Aboriginal and Torres Strait Islander children aged between six months and five years
  • Pregnant women
  • Anyone with with medical conditions that can lead to severe influenza, including people with heart disease, severe asthma and diabetes. A full list of eligible medical conditions can be found here.

Within the over-65 age group, a high proportion of people are vaccinated (more than 70%).

But although the flu vaccine is provided free of charge to vulnerable people, many still don’t get it. Less than 30% of pregnant women and Indigenous people receive the flu vaccine. Only half of those with medical conditions that can lead to severe influenza get vaccinated.

Fit, healthy children can’t always fight off a flu. (Source: Chaikom/Flickr)

Although not included in the government’s free flu vaccine program, children under the age of two years are also highly susceptible to flu.

Once infected with flu, young kids are more likely to be hospitalised with severe illness than those in the over 65 age group. About half of young children who die from the flu are otherwise healthy with no underlying medical conditions or known risk factors.

Most children who die from flu are not vaccinated. Therefore the idea that fit, healthy infants can simply “fight off” a flu infection without any problem is not always true.

Another benefit of preventing flu in children is that it reduces the spread of infections to other vulnerable family members such as grandparents.

What’s in store for us this winter?

The one predictable thing about flu, is that it is unpredictable! However, we often look to the northern hemipshere’s winter flu season to give some insights into what might be expected here.

The recent flu season in the United States and most of Europe was dominated by the A(H3N2) strain of flu. This virus has historically been associated with increased severity in the elderly.

There has been a lot of media coverage about bad vaccine match in the northern hemisphere. This is because most of the serious influenza was caused by the A(H3N2) viruses which had changed over the five to six months when the vaccine producers were manufacturing the vaccine. But the other components of the vaccine were well matched.

Our vaccine has been updated to protect Australians against the new A(H3N2) viruses.

So, if you or a loved one fall within the high-risk groups described above, getting the vaccine remains the most effective way to avoid the inconvenience and potentially severe health risks of the flu – and passing it on.

The ConversationThis article was originally published on The Conversation. (Reblogged by permission). Read the original article.


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Orthorexia nervosa: when righteous eating becomes an obsession

The Conversation

Rebecca Charlotte Reynolds

Orthorexia nervosa, the “health food eating disorder”, gets its name from the Greek word ortho, meaning straight, proper or correct. This exaggerated focus on food can be seen today in some people who follow lifestyle movements such as “raw”, “clean” and “paleo”.

American doctor Steven Bratman coined the term “orthorexia nervosa” in 1997 some time after his experience in a commune in upstate New York. It was there he developed an unhealthy obsession with eating “proper” food:

All I could think about was food. But even when I became aware that my scrabbling in the dirt after raw vegetables and wild plants had become an obsession, I found it terribly difficult to free myself. I had been seduced by righteous eating.

Bratman’s description draws parallels with many modern dietary fads that promise superior health by restricting whole food groups without a medical reason or even a valid scientific explanation.

Raw food followers might meet regularly to “align their bodies, minds and souls” by feasting on “cleansing and immune-boosting” raw foods. Such foods are never heated above 44˚C, so “all the living enzymes in the food remain intact”. No gluten, dairy or “sugar” is allowed.

Clean eaters may follow similar regimes, removing gluten, dairy and even meat from their diets. You might overhear a discussion about “superfood green smoothie” recipes after a yoga class that also happened to “cleanse your gall bladder”.

And finally, around the corner, paleo pushers may “beef up” together with a Crossfit class, followed by a few steaks. Again, with paleo, there is no gluten – or any grains for that matter – and no dairy or other such “toxins” are allowed.

How common is orthorexia?

There is a blurry line separating “normal” healthy eating and orthorexia nervosa, but one way to define the condition is when eating “healthily” causes significant distress or negative consequences in a person’s life.

They may be “plunged into gloom” by eating a piece of bread, become anxious about when their next kale, chia or quinoa hit is coming, or eat only at home where “superfood” intake can be tightly controlled.

Such behaviours can have a significant impact on relationships with family members and friends, let alone on their mental health.

Under the paleo regime, steak is in but dairy is out. (Source: Taryn/Flickr, CC BY-SA)

Orthorexia nervosa is not a clinically recognised eating disorder but researchers have developed and tested questionnaires in various populations to get an idea of its prevalence.

Italian researchers developed the ORTO-15 questionnaire in 2005, with a cut-off score below 40 to signify orthorexia nervosa. Scores above 40 can still signify a tendency to pathological eating behaviours and/or obsessive-phobic personality traits.

Questions include: “Does the thought about food worry you for more than three hours a day?” and “Do you feel guilty when transgressing your healthy eating rules?”

Using this questionnaire and cut-off value of 40, another Italian research group reported a prevalence of orthorexia nervosa of 57.6%, with a female-male ratio of two-to-one. However, using a cut-off value of 35, the prevalence reduced to 21%.

Most studies have been conducted in population sub-groups that may be at increased risk for orthorexia nervosa, such as health professionals. Again using the ORTO-15 and a cut-off value of 40, the prevalence of orthorexia nervosa in Turkish medical doctors was 45.5%, in Turkish performance artists it was 56.4% (81.8% in opera singers to 32.1% in ballet dancers) and in ashtanga yoga teachers in Spain, 86.0%.

Using another questionnaire, the Bratman Test, 12.8% of Austrian dietitians were classified as having orthorexia.

You can test your own tendencies towards orthorexia nervosa using this Bratman test here and access support services via the National Eating Disorder Collaboration page and Body Matters Australasia.

Is it a mental disorder?

Orthorexia nervosa is not listed in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5), which psychologists and psychiatrists use to diagnose mental disorders. The DSM-5 currently lists anorexia nervosa, bulimia nervosa, binge-eating disorder, “other specified feeding or eating disorder” and “unspecified feeding or eating disorder”.

Some clinicians argue orthorexia nervosa should be recognised as a separate eating disorder and have proposed clinical DSM diagnostic criteria. They note distinct pathological behaviours with orthorexia nervosa, including a motivation for feelings of perfection or purity rather than weight loss, as they see with anorexia and bulimia.

Under a strict raw food diet, no gluten, dairy or ‘sugar’ is allowed. (Source: Marta Gal/Flickr, CC BY-NC-SA)

Others disagree and argue that it falls in current eating disorder or other mental disorder categories. As Bratman explained in 2010:

At times (but not at all times) orthorexia seems to have elements of OCD (obsessive compulsive disorder). It may also have elements of standard anorexia. But it is often not very much like typical OCD or typical anorexia.

It’s clear that more research is needed on orthorexia nervosa, including its diagnosis and potential DSM listing as an independent eating disorder.

It’s also important to consider that people can move between mental disorder classifications. Sometimes labels may not be as important as providing solutions to patients with disordered eating, such as cognitive-behavioural therapy.

Striking a balance

As a nutritionist and a recovered sufferer of bulimia, I leave you with some advice:

Don’t trust all-devoted kale consumers, including health professionals and celebrities, if their advice isn’t based on scientific evidence.

Don’t make food the most important focus of your life. As Bratman says:

Rather than eat my sprouts (or kale) alone, it would be better for me to share a pizza with some friends.

Try to be a balanced food consumer with a “mostly and sometimes” mantra.

This article was originally published on The Conversation. (Reblogged by permission). Read the original article.


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Still no good evidence that most complementary medicine works

The Conversation

Ian Musgrave

The complementary medicine industry has been quick to respond to an opinion piece by Cassandra Wilkinson in The Australian newspaper on the lack of evidence for many complementary medicines, and particularly complementary medicines for children.

Alan Bensoussan of the National Institute of Complementary Medicine claimed in a follow-up letter to the Australian that complementary medicines included many well-established medicines (scroll down for the letter). He claimed that these well-established complementary medicines include medicines that prevent spina bifida in newborns, osteoporosis in the elderly, macular degeneration, cognitive decline, and childhood bronchitis.

Except, well, they don’t. You can search for clinical trials of complementary medicines for the above complaints that show them to be “well-established” and you will come up empty handed. You will find one or two studies suggesting that there might be a beneficial effect of some complementary medicine (see here for the inconsistent evidence for Ginkgo and macular degeneration), but nothing “well-established”.

Similarly, a search of systematic reviews, which look at the overall evidence from multiple studies, turns up nothing, although one treatment for osteoarthritis (not osteoporosis) glucosamine, might be beneficial in some patients. This is hardly “well-established” though.

If you go to the web site of the National Center for Complementary and Alternative Medicine and look up “bronchitis” you get the following “There is not enough evidence to support the use of any complementary health practices for the relief of asthma”. If you look up cognitive decline, you get a page that shows all current complementary therapies either do not help (and this includes the favoured herb, Gingko) or have not enough evidence.

So where does Alan Benoussan’s claim come from? Some clarification comes from an article in Pharmacy News, where Steve Scarff, regulatory and scientific affairs director of the Australian Self Medication Industry, also claimed that there is a growing evidence base to support the use of complementary medicines. Mr Scarff used as examples of clinically-supported complementary medicines “calcium and vitamin D for osteoporosis, omega-3 fish oil for heart disease, folate for pregnant women in preventing spina bifida, iron supplementation for anaemia, and evidence to support St John’s Wort for depression”.

One problem here, all but one (St. John’s Wort) of these are conventional medicine, not complementary medicine. It was conventional medicine that researched the physiology, did the clinical trials and developed the therapies and approaches, not complementary medicine (calcium and vitamin D for osteoporosis (note that this is not “one size fits all” medication), omega-3 fish oil for heart disease, folate for pregnant women in preventing spina bifida). Just because you sell vitamin pills doesn’t mean you get to appropriate the hard work of medical researchers and clinicians.

“Complementary” use of vitamins is usually use of high dose vitamins, such as high dose vitamin C for colds and flu’s (which doesn’t really work) or high dose antioxidant vitamins (high dose fat soluble antioxidant vitamin are actually associated with slightly worse outcomes and in some cases a slight increase in death). And vitamin supplementation of healthy, non-vitamin deficient people also has no benefit.

St. John’s Wort does have a modest anti-depressant effect (although very variable due to wide differences in composition). It also has significant side effects and very serious interactions with conventional medicines, so is not recommended for therapy. People have died because of it. Information on the side effects of St. John’s Wort from points of sale are generally very poor and most consumers will be unaware of them (see also here)

The claims from the National Institute of Complementary Medicine and the Australian Self Medication Industry does nothing to address the issues brought up in the opinion piece, namely that there is no evidence that complementary medicine works for children and that between 70-90% of complementary medicines surveyed did not meet regulatory requirements (71% had manufacturing or quality problems). As well, complementary medicine sponsors drag their feet when asked to remove non-compliant medicines (see here and here).

This is what the National Institute of Complementary Medicine and the Australian Self Medication Industry should be dealing with, not claiming the work of conventional medicine as complementary medicine.

The ConversationThis article was originally published on The Conversation. (Reblogged by permission). Read the original article.


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Cluster bomb of new research explodes tobacco industry lies about plain packs

The Conversation

Simon Chapman, University of Sydney

There is near-universal agreement that Australia’s implementation of tobacco plain packaging in December 2012 has seen the most virulent opposition ever experienced from the global tobacco industry.

While the industry bravely insisted early in its campaigning that plain packs “would not work” their legal actions, campaign expenditure, lobbying and general apoplexy rather suggests they feared it would be a devastating policy, with long term global ramifications.

Indeed, eleven other nations (Ireland, England, New Zealand, France, Norway, Finland, Chile, Brazil, India, South Africa, Turkey) have either legislated plain packaging or are now warming up to do so.

University of Sydney researcher Becky Freeman and I catalogued the full range of industry lies in our recently released (free) book Removing the Emperor’s Clothes. The Cancer Council Victoria has also published extremely detailed rebuttals to the major industry scuttlebutt.

Now today, the British Medical Journal’s specialist journal Tobacco Control has published a special collection of new research which puts further 10,000 watt arc lights on specious industry claims.

Key industry claims have included that plain packs would:

  • Drive prices down, as smokers turn away from buying expensive premium brands because they look exactly the same as cheap brands (other than brand names). More affordable cigarettes, they argued, would cause more smoking, including among children
  • Flood Australia with illegal tobacco
  • Cause smokers to stop buying cigarettes at small convenience stores
  • Prompt smokers to use special covers to conceal the large-scale graphic warnings on packs.

Price falls?

One of the new Tobacco Control papers monitors changes in recommended retail prices RRPs from one year before plain packs were introduced until one year after. Prices were adjusted to 2013 prices, and for inflation and average cigarette price stick and grams of roll-your-own tobacco.

The RRPs of tobacco products were higher in real terms one year after the legislation was implemented. Importantly, these increases exceeded increases resulting from consumer price indexation of duty and occurred across all three major manufacturers for both factory made and roll-your-own brands, all three cigarette market segments and all major pack sizes.

Tobacco prices rose most for leading and premium brands 10.0% and 10.1%, respectively) and among packs of 30s (18.3%) and 50s (12.5%). So far from seeing cigarette prices fall across the board, the industry raised prices.

Floods of illicit tobacco?

The tobacco industry’s most common claim was that plain packs would see smokers turn away from buying the purposefully confronting and unattractive plain packs and seek out illegal products not in plain packs.

Tobacco spokespeople made the outrageous claim that about one in seven of all cigarettes being smoked were such illegally obtained cigarettes. Apparently, while ordinary smokers across the country knew where to buy these easily, the full might and resources of the Australian Federal Police could not work out where these were being sold.

Tobacco companies have been proven wrong. Source: Curran Kelleher/Flickr, CC BY

Another study in the collection questioned 8,679 smokers across the country in telephone surveys conducted continuously, from six months before plain packs until 15 months afterwards.

The study found no significant increases in reported purchasing of “cheap whites” (illegally imported Asian sourced brands), of international brands selling for 20% or more less than the normal retail price, or of unbranded loose tobacco (so-called “chop chop”).

Rates of purchase of cheap whites and heavily discounted products were at around half of one per cent of smokers, nothing remotely like one in seven.

Small shops losing customers?

One of the most bizarre claims the industry made was that plain packs would see smokers deserting corner stores for larger retail outlets like supermarkets. This was an appeal designed to tap into wider public sentiment about local corner store owners being crushed under the dead weight of government regulation.

Those making the claim never explained why smokers would abandon small retailers for large ones because of plain packs when the very same packs would be sold in both. Consumer preference for larger retailers is entirely driven by price discounting, something never mentioned in the industry propaganda.

A third paper in the collection examined where smokers purchased their cigarettes. Unsurprisingly, it found no changes from prior to and after the introduction plain packs in where smokers bought their supplies.

Covering up the packs?

In the month that plain packs were introduced, a Queensland small businessman got his 15 minutes of fame from publicity about special pack covers that could block out the unforgettable graphic warnings. Like children covering their eyes from scary scenes in movies, the idea was that many smokers would rush to do the same, outsmarting the hapless bureaucrats who planned the legislation.

A fourth paper which reports on unobtrusive observations of smokers handling their packs in outdoor cafés found that prior to plain packs, just 1.2% of outdoor café smokers used pack covers. This rose to 3.5% in the early months of plain packs and then fell back to 1.9% one year later.

In any event, evidence shows that smokers who actively try to avoid exposure to pack warnings by covering them up, have higher subsequent rates of quit attempts than those who don’t.

Importantly too, these observations recorded that of all café outdoor patrons, one in 8.7 displayed a pack prior to the introduction of plain packs with this reducing to one in 10.3 afterwards. Such a fall is consistent with both a reduction in smoking prevalence and with growing self-consciousness among smokers about showing that they smoke in public.

Impact on adolescents?

There were several principal objectives of the plain packs legislation. But outstanding among these was the goal of making smoking less desirable among young people. This would continue the trend away from smoking, as each successive cohort of children chose not to take up the habit.

A fifth paper used school-based surveys prior to and after plain packs to examine students’ ratings of the “character” of four popular cigarette brands, and variables including perceived harmfulness, look of pack and positive and negative perceptions of pack image.

Positive character ratings for each brand reduced significantly between 2011 and 2013. Significantly fewer students in 2013 than 2011 agreed that “some brands have better looking packs than others” and packs were rated more negatively, with positive ratings decreasing most in smokers.

The tobacco industry and its acolytes can be expected to try to torture these reports to spin yet more denials of the impact it fears will quickly inspire even more countries to follow Australia’s lead.

Australia is fortunate in having some of the very best researchers in the world whose work has contributed to the development of plain packs and now to the evaluation of its impact.

Editor’s note: please ensure your comments are courteous and on-topic.

The ConversationThis article was originally published on The Conversation. (Reblogged by permission). Read the original article.


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So, the NHMRC has found homeopathy doesn’t work. Now how do we get the message across?

The Conversation

By Ian Musgrave

The NHMRC has released its final statement on homeopathy. To no ones great surprise, the report concluded that there was no evidence that homeopathy was effective in treating any of 63 separate medical conditions.

I have already dealt with aspects of the interim report, and articles in The Conversation have already dealt with the report in general (see here and here), so I would like to look at it from a different angle; how do we effectively communicate the science behind the report?

Sure, the report is on the web, and has been mentioned in a variety of media and radio programs, but is this going to be effective? The need to effectively communicate these findings is highlighted by two separate occurrences, the recent debate over vaccination in the light of measles outbreaks overseas, and the recent CSIRO report that up to 40% of Australians are “disengaged” or actively distrust science.

After all, the target audience for this information is not the people who have been following the evidence, and are well aware that homeopathy is ineffective. To some degree the people who want to treat mild or self limiting conditions, for example insomnia, and who think that homeopathy is some form of herbal medicine are also not the target audience.

What we are worried about most is those people with serious conditions who abandon standard therapy for ineffective homeopathy (for example, trying to treat diabetes with homeopathic dilutions of uranium salts). We accept that adults should be able to choose (or reject) their therapies. But we also expect that people choose or reject therapies based on the best available evidence. What happens when people reject that evidence?

A recent paper looked at various ways to communicate with parents to increase vaccination rates. They found that parents accepted that the MMR vaccine did not cause significant side effects after the various communication strategies, but were not inclined to get their children vaccinated. One subset of parents, those who had the least favourable views on vaccination at the beginning of the study, were now LESS likely to vaccinate their children.

This is consistent with other studies (see also here) showing that when people with deeply entrenched beliefs are confronted with facts that disprove those beliefs, paradoxically they become firmer in their beliefs.

So how do we effectively communicate the science in the report? The NHMRC site has meticulous information on what they did, summaries and a FAQ, but we have to get people to read them. Most news articles and radio shows do not provide the information to find the report.

From a science communication point of view, most of the information on the NHMRC site is too technical for the general public. As an example of a good way to convey science around a contentious issue, the Australian Academy of Sciences has a great web accessible document that simply and clearly explains the science behind vaccines.

However, if you google “Vaccine Information Australia” you will see 4 of the top 10 results are vaccine denialist sites (and 3 of the top 5), and the AAS report is nowhere to be found.

As well as finding information in a format accessible to the general public, we need to consider that those most at risk of ignoring conventional medicine for homeopathy are also very likely to be in that 20% that the CSIRO found to be disengaged from or distrustful of science. As well, peoples perception of health and their health philosophy can make this a very emotionally charged issue.

We need to carefully consider how to approach this audience. In the light of the pediatrics paper, referenced above, where factual information led people to be less likely to vaccinate, merely giving people the facts is unlikely to be enough.

However, there are a variety of approaches that can be tried. Most of these have been developed in relation to politics or global warming, but the processes that are involved are similar.

In view of how homeopathy may be deeply linked with peoples world views, and showing homeopathy is no more than placebo may leave a gap in peoples beliefs (accounting for their reluctance to accept the facts), an approach such as replacing the gap with an alternative narrative may be the best approach.

Whatever the approach we use, the publication of the NHMRC report on homeopathy is the beginning of a long process of engagement, not the end of the matter.

The ConversationThis article was originally published on The Conversation. (Reblogged by permission). Read the original article.


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Time to stop abusing the NHMRC for ideological purposes

The Conversation

By Michael Vagg, Barwon Health

The release today of the long-awaited NHMRC Statement and Advice on Homeopathy is just the latest in a series of pointless and ideologically motivated exercises that this peak scientific body has been tasked to undertake.

We have seen this group of professional scientists sent on wild goose chases after Wind Turbine Syndrome, water fluoridation and now homeopathy on behalf of a government that clearly wants science to be done to order for its political agenda. At a time when they are holding valuable, productive and world-class research infrastructure hostage to their unpopular higher education legislation, it is simply impossible to believe that the federal government takes science seriously at all.

Thankfully, the scientists continue to do their job well even when sent on a fool’s errand. The report on homeopathy is a model of science-based enquiry. It really should put to bed the case for supporting this entirely fantastical enterprise with science or higher education dollars. The analysis of the literature was comprehensive, covering some 1800 articles published. The majority of these were of such poor quality that only a couple of hundred even met the most basic criteria for further analysis. The consensus of these acceptable studies was that there was nothing to see here, and science should move on.

If some good is to come out of such a whimsical use of public funds, it should lead to the removal of public subsidies for private health insurance to cover homeopathy services. It should be wielded mercilessly in support of a crackdown by TGA and ACCC on the spivs and hucksters who sell complete moonshine to vulnerable patients. After all, as the Prime Minister reminded us yesterday in another context,

what we can’t do is endlessly subsidise lifestyle choices

This Statement of Advice on homeopathy is reported to have cost around $800,000 to produce, and followed a similar document having been produced in the UK which arrived at the same conclusion just a couple of years earlier. I’m sure a few of Australia’s newly unemployed research scientists could have put that money to good use. The fluoridation and wind turbine fiascos add insult to injury by wasting precious science dollars on fatuous ideological stunts. One wonders whether NHMRC reports on the health effects of “superfoods” or dangers of immunisation will be next. Perhaps Senator McFarlane should just change his job title to Minister for Industry and Junk Science.

The ConversationThis article was originally published on The Conversation. (Reblogged by permission). Read the original article.


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NHMRC Statement on Homeopathy

The National Health and Medical Research Council today released a statement concluding that there is no good quality evidence to support the claim that homeopathy is effective in treating health conditions.

Its release follows a thorough review of the evidence, conducted as part of NHMRC’s responsibility to provide advice and support informed health care decisions by the Australian community. This is the final outcome from the draft information paper the NHMRC released last year.

The conclusion is based on the findings of a rigorous assessment of more than 1800 papers. Of these, 225 studies met the criteria to be included in NHMRC’s examination of the effectiveness of homeopathy.

The review found no good quality, well-designed studies with enough participants to support the idea that homeopathy works better than a placebo, or causes health improvements equal to those of another treatment.

Further information is available here.


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A $2.5m investment in wind farms and health won’t solve anything

The Conversation

By Simon Chapman, University of Sydney

The out-going head of the National Health and Medical Research Council (NHMRC) Warwick Anderson confirmed in Senate Estimates recently that calls for research proposals for up to a total of A$2.5 million over five years will soon be made to investigate questions about wind farms and health.

Under questioning from Greens Senator Richard Di Natale, Anderson told the committee A$2.5m was a paltry fraction of the agency’s total research budget, which in 2014 stood at A$802.42m. So A$2.5m is the equivalent of less than 0.06% of a projected five-year research budget on today’s allocations.

But researchers’ success obtaining grants has never been lower in Australia, with many strong grants falling below the cut-off score, which is ultimately budget determined. In 2014, researchers submitted 3,700 applications for project grants, with only one in 6.7 of these (14.9%) being funded. In the health services research field, 91.8% if applications were not funded.

Anderson has been emphatic that research standards will not be compromised in all this, and that only high-quality applications from suitably experienced researchers will be funded. It is not clear yet whether only one or more applications will be funded, if indeed any are.

The main debate in this area is between those who are adamant that wind turbines emit sounds and vibrations that upset and harm some of those exposed, and those who argue that the available evidence points strongly to health problems and complaints being psychogenic.

Nocebo phenomena – the idea that fear about wind turbines will cause some people to get symptoms – seem to be at the heart of both complaints and claims of illness.

I have documented an Old Testament-length list of 244 different symptoms and diseases alleged by wind farm opponents to be caused by the pestilence of wind farm exposure. The most bizarre of these include herpes, haemorrhoids, lung skin cancer and disoriented echidnas.

Study limitations

In even the best of studies, it will be impossible to separate out nocebo effects from putative direct effects. Here’s why. Ideally, researchers could select a location where a wind farm was being planned and conduct symptom- and illness-prevalence studies well before the wind farm was constructed and operational.

They would then repeat those measures at different times after the turbines began, analysing the influence of variables such as noise levels, economic benefit, pre-existing levels of antipathy to wind farms and “negatively oriented personality”. They could also request the production of medical records to see whether reported health problems long preceded the commencement of the turbines.

But this sort of research design will always be corrupted by wind farm opponents who, at the first hint of any wind farm development, move into a local area with the express purpose of alarming and frightening as many local residents as possible about what’s down the track.

No wind farm developer could ever commence construction without a long and open period of community consultation. These trigger the alarmists to turn on their best efforts to worry residents sick. This nocebo-priming case study I published recently describes in detail how they operate.

Residents fully sworn against wind farms are highly biased and can game such studies where self-reports of symptoms are central.

Lessons from Canada

Canada has already conducted the sort of study that might be proposed in Australia. In response to agitation from anti-wind groups, starting in 2012, it undertook the largest study of wind turbines and health ever attempted.

The study involved 1,235 houses in Ontario and Prince Edward Island, where randomly selected residents of all houses within 600m of 399 turbines on 18 wind farms were compared with those living 600m to 10km away.

In October 2014, Health Canada published the top-line results from the $CAN2.2 million study of the very sort that the NHMRC might well be asked to replicate.

It found the following were not associated with wind turbine noise:

  • self-reported sleep (such as general disturbance, use of sleep medication, diagnosed sleep disorders)
  • self-reported illnesses (such as dizziness, tinnitus, prevalence of frequent migraines and headaches) and chronic health conditions (such as heart disease, high blood pressure and diabetes)
  • self-reported perceived stress and quality of life.

It did find that “annoyance” was related to wind turbine noise, with 16.5% of houses in Ontario and 6.3% on Prince Edward Island being annoyed.

Ontario is the epicentre of Canadian anti-wind farm activism, while Price Edward Island has seen little of this. So this major difference in the prevalence of annoyance lends support to the idea that wind farm annoyance is a “communicated disease” spread by anti-wind farm agitators.

The Canadian study also found that:

annoyance was significantly lower among the 110 participants who received personal benefit, which could include rent, payments or other indirect benefits of having wind turbines in the area e.g., community improvements. However, there were other factors that were found to be more strongly associated with annoyance, such as the visual appearance, concern for physical safety due to the presence of wind turbines and reporting to be sensitive to noise in general.

These findings are consistent with conclusions reached in what is now 24 reviews of the evidence.

Predictably, anti-wind farm groups in Canada rejected the Canadian study’s conclusions. It seems obvious that the only reports that such groups will ever accept are those which confirm their agenda. This is not a debate which will ever be resolved by research.

Political interests

Disturbingly, the NHMRC has allowed itself to be influenced by what reported internal email described as “the macro policy environment” – bureaucratic code for sensitivity to political interests.

Instead, Warwick Anderson and the Council should have stated clearly and emphatically to the parliament and the public that any researcher wanting to investigate wind farms and health was at perfect liberty to submit such a proposal to compete with all those being submitted by researchers considering any other topic. Such proposals would stand or fall on their competitiveness as determined by peer review.

There is no dedicated research funding being set aside by the NHMRC to further investigate the known massive risks to human health from fossil fuel extraction and burning. And it would be unimaginable for the NHMRC to quarantine money for any other non-disease like wifi sensitivity, smart electricity meter dangers or “fan death”. But this is what it has done here.

The money allocated is not much. But the real damage will be that in having this issue thus elevated to privileged research status, its political apostles will be greatly encouraged.

Editor’s note: please ensure your comments are courteous and on-topic.

The ConversationThis article was originally published on The Conversation. (Reblogged by permission). Read the original article.


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