Alternative medicine can be scientific, say besieged academics of Australia

RMIT University’s School of Health Sciences has rejected the suggestion that it peddles pseudo-scientific quackery via its courses in complementary and alternative medicine (CAM).
Acting head of the school Dr Ray Myers has defended RMIT’s health science programs as “evidence-based education and practice”, citing collaboration in clinical research of CAM treatments funded by the National Health and Medical Research Council (NHMRC).
Dr Myers was speaking in the face of a campaign by a coalition of prominent medical researchers to expunge higher education of the “undisciplined nonsense” taught in CAM courses at Australia’s “somewhat lesser universities”.
The campaigning group, Friends of Science in Medicine (FSM), has about 400 signatories, including immunologist Sir Gustav Nossal and Professor Jock Findlay, chairman of the NHMRC’s Embryo Research Licensing Committee. It has written to every vice-chancellor in Australia asking for a review of their health science courses to “ensure that primacy is given to scientific principles based on experimental evidence”. The letter laments the spread of chiropractic studies to 19 Australian universities, and complains that ‘energy medicine’, ‘tactile healing’, homeopathy, iridology, kinesiology, acupuncture, and reflexology are taught “as if they were science”.
Group co-founder Emeritus Professor John Dwyer from the University of NSW said that FSM wants “vice-chancellors to ask their deans of science what’s the heck’s going on … It’s just extraordinary that such undisciplined nonsense is being taught in universities around Australia.”
“One of the complaints that we have about so-called alternative medicine is that it doesn’t strive to be tested. … modern medicine is totally devoted to doing everything we can to take this evidence-based approach and do good science and do good research into the things we do to people,” he said. “Alternative medicine doesn’t do that – it’s more than happy to rely on tradition and anecdote and it doesn’t really want to be tested.”
However, Dr Myers said that CAM research at RMIT was conducted in a thoroughly scientific manner, with the NHMRC funding clinical trials of alternative medicines. In a clinical study granted A$560,000 by the NHMRC and A$30,000 by the National Institute of Complementary Medicine, the university was collaborating with two Melbourne hospitals on a clinical study investigating the use of ginseng, a herb used in traditional Chinese medicine, for improving lung function in patients with Chronic Obstructive Pulmonary Disease (COPD), he said.
The NHMRC had also granted A$400,000 for a project in which the university was collaborating with three Melbourne hospitals on a three-year clinical trial of acupuncture for pain management in emergency departments, Dr Myers said. “The project follows the promising results of pilot studies by RMIT researchers, in which more than 1,000 patients received acupuncture treatment for acute pain relief at the emergency department of the Northern Hospital.”
The professions of Chinese medicine, chiropractic and osteopathy are government regulated, Dr Myers said, with RMIT programs in these fields meeting current professional standards and subject to external accreditation. Chiropractic and osteopathy were areas in which clinical research was limited, but RMIT’s education program incorporated the “best available evidence, while promoting further clinical research into these treatments,” Dr Myers said. “RMIT stands by its long record of evidence-based research and the high quality of its health sciences programs.”
But FSM is not buying it. “Those universities involved in teaching pseudoscience give such ideologies undeserved credibility, damage their academic standing and put the public at risk,” the group’s letter states.
The great danger, said Professor Dwyer, was that people who have chronic health problems or who have been persuaded that doctors do not have the answers are delaying the “proper investigation and treatment” of their illness by instead seeking help from therapists offering alternative medicine.
“These are dangerous delusions, and our campaign at the moment is aimed at those somewhat lesser universities, but nonetheless universities, that are offering and teaching pseudoscience as if there was an evidence base to support it, because obviously that gives credibility in the eye of the public,” Professor Dwyer said.
Citing the late CEO of Apple, Professor Dwyer said that “Steve Jobs spent a year with his cancer of the pancreas trusting homeopathic remedies, and by the time he got to the surgeons it was all over.” It is worth noting the veracity of this claim by Professor Edzard Ernst about Mr Jobs treating his cancer with homeopathy has left some struggling to find evidence for it, while others have claimed that for nine months after his diagnosis, Mr Jobs spurned what could have been life-saving surgery in favour of not homeopathy but a vegan diet and herbal remedies.
The “lesser universities” that have aroused the ire of FSM include the Australian Catholic University, Charles Sturt University, Central Queensland University, Edith Cowan University, Macquarie University, Monash University, Murdoch University, RMIT University, Southern Cross University, Swinburne University, the University of Ballarat, the University of New England, the University of Newcastle, the University of Queensland, the University of Technology Sydney, the University of Western Sydney, and the University of Wollongong. To buttress its case, FSM has gathered a list of offending courses, which includes Chinese Medicine, Wellness studies, Applied Eastern Anatomy, Clinical Science with options to study osteopathy and naturopathy, Mind/Body Medicine, and many others.
“It should be a policy that all universities, higher education institutions, should not be involved in in this woolly teaching,” Professor Dwyer said, adding that “I suspect that these are well attended, popular, money-earning courses for cash-strapped universities.”
The claims of FSM, however, ignore the evidence about CAM in higher education, said Dr Wardle, a NHMRC Research Fellow at the University of Queensland’s School of Population Health and co-director of the Network of Researchers in Public Health and Complementary and Alternative Medicine (NORPHCAM), an international group promoting clinical research in CAM.
“They’re actually not that interested in evidence, because the overwhelming evidence is that putting CAM into universities has increased the standards, decreased the fringe element, and improved public safety, so it definitely smacks of dogmatism,” said Dr Wardle, who is a naturopath.
“They love to say that there’s no such thing as complementary medicine and conventional medicine, there’s just evidence-based and non-evidence-based, but, for example, St John’s Wort for over a decade now has been shown to be equally as effective as any pharmaceutical indication for mild to moderate depression, yet there’s still a large group of doctors who refuse to integrate it simply because it’s a herbal medicine,” Dr Wardle said.
The world of CAM is not a “homogenous entity”, said Dr Wardle. “There is a lot of crap, but there’s good stuff, and treating it like it’s all the same thing is very, very fraught. Taking it out of universities runs a real risk of the fringe element getting a stronger voice in the profession.”
“There are studies from Canada, Australia, and Britain that show that CAM practitioners are less anti-vaccination when they’re university trained, and they refer more to conventional [medical] providers when things get serious if they’re university trained.”
“If you look at chiropractic courses [in universities], most of it is human physiology. Chiropractic is certainly not the dominant part of the course. If you look at naturopathy, they do learn herbal medicine and nutrition but they also learn basic health science: they learn the common language of health practice – they learn what a physio or a medical doctor or a nurse would learn. Putting it into the universities diminishes the fringe element,” Dr Wardle said. “If they [FSM] are really worried about public safety they should be not trying to exclude and ostracise them from the university sector.”
He questioned how representative FSM’s roll call of doctors really is, saying that he has just completed a survey of every rural GP in NSW and qualitative interviews with about 30. “About a third wouldn’t have anything to do with complementary medicine providers, another third were very open to it – maybe too open – and the other third if they knew a practitioner who got results they’d send people on.”
About 70 per cent of Australians use CAM and it thus makes sense for research and training to be carried out within the regulation and scientific rigour of the universities, Dr Wardle said.
Source:The Conversation

Blood Pressure Differences Between Arms Could Signal Heart Risk

People whose systolic blood pressure -- the upper number in their reading -- is different in their left and right arms may be suffering from a vascular disease that could increase their risk of death, British researchers report.
The arteries under the collarbone supply blood to the arms, legs and brain. Blockage can lead to stroke and other problems, the researchers noted, and measuring blood pressure in both arms should be routine.
"This is an important [finding] for the general public and for primary care doctors," said Dr. William O'Neill, a professor of cardiology and executive dean of clinical affairs at the University of Miami Miller School of Medicine.
"Traditionally, most people just check blood pressure in one arm, but if there is a difference, then one of the arteries has disease in it," he said.
The arteries that run under the collarbone can get blocked, especially in smokers and diabetics, he noted. "If one artery is more blocked than the other, then there is a difference in blood pressure in the arms," O'Neill explained.
"Doctors should, for adults -- especially adult smokers and diabetics -- at some point check the blood pressure in both arms," he said. "If there is a difference it should be looked into further."
The report appears in the Jan. 30 online edition of The Lancet.
For the study, a team led by Dr. Christopher Clark, from the Peninsula College of Medicine and Dentistry at the University of Exeter in Devon, England, reviewed 28 studies that looked at differences in systolic blood pressure between arms.
This process is called a meta-analysis. It uses data from previously published studies to find trends that may not have surfaced in the original data.
This analysis found that a difference of 15 millimeters of mercury (mm Hg) or more between readings was linked with an increased risk of narrowing or hardening of the arteries supplying the lower limbs, called peripheral vascular disease.
The risk of reduced blood flow to the legs and feet was increased 2.5 times and the risk of decreased blood flow to the brain was increased 1.6 times, the researchers found.
The difference in blood pressure was also associated with a 70 percent increased risk of dying from cardiovascular disease and a 60 percent increased risk of death from any cause, the authors added.
The risk of having peripheral vascular disease was also increased with a 10 mm Hg difference in blood pressure between arms, the researchers noted.
It makes no difference which arm has the higher or lower pressure, it's the difference between them that matters, the study authors said.
Finding peripheral vascular disease early and treating it by lowering blood pressure and cholesterol as well as giving up smoking can help reduce the risk of death, Clark's group said.
"Our findings suggest that a difference in [systolic blood pressure] of 10 mm Hg or more, or 15 mm Hg or more, between arms could identify patients at high risk of asymptomatic peripheral vascular disease and mortality who might benefit from further assessment," the researchers concluded.
"Findings from our study should be incorporated into future guidelines for hypertension [high blood pressure] and blood pressure measurement," they added.
Another expert agreed that when it comes to blood pressure monitoring, both arms matter.
"These findings further reinforce blood pressure measurement guidelines of the American Heart Association, World Health Organization, International Society of Hypertension and European Society of Hypertension, which recommend that blood pressure should be measured in both arms at initial assessment," said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, and spokesman for the American Heart Association.
He believes that, "individuals found to have differences in systolic blood pressure in between arms of greater than 10 or 15 mm Hg should undergo further vascular assessment."
More information
For more information on high blood pressure, visit the American Heart Association.
Source:HealthDay

Doctors 'should check blood pressure on both arms

Measuring blood pressure on both arms rather than only one can reveal an elevated risk of heart disease or even death, according to a study released Monday.
In a review of medical literature, researchers at the University of Exeter found that a difference in the so-called systolic blood pressure between arms can be a useful indicator of the likelihood of heart trouble.
People with high blood pressure -- also called hypertension -- have an increased risk of developing heart disease, stroke, kidney disease and dementia, previous research has shown.
High blood pressure is defined by the World Health Organisation (WHO) as 140 over 90 millimetres of mercury or more. Mercury is used in blood-pressure gauges.
The first number measures maximum heart pressure (systolic), while the second measures pressure when the heart is in a resting phase (diastolic).
Published in the British medical journal The Lancet, the findings suggest that both-arm blood pressure checks should become standard practise, the researchers said.
The probe reviewed 28 studies with data on the difference in systolic blood pressure between arms.
They concluded that a gap of 15mm of mercury or more was linked with an increased risk of the narrowing and hardening of the arteries that supply blood to the legs and feet.
It was also associated with pre-existing cerebrovascular disease, which affects blood supply to the brain and can contribute to dementia.
Above this threshold, death rates due to cardiovascular problems likewise went up.
Most such cases are "clinically silent" and double-arm checks would better identify those at risk, the study said.
Source:AFP

India, Tunisia to launch joint research projects in biotechnology, medical science

India and Tunisia will launnch joint research programmes in the field of biotechnology, medical sciences and other allied sectors of the science and technology with a view to find out and promote areas of joint research beneficial to the people in both the countries.
The research will be held under the Programme of Cooperation in the fields of Science and Technology for the years 2012-14. The Department of Science and Technology (DST), Ministry of Science and Technology and the Tunisian Ministry of Higher Education & Scientific Research, (MHESR) will partner for the programme.
The proposals have been invited from Indian and Tunisian universities, research centres and institutes to submit joint proposals for scientific and technological research and development projects. The key areas identified included biotechnology, material sciences, medical sciences and science popularisation. The duration of the projects should be of two years which could be extended by one year, on the basis of progress assessment, after mutual agreement of both Coordinating Ministries.
Both the partnering departments also have worked out the mode of supports like visits by the project researchers from the two countries. The jointly approved projects are likely to be started in September 2012.
Tunisia has been looking for opportunities to strengthen the ties with India in the field of science and technology. The third meeting of the Joint Commission Meeting will be held soon in Delhi to take forward ongoing collaborations. Both the countries also have joint working groups in many areas including drugs and pharmaceuticals.
Source:Pharmabiz

Smells can Evoke Powerful Emotional Memories

Smells can revoke powerful and emotional memories from the past more efficiently in comparison to sounds, finds a new study.
A well-known idea called the "Proustian phenomenon" proposes that distinctive smells have more power than any other sense to help us recall distant memories, the Telegraph reported.
The theory is named after the French writer Marcel Proust, who in his novel 'A la recherche du temps perdu' (In search of lost time) describes a character vividly recalling long-forgotten memories from his childhood after smelling a tea-soaked madeleine biscuit.
Experts have suggested that the special impact of odour on our memory could be related to the proximity of the closeness of our olfactory bulb, which helps us process smells, and the amygdala and hippocampus brain regions which control emotion and memory.
However, although the theory is well-known anecdotally, no studies have been able to firmly establish that the phenomenon even exists.
Now researchers could have gone a step closer to proving it after an experiment showed smells trigger more detailed, arousing and unpleasant memories of painful experiences than sounds.
A team from Utrecht University in The Netherlands recruited 70 female students and played them video footage designed to provoke aversion, such as car accidents and reports on the Rwandan genocide.
While the film was played, the smell of cassis was pumped into the room, coloured lights were directed onto the back wall and neutral music was played in the background.
A week later, the participants were asked to recall their memories of the film while exposed to either the same smell, lights or sounds used in the initial screening.
Those who were given the cassis smell remembered more details about the film and found their memories more unpleasant and arousing than those who had the background music as a memory trigger, although the lights and the smell were equally effective.
Researchers said that there was no difference between the triggers in two other categories measuring how evocative and vivid the memories were.
Re-testing participants after a longer period than one week could produce more distinctive results, they said.
The researchers said that the findings "do not confirm the Proust phenomenon", but could prove useful for research into post-traumatic stress disorder, which causes patients to recall vivid and painful experiences.
The study has been published in the Cognition and Emotion journal.
Source-ANI

Sleep Patterns - Problems, Prevalence and Persistence in First Three Years of Life

Sleep problems in early childhood can be easily missed or recognized by parents and doctors. A short and flexible screening tool (like a questionnaire) may help the process of recognizing these children do that corrective measures can be instituted.Sleep is essential for daily functioning, sleep related issues are routinely addressed through anticipatory guidance in pediatric settings. However, research indicates that pediatric sleep problems may go undetected during routine clinical care. Although there is no gold standard for sleep assessment during infancy and early childhood, a study confirms the importance of focused screening for sleep problems during infancy and early childhood that goes further than merely asking if the child has problems sleeping.
This study was performed in United States in which 359 mother/child pairs participated.Sleep questionnaires were administered to mothers when children were 6, 12, 24, and 36 months old. Sleep variables included parent response to a nonspecific query about the presence/absence of a sleep problem and 8 specific sleep outcome domains: sleep onset latency, sleep maintenance, 24-hour sleep duration, daytime sleep/naps, sleep location, restlessness/vocalization, nightmares/night terrors, and snoring.
The sample was 64% white participants and 31% African American participants. In the 6- months survey point, the overall rate of parent-reported sleep problems and behaviors around sleep maintenance did not significantly differ by race or family income at any time point. However, there was differential attrition over time among African Americans and those in the lowest education and income groups. Those from lower-income families were reported to have longer sleep onset latency, shorter overall sleep duration, less independent sleep, and more snoring than were white children and those fromhigher-income families.
Reported napping/daytime sleep, vocalization/restlessness, and nightmares/night terrors differed by race or family income at only one time point. Nightmares/ night terrors and restlessness/ vocalization were significantly associated with parent report of a sleep problem from 12 to 36 months of age.
While the presence of a nonspecific sleep problem was reported by roughly 10% of parents at each time point, parent report of a sleep problem was significantly associated with snoring only at 12 months and with the location of a child’s sleep only at 24 months. Parent report of a sleep problem was significantly associated with longer sleep onset latency across all age ranges, as well as poorer sleep maintenance and shorter sleep duration at 6 to 24months but less strongly at 36 months.
21% to 35% of those who were reported to have a sleep problem during infancy showed persistent sleep problems 1 to 2 1/2 years later. Night waking and shorter sleep duration were perceived as sleep problems by 6 months of age and then remained particular concerns for parents through 2 years of age. Also, across all time points, the majority of children (62.5%–81.9%) were sleeping in their own bed.
Parents did not seem to associate snoring with sleep problems as a result snoring could be completely overlooked during well-child visits, despite its known risk for morbidity. It is noteworthy that the failure of a parent to recognize and report problems related to these domains could lead to errors in clinical decision making. Like sampling error may have influenced prevalence estimates of sleep problems. All sleep measures were based on parent-report. Since there is no single validated instrument for assessing sleep problems in children aged 6 to 36 months, the data was pooled from 2 independent sleep questionnaires. Sleep problem and behavioral domains that were the focus of this study are culturally defined to varying degrees; study did not propose nor examine potential mechanisms underlying sleep problems.
Parent interpretation and report of a sleep problem during early childhood may be inconsistent with clinical criteria for diagnosing pediatric sleep disorders, especially when assessed via a nonspecific query. To clarify parental concerns about sleep during early development and ensure that clinically relevant sleep issues are not overlooked, it is recommended that sleep problems be screened by using a flexible family-centered approach while addressing specific sleep behaviors and symptoms that have known clinical significance.
Reference: Prevalence, Patterns, and Persistence of Sleep Problems in the First 3 Years of Life; Kelly Byars et al; Pediatrics 2012.

Anti-Molestation Device for Women Invented by Indian Schoolboy

An Indian schoolboy from Delhi claims that his invention is a device, which can help women fend off potential attackers.
The device, which can be worn like a wristwatch, delivers an electric shock once it touches the attacker's skin.Manu Chopra, 16, said that he wanted to "use science to provide safety to women on the street".
Parts of many Indian cities, including the national capital, are unsafe for women.
Many working women carry pepper spray to deter attackers.
The latest National Crime Records Bureau figures show that India recorded almost 22,000 rape cases in 2008, 18 percent up from 2004.
Chopra said that it was "shameful" that women consider it unsafe to go out of home at night.
"Even my sister is not allowed to go out when dark because it is unsafe," the BBC quoted the boy as saying.
"This is the state of the national capital.
Chopra, whose sister Kaanchi is 12, said that it took him about six days to make the device and he expects it to be up for sale for as little as 122 rupees.
The student of Delhi's GD Goenka School said the idea to work on the device came to him when he read about a national competition, organised by the National Innovation Foundation (NIF).
The foundation, set up by the government, awards children for their innovation and creativity.
The product is attracting a lot of attention and there is talk of its market launch.
But the foundation says it may take time as the "prototype needs to be refined further to be launched as a product" and tests need to be conducted to prove its efficiency.
The "anti-molestation device" is activated when it records a significant rise in nerve speed and pulse rate of the victim.
For it to be effective, the victim has to ensure the dial of the device touches an exposed part of the attacker's body.
"It gives a feeble shock to the molester, giving precious time to the victim to flee," Chopra added.
The device also has an inbuilt camera to record the image of the attacker.
Source-ANI