the evolving mind

I’m sure it bothers many of you, too. To hear anyone with an alternative view, no matter how whacky and mis-informed, called a skeptic. So we have 911-skeptics, Holocaust-skeptics, vaccine-skeptics, and even evolution-skeptics.

The above is one of the reasons I am partly dissatisfied with the term, skeptic. The general nay-sayer connotation. To me, however, what makes a skeptic a true skeptic are attributes such as these: 1) an initial reaction to any claim with an attitude like this: “I wonder what the evidence is behind the claim?” 2) a commitment to scientific information, reasoning and critical thinking. And, perhaps most importantly, 3) a lack of a guiding commitment to a cause. Besides getting things right.

Consider the vaccine “skeptics.” I’m sure many of them consider themselves skeptics. And we skeptics are the ones being duped by big pharma and the government. But could we consider their general position as truly skeptical? I would say not. Why?

Most importantly, they seem to have prematurely arrived at a conclusion and are stuck there due to commitment to a cause. Their education on the matter is flawed/incomplete. They appear to lack a commitment to scientific information and critical thinking.

An article I found buried on my desk got me thinking about this: Refusing Chickenpox Vaccine Associated With Increased Risk of Disease.

The primary finding of the research was summed up in the lead -

Children whose parents refuse the varicella (chickenpox) vaccine appear more likely to develop the disease, according to a report in the January issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Seems like good, basic information. No fear-mongering, just facts. Further down in the piece we get to this statement, which is relevant to the current situation we have of parents refusing to vaccinate their children because they have been poorly informed of the risks — one of them completely bogus (causing autism):

The findings suggest that if more parents refuse vaccines, the incidence of varicella and related complications also may increase over time, especially among individuals at high risk of severe infection (such as pregnant women, infants and those with compromised immune systems).

Frequently there is a selfishness underlying a guise of skepticism. Because I want to hate the government, I’m going to convince myself that 911 was a conspiracy. Because I hate something or other about Jews or the Jewish state, I’ll find a way to deny the Holocaust. Because I’m over-protective of my child, I’ll reduce its minuscule risk of complications by avoiding vaccines, and indirectly increase the risk of other children becoming ill.

Sometimes the selfishness can merely be a preference for maintaining one’s preferred worldview. The true skeptic, like the true scientist, is committed to the facts first, what they might imply comes later. Often it’s reversed in the pseudo-skeptic.

Speaking of facts. While the numbers weren’t great in the above mentioned chicken-pox study, at least the article provides them. Bravo for that.

Among the 133 children who developed chickenpox, seven (5 percent) had parents who refused the varicella vaccine, compared with three (0.6 percent) refusals among the 493 controls. “Compared with vaccine acceptors, children of vaccine-refusing parents had a nine-fold increased risk of varicella illness,” the authors write. “Overall, 5 percent of varicella cases in the study population were attributed to vaccine refusal. We believe these results will be helpful to health care providers and parents when discussing decisions about immunizing children.”

Yes. Provide information, good information, unbiased information, and let parents choose. Numbers are good information. Raw numbers have yet to be spun into an argument meant to persuade. And that is why they are better.

As an example of weaker science reporting, we have this news release: Cannabis Damages Young Brains More Than Originally Thought, Study Finds. This topic, too, is important and there are people who have very strong opinions about marijuana. If against it, they prefer to hear how bad it is for individual health and society in general. If for it, the opposite.

Me, I just want the facts.

In the article about cannabis damaging brains I encountered no numbers. No specific finding. Just this:

“Teenagers who are exposed to cannabis have decreased serotonin transmission, which leads to mood disorders, as well as increased norepinephrine transmission, which leads to greater long-term susceptibility to stress,” Dr. Gobbi stated.

Decreased by how much in how many subjects? Increased by how much? How much greater susceptibility? And how was it determined?

The lead paragraph of the article strikes me as advocating a position.

Canadian teenagers are among the largest consumers of cannabis worldwide. The damaging effects of this illicit drug on young brains are worse than originally thought, according to new research by Dr. Gabriella Gobbi, a psychiatric researcher from the Research Institute of the McGill University Health Centre. The new study, published in Neurobiology of Disease, suggests that daily consumption of cannabis in teens can cause depression and anxiety, and have an irreversible long-term effect on the brain.

I find this piece subtly biased. It skirts the line of engaging in fear-mongering. Of course, if I were selfishly anti-marijuana I would welcome the article. If selfishly pro-marijuana I’d find reasons to refute it. To deny its conclusions.

As a skeptic I am disappointed by the science reporting not so much for the minor slant I perceive, but because the quality of the information is weak. Where are the specifics, the numbers, the facts?

Job one for the skeptic seeks out information. Not information guided by their pre-existing position, thus likely to confirm it. Rather, he or she seeks out the best, most reliable information available. Specific information, information not yet spun and packaged into emotional implications.

Technorati Links: marijuana, skepticism, vaccinations

Critical thinkers are wary of the naturalistic fallacy, of arguments that make appeals to Nature (capital n, of course) as representative of absolute good. More natural is better than the less natural, simply by the fact it is more natural. And nature is good.

While I certainly could be considered a nature-lover–my favorite hobbies are nature photography, bird watching, and snorkeling–I realize that nature is . . . nature. Sure there is plenty of good in nature, and without some aspects of nature, I couldn’t exist. My life depends upon a big slice of it. But consider mushrooms. Are they good? Some are, particularly when sautéed in butter. Others will kill you.

Many people consider so-called alternative medicine more desirable because, in part, it is more natural. And natural is an absolute good. But is it? A new science finding highlights the folly of this thinking. In Herbal Medicines Can Be Lethal, Pathologist Warns I learned,

An analysis of 251 Asian herbal products found in United States stores identified arsenic in 36 of them, mercury in 35 and lead in 24 of the products.

I would recommend not serving those herbs in a salad. Or using them to treat disease. Not unless the benefits far outweighed the costs.

The article also contained this statement -

Other side effects of herbal medicines can include liver, renal and cardiac failure, strokes, movement disorders, muscle weakness and seizures.

While that claim strikes me as a tad hyperbolic, it is simply the inverse of what many alt-med practitioners of the herbal variety spout. Oh yes, clover blossoms can support immune function and have been known to reverse signs of Alzheimer’s . . .

But back to my main point. Are herbs good? Well, which herb? Good for what? And it seems to me that science is the best way to determine the “good for what” question. And so I turn to it for guidance as to the real value of treatments.

Technorati Links: herbal medicine, skepticism

For some time now, the anti-vaxers have been claiming that vaccines cause autism. And by not vaccinating their children they are causing, in the least, an increased risk of disease outbreak. Now research suggests not a single cause of autism (there are likely to be many contributing factors), but a potential causal link between a single factor and autism. And moms may be partly to blame.

Holy smokes! What are moms doing–feeding their kids too much mercury-rich fish? Nope. They are simply waiting longer to have children. And that is the factor, maternal age, that new research has linked to autism rates.

Advanced maternal age is linked to a significantly elevated risk of having a child with autism, regardless of the father’s age, according to an exhaustive study of all births in California during the 1990s by UC Davis Health System researchers. Advanced paternal age is associated with elevated autism risk only when the father is older and the mother is under 30, the study found. [source]

Hmm. How can you get mad at moms? They aren’t evil. They aren’t corporations or under government control. Shoot. Autism is bad (at least increased rates of), therefore we have to find something bad to blame.

Next thing we’ll learn is that too much apple pie is linked to drug use. (Maybe just marijuana late at night, and perhaps the link is causal in the other direction.)

Technorati Links: autism, psychology

When I first read the article title, my reaction was, “What were they thinking?”

Marijuana Ineffective as an Alzheimer’s Treatment

Giving elderly folk with Alzheimer’s a bong and telling them to “have at it”? I can just imagine them walking the streets, even more confused.

Alright. Sorry. I’m obviously in a Friday state of mind. This was science, so there was no bong smoking by senior citizens. It was an experiment. On mice actually. And here’s what happened:

Over a period of several weeks, some of the Alzheimer’s-afflicted mice were given varying doses of HU210 — also known as cannabinoids — which is 100 to 800 times more potent than the marijuana compounds. Their memory was then tested.

While previous research had suggested marijuana may help alleviate symptoms of Alzheimer’s disease, the results of this test were . . . null. No benefits. And some detrimental effects.

A member of the research team said,

“As scientists, we begin every study hoping to be able to confirm beneficial effects of potential therapies, and we hoped to confirm this for the use of medical marijuana in treating Alzheimer’s disease.”

Yes, hope for an effective treatment for a horrible disease. Seems that scientists do have hearts.

Technorati Links: Alzheimer's, marijuana, science

Placebos can have treatment value and so they do have their place. If one thing can be safely said about acupuncture is that it has proven to effectively elicit a placebo-like response for a variety of conditions. But does it deserve to be classified as anything more than a placebo or placebo-like treatment? I don’t think so. Not at this point. Why? Because research has shown it to be no more effective than sham acupuncture: it doesn’t matter where the needles go or even if they penetrate the skin — the effect is the same (see the Skeptic’s Dictionary for more). Any expert on acupuncture should know this.

Alas, research underway at Rush University Medical Center in Chicago manifests ignorance. And likely promotes it.

The article announcing the new research, Young patients with chronic illnesses find relief in acupuncture, has much in it to criticize.

“Treating children with acupuncture is a new frontier,” said Dr. Paul Kent, pediatric hematology and oncology expert.

Yes, but is that a new frontier that you want to exploit with an ancient treatment of dubious merit?

“Acupuncture could be a potential solution to this dilemma of controlling pain in pediatric patients,” said Angela Johnson, Chinese medicine practitioner at Rush. [bold mine]

Sure, acupuncture could be effective. As could allowing the children to watch their favorite cartoons. Or a number of other benign therapy-ish activities. As for the bold text . . . egads. It seems they are already acupuncture-friendly at Rush, so I’m wondering how objective the results, and the reporting of the results, will be.

Now get a load of this. Here comes the bologna:

Acupuncture is the use of tiny, hair-thin needles which are gently inserted along various parts of the body. The therapy is based on the premise that patterns of energy flowing through the body are essential for health. This energy, called Qi, flows along certain pathways. It is believed that placing the tiny needles at points along the pathways reduce pain and improve the healing process. [bold mine]

What!!! That in a science article? How many people are going to swallow that bologna without chewing? If a treatment work is a separate question for how it works. And the above explanation is pure voodoo. There is absolutely no evidence for Qi and its presumed flow. None. And the fact that sham acupuncture research has shown needle placement to be irrelevant is strong evidence that the “points along the pathways” element is pure bunk.

The article closes with this sentence:

“Parents should be aware that integrative therapies like acupuncture can be helpful from the onset of disease and can have a tremendously positive influence on a child’s quality of life.” [bold mine]

Question: What do you get when you combine a treatment that effectively elicits a placebo-like response with a sales pitch consisting of ancient healing dogma?

Answer: Integrative therapies. Or, in this case, a needle in bologna.

Sales without substance has no place in modern medicine.

Technorati Links: acupuncture, alternative medicine, skepticism

According to a simplistic view of human psychology, stress is bad, and high sensitivity to stress is really bad. But with a more educated, scientific outlook we need to ask more questions. What kind of stress? How much stress? How often? For whom?

Thanks to new research, we now know to add this question: In what type of social setting and structure?

Here’s the lead paragraph to the news release:

Children who are especially reactive to stress are more vulnerable to adversity and have more behavior and health problems than their peers. But a new longitudinal study suggests that highly reactive children are also more likely to do well when they’re raised in supportive environments.

Before sharing the results, I must say that I’m unsure of the strength of the actual science behind the conclusions. This is all I learned about it from the article:

The researchers looked at 338 kindergarteners, as well as their teachers and families, to determine how family adversity and biological reactivity contribute to healthy development.

While 338 is an adequate sample size, what the heck does “looked at” mean?

So, with the results consequently taken with a grain of salt, we find that they were this:

[H]ighly reactive children were more likely to have developmental problems . . .

But wait, that’s not the whole story. The second half to the sentence answers an additional important question:

. . . when growing up in adverse, stressful family settings.

Ah, nice. So for the what we have a when. And there’s more! We can now add a big if to the equation.

But contrary to expectation, such children were also more likely to thrive when they were raised in caring, low-stress families because of their sensitivities to the supportive and nurturing qualities of such environments.

This finding brings to mind ADHD children. Somewhat similarly, one could simplistically ask, Is having ADHD a bad thing? Before answering that question in an educated, scientific manner, we’d have to refine it by asking a number of other questions.

As an offhand tangent, this question comes to mind: Asking people if they’d want a person with ADHD on their “team.” The smart person would ask questions about both the person with ADHD and the team. Who else was on the team? And, importantly, what were the team’s goals and preferred methods of operating?

Science. So many questions. So many questions about those questions. I wonder, are those who are good at asking questions better at answering them?

Technorati Links: ADHD, psychology, science

What does SIDS (sudden infant death syndrome) have to do with serotonin? In new research the neurotransmitter has been identified as a possible culprit in the deadly disorder.

Neurotransmitters, for those unfamiliar, transmit messages across the junctions (synapses) between neurons. There are a number of different neurotransmitters, and these can act on some areas of the brain more than others.

In the study, Low production of serotonin in the brainstem a likely cause for SIDS, it was determined that low serotonin activity may play a role. Yes, it does certainly seem that this neurotransmitter is all the rage lately, being implicated in depression, social phobia, generalized anxiety disorder, panic disorder, irritable bowel syndrome, and poor fashion sense (just kidding about that last one). Yet serotonin is truly a work-horse molecule, and each person’s brain is different.

One thing being clarified lately is that there is more to serotonin than simple levels. The chemical doesn’t appear out of nowhere and then do its work on nothing. Essential parts of the equation to recognize are the synaptic vesicles that collect/store/release the neurotransmitter on the “sending side” of the synapse, and the receptors, which work on the receiving side of the nerve junction to complete the signal transmission.

In fact, it is thought that SSRIs (selective serotonin reuptake inhibitors — they keep more of the stuff circulating in the synapses) may take time to work because it is not just the level of serotonin the the synapses that is important, but the quantity and activity of vesicles and receptors as well. Research suggests that when exposed to increased levels of serotonin, neuronal growth/changes occur that likely results in a greater number of receptors.

All individuals, besides having different levels of circulating serotonin, likely have differing amounts of serotonin vesicles and receptors in different parts of their brain. Thus the possibility that one SSRI-level-influencing drug, such as Zoloft, can treat a number of disorders.

And now we get to SIDS. For years the cause of this tragic phenomenon has been a mystery. What causes some infant to die suddenly during sleep? Low birth weight, second-hand smoke, parents placing infants on their stomachs’ to sleep…?

SIDS has puzzled doctors and families for decades, but once the medical community recognized that a baby’s position while sleeping affects the risk for SIDS, national awareness campaigns sprouted to persuade parents to place babies to sleep on their backs. However, such campaigns haven’t completely solved the problem, prompting ongoing research to find a biological component to SIDS. [bold mine]

And that biological component could be the creation, transmission, and reception of serotonin. In the brainstem, which is the area of the brain that controls sleep. A promising lead -

[R]esearchers at Children’s Hospital Boston have linked sudden infant death syndrome (SIDS) with low production of serotonin in the brainstem, based on a comparison of brainstem samples from infants dying of SIDS compared to brainstems of infants dying from other, known causes. [bold mine]

Of course, the above research is suggestive and not definitive. (The headline writer gets half a nod for including likely before cause.) But it’s certainly something. Progress. Even if it proves to be a dead-end, at least another avenue has been explored.

Technorati Links: psychology, serotonin

Okay, I’ve got to be fair. New research has just come out that with this finding: Abstinence-only intervention may play a role in preventing sexual involvement among teens.

Admittedly, I’m biased. Because it is overwhelmingly religious folk pushing for abstinence-only sex “education” in schools, I’m wary of it. Perhaps extra-skeptical. But because I am committed to science, I’ve got to be fair. If research shows a failure of abstinence-only programs, I’ll note it. And if research shows a success, I’ll note that too.

Here’s the science, in brief:

After two years, one-third of the abstinence-only group reported having sex, compared to one-half of the control group. . . .

While abstinence-only intervention did not eliminate sexual activity all together, this is the first randomized controlled study to demonstrate that an abstinence-only intervention reduced the percentage of adolescents who reported any sexual intercourse for a long period, in this case two years, following the intervention. [bold added]

Alright, a study found effectiveness for abstinence only. I await replication. And a footnote to the article makes that point:

“No public policy should be based on the results of one study, nor should policy makers selectively use scientific literature to formulate a policy that meets preconceived ideologies. Well-done studies, especially randomized controlled trials, are an important element of the data on which informed policy rests. They should be reviewed carefully to develop policies that promote the health of our nation.” [bold added]

Hear, hear, for the “preconceived ideologies” part. Yet even if replicated, I would not be for abstinence-only programs. Why? Because the effectiveness of a program is just one element. While a theory-based abstinence-only programs may lack any overt connection to religion, it is a moral issue, despite this passage:

The abstinence-only intervention was based on principles shown to be effective in reducing the risk of sexually transmitted infections (STIs), including HIV/AIDS, and did not use a moralistic tone or portray sex in a negative light. It encouraged abstinence as a way to eliminate the risk of pregnancy and STIs. [bold added]

Sex and morals are tightly interwoven. Look at the big issues in the major religions. Sex, sex, sex. Abstinence-only programs, in the least, have social and moral implications. The title alone, “abstinence-only” is exclusive.

Effectiveness aside, I’d opt for sex-ed programs that include not-only abstinence information. For I believe in providing education for education’s sake, with an eye out to pragmatic concerns, sure, but not limited by them. My values include honoring the freedom of all individuals and families to select their own path in a full range of alternatives.

Technorati Links: morality, sex education

Since hitting mid-life I have done some thinking about how I want to age. Age? Do I have to?

Hair starting to go gray . . . needing reading glasses of increasing strength . . . muscles that respond to work-outs less like they are pep rally sessions for growth, more like they are a form of torture . . . a metabolism that seems much more capable of converting food into not energy, but mass. So no, I won’t have a second piece of pie. In fact, I better skip that first.

How do I want to age? Well, to continue being happy tops the list. Maybe “content” is a better term. That one I have quite a bit of control over. For me, making progress on projects gives me quite a bit of satisfaction. Heck, I even do quite a bit of work on weekends. Pure leisure seems a bit pointless to me. Fortunately, my projects do not involve heavy lifting. I should be able to persist at them until very late in life.

Active? I have some control over this, too. If I keep active now, chances are better I can remain relatively active. But my muscles and, more so, my joints may have some say about just how active that will be.

And . . . fat? But I’m not fat now, and for the first few decades of life I was on the opposite end of the spectrum. A bean pole, if anything. But that bean pole has added some padding over this past decade. Not a lot, but enough to notice. It’s been unintentional, and has occurred despite some effort to prevent it.

Maybe I’ll do less to prevent it in the coming years. Intentionally.

Huh!? Let myself get (relatively) fat? Though my social self recoils at the thought (and my self-concept will likely say, upon looking in a full-body mirror, “Who dat heavier dude?”) it could actually be good for me.

But wait, fat is bad, right? Maybe not. At least not always. Again we are discovering that black-and-white thinking misses a more nuanced reality. New research suggests that being overweight during your seventh decade and beyond is actually good for your health. All other things being equal, of course.

Here’s the results of research published yesterday in the Journal of The American Geriatrics Society:

The study began in 1996 and recruited 4,677 men and 4,563 women. The participants were followed for ten years or until their death, whichever was sooner, and factors such as lifestyle, demographics, and health were measured. The research uncovered that mortality risk was lowest for participants with a BMI classified as overweight, with the risk of death reduced by 13% compared with normal weight participants. The benefits were only seen in the overweight category not in those people who are obese. [source, bold added]

Wow. That’s interesting. But no, I’m not going to buy a dozen donuts anytime soon. Question is, will I ever feel differently about the appearance of excess weight? As a member of our thin-obsessed culture, shaking that bias isn’t going to be easy. If the research holds up, however, perhaps my future focus should change from shedding pounds to dropping an unhealthy bias.

Technorati Links: aging, mid-life

Black-and-white thinking is juvenile, immature, uninformed, unsophisticated, naive. Sure, it would be nice and simple if everything in our world could be fitted with a black or white hat, like in a old-fashioned Hollywood Western: black for all bad, white for all good. But the world is more complicated than that. The adult who insists it isn’t behaves like a simpleton.

In terms of large (successful/efficient) pharmaceutical companies, yes, some of what they do could be classified as bad. But do they no good?

Yesterday I came across this science article: Little Pill Means Big News in the Treatment of Multiple Sclerosis.

MS is a fairly nasty degenerative disease, and over a quarter of a million people in the US suffer from it.

Multiple sclerosis is a disabling neurological condition which usually starts in young adulthood. It results from the body’s own immune system damaging the central nervous system. This interferes with the transmission of messages between the brain and other parts of the body and leads to problems with vision, muscle control, hearing and memory.

The news of a promising treatment for MS is a good thing. Medical researchers at Queen Mary, University of London, have discovered that the drug Cladribine holds such promise (generic form of LEUSTATIN, originally developed by Janssen-Ortho Inc.).

Compared to patients who were taking a placebo, those taking Cladribine tablets were over 55 per cent less likely to suffer relapse, and 30 per cent less likely to suffer worsening in their disability due to MS.

That’s a robust result. Will it hold up in subsequent trials? For the sake of those with MS — NOT the sake of Big Pharma’s bottom line — I hope it does.

I have no blind allegiance to pharmaceutical corporations. I recognize there are better drugs, there are worse drugs; there are better industry practices, there are worse. I also recognize that in our current healthcare system, it is important for drug companies to prosper. No, not to generate extravagant profits. But to make the money it takes to continue to research and develop drugs. Drugs that hold great promise for whomever may need them.  If Big Pharma doesn’t develop and test medicines, who will?

Technorati Links: healthcare, skepticism