Tuesday 30 April 2013

365 Project: Photo 120

Another beautiful day in London. This is taken in the garden of St. Thomas' Hospital. I came here specifically to try and get a shot with the interestingly shaped fountain and, what is now called, Elizabeth Tower but my composition wasn't great and so I went with this wider shot. I'll go back and nail the picture I had in mind at some point in the future.


Sunday 28 April 2013

365 Project: Photo 118

This gave me a chuckle when I saw it. It's an old maternity hospital, now a mid range hotel, but the more modern interpretation of it's name made me smile.


Chiropractors

You may have heard in the news recently that the Libel Reform Bill finally made it through both Houses of Parliament and is now just awaiting the formality of Royal Assent. This is great news for Britain as a country; in recent years we have increasingly become an international joke for the state of our libel laws, some of the laughable decisions that judges came up with (most notably, Justice Eady), the eye watering costs involved in defending libel actions and for becoming the centre of so called Libel Tourism - the phenomenon where foreign billionaire oligarchs use our outdated and inappropriate libel laws to sue people in other countries that never even published their criticisms in this country.

But what has all this got to do with chiropractic? Well, one of the most famous libel cases of recent years was The British Chiropractic Association vs Simon Singh. Singh, a mathematician by trade that has also become a science journalist and author of several popular science books, published this article in 2008 criticising the BCA for making claims of being able to cure multiple childhood afflictions including colic, excessive crying, bed wetting, asthma, ear infections, feeding problems and much more all through manipulating their spines. Hopefully, most of you are now thinking "How on Earth would that work?". Well, it doesn't. Singh correctly called such treatments 'bogus' and was promptly sued by the BCA. Due to the way libel laws worked in this country at the time it took 4 years of court actions, appeals and costs in the hundreds of thousands of pounds for Singh to defend himself. He initially lost his case but, fortunately, the appeal courts eventually found in Singh's favour and ordered the BCA to pay his costs; costs that all but financially ruined the innocent Singh. The bravery required to fight such a cause with such potentially high personal costs should not be underestimated. In light of defeat it might have been reasonable for the BCA to apologise, to take a look at itself, what it does and look to reform itself. This is not what happened. Richard Brown, the President of the BCA and proud holder of a prestigious Doctor of Chiropractic degree from the Anglo-European Chiropractic College, instead issued a bullish response where he recites many of the tropes that caused the problem in the first place; a classic tactic frequently deployed by pseudoscientists the world over.

BCA vs Singh was one of many reasons why a growing well spring of public concern about our libel laws led to the formation of the Libel Reform Campaign whose triumph last week, despite the efforts of some of our worst Parliamentarians like Lord Puttnam and Sir Edward Garnier, we should all be proud of. I wrote the bulk of what is to follow in this post several months ago, it isn't difficult to find ways to criticise chiropractic, but I wasn't entirely comfortable with the idea of publishing it in case an organisation like the BCA decided to take offence at it. This blog is only read by a few thousand people per month but if an advocate of chiropractic were to stumble across it they certainly wouldn't be happy, and the thought of having to go through even a fraction of what Simon Singh endured is, frankly, scary. I suspect I won't be the only blogger this month that finally feels they can publish what, in any other western society, would be considered common sense and in the public interest. So, introduction over; let's get to it....


* * *


The cornerstone of chiropractic (which I'll mostly be abbreviating to 'chiro' as it's a pain in the neck, geddit!, to type it out all the time) is a technique called subluxation. Subluxation is a real thing, it refers to when one bone displaces over another, these can cause quite serious complications, as you might expect, and can be detected by a trained osteopath or by x-ray or other exam. Chiropractors (chiros) use the term subluxation much more loosely though, in fact it has no real definition in their circles. Blinded studies have repeatedly shown that a) different chiros cannot agree where a subluxation has occurred in a patient and b) that different chiros do not agree on whether the same subluxation correlates with the same illness or set of symptoms. This should immediately set off a red flag as it clearly indicates that there is no actual modality to the alleged basis of what chiropractors do.

The work of fiction that is chiropractic was first made up in 1895 by a man with an idea but no medical training whatsoever. His name was Daniel David Palmer and his idea was that greater than 95% (yes, 95%) of all health conditions are caused by subluxations that, although they were mostly undetectable at the time, somehow manage to stop a life force that apparently flows through us all. All you have to do to be cured is to allow someone with no qualifications to speak of to dangerously manipulate your possibly already painful spine so that your life force can flow freely once more and heal you. I'm not making this up; the premise of chiro is that life force falls out of the sky, enters us through our skulls and is then distributed through our body along our spine.

Palmer, shockingly, wasn't taken seriously in the medical profession and was on the verge of being banned from practising chiropractic all together, as it clearly has the potential to do harm whilst having no basis for achieving anything good; what's known in the medical community as being dangerous and unethical. Like all quacks everywhere, and unlike all scientists everywhere, Palmer decided that instead of changing his opinion in the light of the evidence he would merely state his case ever more vociferously and claim to be a victim of persecution; a proud tradition maintained by chiropractors the world over to this very day. His cunning plan was to claim that chiropractic was a religion which would basically allow him to say anything he likes with impunity. This happens to be the same tactic used by charlatan extraordinanaire and mediocre sci-fi writer L. Ron Hubbard with dianetics in the late 1940s. His despicable and demonstrably wrong views on mental health were about to get him in a lot of legal hot water and so he claimed that it was actually a religion - and so Scientology, one of the worlds fastest growing and most dangerous cults, was born. For better or for worse, Palmer wasn't forced to play this gambit; public opinion softened and he was allowed to get away with practising nonsense on the gullible and ill informed.

Many modern chiros have tried to distance themselves from these shady beginnings and desperately try to bring a veneer of legitimacy to what they do by not mentioning any of the life force woo woo stuff. They may well be able to call upon a list of published papers that support their views but these are universally poorly designed, ill-executed, badly controlled studies riddled with conflicts of interest that supposedly legitimise their points and therefore their fees; but these papers do not stand up to much scrutiny. Not all scientific, peer reviewed articles are created equal; unfortunately there is such a thing as bad science and it can take a lot of digging around to separate the wheat from the chaff.

Luckily, there is an organisation called the Cochrane Collaboration and what they spend their time doing is going through all the research that has ever been done on a particular medical intervention and amass the data into one coherent, authoritative review; this normally takes place some years after a treatment has been introduced so that time can be allowed for high quality, large studies to be done. It is difficult, laborious and vital work and a Cochrane Review is internationally considered to be the highest possible standard in evidence-based healthcare. They are named after Archie Cochrane, a British epidemiologist who believed that the best way to see if a treatment actually worked was through randomised, blinded trials. If they say something is beneficial then it probably is. If they say it doesn't work or is dangerous then it is quite likely the final nail in the coffin of said treatment. They might also say that there is no clear evidence either way and that the treatment is indistinguishable from a placebo. This is the category that chiropractic fell into in a review in 2011. The reviews are regularly updated so that new evidence can be factored in.  They can say this with confidence because they are independent and exhaustingly thorough. Part of producing such a comprehensive, systematic review is sorting the good papers from the poor ones when it comes to deciding which studies should be considered. A study where the inventor of a new treatment tests it out just once on his wife and she says she's much better now thank you darling is clearly not going to cut the mustard; that's not how you build a reputation for quality.

The reason I am mentioning all this is that I want to ask you a question: once the Cochrane review for chiropractic was released do you think that, like good responsible practitioners of evidence based medicine, the chiropractors held up their hands and said yep, it doesn't look like this works, we should either conduct some more rigorous studies or maybe even quit this charade altogether; or do you think they merely began libelling the Cochrane Collaboration, that bastion of modern medicine, crying Foul Play! and Conspiracy! and generally doing anything they could to weasel themselves out of their grubby, little hole other than providing good evidence for their claims? It's hard to believe, I know, but what they did was claim that they were screwed over because certain trials weren't included, trials that by their own admission were '1) non-randomised, observational or uncontrolled; 2) or trials where the chiropractor delivered the treatment in both study arms'. What that means is that the trials weren't double blinded. What that means is that the trial wasn't worth the paper it was written on. They then went on to say that the 'slavish adherence' to the blinding of patients and treatment providers shouldn't be considered a mark of quality in a study. If this were a story in a book or film you wouldn't believe it because it's just too stupid. The thing about the studies that the chiros like is that they're very poor and would be unlikely to ever get through the peer review process of most journals, indeed, they don't tend to make it through very often at all. They're not the kind of people to let a little thing like being considered a complete joke stop them though, so what they did is they made up their own journals like the Chiropractic Journal and the Journal of Chiropractic Medicine where they're not quite so fussy about things like the rules of evidence, logic or not being a dick.

So, given that all the evidence is against them, how is it that chiropractic continues to do well in 21st century Britain? There seem to be many reasons, a lack of public awareness as to what chiro actually is; the wilful deceit of organisations like the BCA (thank you Libel Reform Bill for letting me say that); endorsement from high profile idiots like Prince Charles; and an inclination for people to fall for the Natural Fallacy, the idea that because something is natural it is automatically good and/or better than an 'unnatural' alternative. Arsenic is natural, I recommend you don't eat it.

Another difficulty is where the burden of proof falls. In every day life, and certainly in the realm of science, if someone makes a bold claim then they have to provide evidence for that claim, especially when that claim goes against the established or perceived facts, and the more extraordinary the claim the more extraordinary the evidence required to back it up. The modality of chiro is a bold claim indeed but somehow we find ourselves in a situation where they don't need to do anything to prove that what they say is correct; instead, the scientific and sceptical communities are left trying to prove a negative. Frustratingly, you can never 100% prove a negative. Although it can't be done conclusively it is possible to use science to put bounds on the likelihood of a phenomenon existing. If all possible tests have been carried out at a high degree of sensitivity and nothing is discovered then it can be considered highly likely that the phenomenon isn't real. If the response after such testing from the proponents of the theory is merely 'well it doesn't work like that' or some such other bull crap then we have strayed into the realm of special pleading, one of the top five logical fallacies you're likely to encounter.

Another problem is anecdotal 'evidence'. Anecdotal evidence, of course, isn't evidence at all, it's an anecdote. "Well, it worked for me," is a defence I have often encountered from people. I'm sure that they believe it did, but that still doesn't mean that it works. For example, many people will only seek treatment once their symptoms have become quite bad and they get desperate for some sort of relief; however, in most chronic illnesses there is something known as regression to the mean. Yes, the symptoms may get bad periodically but then, after a while, they settle down into their more usual form - they regress to the mean. So if, a few days after a treatment, the symptoms settle back down it can be very easy to attribute the benefit to whatever the most recent treatment was. This is the post hoc ergo propter hoc logical fallacy which basically translates as 'after this, therefore because of this'; put another way, it is confusing correlation with causation. Also tied up in this is confirmation bias; this is where we tend to believe what we want to believe and ignore evidence to the contrary. For example: a psychic says they can predict the sequence of a shuffled deck of standard playing cards. Maybe they go through the deck several times trying to display their talents. Over the course of several hundred guesses the chances are that they'll get the right card every now and then (I don't know the exact odds); I would interpret this as them not having any special powers to speak of, of course they got the right answer a couple of times, it would be weird if they didn't; but they interpret the same data as confirming that they have powers, the times when it worked weren't random but examples of when their powers 'switched on'. Their inherent bias confirmed their initial premise. This is a very easy trap for us all to fall into.

Another factor is self defence. Someone who opts for an alternative treatment (point of order: there is no such thing as alternative medicine, there is science-based medicine and there is quackery) might be a bit embarrassed about doing so. They're going out on a limb, they know there's probably nothing to it, maybe they've been teased by a horrible, mean sceptic like me, and so they may fall into a trap of defending the alternative treatment as a way of legitimising their choice.

These psychological reasons then: confirmation bias, confusing correlation and causation, optimism bias, risk justification, suggestibility, the Natural Fallacy, the Lottery Fallacy, embarrassment and many others all play their part. It is all but the definition of the scientific method to find ways of excluding these inherent biases that we all have. I know, though, for all this, that there are people out there who just don't trust science; they don't like it, they don't understand it, they think it is a matter of opinion. These people are wrong but if I haven't convinced them of that by now then I'm unlikely to ever do so. In one final attempt to show them the light, if you'll forgive such an overtly religious phrase, let's look at another viewpoint, let's not take my word for all this; question everything. Perhaps the people we should listen to most carefully are those lovely chaps down at the General Chiropractic Council. Although they are obviously very keen on promoting their particular brand of nonsense they, nonetheless, have no choice but to admit that the idea that subluxations are the cause for illness 'is not supported by any clinical research evidence' and that this idea should be taught as 'a historical concept and not a current theoretical model'. So there you have it, friends; don't take my word for it. If your back hurts go to your GP and ask to be referred to an osteopath. Job done.

Friday 26 April 2013

365 Project: Photo 116

Didn't quite take this photo today but who cares? It was a nice day and I was on the Thames, enough said.


Thursday 25 April 2013

Wednesday 24 April 2013

365 Project: Photo 114

There's a lot of building work going on at work currently. This is a spare bit of cable that a builder left behind.


Monday 22 April 2013

365 Project: Photo 112

I didn't take this photo today but I wanted to throw it in. Anyone that has been into central London is likely to have gone to Trafalgar Square, where this was taken. It was one of the first nice days of what has been a pretty dreary year thus far. This is the National Gallery at the north end of the square.


Sunday 21 April 2013

365 Project: Photo 111

Another lucky adherence to the theme, Blooming. I loved the frame that the old bench provided for these daffs; the contrast of the fresh blooms with the lichen encrusted wood is particularly pleasing.


Saturday 20 April 2013

365 Project: Photo 110

A last flourish from the snow drops, which all fits with today's theme of White.


Friday 19 April 2013

365 Project: Photo 109

Today I am on prompt, but only by a fluke. The idea was On The Edge and it doesn't get much more on edge than this. This photo may not look like much but that streak in the middle represents one of the greatest achievements of all mankind; it's the International Space Station. Let's take a moment to reflect on what this means. That streak of light is is an inhabited, man-made, 100 metre diameter science facility orbiting 200 miles above the surface of our little planet at 17,000 mph. There are 6 human beings currently living and working on it in what is now its 12th year of constant inhabitation.

That is amazing.

That's us. That's what humans can do when we put our mind to it. When we're not busy killing each other or trying to screw each other over we can come together and do awesome things, just to satisfy our curiosity; because we can.


My photo, in of itself, is not a good one; but in fairness this is my first ever attempt at photographing a moving target in the night sky from a car park. The bright blob is the moon and the 'star' to the right of the trail is the planet Jupiter. It's a 13 second exposure and one of only two I was able to get before it streaked off into the eastern horizon.

One of the current inhabitants of station is a Canadian, Commander Hadfield. He isn't the first person to go up there with a camera but he is certainly the first to produce so many impressive images of the Earth and the station at large and publicise them. I highly recommend his Tumblr feed.

If you want to see the man-made wonder for yourself then it's pretty easy. There are loads of apps on your phone that you can download that will alert you, just search. You can also use the Heavens Above website which is an excellent resource for tracking many objects in the sky. It'll definitely be handy later in the year when comet ISON starts getting excitingly close.

Eyes to the skies, people.

Thursday 18 April 2013

Wednesday 17 April 2013

365 Project: Photo 107

By a total fluke I happen to have taken a photo that perfectly fits today's prompt, A Sign. I was in Covent Garden entering the market itself and I spotted this long list of rules and bye-laws for traders, it dates from the late 1820s. This picture doesn't really give a sense of how large this stone carving is; it's a good 5-6 feet in height and this only shows about 50% of what is there. I like how the differing amounts for the fines conveys a sense of what the Georgians considered acceptable or otherwise.


Tuesday 16 April 2013

365 Project: Photo 106

It's been a while since I've been down this way, but I finally decided to pay a visit to my old friend Waterloo Bridge today. It was good to see her again.


Monday 15 April 2013

365 Project: Photo 105

A trip to Kew Gardens today. It was my first time there and was most pleasant although the food is extortionately priced. This was snapped on my phone and given the SnapSeed treatment.






Sunday 14 April 2013

Saturday 13 April 2013

365 Project: Photo 103

We went up the ArcelorMittal Orbit today. I was quite excited initially as I love any opportunity to get up high and have a look about but that excitement soon turned to frustration as I quickly realised that a lot of the vista was compromised by both the wire mesh that covered the outside areas but also the structure itself. It's almost like it was built the wrong way around; to the south and the west there are unbroken views to docklands and the City respectively. I can't help but feel, though, that many people are going to want to look the other way towards what was the London 2012 Olympic Site and is slowly becoming the Queen Elizabeth Olympic Park. Sadly, the views in these directions are all universally blocked; there's certainly no wide open, panoramic opportunities; the best you can do is to stick a long lens on and try to get some detail shots. So it would appear that they have managed to make a viewing platform without a view. Good job.

Compounding this is that I don't care about the Olympics; I don't have that well spring of good will and joy that many people seem to. I didn't watch any of the Olympics, either on TV or live. I'm pleased that it went well and that Team GB was successful but basically I just don't care about and, for me, there is no justification, under any circumstances, for spending £12,200,000,000 on a month of sport. None. And there's not even a good view of it.


Friday 12 April 2013

365 Project: Photo 102

I mostly ignore the hints and prompts these days and just freestyle with whatever happens to be in front of me. Of late, when I do post something that fits the theme, it is mostly a fluke; like today. A Touch of Yellow was today's aim and I can certainly see a golden glow in the Portland stone on the west towers of Westminster Abbey as the sun sets. The composition isn't quite how I would like it. I was aiming to have the place between the two towers as is but that unfortunately coincided with a dirty great lorry being in front of the main door, which rather ruined the bottom end of the photo, so I cropped it all out.


Thursday 11 April 2013

365 Project: Photo 101

This is an art work that can be found in the British Museum that I often go by if I want to get to the Mexican gallery, which I frequently do. It is a poor photo but the art work is a representation of all the drugs the average person is likely to have to take over the course of their life time. There are many thousands of pills here and it tends to be more for women, with the likes of long term drugs like the contraceptive pill and HRT, than it is for men. It is apparently the case that 90% of the pills we will take will be in the last 5 years of our lives, which makes sense.


Wednesday 10 April 2013

365 Project: Photo 100

Presumably it was a slow day at Kensal Green tube station. How awesome is the writing though?


Tuesday 9 April 2013

365 Project: Photo 099

It probably wouldn't be difficult to convince readers that this is a picture of my grandfather giving me a cuddle sometime in the early 80s but that isn't the case. It's actually a photo I took today of my friend Ben with the new born Anna attending her first curry; an important right of passage to any Englishwoman of stout heart. Obviously I've given it a bit of treatment to make it look older than it truly is but, yes, Ben really does look like that.


Monday 8 April 2013

365 Project: Photo 098

As most of Britain is surely aware, former Prime Minister Margaret Thatcher died today. I wasn't born when she came to power and was still young when she left so I have no real direct experience of her. I suspect that if I were a decade or two older I would hate her with a passion that would probably require therapy; as it is, I mostly don't care. I found myself in Parliament Square again today, which seemed apt. The tower in the foreground is that of the north transept of Westminster Abbey, the one in the background is Victoria tower at the south end of the Palace of Westminster. I've always felt a bit sorry for the Victoria Tower, it's far more impressive than St. Stephen's Tower which houses Big Ben but is frequently overlooked.

As I said, I mostly don't care about Thatcher but, for me, there is certainly something quite emotive about seeing so many flags in London at half mast, regardless of the reason.


Saturday 6 April 2013

365 Project: Photo 096

There was only really one contender for the photo today. Some of my oldest and closest friends became parents yesterday and I took this photo of not so little Anna on our visit to them today. 


Friday 5 April 2013

365 Project: Photo 095

My adventures around Parliament Square continue. I need to work on my composition here but you get the idea. I'll have another crack at it next week.


Thursday 4 April 2013

365 Project: Photo 094

Brand New is the theme and here is another picture of my new dip pen and ink pot. I like it.


Wednesday 3 April 2013

365 Project: Photo 093


In Parliament Square again. The theme was Where You Stand which is just as well because as I was standing there OH MY GOD RUN FOR YOUR LIFE IT'S GIANT KILLER ZOMBIE MANDELA!!!!!!!


Tuesday 2 April 2013

365 Project: Photo 092

I made a bread. Today's theme was Strut and I guess I'm quite proud of this loaf. It's my second attempt doing it completely by hand and from scratch; the first was edible but didn't look great; this one was awesome even if I do say so myself. This reminds me of a quote from the legendary Carl Sagan: To make an apple pie from scratch you must first create the universe.


Monday 1 April 2013

365 Project: Photo 091

The theme for today, unsurprisingly, is Foolish. Well, this is a picture of my new toy, a quill-effect dip pen and, considering how terrible my handwriting is at the best of times, it is definitely foolish to try and write with this thing. I quickly remembered why it is I never used a fountain pen as a kid and why, well over a decade ago when I realised I could barely read my own hand, I stopped writing joined up. With that in mind I did some practice scribbling with reasonable success. I also got some new waxes for my seal, which I also love.

Why do I use these things? I don't know. I just like them and think they're beautiful.