Tuesday, March 31, 2015

Save us from cant and quackery


Once again, the redoubtable Globe and Mail health columnist André Picard tells it like it is when he takes on the Ontario Homeopathy Act, which comes into force on April 1st. The Act, which purports to regulate homeopathy practitioners in Ontario, has the effect of validating the practice of homeopathy, putting it on a level with other medical practices, even though there is not a scrap of evidence to suggest that homeopathy is anything other than cant and quackery.
Homeopathy is based on the 18th century belief that "like cures like", that diluting a medication somehow mysteriously makes it stronger, and that water molecules retain some kind of "memory" of a previously dissolved substance. There is no scientific basis for such beliefs, and the latest large-scale investigation, by the Australian National Health and Medical Research Council, concludes unequivocally that: "There is no condition for which there is reliable evidence that homeopathy is effective... People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness."
It doesn't get much blunter than that. At best, homeopathy can be considered equivalent to a placebo; at worst, it can be downright injurious.
And yet the Ontario government is going ahead and legitimizing the practice by regulating it, presumably on the basis that to leave it unregulated is an even worse position. In the same way, Health Canada has licensed various homeopathic products on the grounds that, being almost 100% water, they are not actually unsafe, and these products are widely available in high street pharmacies throughout Canada.
But such validation gives the impression that they are also effective, which is demonstrably not the case, and, by failing to mention that part, the province (and the country) is allowing people to spend their hard-earned money on placebos instead of proven scientific treatments. An example of this is the use of unproven homeopathic nosodes instead of vaccinations during the recent measles scare, which has been the subject of a previous rant of mine.
Sometimes people need saving from themselves, and I believe that not speaking out against homeopathy is out-and-out unethical.

Arctic apple just the tip of the iceberg

Health Canada's approval of the genetically modified Arctic apple earlier this month has reinvigorated discussion of GMOs (genetically modified organisms) in Canada. The whole genetic modification question is one of those hot-button ethical/medical/environmental issues that many people find difficult to decide on, and I must confess I am among them.
I could easily dismiss the Arctic apple in particular because its value seems so flimsy and vague. Five years and millions of dollars in the making, the Arctic apple has had its DNA tweaked with the sole purpose of ensuring that it does not turn brown when sliced. Now, most people I know just buy an apple an eat it; turning brown is just not an issue. If you want to put sliced or diced apple into a fruit salad or such like, then you just coat them in lemon juice. This method has worked fine for centuries.
The only application I can see for a non-browning apple slice is for those extortionately priced pre-packaged apple slices supermarkets now sell (and which apparently employ a cocktail of chemicals for the purpose), or for fancy garnishes in upper-end restaurants (which I have always assumed use lemon juice, but then, who knows?) As far as I can see, this is not going to solve the world hunger problem, not is it even going to cut down on the use of chemical fertilizers or insecticides, or to improve our nutritional intake. This is culinary frippery and supply-directed marketing, pure and simple. It is the tail wagging the dog.
However, the GMO/bioengineering issue in general is not so easily dismissed. As every article I have ever read on the subject always points out, GMO crops are approved and endorsed by Health Canada, the World Health Organization, the US Academy of Sciences and the American Medical Association. Even if we not necessarily aware of it, they have been with us now for over 20 years (at least in North America). Over 2,000 scientific studies have concluded that GMOs pose no greater health risk than any other food, and only a handful of studies suggest otherwise, and most of those have since been retracted or are at least hotly contested. Vitamin A-enriched golden rice in particular has been touted as a huge humanitarian boon (although its claims are hotly contested and, frankly, anything owned and distributed by Monsanto should be treated very skeptically).
But...
My gut feeling still tells me to be wary of GMOs (and, where food is concerned, the gut should be listened to). While they may not necessarily apply to the Arctic apple, there are several potential drawbacks to GMOs that I have not been able to shrug off: many GMOs have antibiotic features built into them, which over time may reduce the effectiveness of prescribed antibiotics on humans (a trend we have already seen, although its cause remains vague); added and mixed up proteins in some GMOs may exacerbate the growing allergy problems the world seems to be experiencing; modified genes from GMOs may escape into the wild, potentially resulting in herbicide-resistant "superweeds" or genetically-enhanced organisms that can out-compete native populations, leading to species extinctions; typically, the companies that develop and patent GMO seeds (of which Monsanto is the largest and most notorious) are the same companies that develop and patent the pesticides and herbicides to which the unique seeds are resistant, creating a closed proprietorial system; etc.
This is not an isolated or minor issue. An estimated 90% of the corn, soybeans and cotton grown in America is now genetically modified (and corn and soya are in everything these days), and many other GM crops are produced in smaller quantities. In Canada, GM varieties of corn, soya, sugar beet and canola (all of which are also used in animal feed) are now widely planted, and many other GM crops are approved but not actively farmed - yet.
Currently 64 countries around the world - including the 28 countries in the European Union, Japan, Australia, Brazil, Russia, and even China - require mandatory labelling of genetically modified foods. In North America, the source of most of the world genetically modified crops, there is no such requirement (currently, Vermont is the only US state that has recently brought in GMO labelling, although some 28 other states apparently have pending legislation on the matter).
Even after 20 years, my feeling (yes, my gut feeling) is that there may well turn out to be some long-term damage resulting from the practice. This is obviously not a rigorously scientific position, but it seems to me that, at the very least, we should be labelling this stuff, and giving people the right to a choice.
The B.C. bioengineer-turned-farmer Neal Carter, the creator of the Arctic apple, obviously, does not want to go down this route, stressing that "we don't want to demonize the technology". But some of his other comments on the subject are perhaps more pertinent: "If we put a GM label on them, basically we are capitulating. The anti-GM crowd has won." For him, this seems to be just a (potentially lucrative) game. I don't think we want to play that game. Just because we can do something, doesn't mean that we should.

Wednesday, March 25, 2015

How your brain can control chronic pain

I am currently entranced by Norman Doidge's new book, "The Brain's Way of Healing", the follow-up to his bestseller "The Brain That Changes Itself". The title sounds somewhat new-agey, but this is definitely hard, cutting-edge science (Canadian-born Doidge is a trained psychiatrist, and a research fellow at Columbia University in New York and at the University of Toronto). It is, however, cutting-edge science presented in clear, everyday English, and explained in a lucid and straightforward manner ideal for ignorant laymen like me, rather in the mold of fellow science writer Oliver Sacks.
The book looks at how the brain's amazing plasticity - one of the breakthrough discoveries of modern science - can be co-opted to ameliorate, and sometimes even cure, some debilitating disorders and conditions, from chronic pain to autism, ADHD, Parkinson's, multiple sclerosis, stroke damage, even some kinds of blindness.
As an example, one chapter of the book looks at chronic pain, and in particular the work of pain specialist Michael Moskowitz, M.D. Here is a little potted summary of that chapter.
Acute pain is a physiological and mental mechanism designed to alert us to bodily damage and injury, and to warn us not to do anything that might make the injury worse. Pain receptors in the body trigger particular areas of the brain that relate to the body region in question, in what is sometime referred to as the "body image" or "virtual body" in the brain. In theory - and sometimes in practice - we can turn off acute pain by just keeping very still, so that the brain does not foresee any likelihood of the injury being aggravated.
Chronic pain, on the other hand, occurs when this pain mechanism becomes corrupted or exaggerated, and the pain receptors and the neurological processes they trigger become over-sensitized. With this kind of "learned pain", the body's pain alarm system becomes stuck in the "on" position. Sometimes the brain begins to enlarge the area where pain is felt, or "referred pain" may be experienced in an entirely separate physical region. Such pain is notoriously difficult to treat.
Moskowitz's happy idea was to try and take back those brain areas that had been taken over by this excessive pain processing, by forcing the patient to counter-stimulate them with some other activity (e.g. visual, auditory, tactile, etc) not related to pain, in a process of "competitive plasticity". He found visual stimulation the easiest sense to co-opt in this regard, and called on patients to visualize images of the brain's pain-processing areas shrinking to zero whenever the chronic pain occurred (other images would serve the same purpose, but this was his first idea). This procedure must be applied consistently and relentlessly whenever the pain appears, so that over time the brain relearns, and the neural networks that were once used to trigger the chronic pain are reconfigured.
Typically, progress is slow and somewhat dispiriting at first, but with dogged and consistent application the theory apparently works, and long-term chronic pain can be entirely eliminated. Furthermore, unlike with the use of pain medications, the change is permanent and relapses tend not to occur.
Perhaps this sounds a bit like hocus pocus, or at least like self-hypnotism or even the placebo effect. But, this is based on up-to-date neurological science and, unlike with the use of placebos and hypnotic suggestion, the results appear to be long-term and possibly permanent. If the patient's initial problem is not resolved, acute pain may reappear (as indeed it should, as part of the body's built-in warning system), but the chronic pain does not. Neither is it a generalized relaxing effect like meditation; Moskowitz's technique targets the chronic pain with laser-like precision.
Fascinating stuff, and I look forward to reading how similar techniques can be used to deal with a variety of other conditions and diseases.

UPDATE
I must confess, after the first few chapters - and particularly after the chapter on Parkinson's disease, which has particular relevance for my wife - I found my enthusiasm for, and attention to, the book beginning to wane, and I found myself skimming and skipping towards the end.
There is certainly much food for thought in the book, but among other things, I found the detailed back-stories (of both patients and medical practitioners) just a bit too long and comprehensive after a while. I understand the need for the back-stories, both to establish baselines for patients' conditions, and also to add a little human interest to what could be a very dry and clinical account. But somehow they seemed to be just a bit too front-and-centre and intrusive after a while.
I also found myself wondering, after reading about one miraculous cure after another, why these techniques were not more widely adopted if they were indeed as effective as they seem to be. Now, of course, that is part of the point of the book, that the medical establishment is overlooking such non-standard approaches to treatment. But I found myself thinking that surely even a staid medical establishment would not ignore such promising and apparently side-effect-free cures if they were truly as miraculous as reported. Would they?

Friday, March 20, 2015

Memorial to the Victims of Communism inappropriate


I have grave reservations about the proposed Memorial to the Victims of Communism, which some people want to build in the centre of downtown Ottawa, right on the doorstep of Parliament Hill and the Supreme Court of Canada.
The selected site, which is front and centre in the ceremonial heart of Canada's national capital, was initially earmarked for the Pierre Elliott Trudeau Judiciary Building until current Prime Minister Stephen Harper (no fan of Trudeau or his legacy) cancelled it. Mr. Harper's Conservative government is, predictably, gung ho for the project; most others that have expressed an opinion are not.
It seems to me inappropriate that a partisan, politically-motivated and in-your-face monument of the size and scale proposed be sited right in the democratic and legislative nucleus of the country. Perhaps the victims of communism deserve a monument of some sort (although personally I am skeptical of the value of such gestures), as arguably do the victims of fascism, capitalism, religion and many other belief systems. But this is not a defining issue for this particular country, and it definitely does not memorialize something equally pertinent to all Canadians. I believe that locating it in such a central and symbolic position would give a skewed impression of Canada and its values and history.
Some of the machinations behind the scenes are also worth noting. The project is being financed by a somewhat shady (but apparently incredibly wealthy) non-profit organization called Tribute to Liberty, spearheaded by the Polish-Canadian financier Ludwik Klimkowski and run by a group of vehemently anti-Communist Canadians with roots in Eastern Europe and the ex-Soviet Union. The organization's raison d'être appears to be the exposé of the repressive regimes of Soviet Russia and its puppet states, and has little to say about Canada per se.
And we are not talking here about some modest statue, like the US Victims of Communism Memorial in Washington D.C. This one is a city block in size, and incorporates a 12-metre high viewing structure, and a broad, ridged concrete form coated with 100 million squares (symbolically, one for each of the victims of Communist regimes).
There is plenty of opposition to the project. The National Capital Commission, which would normally be responsible for such strategic decisions in Ottawa, opposes it, but one Stephen Harper (who, predictably, is very much for it)  has moved responsibility for the decision to the much more amenable Ministry of Canadian Heritage. Ottawa's mayor is against it; the Chief Justice of the Supreme Court and a group of 17 former presidents of the Canadian Bar Association are also against it; as are a broad swath of architects and urban designers, including the Royal Architectural Institute of Canada and the Ontario Association of Architects.
The Tory government of the day, however, seem very much in favour, and they are not known for accommodation or compromise.

UPDATE
One of the early decisions by the new Liberal government that was elected in October 2015 was to redesign and scale down the proposed monument, to move it further west and away from the original in-your-face location by the Supreme Court, and to slash its budget from $5 million to $3 million. Finally, some common sense prevails.
Not long after (February 2016), came a similar common sense re-think of the equally controversial Mother Canada monument, planned by the Conservatives for a plumb spot in Cape Breton Highlands National Park.

Thursday, March 12, 2015

Mayor Tory's 100-Day Adventure

100 days seems to be the standard time period for initial assessments of politicians, and there have been several such assessments of Toronto Mayor John Tory in recent days. Most of those I have read have been cautiously positive and optimistic, but I have a suspicion that much of this optimism is actually just relief at not having to comment on Rob (or even Doug) Ford. After the debacle of the Ford years, the bar is set very low, and people are willing to put up with a lot (or a little) for just a whiff or normality.
But what has Tory really achieved?
Well, in almost his very first act in power, he threw $2 million of taxpayers' money at expediting the repair work on the Gardener Expressway, which seems to have garnered almost unanimous praise. But this just seems to me to be a $2 million sop to placate the car lobby, money that would be better utilized in investment in  much-needed transit.
Speaking of which... Tory has been making lots of noises, but very little concrete action, about his ballyhooed SmartTrack project, which I still find riddled with unexplained holes. So, just as Rob Ford, at the start of his mayoralty, made an executive decision which put back transit in Toronto by at least 4 years, and threw all transit discussions into interminable disarray, is Tory's SmartTrack going to do just the same? It is already having the effect of slowing down the Downtown Relief Line project (which EVERYONE agrees is needed), and don't even get me started on the money earmarked for a paltry extension of the subway line in Scarborough instead of a much more extensive, and much better value, rapid light transit system...
Much was also made of his perspicacity and ingenuity in "balancing the budget" this year. Except what he actually did was borrow out of the city's own funds - when his original plan of borrowing from the province did not pan out - which in my books (sic!) means that the budget was not balanced at all.
And now, instead of increasing property taxes above the rate of inflation (which of course has bad optics and would be contrary to his campaign promises), he is instead significantly increasing water and garbage collection fees, the old fees-instead-of-taxes gambit. So, instead of a progressive taxation on the property-owning classes who can best afford it, we have flat-rate fees inflicted on all and sundry, thereby imposing the worst of the burden on poorer, larger families rather than on retired bankers in Rosedale.
I don't mean to rain relentlessly on Tory's 100-day parade, and it is admittedly refreshing not to have to be wringing my hands over Rob Ford's shenanigans. Indeed, I'm sure that someone else could couch these very same matters in quite different terms (that's what politics is all about, isn't it?). But, when looked at from this point of view, things maybe don't look quite so rosy, do they?

Friday, March 06, 2015

IS destroys ancient Assyrian statues

The BBC has some disturbing and affecting video of the IS destroying irreplaceable 3,000-year-old statues in the ancient Assyrian city of Nimrud in Iraq.
I don't mean to suggest that this represents a greater crime than the IS's killings of people, but it does give a good indication of just how ill-advised and benighted these people are. They really believe that such ancient statues are "false idols" which need to be destroyed. They are basically clueless, blinded by their religious obsession and hatred to almost everything else, including the value of history and culture.
Certainly, it is a poignant and heartrending experience to watch these ancient monuments - some of the oldest art in the world - being wilfully broken up and destroyed by these ignorant schmucks.

Thursday, March 05, 2015

Netanyahu's speech debacle shows the ugly face of politics (again)

I don't usually comment much on purely political issues, what you might call politics for politics' sake. To tell you the truth, it doesn't really interest me much; in fact, it bores as well as depresses me. But Benjamin Netanyahu's speech to the US Congress probably takes politics-for-politics'-sake into the realms of the transcendental and psychological.
The whole episode has a bad taste from start to finish, from Republic Speaker of the House John Boehner's initial invitation for Netanyahu to speak at Congress without the usual protocol of asking President Barack Obama's permission, to the speech itself, which seems to have been more aimed at an Israeli audience than an American one, given that Netanyahu is fighting for his political life in a tight election race. Incredibly, he had the audacity to begin the speech by saying, " I deeply regret that some perceive my being here as political. That was never my intention."
The whole thing may, however, still backfire on the Republicans. The main US network television stations refused to cover the speech live. Polls of Americans-on-the-street have expressed their disapproval of Boehner's tactics. Then, a hurried attempt by Republican Leader Mitch McConnell, shortly after Netanyahu's speech (and three weeks before the currently agreed timeline), to fast-track and push through the currently-debated legislation calling for congressional approval for any nuclear deal with Iran met with disapproval in both Democratic and Republic quarters, and failed miserably.
Whether the vote ultimately succeeds in taking away the President's power on this issue or not, the recent shenanigans has probably poisoned and soured the process irrevocably. Certainly, Netanyahu has burnt his boats and destroyed whatever vestiges of respect may have remained between himself and President Obama.
I have never understood the North American love affair with Israel, which I have always seen as a militaristic, repressive and unstable regime, operating a system disturbingly reminiscent of South African apartheid. And yet decades of American politicians (and now our own Stephen Harper, who is perhaps the ultimate Israel cheerleader) have kowtowed to Israeli sensibilities, and bent over backwards to ignore the more egregious missteps and political drivel that seem to keep emanating from that unfortunate country. To some extent, Canada has recently taken over the traditional US role of shielding Israel from the rest of the world in UN sessions. Barack Obama is the only American President in living memory to treat Israel with the skepticism and wariness it deserves.
I know the Jewish lobby in North America (and particularly in the USA) is both disproportionately rich and powerful, but I'm always surprised at just how influential they seem to be. I can't believe they merit such attention by sheer electoral numbers (in fact, I checked: the Jewish population of the USA is in the region of 6 million, about as many as live in Israel itself, but this is only about 2% of the overall US population; the percentage in Canada is even less, about 1%). But surely this local influence can be the only explanation for America's (and Canada's) continued support for such a dubious administration (Wikipedia has a good article on the extent and sources of this influence).
Neither have I ever understood why we should listen to one nuclear weapon power vociferously denouncing the rights of an antagonistic neighbour's right to the same. Israeli nuclear weapons are arguably the single biggest obstacle to a long-term solution to the Iranian nuclear problem.
Ah, well, time to stop: I have probably offended enough people now (another good reason not to comment on politics).

UPDATE
Despite many polls consistently showing Benjamin Netanyahu's rightist Likud to be trailing the centre-leftist Zionist Union party in popularity, on the day of the election, Netanyahu did in fact win enough seats to allow him to form another coalition government. This turnaround is widely attributed to his election day Facebook campaign in which he adopted bare-faced and racist scare tactics, alleging that "Right-wing rule is in danger. Arab voters are going to the polls in droves. Left-wing organisations are bringing them in buses."
In addition, the day before the election, he completely reversed his position in the previous election by assuring Israeli right-wingers that there would be no two-state solution to the Palestinian problem under his leadership. The day after his victory, however, he back-tracked once again (at least when interviewed for an American audience), saying that he DID want a two-state solution after all! He said that he is proud to represent both Arab and Jewish citizens.
Basically, this guy will do whatever he has to in order to retain power and, amazingly, it seem to work for him. Just don't believe a word he says.

Tuesday, March 03, 2015

Electric cars make sense (at least in Ontario)

I had a long-standing question about electric cars answered for me the other day, by (who else?) the good old Globe and Mail.
Electric cars always seem like a good idea - or at least they will be when the battery technology and the costs improve a bit - but I always had this nagging doubt about how much greenhouse gases (GHG) they really save, given that they use electricity from the grid as their fuel, which carries with it its own GHG load. I've never seen this issue addressed.
A paper published recently in the journal Nature Climate Change answers just this question. It turns out that shifting to electric vehicles will only reduce overall emissions if the plants that make the power used to charge the cars generate less than 600 tons of greenhouse gases for every gigawatt-hour of electricity they produce. So, given the relatively good GHG profile of my home province of Ontario's electricity production, electric cars make sense here (and in other responsible provinces like Quebec and British Columbia).
In fact, Canada as a whole produces power at a level of about 200 tons of GHG per kWh, well below the critical level. But, as we know, not all provinces are created equal, and places that still have lots of coal power plants (calling out Alberta and Saskatchewan) spew out about 750 tons of GHG/kWh produced. So, switching to electric cars there would actually worsen the overall GHG situation.
Worldwide, the rate of GHG from electricity production is apparently 536 tons/kWh, and so marginally below the 600 ton threshold rate, but this of course hides some large discrepancies between countries (and within those countries). Therefore, electrification does not actually make environmental sense in counties like India, China, Australia, Saudi Arabia and Indonesia, whose GHG production from electricity generation is bad.
So, there you go: wait long enough and the good old Globe will answer your questions.