Chiropractic cures for Asthma? Yes, that is as stupid as it sounds, but some Chiropractors seems to believe it.
Below is my reposting of the article that Simon Singh wrote regarding this crap. I'm a day late, but it's being reposted around the internet to protest the fact that the British Chiropratic Association sued Singh for libel for writing it. I'll repeat the explanation and the article below.
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On 29th July a number of magazines and websites are going to be publishing Simon Singh’s Guardian article on chiropractic from April 2008, with the part the BCA sued him for removed.
They are reprinting it, following the lead of Wilson da Silva at COSMOS magazine, because they think the public should have access to the evidence and the arguments in it that were lost when the Guardian withdrew the article after the British Chiropractic Association sued for libel.
We want as many people as possible around the world to print it or put it live on the internet at the same time to make an interesting story and prove that threatening libel or bringing a libel case against a science writer won’t necessarily shut down the debate.
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You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.
In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.
You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.
I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.
But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.
In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.
More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.
Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.
Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”
This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.
If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.
Thursday, July 30, 2009
Tuesday, May 5, 2009
Espresso Book Machine dubiousness
I keep seeing libraries and library blogs get excited about the Espresso Book Machine, but you can count me among the unconvinced. Let me preface my comments by saying that I tend to be a bit of a pessimist so it is certainly possible that I am underestimating the public's desire for a machine like this.
I am going to sum up my thoughts by comparing my dream book machine to the product that Blackwell actually seems to be making available.
Would I like to be able to go to any corner store or nearby book store and be sure that I could get a good, cheap copy of any book I wanted? Hell yes! Would I like that book to be accurately printed with any original images and/or charts in it? Once again I would have to say yes. Is this what Blackwell says they can give us us? No. Not even close.
What struck me most about the Gizmodo article that I linked to above was that the cost of a 300 page book is estimated to be $43. This is the first time that I had seen any actual cost estimates. That price seems way too high. Actually, it may be appropriate for textbooks and other reference-type books, but since most of the current titles that are available are out-of-copyright and out of print books I find it hard to imagine that anyone is going to fork over almost $50 for a copy. I am also concerned about images. I'm going to assume that the machine only prints in black and white, although it's possible I'm mistaken there. That will work for a lot of books, but it is going to exclude a lot of illustrated works. What I can maybe see it being useful for is if I'm gift shopping or in desperate need of a book today and there are no local shops with a copy. How often does that happen, though? Most of the time I can go to Amazon and find even an out of print title and get it overnighted, usually for less than $50. Still, it wouldn't hurt a book shop to keep an Espresso Book Machine around, at least not if Blackwell rents them out or licenses them at a reasonable rate. Somehow the $43/book charge makes me doubt that.
What seems extremely unlikely is that these machines will see much use in libraries. What is the main benefit of getting a book from a library? It's free and that's about it. Sure, there are some titles that are only available at libraries and they let you browse a large number of titles before selecting one, but the primary reason for going to a library is to pick up a book without paying for it. A $50 book machine simply doesn't interact well with that advantage.
My final verdict is: might kinda sorta work in bookstores, but not a chance in hell for libraries. We'll see if the market can prove me wrong.
I am going to sum up my thoughts by comparing my dream book machine to the product that Blackwell actually seems to be making available.
Would I like to be able to go to any corner store or nearby book store and be sure that I could get a good, cheap copy of any book I wanted? Hell yes! Would I like that book to be accurately printed with any original images and/or charts in it? Once again I would have to say yes. Is this what Blackwell says they can give us us? No. Not even close.
What struck me most about the Gizmodo article that I linked to above was that the cost of a 300 page book is estimated to be $43. This is the first time that I had seen any actual cost estimates. That price seems way too high. Actually, it may be appropriate for textbooks and other reference-type books, but since most of the current titles that are available are out-of-copyright and out of print books I find it hard to imagine that anyone is going to fork over almost $50 for a copy. I am also concerned about images. I'm going to assume that the machine only prints in black and white, although it's possible I'm mistaken there. That will work for a lot of books, but it is going to exclude a lot of illustrated works. What I can maybe see it being useful for is if I'm gift shopping or in desperate need of a book today and there are no local shops with a copy. How often does that happen, though? Most of the time I can go to Amazon and find even an out of print title and get it overnighted, usually for less than $50. Still, it wouldn't hurt a book shop to keep an Espresso Book Machine around, at least not if Blackwell rents them out or licenses them at a reasonable rate. Somehow the $43/book charge makes me doubt that.
What seems extremely unlikely is that these machines will see much use in libraries. What is the main benefit of getting a book from a library? It's free and that's about it. Sure, there are some titles that are only available at libraries and they let you browse a large number of titles before selecting one, but the primary reason for going to a library is to pick up a book without paying for it. A $50 book machine simply doesn't interact well with that advantage.
My final verdict is: might kinda sorta work in bookstores, but not a chance in hell for libraries. We'll see if the market can prove me wrong.
Monday, April 27, 2009
Salaries of UK Librarians
Remember when I said I would write weekly updates to my blog? Yeah, well, that obviously didn't happen. I may try that again or not, but in the mean time I've been meaning to post an updated list of the salaries of UK Librarians:
http://spreadsheets.google.com/ccc?key=r5aYW8zA5_YdvQPVrrwRaIw
This data is taken from the Info Center at the Herald-Leader's kentucky.com site. I copied this data out today (4/27/09), but it most certainly reflects the salaries at an earlier date than that. I would make an educated guess that these salaries are from somewhere between 8/08 and 11/08, but I can make no guarantee as to the exact time period. On the bright side (?), UK is still in the middle of a multi-year salary freeze so these numbers are unlikely to have changed much except where employees have left or been added. One last thing I should mention, is that there are probably a few librarians that have been left out of this list. I only pulled the information on employees who had "Libraries" or "Library" in their department name.
http://spreadsheets.google.com/ccc?key=r5aYW8zA5_YdvQPVrrwRaIw
This data is taken from the Info Center at the Herald-Leader's kentucky.com site. I copied this data out today (4/27/09), but it most certainly reflects the salaries at an earlier date than that. I would make an educated guess that these salaries are from somewhere between 8/08 and 11/08, but I can make no guarantee as to the exact time period. On the bright side (?), UK is still in the middle of a multi-year salary freeze so these numbers are unlikely to have changed much except where employees have left or been added. One last thing I should mention, is that there are probably a few librarians that have been left out of this list. I only pulled the information on employees who had "Libraries" or "Library" in their department name.
Monday, April 6, 2009
WebCite
Damn! Why have I not heard of WebCite before this?
Everyone who cites websites needs to hear about this tool. Really. I cannot count the number of times that I have seen websites referenced that no longer looked the way they did when they were first cited. This is most obvious when people are pointing out typos or poor Photoshop jobs, but this sort of thing happens all of the time. And look at this, now we have a tool that can take care of that problem. Now, if we could only get people to start using it.
Everyone who cites websites needs to hear about this tool. Really. I cannot count the number of times that I have seen websites referenced that no longer looked the way they did when they were first cited. This is most obvious when people are pointing out typos or poor Photoshop jobs, but this sort of thing happens all of the time. And look at this, now we have a tool that can take care of that problem. Now, if we could only get people to start using it.
Wednesday, April 1, 2009
LibraryThing Widgets
Ooo, I like the new customizable LibraryThing widgets. See sidebar for example. It took me a little while to figure out I had to hot the "Refresh!" button on the customizing page rather than the "Reload" link if I wanted the example on the right to appear the way my customized widget would look before I copied it out, but other than that the whole thing is pretty fun and intuitive to use. Way to go Tim!
Thursday, March 26, 2009
Too Much Data?
A senior designer at Google recently left the company for an interesting reason. That reason? Design is dictated to too large a degree by data.
This is not a problem I have ever heard from libraries and their staff, but perhaps there are still some lessons we can pick up here. For the most part I am a data fiend. I rely on my usage statistics to judge the effectiveness of my library, I arrange my hours based on them (despite the fact that I would prefer to open up at 10:00 AM or later, my statistics just won't allow it), and I cancel journals and other publications because of statistics. This is not necessarily a bad thing. However, even I can see that demanding statistics to decide "whether a border should be 3, 4 or 5 pixels wide" is a bit ridiculous.
So where do you draw that line? When does data stop becoming important and start becoming nit-picky, or worse yet, a waste of everyone's time? I've just started thinking about the issue, but I think the answer has to do with when data collection takes more time and effort than the best possible solution is worth. Admittedly, that is an extremely hard problem to quantify and this is probably why Google can continue to justify their data demands. When a search engine is used by millions of people a day and generates billions of dollars in revenue, very small differences in usage by a very small percentage of users can still mean that a million people are negatively effected and you've lost hundreds of thousands, or even millions, of dollars. This is not the problems that most libraries face and for most libraries this kind of decision cannot be based on cost because they are non-profit organizations. So what do you base these decisions on? Mostly, I would say research. Look at your benchmarks or even unrelated organizations with similar audiences and see what similar changes have done for them. Off the top of my head, I would consider a 10% positive change to be worth a couple of weeks of work hours. Be sure to adjust that number based on how large your audience is and how many staff members you have. Also, be aware that if what you thought would be a 10% increase turns out to be a 10% decrease, then it may be time to revert to what you had before.
On a similar note, how big a number of complaints trumps how big of an increase in usage? Two sites that I use on a regular basis have recently gone through redesigns, Woot and Facebook. Neither site had a very positive response from current users regarding the changes. Facebook, in particular, had a huge public backlash against their new layouts with 100s of "I hate the new Facebook" groups popping up on the site itself, some of them with tens of thousands of members. Did many people actually stop using Facebook since the change? That's harder to say and I haven't yet found the numbers to tell me for certain, but my guess is that there wasn't much actual change in usage. Still, Facebook is responding to complaints since they've been getting a lot of press and they are trying to placate their disgruntled users. Should Facebook have bothered responding if the changes actually brought in more people? What if the number of users stayed the same? Complaining users tend to be those who will stick around and complain until they decide you're not listening and then they jump ship. If the number of complainers is significantly less than the increase in users, then I'd argue that you're safe to ignore them or at least not do anything drastic to appease them. You'll probably still try to address some of the concerns since happy customers are, after all, always better than angry ones. Most of this stuff I'm talking about is data driven, primarily by the usage data. On the other hand, people are fickle and all those students who complained when Facebook stopped being a site for students only and started being open to the public don't seem to have run away too far. In general, I do think you're better off looking at the usage trends rather than responding to the squeaky wheels.
Alright, I've pretty much gone off the rails now and stopped talking about when you can make decisions without data. Before I stray any further afield, I'll go ahead and wrap this up. When it comes right down to it you need to decide if collecting data is worth the cost of the collection. You may have to figure out your own formula to decide how this decision is made, but don't forget that sometimes data isn't worth the cost.
This is not a problem I have ever heard from libraries and their staff, but perhaps there are still some lessons we can pick up here. For the most part I am a data fiend. I rely on my usage statistics to judge the effectiveness of my library, I arrange my hours based on them (despite the fact that I would prefer to open up at 10:00 AM or later, my statistics just won't allow it), and I cancel journals and other publications because of statistics. This is not necessarily a bad thing. However, even I can see that demanding statistics to decide "whether a border should be 3, 4 or 5 pixels wide" is a bit ridiculous.
So where do you draw that line? When does data stop becoming important and start becoming nit-picky, or worse yet, a waste of everyone's time? I've just started thinking about the issue, but I think the answer has to do with when data collection takes more time and effort than the best possible solution is worth. Admittedly, that is an extremely hard problem to quantify and this is probably why Google can continue to justify their data demands. When a search engine is used by millions of people a day and generates billions of dollars in revenue, very small differences in usage by a very small percentage of users can still mean that a million people are negatively effected and you've lost hundreds of thousands, or even millions, of dollars. This is not the problems that most libraries face and for most libraries this kind of decision cannot be based on cost because they are non-profit organizations. So what do you base these decisions on? Mostly, I would say research. Look at your benchmarks or even unrelated organizations with similar audiences and see what similar changes have done for them. Off the top of my head, I would consider a 10% positive change to be worth a couple of weeks of work hours. Be sure to adjust that number based on how large your audience is and how many staff members you have. Also, be aware that if what you thought would be a 10% increase turns out to be a 10% decrease, then it may be time to revert to what you had before.
On a similar note, how big a number of complaints trumps how big of an increase in usage? Two sites that I use on a regular basis have recently gone through redesigns, Woot and Facebook. Neither site had a very positive response from current users regarding the changes. Facebook, in particular, had a huge public backlash against their new layouts with 100s of "I hate the new Facebook" groups popping up on the site itself, some of them with tens of thousands of members. Did many people actually stop using Facebook since the change? That's harder to say and I haven't yet found the numbers to tell me for certain, but my guess is that there wasn't much actual change in usage. Still, Facebook is responding to complaints since they've been getting a lot of press and they are trying to placate their disgruntled users. Should Facebook have bothered responding if the changes actually brought in more people? What if the number of users stayed the same? Complaining users tend to be those who will stick around and complain until they decide you're not listening and then they jump ship. If the number of complainers is significantly less than the increase in users, then I'd argue that you're safe to ignore them or at least not do anything drastic to appease them. You'll probably still try to address some of the concerns since happy customers are, after all, always better than angry ones. Most of this stuff I'm talking about is data driven, primarily by the usage data. On the other hand, people are fickle and all those students who complained when Facebook stopped being a site for students only and started being open to the public don't seem to have run away too far. In general, I do think you're better off looking at the usage trends rather than responding to the squeaky wheels.
Alright, I've pretty much gone off the rails now and stopped talking about when you can make decisions without data. Before I stray any further afield, I'll go ahead and wrap this up. When it comes right down to it you need to decide if collecting data is worth the cost of the collection. You may have to figure out your own formula to decide how this decision is made, but don't forget that sometimes data isn't worth the cost.
Tuesday, March 24, 2009
Ada Lovelace Day: Stacey Greenwell
Stacey Greenwell has been a technological innovator for the University of Kentucky Libraries for many years. She started as the desktop support person for the libraries’ public and staff computers and has continued to bring her technological expertise to bear on the duties of her more recent position as the Hub Librarian. Stacey was one of the first in the libraries to start using online reference tracking software and also initiated and oversaw several video projects in the Hub, including video windows and projected floor signs. These projects as well as others that she has been involved in have helped keep the University of Kentucky Libraries current and relevant to the students and staff they are there to serve.
One of the most impressive aspects of Stacey’s work, though, is the ability to get people to come together and be excited about technology and innovation. She is the one who showed me the value of maintaining an RSS feed reader to stay current in my field . . . which subsequently led to my feed addiction, but that’s a topic for another day. She has been an outstanding technology advocate in her libraries as well as the professional organizations that she works in. Stacey’s time as Chair of SLA’s IT Division was marked by a number of new faces on the board, including my own, and a high level of activity by those board members. This was, in fact, no accident. Stacey is a master of getting people involved and working together on technology that benefits everyone. Her work in the UK Libraries is also notable for the close relationships she formed between Campus IT and the Library System. The ability to get these groups to work together helped to improve the services in available to students in many ways, including having an IT help desk staffed for student questions in the library itself. Stacey has made communication and collaboration a cornerstone of the relationship between IT and the Libraries, to the benefit of all involved.
Stacey Greenwell is definitely the person to have on your side if you are thinking of starting any new technology project. She is an expert at getting the ball rolling and then promoting the project once it has started. Stacey is a person who I hope to some day match in both technical achievement and skill as well as personal initiative, but I will have a high hill to climb in order to get there. This is why I am writing to recognize Stacey's technological expertise on this Ada Lovelace Day.
One of the most impressive aspects of Stacey’s work, though, is the ability to get people to come together and be excited about technology and innovation. She is the one who showed me the value of maintaining an RSS feed reader to stay current in my field . . . which subsequently led to my feed addiction, but that’s a topic for another day. She has been an outstanding technology advocate in her libraries as well as the professional organizations that she works in. Stacey’s time as Chair of SLA’s IT Division was marked by a number of new faces on the board, including my own, and a high level of activity by those board members. This was, in fact, no accident. Stacey is a master of getting people involved and working together on technology that benefits everyone. Her work in the UK Libraries is also notable for the close relationships she formed between Campus IT and the Library System. The ability to get these groups to work together helped to improve the services in available to students in many ways, including having an IT help desk staffed for student questions in the library itself. Stacey has made communication and collaboration a cornerstone of the relationship between IT and the Libraries, to the benefit of all involved.
Stacey Greenwell is definitely the person to have on your side if you are thinking of starting any new technology project. She is an expert at getting the ball rolling and then promoting the project once it has started. Stacey is a person who I hope to some day match in both technical achievement and skill as well as personal initiative, but I will have a high hill to climb in order to get there. This is why I am writing to recognize Stacey's technological expertise on this Ada Lovelace Day.
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