Mis establos!!!

None of the science or medical information I might post to this blog should be taken as medical advice (I'm not medically trained). Think of this blog as a sort of nursery for my half-baked ideas hence 'stuff that occurs to me'.

I work on the EPSRC-funded @CHI_MED project; all views are my own. I used to work at Diabetes UK (until 22 June 2012) as a Science Information Officer (effectively a science-specialist librarian but not quite a clinical librarian). Before that it was ScienceLine and back in the mists of time it was lipid chemistry & neuroscience.

Contact: @JoBrodie or reconfigure this email address me.meeeee @ gmail.com (replace me and meeeee with obvious letters, eg... jo.brodie@ etc).

Oh OK then it's jo dot brodie at gmail dot com

Wednesday, 27 August 2014

Home-made Pomodoro timings - a spreadsheet with hard sums pre-calculated :)

I've read positive and negative things about the Pomodoro technique (basically using a timer to restrict the time in which you work / break / work in the hope of reducing distraction and getting more stuff done in a shorter time-frame). I don't suffer from procrastination particularly (no more than the usual) but I do often find that (a) I think of something unrelated to the task and think 'well I'd better do that now' and / or (b) find that in order to do something I first need to do something else that is related to the task.

While I can't think of anything that will help with (b) I use Workflowy.com for (a) and just enter a one-line reminder and then forget about it until I next have a break / bit of time to deal with it. What I've found with Pomodoro is that it removes me from the equation. I am the rate-limiting step in getting stuff done because other stuff pops into my head, but a combination of 'dump it here and forget about it' and 'get on with what I started' seems to be productive. Of course I may acclimatise and will have to add in 5 minute beatings to motivate myself ;)

It's easy to do, just start a timer for 25 mins, do something useful. Stop for 5 mins, do it again and so on with longer breaks in between 'sets' of Pomodoros.

But I wanted to see how a day would look if it were full of Pomodoros (I'd never do as many as listed but did a big calculation just in case). One of my afternoon tasks today (that I gave myself when I'd finished other stuff, which I did woohoo), was to create a shareable Excel spreadsheet with the timings I'd worked out this morning.

Here it is, instructions are appended below but also embedded in the first tab of the sheet.

Jo's Pomodoro pre-calculated time wrangling spreadsheet:

and here's a better one from Alan Hennness, my new mortal enemy ;)

Hope you find it useful. Tough luck if you don't (no need to tell me, it works fine for me and that is its primary* purpose) ;)

*sole, but I'm being polite.

Basic instructions
Go to tab marked 'Pomodoro calculations'. Leave the 9am example (the one on the left) and use the one on the right - enter your preferred start time and press enter. The table should populate itself with the suggested timings.

Obviously you still need to use some sort of timer device, but I made this for myself so that I could see how a day might look. Feel free to ignore it entirely :)

Ones in green are timings you may wish to change as these are the breaks. You can amend the calculation in Cells L10, L18 or L26 and the remaining calculations should update accordingly.

Use the guide in columns J and K to amend any timings - this is based on the fact that there are 288 x 5 minutes in 24 hours.

The formula for adding 25 minutes to the time in a cell (where the cell is C3) is

The formula for adding 5 minutes to Cell C3 is

If nothing else, and let alone whether or not Pomodoro is of any use, I'm delighted to have learned how to wrangle time formatting in Excel. 

The locked spare is in case anyone mucks up the first sheet - the password is jobrodie
Since I made this for me, and it seems to work, I imagine that's the end of it but if you need to contact me I'm on jo.brodie@gmail.com but I'm afraid I'm not going to be doing any more calculations. I'm certain there's a better way of doing this sort of thing but since I've found a solution to how to do this my interest in it has dropped back to zero ;)

Happy productivity, or time-wrangling,

This page was what pointed out to me the 5/288 style of calculation for 25 minutes:

Tuesday, 26 August 2014

What is a misleading homeopathy claim, and how to report it to the ASA

by @JoBrodie, brodiesnotes.blogspot.com

This post is written for people who might not have made a complaint to the Advertising Standards Authority before.

If you're irritated by homeopaths making misleading claims on Twitter, Facebook or on their websites (or in-shop leaflets or any other marketing) you can complain about those claims to the Advertising Standards Authority (the ASA).

1. Make a complaint in the UK
This is the page on the ASA's website where you can make a complaint (you give your name and address but it isn't published): http://www.asa.org.uk/Consumers/How-to-complain.aspx

2. Make a complaint in other countries too
The ASA deals with claims made on UK websites or leaflets but, thanks to its cross-border agreements, it will liaise with the relevant advertising standards authority in the following countries too -
Australia, Austria, Belgium, Brazil, Bulgaria, Canada, Chile, Czech Republic, Finland, France, Germany, Greece, Hungary, India, Ireland, Italy, Lithuania, Luxembourg, The Netherlands, New Zealand, Poland, Portugal, Romania, Slovakia, Slovenia, South Africa, Spain, Sweden, Switzerland, Turkey and of course the United Kingdom.

And that's it.

There's some background information below too.

3. What happens next?
It used to be that any complaint to the ASA would result in them asking the homeopath for evidence and then considering each case. If the marketer agreed to amend their website then the case was closed and it appeared on the ASA's website as an 'informally resolved' case. If the marketer argued their case then the complaint went to the Board for an adjudication. Either the case was upheld against the marketer or it wasn't, and these were listed on the ASA's weekly adjudications. Persistent web marketing offenders find themselves on the non-compliant list of online advertisers.

4. Things changed in 2011
However after it became possible to complain about marketing material on websites too (from March 2011) the number of complaints about misleading homeopathy claims increased dramatically.

The ASA handled so many complaints about homeopathy in 2011 that it undertook a review of the evidence and, finding none of good quality, appears to have simplified the complaints procedure - it seems that the ASA no longer asks homeopaths for evidence for their claims but instead passes the complaint directly to the Compliance team (theyr'e the ones that ask the marketer to remove the claims for which there's no evidence).

Because the Compliance team don't report on their work directly you may not hear about the outcome of your complaint in quite the same way but you can follow @NightingaleC on Twitter to see published lists of adjudications / rulings and informally resolved cases.

5. What can you complain about?
It is perfectly legal to sell homeopathy pills or consultations / treatment. Most homeopaths comply with advertising regulations and their websites talk about how they support people's health (which is true). The Society of Homeopaths has worked with the ASA to encourage their members to ensure that their marketing material is acceptable, see their guidance document for more info: http://www.homeopathy-soh.org/wp-content/uploads/2014/06/Mktg-Prom-guidance2014.pdf

However, if a homeopath is not medically trained and their website...

(a) claims that homeopathy is effective in treating various conditions for which there's no good evidence or
(b) refers to serious medical conditions

...then they may be in breach of the advertising recommendations. Following the 2011 review the Committee of Advertising Practice produced a set of guidelines for what is / isn't permitted in homeopathy marketing, it's worth a read. Note this sentence in particular:
"Those practitioners who are not medically qualified should not make claims about the efficacy of their treatments and should not refer to serious medical conditions..."
5a) for which conditions is homeopathy already known to lack evidence?
From a look at several adjudications in which complaints were upheld against homeopathy sites the following conditions were listed as being of concern. That is, the ASA asked a homeopath to remove reference to one or more of these conditions from their website after finding the evidence was insufficiently good.

acne, anxiety, arthritis, Candida, cataracts, cold flushes, dengue fever (prevention of), depression
diphtheria prevention, genital warts, hot flushes, exhaustion, heavy periods, influenza (prevention of)
irregular periods, irritability, Japanese encephalitis prevention ('homeoprophylaxis'), loss of libido, low mood, malaria prevention, menopausal symptoms, meningitis prevention, mood swings, mosquito bites, night sweats, other skin problems, PMS, PMT, polio prevention, psoriasis, serious medical conditions (this could include asthma, diabetes, high blood pressure etc), side-effects of the Pill, tetanus prevention, tick-borne encephalitis prevention, tiredness, typhoid prevention, vaginal dryness, yellow fever prevention.

It's not an exhaustive list.

5b) what are serious medical conditions?
Any condition where you'd reasonably expect someone to be under the care of a qualified medical doctor might include hypertension, asthma or diabetes and they're generally bit of a no-no on websites. Obviously there's no good evidence that homeopathy's of any use but the ASA is additionally concerned if, by mentioning serious conditions, consumers may be discouraged from seeking appropriately qualified advice.

5c. A note on cancer
In the UK it's actually illegal to make any claims to treat cancer - there is a separate act for this (the Cancer Act 1939) - very few homeopaths mention cancer on their website for obvious reasons.

6. What else can you do?
a) ask marketers to amend their website directly and / or
b) blog about misleading claims 

The ASA has to deal with a lot of enquiries, some of them much more problematic than minor misleading claims on homeopaths websites, so don't assume that your complaint will be a priority unless it's a seriously dodgy claim. So what else can you do?

a) Ask them yourself to amend their website
There's nothing to stop you from contacting a marketer directly and asking them for evidence for their claims or pointing out that you have concerns about what their website says. But go carefully. You are not there to tell people what they can and can't advertise (that's what the ASA is for) and it's a bad and unpleasant idea to go around threatening people and generally being a jerk. It's fine to contact people politely and express reservations about their adverts but let's not be mean-spirited about it. I've seen comments on some skeptic blogs that make me a little worried about people's motivation - it really comes down to the fact that people should be advertising their wares responsibly.

In general I'm not hugely in favour of contacting people directly though I do do it on occasion (politely) to see what happens (not much). You might think that discussing it informally (ie without involving regulatory bodies, saving everyone time) might be a positive thing but it can easily be misinterpreted and relations between skeptic bloggers / activists and homeopaths are at an all time low. So don't be surprised if your approach is not met with enthusiasm. Proceed with caution. I've written more on the 'ethics' of contacting misleading advertisers directly.

a) Blog about misleading claims and good evidence
Blogging is just a way of increasing the amount of information about a topic. You may not be able to remove bad information from the internet but you can slightly increase the amount of better information. When people search for a topic there' s a chance that they'll read your information instead of something worse. Blogging also raises awareness of a topic and connects you to a network of people who are trying to improve online information about health.

Sunday, 24 August 2014

How the pharmaceutical industry interacts with healthcare professionals, etc - consultation closes 5 Sep

Before we get going let's familiarise ourselves with some acronyms...

ABPI = Association of the British Pharmaceutical Industry
EFPIA =  European Federation of Pharmaceutical Industry Associations
MHRA = Medicines and Healthcare Products Regulatory Agency
PMCPA =  Prescription Medicines Code of Practice Authority 

This arrived in my inbox yesterday from the Prescription Medicines Code of Practice Authority (PMCPA) and is about a consultation that's currently taking place regarding several things including the way in which the pharmaceutical industry interacts with healthcare professionals.

Consultation on proposals to amend the 2014 ABPI Code of Practice (14 July 2014) ABPI

"Consultation launched on proposed changes to the ABPI Code of Practice for the Pharmaceutical Industry and the Constitution and Procedure for the Prescription Medicines Code of Practice Authority

Changes are proposed to the 2014 ABPI Code of Practice for the Pharmaceutical Industry and the PMCPA Constitution and Procedure.

There are a number of reasons for the changes including the work done by the group established by the ABPI Board to review the Code. Additional changes are also needed to implement fully the European Federation of Pharmaceutical Industry Associations (EFPIA) Code on Disclosure of Transfers of Value from Pharmaceutical Companies to Healthcare Professionals and Healthcare Organisations. Updates to the EFPIA Disclosure Code and the EFPIA Code on the Promotion of Prescription-Only Medicines to, and Interactions with, Healthcare Professionals were agreed at the EFPIA General Assembly on 6 June 2014. The Medicines and Healthcare Products Regulatory Agency (MHRA) consultation as part of the red tape challenge and the regular update of the Code and its operation have also resulted in proposals."
I'm not sure why it arrived by email yesterday when the consultation begain in July and ends in a couple of weeks - I've only found one mention of it on Twitter too.

Here are the documents, however the link for the "copy of the draft Code of Practice" which is given on the site doesn't work.
  1. Proposals to amend the ABPI Code of Practice for the Pharmaceutical Industry
  2. Proposals to amend the PMCPA Constitution and Procedure
  3. EFPIA Disclosure Code
  4. EFPIA template
  5. EFPIA HCP Code
  6. Draft template (UK amendments to EFPIA version).  (Further work maybe required.  The differences between the EFPIA template and the UK template are limited to those changes necessary to reflect requirements of the ABPI Code and to provide the data in a form suitable for the ABPI searchable database.)
Visit the website for info on how to contribute to the consultation: Consultation on proposals to amend the 2014 ABPI Code of Practice (14 July 2014) ABPI.

This list of health conditions should not be on homeopathy websites

Homeopaths have to be a bit careful about mentioning conditions on their websites, particularly conditions that would be considered serious and that would typically be under the care of a qualified doctor.

Advertising Standards in the UK do not permit homeopaths (the ones that aren't medically trained at any rate) to make claims about treating anything if they do not have any evidence (and let's face it, their evidence is uniformly poor) - they should not "make claims about the efficacy of their treamtents..."

But, and this is an important but, the authority that regulates advertising and marketing claims additionally does not permit homeopathy marketers to "refer to serious medical conditions" (this is irrespective of any evidence) if the marketer is not medically trained or if there's no doctor working at the clinic.

They can't mention conditions like asthma, diabetes, high blood pressure etc. In the UK cancer is always an extremely unwise thing for a homeopath (or anyone for that matter) to claim to treat as there is actually an Act that makes doing so a criminal offence (the Cancer Act 1939), most people do not mention cancer treatments on their website for that reason.

If a homeopath lists on their website one or more serious medical conditions then they are going beyond the limits of what is possible for them to mention in their marketing material.

There are two separate things here
(1) evidence, or not and
(2) merely mentioning serious healthcare conditions

To the best of my knowledge the Advertising Standards Authority (ASA) and the Committee of Advertising Practice (CAP) are no longer seeking evidence about homeopathy because they did a massive investigation into it a couple of years ago. This resulted in guidance which informs their future decisions about misleading marketing claims.

Additionally, my experience has been that where a homeopath has listed conditions the approach has been to focus on (2) rather than asking them for any evidence.

However these days the ASA no longer seems to be adjudicating on homeopathy claims and they don't appear to be taking them on as individual cases. Instead they seem to be simply asking the homeopath to remove the misleading claims. Failure to do so can result in the website being listed on the ASA's non-compliant online advertisers page and may also result in removal of any paid-for search-engine ads and in addition the ASA may publish an advert to appear in search engine results, warning consumers of the organisation's advertising status.

When I put in a homeopathy ASA complaint now I no longer get updates on how it's going because the case is immediately passed to the Compliance team, who do not report directly to the public. I generally hear only if the website is added to the non-compliants list (eg Islington Homeopathy)

With that in mind, it's entirely possible that I won't hear anything much about the outcome of my complaint about the website below, which I've recently submitted.

The web address is embedded here http://www.donotlink.com/bahk

There is sliding scale of fees for a consultation, depending on its length and costs for individual remedies so this site is marketing a service for which people pay.

Here is the list of conditions, apparently "just a small selection". Oh dear.

The ones that particularly concern me include asthma, bronchitis and depression but 'hormonal imbalances' should clearly have support of a doctor or endocrinologist. There are plenty others listed that worry me but those were the ones I highlighted in my complaint to the ASA.

Amazingly and amusingly there's also a seminar listed on that site, all about endocrinology. Clicking through to the seminar's own page (on another site) suggests that discussions about chakras will feature.

Saturday, 23 August 2014

How to favourite tweets covertly, thwarting this new irritation from Twitter

I've not seen it myself but apparently Twitter's rolling out a new irritation for its users - showing in people's timelines some of the tweets that their followers have favourited. While it's always been possible to find out what people you follow are favouriting this is the first time it's been presented in your timeline. Possibly this will delight everyone but so far everything I've read on the topic suggests the opposite (it's been rolled out in a small number of users).

If you're favouriting a tweet to send a message to someone, eg "I liked your tweet" or "I've read your tweet" - carry on, but be aware that if this new thing rolls out to all users then this may be made more obvious to your followers (though it has always been public information, just not 'surfaced' in this way).

If you use favourites more as a 'saving for later' bookmarking kind of thing then do any of these instead. Instructions are for people using Twitter via a web browse.

1. Bookmark the tweet
Each tweet has its own web address. You can find it in its timestamp and right-click, bookmark the link, copy or save it into a new tab and bookmark it that way (this will depend on your browser settings).

2. Email it to yourself
Look for the "More..." option when is more visible when you hover over the tweet - emailing the tweet is an option there

3. Take a screenshot and save the image as a file

4. Storify it
Storifying is an imperfect tool for covert tweet-saving because if you publish the Storify and the person whose tweet you've saved has also registered with the site then I think they will be auto-informed by email and there's not much you can do about it, even if you avoid sending them the 'I've included one of your tweets in my Storify' tweets. However if you keep it as a draft it's nicely under the radar.

Further reading
Twitter starts to change the central logic of its service (17 August 2014) The Atlantic
How to understand Twitter's new bad direction (23 August 2014) Computerworld (page three)
"Additionally, when we identify a Tweet, an account to follow, or other content that's popular or relevant, we may add it to your timeline. This means you will sometimes see Tweets from accounts you don't follow. We select each Tweet using a variety of signals, including how popular it is and how people in your network are interacting with it. Our goal is to make your home timeline even more relevant and interesting."
From What's a Twitter timeline? (date unknown) Twitter Help Center