Stuff that occurs to me

All of my 'how to' posts are tagged here. The most popular posts are about blocking and private accounts on Twitter, also the science communication jobs list. 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'.

Contact: @JoBrodie Email: jo DOT brodie AT gmail DOT com

Science in London: The 2018/19 scientific society talks in London blog post

Saturday, 26 March 2016

Maternal death in Australia - was homeopathy to blame? Perhaps not.

Earlier this evening I was challenged on Twitter about a tweet I'd made in response to a series of tweets about the death (which happened in 2012) of a young mother and which has recently been reported in the Australian press. Others were also challenged about tweets they'd made.

The mother's death occurred shortly after giving birth and resulted from massive blood loss from a tear that seems to have been missed. There were a series of events that combined to slow down an appropriate emergency response which came too late, and the mother died. The detailed coroner's report is here. I found that no amount of using Ctrl+F to 'find' words on a page worked on my computer (not sure why) so I've read the 86 page document.

Some of the press articles present the story as a homeopath midwife failing to call an ambulance (even after the mother begged for one), and giving the mother a homeopathic remedy instead of doing something useful. There has also been the implication that, being of a homeopathic mindset, the midwife eschewed real medical interventions in favour of homeopathy, and gave bad advice. Naturally there has been much amazement and horror among the skeptic / medical community that there has been another homeopathy-related death.

I, and others, were challenged to find mention of homeopathy in that coroner's report and here's what I found, on page 70 of 86.

But is it homeopathy?
Two remedies are mentioned here - (i) Arnica and (ii) Rescue Remedy. Only the latter is listed as being a 'homeopathic Bach flower remedy' though in fact I think that may be mistaken. Bach flower products (in the UK they are no longer allowed to call them medicines and are now classed as a foodstuff) would not be considered homeopathic: neither in the way they are prepared (they are not diluted beyond the point of reasonableness) nor in the underlying philosophy of 'like treating like' - but see note on flower remedies below. I do not know how they are prepared in Australia however, but assume it's the same product. That leaves Arnica and it's not clear from the report whether the remedy used was a homeopathic one that contains no or negligible amounts of actual Arnica plant material or a herbal preparation that does contain measurable plant material.

Though note...

So from the information I can access I think it is difficult to know whether homeopathy was directly involved in the treatment of this young woman, or indirectly as a (speculative) ideological barrier to real treatment. It is possible that it was not involved at all.

 From page 77 of 86 - of course this bias doesn't prove that the midwife was a fan of homeopathy or that any beliefs about homeopathy caused her to deliberately avoid hospitals.

I've also done a fairly extensive search of what I believe to be the midwife's Twitter feed (unconfirmed) and can find only a single reference to homeopathy from a few years ago (I checked the terms homeopathy homOeopathy and the -path endings) - of course it is possible that any homeopathy-mentioning tweets have since been deleted. A search on google didn't bring anything up that confirmed that she was a homeopath, or had administered homeopathy in her usual practice - beyond the news reports implying that she did. I don't know where the news reports got their information (they may have interviewed people and got more information than is available to me via Google or the coroner's report).

So at this stage I do not know from the available information if it is true that the midwife was a homeopath or user of homeopathy - or if she was ideologically opposed to getting prompt medical treatment. In other words I don't know if this post is a mea culpa or a 'dangerous homeopathy fan strikes again'. Clearly, as this isn't the only death she's been linked to, I'm not sure she should be doing too much midwifery.

But it is possible that homeopathy has been unfairly maligned in the reporting of this story. Homeopathy is most decidedly unmitigated twaddle but we skeptics can't blame it for everything

Note on flower remedies
"Flower remedies are produced by dropping fresh flowers into water; this yields the “mother tincture” to which brandy is subsequently added as a preservative. Thus they do not contain pharmacologically relevant amounts of constituents of the flowers they originate from. Flower remedies thus have similarities to homeopathic medicines, yet there are clear distinctions between the two systems. According to proponents of flower remedies, their mode of action does not depend on molecular or pharmacological mechanisms but on the subtle “energy” that is transmitted from the flowers to this remedy. This “energy” has so far defied quantification, and critics therefore argue that flower remedies are pure placebos."
Bach flower remedies: a systematic review of randomised clinical trials (2010) Edzard Ernst, Swiss Medical Weekly 

Further reading
Why birth is a feminist issue (December 2013) - written by the midwife in question

News articles about this case
Coroner says Caroline Lovell died after midwife Gaye Demanuele let her 'bleed out' in birthing pool (24 March 2016) The Age
"Around this time, Ms Demanuele gave Ms Lovell a homeopathic "rescue remedy" for anxiety despite her body shutting down due to massive blood loss." - is it homeopathic?

Coroner recommends criminal action be considered against home birth death midwife Gaye Demanuele (24 March 2016) Geelong Advertiser  
"“We are aware of another home birth, in mid 2011, when a woman begged for Ms Demanuele to call an ambulance. Demanuele refused. The baby died."

Mother of two died in a birthing pool after her midwife would only offer a homeopathic 'rescue remedy' as she 'bled out' while begging for an ambulance (24 March 2016) Daily Mail
"Despite Ms Lowell being in an extremely distressed state, Ms Demanuele would only give her a homeopathic 'rescue remedy' in spite of the massive blood loss causing her body to shutdown." - same question as above, were either of the two remedies given homeopathic.

Monday, 21 March 2016

Questions I have about iPads or tablets - do you know the answers?

I am thinking of getting my dad a tablet to play with (he's an elderly but technologically competent nerd, though is a bit puzzled by touchscreens).

My main enthusiasm for the idea of these devices (I don't have one myself but have an iPhone) is the instancy with which they can be switched on and used, no waiting for it to boot up (unless you do a hard shut down) and the fact that he'd be able to send and receive emails with it as well.

My mental model of tablets is that they're basically identical to my iPhone except that they can't make telephone calls (other than Skype of course) and are useless outside the home unless they have a 3G or similar connection.

With my level of understanding established these are my questions about them, but if I've missed a question I should have asked please suggest it, along with an answer if possible.

  • Is it only iPads that have 3G or 4G capability, not generic £79 tablets from Argos? Are they all, pretty much by definition, wifi-enabled? I suppose if it's something that doesn't have to be useless if taken outside the home then that might be a plus so I would consider 3G if available.
    • If we get a 3G-ready one is it possible to do it as a pay-as-you-go thing rather than a contract thing, and what's the 'distance' between payments. Eg if he wants to use it outside the house in May and then not again until August is that possible or does he have to pay even if unused. I suppose what I want is the equivalent of the 'dongle' device that I can buy for £30 and plug into a USB port on my laptop and 'get internet' for £5/day but months can go by without me using it, at no extra cost. I just pay for what I use. 
  • Presumably the fact that it can't make telephone calls (bit awkward to hold to the ear though increasingly I see people holding their phones in what I think is an unnatural way anyway) is offset by the fact that they can do Skype via voice-over-internet-protocol (VOIP) or whatever technology they're currently using?
  • How easy is the touchscreen and on-screen keyboard to use, particularly for older arthritic fingers and eyesight that's not terrible but not awfully keen. Apple seem very good at making products that are easily usable by a variety of folk but are cheaper generic tablets also perfectly adequate at letting you change the size of the text etc? 
  • I assume the wifi connection will let him use the internet, get email, watch YouTube videos and general stuff that he also gets on his regular computer.
  • If he can't get to grips with the on-screen keyboard how easy is it it to attach an external keyboard?
  • Do iPads (or any tablet) have USB ports?
  • He'd be able to take a photograph of something and email it to me wouldn't he? Some iPads have two cameras. To be honest I was a bit surprised to find that my iPhone has two cameras.
  • Can he download apps like Kindle and stuff from the app store? Presumably he can't get the App Store from Apple on a non-Apple product but what are the apps like on generic tablets?
  • I can't imagine he'd fill it with stuff so I assume the lower 16GB is sufficient but happy to hear otherwise. 
  • I think I'd probably go for a large thing, I really like the iPad version 1 or 2, quite like the mini but I prefer the bigger screen (though a slightly smaller one might be easier for him to handle).
Thanks :)

Saturday, 19 March 2016

Acanthus leaves (ridiculously curly things that appear in William Morris-style crafts) in art and heraldry

Image from page 153 of "An illustrated dictionary of words used in art and archaeology. Explaining terms frequently used in works on architecture, arms, bronzes, Christian art, colour, costume, decoration, devices, emblems, heraldry, lace, personal orname

Big fan of idealised acanthus leaves. Big big fan. They're absolutely everywhere yet it's only recently that I realised I'd not come across much instruction on how to draw them from scratch. I assume designs would have been passed on to apprentices and so on, although I'm sure plenty of clever / lucky people can draw them freehand.

As far as I'm aware most reasonably complex artforms, particularly those that are designed to fit in a particular space, are designed from the ground up with an underlying 'scaffold' upon which the final form is drawn. This is how (it is believed that) Celtic knotwork was created, or at least it is possible to reconstruct this type of art using simple mathematical grids, building up to a full pattern. In fact I did this myself a couple of weeks ago at a 'crafternoon' with friends, using George Bain's 'Celtic Art: the methods of construction' (the edition linked to is a later one than mine) to create a copied pattern from scratch. It was the scaffolding that was actually copied, measured and scaled up to fit a particular space, then the final pattern emerged from the gridlines. You can see the photos of the work in progress and its final form on my secondary blog here.

I've not found a user-friendly equivalent of the Celtic knotwork book for acanthus leaves, though there is a detailed digitised book of yore that explains how it was done. I've not really got to grips with it. Some examples of acanthus leaves in art and heraldry are below, taken from the amazing Internet Archive Book images of out-of-copyright image resource, click on the image below to visit its page on Flickr and there are further links there to see it in its original context.

There are a couple of instructional drawing videos below and 'how to draw' books and blog posts I've found so far. More examples of acanthus art are further below.

Acanthus drawing instructions

How to draw the Acanthus, Part I // Part II // Part III / Part IV, Surface Fragments blog

Guide for the drawing of Acanthus, and every description of ornamental foliage
(1843), James Page
Google Books // Google Play (same thing, formatted differently, probably suitable for Android!) / Internet Archive version

Calligraphy design: acanthus leaves, Calligraphy Pen blog - simple instructions for turning a slightly wiggly line into something rather lovely. And another method for Acanthus Drawing

General guidelines for drawing an acanthus leaf (PDF) from Mary May's woodcarver journey blog on 'acanthus leaf step by step' - this one is the multi-lobed straight leaf form.

Acanthus leaves
Twirling Ribbons and Twirling Acanthus Leaves
Painting acanthus leaves: Instruction from the Göttingen Model Book
Using freestyle acanthus leaves

art+works blog series
 How to draw an acanthus leaf - picture from V&A collection, not actually that instructive

See also this heraldic stone carving time-lapse video showing acanthus leaves being carved from portland stone for the Holywell music room in Oxford.

More acanthus examples

William Morris 'Acanthus' wallpaper, example from V&A collection

Acanthus A5 sketchbook, from William Morris gallery shop

Filigree, flourishing, mantling - a reference on Pinterest 

Wikipedia - Acanthus (ornament)

Image from page 122 of "The Decorator's assistant" (1847)

Image from page 70 of "The Decorator's assistant" (1847)

Image from page 226 of "The standard cyclopedia of horticulture; a discussion, for the amateur, and the professional and commercial grower, of the kinds, characteristics and methods of cultivation of the species of plants grown in the regions of the Unite

Image from page 309 of "Armorial families : a directory of gentlemen of coat-armour" (1905)

Acanthus leaves feature very heavily in heraldic mantling (the bit next to the crest which is above a coat of arms) though other similar-looking stylised leaves are also involved.

The intersection of live blood analysis, pH quackery, cancer cures, fraud and criminal convictions

I've just been reading one of Orac's recent blog posts on the fate of American naturopath Robert O Young (ROY), currently awaiting trial for more charges of fraud relating to medical quackery.

Bad news continues to accumulate for “pH Miracle Living” quack Robert O. Young (16 March 2016) Respectful Insolence blog

Orac mentioned he'd been aware of ROY for about nine years and I realise I've probably been aware of him for a few years less, but still a good long time. He first came to my attention while a science information officer at Diabetes UK as someone who was making claims to cure diabetes (and all sorts of other conditions) by advising people to follow his pH miracle diet plan. We got a few enquiries from people wondering if it was something they should try and, having never heard of it, I investigated. I couldn't quite believe that his stuff had been printed and advised anyone who asked to (a) get proper advice from a doctor or proper dietitan and (b) to save their money on Young's books and related supplements.

He is probably the main proponent of the idea that the acidity ('pH') of your blood is related to your health. That in itself is uncontroversial - your body regulates blood pH extremely tightly and you'd be spectacularly ill if it wasn't able to. But eating particular foods doesn't make any difference to your blood's pH, in the same way that eating sugar or drinking water (both contain oxygen) don't help you breathe any better.

Live blood analysis (LBA) / nutritional microscopy

I've pinched the text below from ROY's Wikipedia page and pruned out some of the links and references -
"Young bases some of his theories, research, and written works on the alternative medical approach of live blood analysis. Young teaches microscopy courses in which he trains people to perform live blood analysis as well as dry blood analysis. Young has stated that he teaches live blood analysis solely for research and educational purposes, and not for use in diagnosing medical conditions, which the San Diego Union-Tribune characterizes as "a legal distinction that some might find elusive in practice".

Live blood analysis is used by alternative medical practitioners, who claim it to be a valuable qualitative assessment of a person's state of health. Live blood analysis lacks scientific foundation, and has been described as a fraudulent means of convincing patients to buy dietary supplements and as a medically useless "money-making scheme". Live blood analysis has been described by the U.S. Department of Health and Human Services as an "unestablished laboratory test", or test that is not generally accepted in laboratory medicine."
He's apparently taught live blood analysis to a number of people who've since tried to practice it in the UK, hopefully with decreasing success.

Live blood analysis is utter nonsense but we've recently had some success with (a) convictions (particularly in the UK relating to the Cancer Act 1939) and (b) regulatory action from the Advertising Standards Authority and the Committee for Advertising Practice who produced a specific guidance document relating to the way it's advertised to consumers.

The best bit about that document is that it's not permitted for someone to advertise that live blood analysis or nutritional microscopy can DO anything, they can only mention that they offer it without saying what it's for (it's not for anything).

"...CAP is yet to see any evidence for the efficacy of live blood analysis as a diagnostic tool or treatment therapy and so without rigorous evidence to support it, it should be advertised on an availability-only platform."

This is a very good thing, but we've not wiped LBA from the UK, but one can dream.

Further reading (and listening)

1. The recent regulatory action 
Harley Street practitioner claimed he could cure cancer and HIV with lifestyle changes and herbs, court hears The Telegraph (11 December 2013)

'Cancer cure' alternative health practitioner appears in court Trading Standards Institute news (~December 2013)
• "Westminster Trading Standards has instigated legal proceedings against an alternative health practitioner who uses a room in London’s Harley Street, for making various claims contrary to the Cancer Act 1939. "

2. Audio clips on some of the ASA's adjudications
Blood tests BBC You and Yours (11 March 2013)
• The ASA upholds more complaints against a man offering ‘live’ blood tests.

Live Blood Tests BBC You and Yours (15 March 2012)
• "Why adverts for a test which lets you see your own 'live' blood cells on a computer screen have been criticised for failing to prove claims they have the potential to prevent illness or disease."

3. The ASA adjudications against claims made about live blood testing
• ASA (24 April 2013) ASA adjudication on Live Blood Test
• ASA (27 February 2013) ASA adjudication on Live Blood Test
• ASA (6 March 2013) ASA adjudication on Steps to Perfect Health
• ASA (16 January 2013) ASA adjudication on the Natural Health Clinic 
• ASA (2 November 2011) ASA adjudication on Fitalifestyle Ltd: Fitalifestyle Ltd
• ASA (19 October 2011) ASA adjudication on Optimum Health UK
• ASA (7 September 2011) ASA adjudication on MyCityDeal Ltd: MyCityDeal Ltd t/a GrouponUK
• ASA (1 June 2011) ASA adjudication on Fitalifestyle Ltd t/a
• ASA (13 October 2010) ASA adjudication on Live Blood Test

4. ASA Non-compliant online advertisers offering live blood analysis
ASA (12 March 2013) Live Blood Test - this person has since removed their misleading website claims and so has now been removed from the non-compliant list
ASA (15 February 2013) The Natural Health Clinic - this person has since complied too
ASA (26 June 2012) London Natural Therapies - this person has since complied too
ASA (15 November 2011) Fitalifestyle (claims about blood-cleaning properties of chlorophyll) - this person has since complied too

5. Background reading on live blood analysis as a bogus test
• Edzard Ernst (2005) A new era of scientific discovery? The Guardian
• Mark Crislip (2009) Live Blood Analysis: The modern auguries Science Based Medicine blog 
Wikipedia's article on Live blood analysis
• Thomas Patterson (2012) The Pseudoscience of Live Blood Cell Analysis Skeptical Inquirer
• Zachary Rubin (2009) Live Blood Analysis: New Diagnostic Method or Quackery? Case report and Review of the Literature UCLA Department of Medicine
Posts tagged with Live Blood Analysis on Josephine Jones' blog