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Posted by Jann Bellamy

George Washington dollar bill

The Federal Funding Accountability and Transparency Act (FFATA) was signed on September 26, 2006. The intent is to empower every American with the ability to hold the government accountable for each spending decision. The end result is to reduce wasteful spending in the government. The FFATA legislation requires information on federal awards (federal financial assistance and expenditures) be made available to the public via a single, searchable website, which is www.USASpending.gov.

And what subject is more deserving of being held accountable by the American people than complementary/alternative/integrative medicine?  After all, in what other area of government spending does scientific implausibility – indeed, even scientific impossibility – offer no impediment to spending millions of taxpayer dollars in research funds? We’ve complained about NCCAM’s wasteful spending on pseudomedicine here on SBM several times: here, here, here and here, among others, but, as you shall see, the problem doesn’t stop at that particular $2.5 billion.

I ask you: does NASA fund astrology research?  No. Does it give money to schools teaching astrology? No. Does the Department of Transportation fund studies of perpetual motion machines as an “alternative” engine for vehicles?  Not to my knowledge.  How about the Department of the Interior?  Do they give people money to look for woodland nymphs?  Don’t think so.

The beauty of www.USASpending.gov is that it allows us to hone in on exactly who the beneficiaries of this wasteful government largesse are and for what are they being compensated, over a period of 2001 to 2014. (Imperfectly, however.  The website is somewhat creaky and it’s not always clear how they are getting their totals. Also, I’m using amounts from a search of the “prime awards” only. Your results may differ.) That’s how I know the federal government has not spent a single penny on perpetual motion machines or locating woodland nymphs.  I did find one study of Art and Astrology in Renaissance Italy that got $40,000 from the National Endowment of the Humanities.  Of course, the 1300s – 1500s is exactly where astrology should be, along with acupuncture and other pre-scientific concepts.

Acupuncture

Acupuncture, on the other hand, has received more government funding than astrology.  Much, much more.  A whopping $76,848,958 since 2001, in the form of contracts, grants and direct payments.   Small Business Association loans accounted for an additional $250,000, including $80,000 to the Eternal Health Wellness Acupuncture Center in San Jose, California, which claims to treat a wide variety of diseases and conditions, such as MS, macro [sic] degeneration, bipolar disorder and herpes, among many others.

The biggest beneficiary of acupuncture research funds has been Massachusetts General Hospital, which received $23,229,593 from NIH between 2009 and 2014 (we are just shy of finishing the 2014 fiscal year).  Many of those research dollars went into brain imaging studies of patients being treated with acupuncture, or who were thinking about being treated with acupuncture (“An fMRI study of expectancy on acupuncture treatment outcomes in knee OA”).  As Steve Novella and David Coloquhoun pointed out, looking at surrogate outcomes is inappropriate until it is shown that patients get a useful degree of relief, and that hasn’t happened yet. (You can see some of the fruits of your tax dollars being used to stick people with needles and look at their brains  here.)

The Department of Defense and Veterans Administration are also big fans of acupuncture research.  Although they can’t match NCCAM, they’ve spent close to $8 million on such unpromising research projects as that conducted by the New England School of Acupuncture for “Effectiveness of Acupuncture in the Treatment of Gulf War Illness.” The school, recipient of a little over $5.5 million, promotes such appalling quackery as this:

Pediatrics in general and neurodevelopmental pediatrics in particular are perfect opportunities to apply the principles and practices of Chinese Medicine to help children manifest their destiny. In this two-day workshop, Stephen Cowan MD, developmental pediatrician and author of Fire Child Water Child will offer an in-depth discussion of the physiological unfoldings in child development and the treatment approaches to common developmental dysfunctions that include: attention deficit disorder, emotional dysregulation, learning disabilities and autism.

To add insult to injury, the school has a white coat ceremony for students.  Yet another honored medical tradition corrupted by “alternative medicine.”

The Department of Defense paid $750,000 to the Samueli Institute for “Acupuncture for the Treatment of Trauma-Induced Spectrum Disorder: A Three-Arm Randomized Pilot Study.” (The results of a Samueli sponsored study of acupuncture for PTSD touted before a Congressional Committee still have not been reported, as far as I can tell.)

The Samueli Institute is led by Wayne Jonas. M.D., and promotes “integrative medicine” and various “alternative” therapies, such as acupuncture and guided imagery, an issue I addressed before on SBM.  All in all, the Institute has received over $31 million in taxpayer funds from the Department of Defense and over $43 million in taxpayer dollars altogether since 2003, although none in 2014. 

Dr. Jonas recently wrote an opinion piece in JAMA Internal Medicine in which he expressed concern over opioid use for pain in the military and called for a “better way.”  And how might we discover this “better way?” More research on integrative medicine.  I think we can see where this is headed.

Perhaps just as disturbing as the actual studies are the monies spent in spreading acupuncture throughout the military.  Last year, the Henry M. Jackson Foundation for the Advancement of Military Medicine Research got over $3 million for acupuncture training “across clinical settings.”  Joseph M. Helms, MD, PC, (a proponent of medical acupuncture) has received $1.3 million,  much of it for education and curriculum development

Chiropractic

The government has spent almost $120 million on chiropractic, including $4.4 million on Small Business Administration loans to chiropractic practices.  There are also direct student loans but those show up as $0, a curious outcome considering the default rate on chiropractic student loans runs into the millions of dollars. (Again, it’s not clear how the government is reaching the totals given on the website.) The balance is in grants, contracts and direct payments.

One of the primary benefactors of government monies is Palmer Chiropractic College, which received $14 million from the NIH and the Department of HHS Health Resources and Services Administration, as well as the military. These monies have gone toward the establishment of, and research conducted by, the Palmer Research Center. We’ve mentioned the Center before, in its conduct of a study which didn’t seem to produce much of anything in the way of useful results. (See Orac’s dissection here.)  That didn’t stop another $7 million plus from going to the RAND Corporation, which will, with the help of the Research Center and the Samueli Institute, conduct an even larger study of standard medical care alone plus standard medical care and “chiropractic care.” One wonders why not just spinal manipulative therapy, not “chiropractic care.”  At least that would help isolate the variable that may produce an effect. Or why not medical care and physical therapy?

The study’s title reveals a curious mixture of subjects: “Assessment of Chiropractic Treatment for Low Back Pain, Military Readiness, and Smoking Cessation in Military Active Duty Personnel.”  Smoking cessation, by the way, will not be a part of standard medical care – only the chiropractors will get to do that.  Let’s just imagine what the results will be: patients who get the extra time and attention beyond standard medical care will do better and this study won’t tell us why, including whether it was simply the extra attention.

But the problems with giving Palmer College all this money go beyond the questionable utility of spending millions of dollars on this study.  Palmer is firmly rooted in the non-existent subluxation and its students are required to be proficient in its “detection” and “correction.” As befitting a school loyal to the subluxation, it teaches quack diagnostic and treatment methods like the NUCCA technique and the Atlas Orthogonal Technique.  And although the Palmer College website is suspiciously silent on immunizations, chiropractic opposition to vaccination is well-known and one doubts that students are taught objective, evidence-based guidelines for immunizations.

The Center has also participated in other sketchy government-funded research, the TACT trial.  This year, a study was conducted on “Effect of Lumbar Hypo & Hypermobility on Sensory Responses to Spinal Manipulation.”  Let’s decode this title.  Hypo/hypermobility of the vertebrae is of legitimate concern to manual therapists, but to some chiropractors this hypo/hypermobility is an indication of the presence of a “subluxation.”  In other words, it appears Palmer researchers are continuing to look for evidence that the elusive subluxation actually exists.

Why do I think this is a reasonable suspicion?  One, as discussed, Palmer College is loyal to the subluxation as a viable “theory” and teaches the concept to its students.  Two, although the page was removed after I mentioned it in a post last year, as of July, 2013, the Center said that one of its three areas of research was “mechanisms of care, which encompass normative data, spine lesions (e.g. vertebral subluxation complex) and spinal manipulation/adjustment.”

Contrast the school’s credulous acceptance of a pseudo-scientific concept with the Palmer Research Center director’s taking the American Heart Association/American Stroke Association “to task” over their warning that stroke “may be” associated with cervical manipulation.  Here’s what Christine Goertz, DC, PhD, had to say about that:

“The facts are that VADs are very, very rare events, and there’s absolutely no research that shows a cause-and-effect relationship between chiropractic care and stroke,” said Dr. Goertz. “Doctors need to be careful about how they counsel patients based on misleading statements, like this one from the American Heart Association.” 

(Note the euphemistic “chiropractic care” used as a substitute for neck manipulation.)

In sum, looking for evidence of the non-existent chiropractic “subluxation” is perfectly reasonable, but we need research “that shows a cause-and-effect relationship between chiropractic care and stroke” to conclude that stroke “may be” associated with cervical manipulation.

Naturopathy, etc.

Compared to acupuncture and chiropractic, naturopathy has received a paltry $6 million since 2003, and the amount has dwindled to a less than $400,000 this year.  The majority of that was spent at naturopathic schools to teach naturopaths how to do research and most of it went to the National College of Natural Medicine, with a small portion going to Bastyr.  Educating naturopaths in research seems like a fool’s errand, since the evidence indicates they care little about evidence-based practice.  (See also: here, here and here, among others.)

A small amount of naturopathic funding went to actual research, including “Carpal Tunnel Syndrome and Static Magnetic Field Therapy.”  There was also a small (n=40) prospective study of adjunctive naturopathic care for Type 2 diabetes, in which patients got up to 8 visits to a naturopath in addition to medical care, but any positive results could not be attributed to anything the naturopaths did.  (This seems to be a recurring theme in CAM practitioner research: giving CAM an advantage in comparing it to standard medical care by providing extras to the CAM care group.)

Homeopathy got about $230,000 in government funding (including a study titled “Polysomnography in Homeopathic Remedy Effects” at the University of Arizona) although no money’s been spent since 2008.  Reiki, on the other hand, has gotten almost a million dollars, including over $400,000 paid by the Department of Defense to a “Reiki Master” in El Paso, Texas.

Why are we doing this?

As has been pointed out before, the government should not be funding research of pseudomedicine and quackery because it doesn’t appear to affect CAM practices. Why bother? It is also a terrible waste of resources.  How many other worthy projects went wanting due to lack of available funding?

But the spending has another deleterious effect.  It perpetuates institutions that have little respect for science.  It helps businesses get started that promote quackery.  Even where their operations are not directly affected by government largesse, this money allows those institutions to burnish their images with the presumed respectability of, for example, NIH research funding. It also builds infrastructure and allows the hiring of staff. I doubt there would be a Palmer Research Center without government funding.  According to it’s 2011 tax return, over half of the Samueli Institute’s annual expenses of about $12.5 million came from the government.  Dr. Jonas’s salary from this and a related organization were reported at just over $500,000.

Gosh, what we wouldn’t give for a measly half a million dollars to promote science-based medicine?

oursin: My photograph of Praire Buoy sculpture, Meadowbrook Park, Urbana, overwritten with Urgent, Phallic Look (urgent phallic)
[personal profile] oursin

(It is round about 100 years* since my darling Dame Rebecca, then a fiery young thing, remarked that 'men are terribly poor stuff'.)

This week I had occasion to read some essays by a younger historian who works within the same general field that I do, one of which was a self-reflexive one about people's assumptions about why we do what we do, and the episode of the young man she met during a research trip who assumed that somebody who was spending her days reading Victorian pornography from the British Library Cupboard would surely be a right goer.

I don't even. If I'd spent the day reading Victsmut I would be more 'long hot bath please, followed by mug of Horlicks and something v soothing and non-sexual to read, how about Winnie the Pooh?'

Plus the simplistic connection between what people study and their personal interests.

I also came across the case of the tech developer person who felt it quite appropriate to send texts to female colleagues he had recently met in a professional context indicating that he would like to shag them.

Okay, there is probably an (?ageing) subset of men who believe that it is appropriate and even mannerly to indicate to a woman that they find her attractive and sexually desirable, this is a compliment! (I still want to scrub myself over the acknowledgement in a scholarly work where I had been of some assistance to the clueless researcher which referred to me as 'petite and charming': no, the words would actually be 'knowledgeable' and 'professionally competent'.)

And then after making the spurious plea that somebody had hacked his account, conceded, fauxpologised and made some comment about sending roses to the women in question.

Aaaaaaaaarrrrrgh. Point thahr SO misst. Recalled to me the story recounted somewhere by Katharine Whitehorn about a colleague who had been picked for an exciting and exotic work trip, and then, as the date approached, after she had made extensive preparations including necessary inoculations, was told, sorry, no, by her male boss and presented with a bouquet of flowers.

Flowers as a spontaneous gift are lovely. They do not, however, constitute a panacea for hurt, as KW pointed out. He would not have done this to a man. Women are not going to be distracted from causes of hurt by ooooh pretty blossoms.

*I am away from my copy of The Young Rebecca so am unable to be precise, but it would have been around 1914 or so.

QotD

Aug. 21st, 2014 05:24
dglenn: Me in kilt and poofy shirt, facing away, playing acoustic guitar behind head (Default)
[personal profile] dglenn

"The politics of respectability are, at their root, the politics of changing the subject -- the last resort for those who can not bear the agony of looking their country in the eye." -- Ta-Nehisi Coates, 2014-08-15 [thanks to @mackenzian for quoting this earlier]

[syndicated profile] zarhooie_tumblr_feed

perks-of-being-chinese:

iguanamouth:

birds are so ridiculous how do they even all exist???

image

fuckin

image

crazy ass

image

bobbleheaded

image

tiny motherfuckin

image

i dont even

image

things that dont make any sense

image

dragon faced

image

jesus christ is that a duck

image

some kind of prehistoric nonsense

image

holy shit where is your beak even birds, BIRDS

birds are so cool omg

beren_writes: Wittegen Press Logo (wittegen press)
[personal profile] beren_writes
Soph and I have used WordPress to rebuilt our website and so I thought I might put together the odd blog post about things I am discovering as I go. This is the first. The is a complete list of plugins and what steps we took to build the site over here (How We Built This Site (wittegenpress.com) With WordPress), but my other post will be more detailed.

For a very long time I thought WordPress was just a blogging platform because we used it once on a site we had running and that was all it was at the time. However, when Soph and I rebuilt our website (WittegenPress.com) we found out just how wrong we were.
Click to see the rest of the article )

The Blood is The Life 21-08-2014

Aug. 21st, 2014 10:00
miss_s_b: (Default)
[personal profile] miss_s_b

Daily posting more things

Aug. 21st, 2014 01:19
aris_tgd: Richard II looking in his mirror (Hollow Crown Richard with Mirror)
[personal profile] aris_tgd
Tomorrow we're moving the futon out and the couch in, and I'm going to be spending the entire day at work. I would have taken the day off, but we're already going to be short our 12-hour shift person, so I kind of need to be there. Frustrating.

I got a little writing on my porn done yesterday, but today I decided work breaks were for reading instead, since I don't have any idea how to get out of the conversation I started. More porn? More porn would be good, and yet. *shrugs* I have started making progress by telling myself that I'm not allowed to start my next project until I finish this one.

How do you tell when you go over the line from "id fic that other people would find fun to read" and "Now you're just wanking"? I worry that in my plotting for "story I want to write next" I've gone way over the line. I suppose I can just write it and find out.

I rewatched Gilda last night. Damn, that's a good movie. Also makes me want to write fic. Can't start any new projects until I finish this one, dammit! I can tell myself that it'll be short, but that's what I told myself about the current story, and that's... *checks* nearly 26k already! This was supposed to be short!

Oh, well. I guess the best thing about Frozen is that it got me writing again.

Let's see... I finally got Marvel Unlimited to work on my Nook, which is great; I've been reading old X-Men comics and trying to catch up to the current episode of Rachel and Miles X-Plain the X-Men. (Which I highly recommend.) I've been hampered by loading times, though. I read a bunch of the comics while I was procrastinating on my thesis, so it's not like I'm completely unfamiliar, but I'd like to read them again! It's been a while. Of books I'm currently reading, Ms. Marvel remains adorable, Captain Marvel remains badass, and Princess Ugg doesn't update near fast enough, but the first two issues are great.

I guess I can do the reading meme, since it's Wednesday... still, somewhere:

Currently reading: Full Fathom Five by Max Gladstone. I'm really enjoying it so far! I really liked his previous two books, and I really dig the magic as currency/exchange/economy thing he's got going on.

Just finished: Serpent's Reach, by C. J. Cherryh, which finishes off all the obvious books of hers to read--I have more, but I'm not sure if I want to dive right back into the Foreigner series or if I want to read all her other novels first.

Reading next: I actually got a hard copy of Alif the Unseen by G. Willow Wilson that I'd like to check out, but my track record of reading things not on my kindle isn't great. But I'd like to plan for that being my next book.

Due South; Fanart; G

Aug. 21st, 2014 04:27
love_jackianto1: (Default)
[personal profile] love_jackianto1 in [community profile] duesouth
Title: Dief and Doughnut (fanart)
Characters: Dief and Ray's Doughnut
Rating: G
Summary: a quick sketch of one of my favorite Dief scenes.

Dief
[syndicated profile] zarhooie_tumblr_feed


dangerhamster:

SCREEN JUNKIES DID AN HONEST TRAILER FOR THE WINTER SOLDIER BUT IT WAS SO GOOD THEY COULDN’T EVEN TAKE THE PISS OUT OF IT SO THEY JUST TALKED ABOUT WHAT A GOOD FILM IT WAS

Due South; Fancomic; G

Aug. 21st, 2014 04:07
love_jackianto1: (Default)
[personal profile] love_jackianto1 in [community profile] duesouth
Title: Frannie's Enemy (Fancomic)
Fandom/Characters: Due South. Frannie/Turnbull
Rating: G
Summary: Frannie has an enemy
Made for the Fan_flashworks prompt Enemies

Frannie

Sundiver

Aug. 21st, 2014 07:55
[syndicated profile] goodshowsir_feed

Posted by admin

AH god... here he goes again on his UFO talk...Click for full image

Dead Stuff With Big Teeth Comments: Christ…he’s not doing that party trick with the jam buns, is he?
Published 1995 (maybe)

(no subject)

Aug. 21st, 2014 10:44
hagar_972: "I believe in life after coffee" (Coffee)
[personal profile] hagar_972
* Yesterday when I went over to water [personal profile] antongarou's and [personal profile] ernads's plants I opted for the bus, because I was having exhaustion issues. On the way there it was no problem, but on the way back I had the option of cross to HaRoeh or walking back to Yerushalayim to get a bus stop. I opted for the latter, because the distance to HaRoe is not considerably shorter and because it would allow me to survey the playground at the corner of Yerushalayim.

So ~500m turned out to be almost more than I could handle, but the playground's awesome. It has a a padded area near one of the fences (extra tall, good for safety as I'd be using it as a grab bar) sufficiently far away from the kids' play area (unlike the playground on Katzenelson, where I didn't like the distances) and it also has an open-air gym and restrooms. 700m is walkable, and for bad days I have a line 67 stop right on top of it.

* Also yesterday [personal profile] lea_hazel and I did the Eden run for the party... and then hung out at [personal profile] lovechilde's until entirely too late.

* No commute today, since party tomorrow morning. I do, however, need to pack up my bags so that tomorrow I need to do absolutely nothing about that.
[syndicated profile] zarhooie_tumblr_feed

arrafrost:

littlejehan:

I bet Clint was on a mission.

I bet halfway through he called for his extraction and his handler didn’t answer.

I bet he was stranded for days behind enemy lines with no backup and no way of reaching Nat.

I bet he finally crawled his way to somewhere with some kind of electricity and stole enough money to call someone only to find out that number after number was no longer in service.

I bet he finally went through every number and caved and called Tony.

I bet Tony, in his own way, was relieved to hear he wasn’t dead in the remains of HQ and was cracking ‘showing up 15min late’ jokes.

I bet he personally rushes there in his private jet and finds Clint covered in bruises and cuts and with fractured bones and almost hysterical because no one is reachable and there’s always /someone/

Tony having to gently break it to Clint that things went fucking tits up and that Steve and tasha were ok but SHIELD was fucked and that was probably a good thing

Clint having to redefine himself for the second time in two years because things keep tearing everything he knows apart.

first of all how dare you

Guardians of the Galaxy thoughts

Aug. 21st, 2014 00:27
owlmoose: (hp - a few words)
[personal profile] owlmoose
We got around to seeing GotG this weekend. It was fun and I enjoyed it. Fortunately I had been warned about the casual sexism in advance, so it didn't punch me in the face quite as badly as it otherwise might have. I did, however, roll my eyes a lot. Other people have already said more or less what I think and have done it better, so I will refer you to them. I also felt the villains were underdeveloped -- Ronan is the worst MCU antagonist so far, even less compelling than the barely-there villain of Thor 2, and the others (Nebula, Thanos, the Collector) were barely more than cameos. (It occurs to me that this has been a problem throughout Phase 2 of the MCU -- of the films released so far, only CA:TWS had a fully-realized antagonist.) On the other hand, I liked the main team a lot, and I look forward to seeing more of them. Let's hope that they're saving the other antagonists for the next film, or possibly Avengers 3.

I do have to say that I'm pretty excited about the prospects for how this might tie in to the wider cinematic universe. Cut for Agents of SHIELD spoilers and speculation about other Marvel properties. )

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renaissance poisson

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