text:
Edzard Ernst
MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.
commercial interests
'Good clinical effects' of herbal remedies in paediatric patients?
Published Tuesday 21 January 2020
About 85% of German children are treated with herbal remedies. Yet, little is known about the effects of such interventions. A new study might tell us more.
This analysis accessed 2063 datasets from the paediatric population in the PhytoVIS data base, screening for information on indication, gender, treatment, co-medication and tolerability. The results suggest that the majority of patients was treated with herbal medicine for the following conditions:
common cold,
fever,
digestive complaints,
skin diseases,
anxiety.
The perceived effect of the therapy was rated in 84% of the patients as very good or good without adverse events.
The authors concluded that the results confirm the good clinical effects and safety of herbal medicinal products in this patient population and show that they are widely used in Germany.
If you are a fan of herbal medicine, you will be jubilant. If, on the other hand, you are a critical thinker or a responsible healthcare professional, you might wonder what this database is, why it was set up and how exactly these findings were produced. Here are some details:
The data were collected by means of a retrospective, anonymous, one-off survey consisting of 20 questions on the user's experience with herbal remedies. The questions included complaints/ disease, information on drug use, concomitant factors/diseases as well as basic patient data. Trained interviewers performed the interviews in pharmacies and doctor's offices. Data were collected in the Western Part of Germany between April 2014 and December 2016. The only inclusion criterion was the intake of herbal drugs in the last 8 weeks before the individual interview. The primary endpoint was the effect and tolerability of the products according to the user.
And who participated in this survey? If I understand it correctly, the survey is based on a convenience sample of parents using herbal remedies. This means that those parents who had a positive experience tended to volunteer, while those with a negative experience were absent or tended to refuse. (Thus the survey is not far from the scenario I often use where people in a hamburger restaurant are questioned whether they like hamburgers.)
So, there are two very obvious factors other than the effectiveness of herbal remedies determining the results:
selection bias,
lack of objective outcome measure.
This means that conclusions about the clinical effects of herbal remedies in paediatric patients are quite simply not possible on the basis of this survey. So, why do the authors nevertheless draw such conclusions (without a critical discussion of the limitations of their survey)?
Could it have something to do with the sponsor of the research?
The PhytoVIS study was funded by the Kooperation Phytopharmaka GbR Bonn, Germany.
Or could it have something to do with the affiliations of the paper's authors:
1 Institute of Pharmacy, University of Leipzig, Brüderstr. 34, 04103, Leipzig, Germny. nieberkaren@gmx.de.
2 Kooperation Phytopharmaka GbR, Plittersdorfer Str. 218, 573, Bonn, Germany. nieberkaren@gmx.de.
3 Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
4 ClinNovis GmbH, Genter Str. 7, 50672, Cologne, Germany.
5 Bayer Consumer Health, Research & Development, Phytomedicines Supply and Development Center, Steigerwald Arzneimittelwerk GmbH, Havelstr. 5, 64295, Darmstadt, Germany.
6 Kooperation Phytopharmaka GbR, Plittersdorfer Str. 218, 53173, Bonn, Germany.
7 Institute of Pharmaceutical Biology, Goethe University Frankfurt, Max-von-Laue-Str. 9, 60438, Frankfurt, Germany.
8 Chair of Naturopathy, University Medicine Rostock, Ernst-Heydemann Str. 6, 18057, Rostock, Germany.
Posted in alternative medicine, bias, bogus claims, causation, children, commercial interests, conflict of interest, critical thinking, herbal medicine, naturopathy, patient choice, pseudo-science, risk/benefit, scientific misconduct, study design, supplements, survey | 4 Comments
We all have misungerstood good old Gwyneth Paltrow. At heart, she is a true sceptic!
Published Monday 20 January 2020
Even the NEW SCIENTIST seems alarmed about Gwyneth and her activities:
Psychic readings, energy healing and vampire facials are just a few of the adventures had by actor and alternative health guru Gwyneth Paltrow and her team in her forthcoming Netflix series The Goop Lab. Goop, Paltrow's natural health company, has already become a byword for unrestrained woo, but the TV series takes things to the next level.
Don't make the mistake of thinking you can stick your fingers in your ears and pretend it isn't happening. There is unlikely to be any escape from The Goop Lab after it is released on 24 January, judging by the current explosion of interest in Goop's latest offering, a candle scented like Paltrow's vagina, which has reportedly sold out…
Yet, I am sure we got her all wrong!
Good old Gwennie is really one of us – she is a true sceptic!
Think about it; it's the only explanation.
When she first started dabbling in woo, she only wanted to test us. I'll just display a few cupping marks and see how they react, she thought.
Then she saw that most people were so gullible that they bought it. Of course, she thought, if they buy it, I might as well take their money. In her attempt to see how far she can push her boat out, she decided to conduct a sceptical experiment and went further and further. This is when she started to focus on her vagina – jade eggs, steaming it, etc. Surely, she thought, eventually they must realise that I am a sceptic taking the Mikey!
But they never did realise it; at least not so far.
So, she decided to do something even more brazen and sell candles to dispense the smell of her vagina in the homes of her fans. That will do it, she felt, now they will realise what I want to achieve with all this.
But what happened? They sold out in no time (actually, both the candles and the gullible public)! That was a surprise even to our Gwennie. She thought she had seen it all, but she was wrong.
Now she is trying to think of something even more outrageous – but she admits, it's not easy. What can be a more obvious and disgusting hoax than filling people' homes with the smell of my genitals and let them pay through their noses for the pleasure? she asks herself.
Yes, poor old Gwennie is at loss! Stuck in her own vagina, so to speak.
Perhaps you can help her? Please suggest what vaginal gimmick she might sell next to make her position inescapably clear to even the dumbest of the gullible. Just mention your ideas in the comment section below; I have a feeling she is an avid reader of this blog. Gwennie might even show herself generous; if she likes your innovation, she will certainly make it worth your while.
Because, by Jove, she can afford to be generous. Apparently her business is now worth a quarter of a billion US$. But we must not be envious. Knowing that she did all this merely to stimulate sceptical thinking in the general public, you will not be surprised to learn what she intends to do with all this dosh: once she has succeeded in demonstrating to all the gullible pin heads and devotees that she really is on the side of the angles, she will donate all of it to sceptic organisations across the globe.
So, sceptics of the world: stop snarling at my friend Gwennie, rejoice and prepare for a major windfall.
Posted in alternative medicine, bogus claims, charlatan, commercial interests, critical thinking, cupping, detox, patient choice, pseudo-science, quackery, satire, supplements | 4 Comments
The extraordinary popularity of homeopathy = an extraordinary lie
Published Saturday 18 January 2020
I am beginning to think that a devotion to homeopathy is conducive to telling porkies. When I read texts by homeopaths, I almost invariably discover untruths. Take this article on the popularity of homeopathy, for instance:
Worldwide, over 200 million people use homeopathy on a regular basis.1, 2
Homeopathy is included in the national health systems of a number of countries e.g. Brazil, Chile, India, Mexico, Pakistan, Switzerland.
India leads in terms of number of people using homeopathy, with 100 million people depending solely on homeopathy for their medical care.1
There are over 200,000 registered homeopathic doctors currently, with approximately 12,000 more being added every year.3
100 million EU citizens, some 29% of the EU's population, use homeopathic medicines in their day-to-day healthcare.2
Homeopathy is practised in 40 out of 42 European countries.4
10% of people in the UK use homeopathy – an estimated 6 million people.5
In Britain, the market for homeopathy is growing at around 20% per year. In 2007, it was estimated to be worth £38m, and is projected to reach £46m in 2012.6
There are ~ 400 doctors in the UK that use homeopathy, regulated by the Faculty of Homeopathy and promoted by the British Homeopathic Association.7
There are ~1,500 professional homeopaths (non-medically qualified homeopaths) in the UK,8 regulated by the Society of Homeopaths (65%), Alliance of Registered Homeopaths and Homeopathic Medical Association. They largely operate in private practice outside the NHS.
See NHS spending on homeopathy
According to the National Institutes of Health, over 6 million people in the United States use homeopathy, mainly for self-care of specific health conditions.
Of those who use homeopathy, ~1 million are children and over 5 million are adults.9, 10
Prasad R. Homoeopathy booming in India. Lancet, 2007; 370:1679-80 | Full Text
Homeopathic medicinal products. Commission report to the European Parliament and the Council on the application of Directives 92/73 and 92/74 | Full Text
Ghosh AK. A short history of the development of homeopathy in India. Homeopathy, 2010;99(2):130-6 | PubMed
Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review, World Health Organization, 2001 | Full Text
Professor Woods of the MHRA, response to Q211, House of Commons Science and Technology Committee hearing of evidence in preparation of Evidence Check 2: Homeopathy report (London: The Stationery Office Limited, 2010) | Full Text
Mintel, Complementary Medicines, April 2007 | Link
Faculty of Homeopathy | Link
Society of Homeopaths | Link
Black LI, et al. Use of Complementary Health Approaches Among Children Aged 4–17 Years in the United States: National Health Interview Survey, 2007–2012. National Health Statistics Reports, 2015; 78: February | Link
Clarke TC, et al. Trends in the Use of Complementary Health Approaches Among Adults: United States, 2002–2012. National Health Statistics Reports, 2015; 79: February | Link
Contrast this with the (as far as I know) only systematic review on the subject:
Aim: To systematically review surveys of 12-month prevalence of homeopathy use by the general population worldwide.
Methods: Studies were identified via database searches to October 2015. Study quality was assessed using a six-item tool. All estimates were in the context of a survey which also reported prevalence of any complementary and alternative medicine use.
Results: A total of 36 surveys were included. Of these, 67% met four of six quality criteria. Twelve-month prevalence of treatment by a homeopath was reported in 24 surveys of adults (median 1.5%, range 0.2-8.2%). Estimates for children were similar to those for adults. Rates in the USA, UK, Australia and Canada all ranged from 0.2% to 2.9% and remained stable over the years surveyed (1986-2012). Twelve-month prevalence of all use of homeopathy (purchase of over-the-counter homeopathic medicines and treatment by a homeopath) was reported in 10 surveys of adults (median 3.9%, range 0.7-9.8%) while a further 11 surveys which did not define the type of homeopathy use reported similar data. Rates in the USA and Australia ranged from 1.7% to 4.4% and remained stable over the years surveyed. The highest use was reported by a survey in Switzerland where homeopathy is covered by mandatory health insurance.
Conclusions: This review summarises 12-month prevalence of homeopathy use from surveys conducted in eleven countries (USA, UK, Australia, Israel, Canada, Switzerland, Norway, Germany, South Korea, Japan and Singapore). Each year a small but significant percentage of these general populations use homeopathy. This includes visits to homeopaths as well as purchase of over-the-counter homeopathic medicines.
Spot some discrepancies?
I wonder why the author (no name was provided) failed to cite the systematic review (it was published by pro-homeopathy researchers in a journal which they surely know – it's called 'Homeopathy'!). Perhaps because he/she writes for the 'Homeopathy Research Institute'. This organisation states that the HRI is an innovative international charity created to address the need for high quality scientific research in homeopathy. The charity was founded by physicist, Dr Alexander Tournier, who previously worked as an independent researcher for Cancer Research UK, conducting interdisciplinary research at the boundaries between mathematics, physics and biology.
The HRI also claims that the evidence suggests that homeopathy could provide solutions to many of the challenges facing us today – from overuse of antibiotics to spiraling healthcare budgets…
You see, now it all makes sense!
Posted in alternative medicine, commercial interests, critical thinking, evidence, gullible consumer, homeopathy, politics, progress, pseudo-science, quackery, satire | 7 Comments
Homeopathy has greater effects than placebo – BUT ONLY IF YOU CHEAT QUITE HEAVILY
Published Friday 17 January 2020
An enthusiast of homeopathy recently posted an overview of systematic reviews of homeopathy concluding that the data we do have point towards homeopathy as having an effect greater than that of placebo:
In recent decades, homeopathy has been examined via a number of clinical trials, the number of which now allow meta-analysis. As we can see from the study findings, the type of homeopathy research (ie, individualized vs non-individualized, placebo-controlled vs non-placebo-controlled) can have a strong influence on the results, although trial quality also has a strong effect.
All meta-analyses performed in at least a somewhat open and rigorous manner have found statistically significant effects. This suggests that homeopathy has a greater-than-placebo effect, or at least a strong trend in that direction, when using data from the totality of homeopathy research, or from individualized, placebo-controlled trials. The meta-analyses with questionable methodology, one of which is undergoing government investigation for academic irregularities, have produced negative results, which have been demonstrated to be a direct result of their exclusion of vast swathes of the homeopathic clinical trial literature (based on arbitrary and unexplained criteria), as well as of their failure to differentiate – as Mathie has done – different types of homeopathic research.
The clinical data are flawed. Issues with methodology used in homeopathy RCTs, combined with a lack of research funding, have produced a lack of high-quality trials and data. However, the data we do have point towards homeopathy as having an effect greater than that of placebo.
There can be no argument with this conclusion, aside from possible new data emerging. Anyone who disputes this is going against the existing set of the highest-quality evidence on homeopathy.
His overview is based on the following publications:
Kleijnen, 19911 All types of homeopathy (eg, single remedy vs combination). Methodological quality assessed; 105 trials. Results: Positive trend, regardless of type of homeopathy; 81 trials were positive, 24 showed no effect.
Linde, 19972 All types of homeopathy. Out of 185 trials, 119 met inclusion criteria; 89 of these had extractable data. Results: OR = 2.45 (95% CI 2.05-2.93).
Ernst, 19983 Individualized homeopathy; 5 trials determined to be high-quality. Results: OR = 0.
Linde, 19985 Individualized homeopathy; 32 trials, 19 of which had extractable data. Results: OR = 1.62 for all trials (95% CI 1.17-2.23). Only high-quality trials produced no significant trend.
Cucherat, 20009 All types of homeopathy; 118 trials, 16 of which met inclusion criteria. Used unusual method of combining p values. Results: All trials = p< 0.000036. Less than 10% dropouts: p<0.084; less than 5% dropouts (higher standards than most trials considered reliable): p<0.08 (non-significant).
Shang, 200511 All types of homeopathy; only 8 trials selected from 21 high-quality trials of 110 selected with unusual criteria. Results: OR = 0.88 (0.65-1.19). Result strongly disputed by statisticians.
Mathie, 201413 Individualized homeopathy; of the analysis pooled data from 22 higher-quality, individualized, double-blind RCTs. Results: OR = 1.53 (1.22-1.91) for all trials pooled; OR = 1.93 (1.16-3.38) for the 3 reliable trials.
NHMRC, 201516 Out of 176 studies, 171 were excluded, leaving only 5 for the study. Investigators used unprecedented methods, did not combine data, and are currently under investigation for outcome shopping. Results: Negative results.
Mathie, 201720 Non-individualized homeopathy; very few higher-quality trials. Results: For 54 trials with extractable data, SMD = -0.33 (-0.44, -0.21). When these were adjusted for publication bias, SMD = -0.16 (-0.46,-0.09). The 3 high-quality trials had non-significant results: SMD = -0.18 (-0.46, +0.09).
Mathie, 201821 Individualized, other-than-placebo-controlled trials; 11 trials found, 8 with extractable data. Results: 4 heterogeneous comparative trials showed a non-significant difference. One trial in this group was positive. Three heterogeneous trials with additive homeopathy showed a statistically significant SMD. No definitive conclusion possible due to trial heterogeneity, poor quality, and low number of trials.
Mathie, 201922 Non-individualized, other-than-placebo-controlled trials; 17 RCTs found, 14 with high risk of bias. Results: Significant heterogeneity prevented much comparison; 3 comparable trials showed a non-significant SMD.
Apart from getting the wrong end of the stick when interpreting the results of these papers (see for instance here, and here), there are other rather embarrassing flaws in this overview:
Many older systematic reviews were omitted (including about 10 of my own papers). This is relevant because the author of the above review went beck until 1991 to find the reviews he included.
Several new papers were missing as well. This is relevant because the author evidently included reviews up to 2019. Here are the key passages from the conclusions of some of them:
… homoeopathy as a whole may be considered as a placebo treatment.
We tested whether p-curve accurately rejects the evidential value of significant results obtained in placebo-controlled clinical trials of homeopathic ultramolecular dilutions. Our results suggest that p-curve can accurately detect when sets of statistically significant results lack evidential value.
We found no evidence to support the efficacy of homeopathic medicinal products
… no firm conclusions regarding the effectiveness and safety of homeopathy for the treatment of IBS can be drawn.
Due to both qualitative and quantitative inadequacies, proofs supporting individualized homeopathy remained inconclusive.
… the use of homeopathy currently cannot claim to have sufficient prognostic validity where efficacy is concerned.
I am, of course, not saying that this overview amounts to anything like a systematic review. It merely gives you a flavour how trustworthy proponents of homeopathy are when they pretend to provide us with an objective evaluation of the best available evidence.
Posted in alternative medicine, bias, bogus claims, commercial interests, critical thinking, evidence, homeopathy, meta-analysis, pseudo-science, scientific misconduct, systematic review | 1 Comment
Homeopathy: it's time to stop the double standards
'HOMEOPATHY360' are fiercely decided to defend homeopathy, no matter what. They state that we promise to stand by your side always to fight against the critical attacks on Homeopathy… Therefore, I was not really surprised when, a couple of days ago, I received an email by them urging me to support US homeopaths against the threat by the FDA. Here is part of this correspondence:
… If you want to know more about the FDA's proposed new rules for homeopathic medicines, here's a summary of the most important points:
The new rules, if adopted, will allow the FDA to withdraw even properly manufactured and labeled homeopathic medicines from the marketplace. This is puzzling because these have never posed any sort of safety concern according to an initial review of public FDA records by Americans for Homeopathy Choice.
It is clear that the FDA intends to use this authority and has even mentioned specific medicines such as Belladonna, Nux vomica and Lachesis muta in its public statements regarding enforcement.
The authority for this kind of assault on homeopathy will result from the declaration by the FDA that all homeopathic medicines are "new drugs." We all know this is nonsense. Homeopathic medicines have been around for 200 years.
But this nonsense declaration means that under U.S. law all homeopathic remedies will become technically "illegal" and subject to withdrawal from the marketplace. If the FDA just thinks there is a problem with a homeopathic medicine, it can withdraw it forever without conducting any sort of investigation.
Since the agency has already said that it thinks that Belladonna, Nux vomica, Lachesis muta and several other remedies are dangerous, we can anticipate that it will try to remove them from the marketplace as soon as its new rules are adopted.
But, it won't be possible for Americans to get remedies that are banned sent to them from abroad. The FDA will simply stop these remedies at the border.
I could tell you more, but what I've told you so far should convince you that we ought to help the American homeopathy community defeat these unreasonable and misinformed rules. The rules simply do not reflect the realities of homeopathic medicines, namely, that they are nontoxic, mild, effective and have few, if any, side-effects. And, homeopaths use them in ways that individualize treatment. That this is the best way to treat patients was discovered by Samuel Hahnemann 200 years ago.
The enemies of homeopathy are everywhere and they appear to be stepping up their attacks. That's why the world homeopathy community must work together to stand up to them…
I have reported about the FDA initiatives on homeopathy before. In 2015, they started it with a public hearing. Since then, the FDA also issued several warnings to manufacturers who were putting consumers at risk (see, for instance, here, here, and here).
What the FDA seem to be trying to do is nothing else but meeting their ethical, moral and legal responsibility vis a vis consumer safety. Homeopathy has had a free ride for far too long. It is high time that this sector joins the 21st century.
The above quote, with its bonanza of bogus claims and falsehoods, shows the urgency of this task. The defenders of homeopathy seem to live on a different planet where rationality, facts and evidence can easily be over-ruled by creed, dogma and wishful thinking. If homeopaths want their trade to join the realm of real medicine they need, at the very minimum, to show with sound evidence:
that their remedies generate more good than harm,
that they adhere to acceptable quality standards.
Failing this – and so far, homeopaths not only failed at this task but continue bombarding us with an incessant flow of bogus and dangerous claims – homeopathics cannot be considered to be medicines, and homeopaths cannot be called responsible healthcare professionals. It is high time to stop turning a blind eye to the double standards that have been applied for 200 years.
Posted in alternative medicine, alternative therapist, bogus claims, charlatan, commercial interests, critical thinking, EBM, evidence, fallacy, homeopathy, medical ethics, progress, pseudo-science, quackery, risk/benefit | 28 Comments
The 'bionutrient meter' – is someone having us on?
Yesterday morning, I was listening to the Today Programme on BBC 4 when a man called Matt Adams was given airtime to explain and promote his 'bionutrient reader'. What he said sounded like pure quackery – but this is quackery outside my area of expertise. Therefore, I looked it up; here is what the website tells us (apart from the fact that, for ~ US$ 400, you can buy the device):
The bionutrient meter is actually, in many ways, a shockingly simple device. It has lights (LEDs – light emitting diodes) that emit light at very specific wavelengths (fancy sciency word for colors), which then bounce off objects (like carrots, or carrot pulp, or spinach, or soil), while some of it is absorbed (turned into other forms of energy like heat) by the object, and then a light sensor in the device reads how much light bounces back (for each wavelength, multiple times, very quickly).
Why this matters (light bouncing off) is because this is actually a characteristic of objects that is directly correlated to the chemical compounds that the object is made of. So in the case of food, there are known correlations between light reflectance, at specific wavelengths, and the amount of different nutrients found in that food (vitamins, antioxidants, and aromatic compounds [things that smell, and also usually contribute to taste and health-giving attributes of food], to name a few). What makes this extra complicated though, is that these light-bouncing characteristics and compounds "overlap" with each other – so we need to look at lots of data to try to parse out what is causing the response we're seeing.
To me, this does look suspiciously close to quackery to me.
Posted in antioxidants, bogus claims, commercial interests, pseudo-science, vitamin | Tagged nutrition | 20 Comments
Now that you have paid through your nose for the 'tox', how about a 'detox' through your nose?
Published Thursday 02 January 2020
If you, like many of us, have heavily 'toxed', you might now consider 'detoxing'. What I mean is that we have probably all over-indulged a bit over the holidays. Unless you were the guest of someone, you had to pay dearly for it (Champagne is not cheap!). And now, a whole industry of 'detox' entrepreneurs tells you to pay again – this time, for detox.
As you payed 'through your nose' for the 'tox', you might as well use the same orifice for the 'detox'. An Indian tradition called Nasiyam (or Nasyam? or Nasya? – I am confused!) makes it possible. This website explains:
Nasal Instillation (Nasyam) is the practice of instilling medicated oils, fresh juices of leaves or flowers in the nostrils … Nasyam is specially directed towards the purification of various parts related to the head…
I don't know about you, but I always felt that all my parts were related to my head! So, Nasyam is for purification of all my parts? The announcement below – I picked it up on Twitter – is much clearer: detox through the nasal doorway! Who would refuse such an offer after the festivities of late?
This sounds fascinating, I thought. Thus I ran a quick Medline search but only found this abstract:
Ardita (facial paralysis) is a medical condition that disfigures or distorts the facial appearance of the sufferer causing facial asymmetry and malfunction. Ardita patients may benefit from considering alternative treatments such as Ayurveda, including Taila Nasya (nasal instillation of medicated oil).
To synthesize the best available evidence on the effectiveness of different Nasya oils in the treatment of Ardita.
INCLUSION CRITERIA TYPES OF PARTICIPANTS:
Studies conducted on adult sufferers (18-70 years) of Ardita (chronic or acute) in any setting were considered. Studies including participants who were pregnant or suffered allergic rhinitis, fever, intracranial tumor/hemorrhage and bilateral facial palsy were excluded.
INTERVENTION(S)/COMPARATOR(S):
Standalone treatment of Nasya (at all dosages and frequencies) compared to Nasya in combination with other Ayurvedic treatments was considered. Comparisons between different interventions including Taila Nasya alone, Taila Nasya in combination with other Ayurvedic interventions and Ayurvedic interventions that did not include Taila Nasya were also considered.
OUTCOMES AND MEASURES:
Changes in Ardita symptoms, including facial distortion, speech disorders and facial pain, were measured.
TYPES OF STUDIES:
All quantitative study designs (experimental, quasi-experimental and observational) were considered.
SEARCH STRATEGY:
Relevant studies were identified following a comprehensive literature search. References provided within these key studies identified additional resources. Indian universities were also contacted for results of Ardita studies undertaken in their institutions.A three-step search strategy aimed to find studies of published and unpublished studies was undertaken. Studies published in the English language were considered for inclusion, irrespective of publication date/year. Following an initial limited search of MEDLINE and CINAHL, the text words contained in the title and abstract, and of the index terms used to describe each articles were analyzed. From the identified keywords and index terms, searches were undertaken across all relevant databases such as PubMed, CINHAL, Cochrane (CENTRAL), Scopus, Centre for Review and Dissemination databases, Turning Research into Practice (TRIP), EMBASE, EBM Reviews, DHARA, Google Scholar, MedNar and ProQuest Dissertations. Finally, reference lists of identified theses and articles were searched for additional studies. Universities and website operators related to Ayurvedic research in India were contacted, including the National Institute of Ayurveda for relevant studies. Besides this, the University of Adelaide librarian was contacted to retrieve those studies identified in the reference lists of theses and articles.
METHODOLOGICAL QUALITY:
Studies were critically assessed by the review author and a secondary reviewer prior to inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute.
DATA EXTRACTION:
Data was extracted by the primary reviewer using the standardized data extraction tool from the Joanna Briggs Institute.
DATA SYNTHESIS:
Different interventions and comparators across studies precluded meta-analysis. Narrative synthesis was performed.
Only two pseudo randomized studies with a small number of participants met inclusion criteria and were included in the review. One study with 20 participants, divided equally into two groups compared the effectiveness of two nasal instillations in alleviating four Ardita symptoms. The second study of 15 participants each in two groups compared the effectiveness of nasal instillation with placement of medicated oil on the head on seven Ardita symptoms. Observational measurements of Ardita symptoms were graded as Mild, Moderate or Marked at baseline and after one month. The study conducted on 30 participants using Nasya intervention showed participants had better relief from the symptoms of facial pain, speech disorder and earache within the range of 78.2% to 90.9%, graded as Marked. Along with statistical data available in the studies, this review found low levels of evidence favoring Taila Nasya intervention. The review did not include any studies examining effectiveness of Nasya compared to conventional treatment for Ardita.
This review presents extremely limited evidence from only two small experimental studies that administration of Nasya oil alone may provide some relief from Ardita symptoms of facial distortion, speech disorder, inability to shut eyelids/upward eye rolling and dribbling of saliva in adult patients. No strong conclusions may be drawn from the evidence included in the review due to the limited number of studies, limited number of participants and poor quality of studies.
IMPLICATIONS FOR PRACTICE:
Practitioners should advice Ardita patients that there is extremely limited evidence suggesting the potential effectiveness of Nasya oils alone or Nasya in conjunction with other Ayurvedic treatments in managing symptoms. However, given the absence of a strong evidence base, practitioners should be guided by clinical wisdom and patient preference.
IMPLICATIONS FOR RESEARCH:
Well controlled clinical trials comparing standalone Nasya therapy to other Ayurvedic treatments and/or conventional medicine for Ardita symptoms need to be conducted to examine the relative effectiveness of different Nasya oils in treating.
I think you agree, that's nothing to write home about.
So, on second thought I might give Nasya (or whatever it is called) a miss. The same applies, by the way, to any other form of detox.
Posted in alternative medicine, Ayurvedic medicine, bogus claims, charlatan, commercial interests, critical thinking, detox, diet, evidence, gullible consumer, herbal medicine, prevention, pseudo-science, quackery, satire | 3 Comments
Surprise, surprise! Chiropractors recommend chiropractic management of neck pain
Published Thursday 26 December 2019
The current Cochrane review of clinical trials testing the effectiveness of manipulation/mobilisation for neck pain concluded as follows:
Although support can be found for use of thoracic manipulation versus control for neck pain, function and QoL, results for cervical manipulation and mobilisation versus control are few and diverse. Publication bias cannot be ruled out. Research designed to protect against various biases is needed. Findings suggest that manipulation and mobilisation present similar results for every outcome at immediate/short/intermediate-term follow-up. Multiple cervical manipulation sessions may provide better pain relief and functional improvement than certain medications at immediate/intermediate/long-term follow-up. Since the risk of rare but serious adverse events for manipulation exists, further high-quality research focusing on mobilisation and comparing mobilisation or manipulation versus other treatment options is needed to guide clinicians in their optimal treatment choices.
Such a critical assessment must be tough for chiropractors who gain a substantial part of their income from treating such patients. What is the solution? Simple, convene a panel of chiros and issue recommendations that are more prone to stimulate their cash flow!
Exactly that seems to have just happened.
The purpose of the researchers was to develop best-practice recommendations for chiropractic management of adults with neck pain.
A steering committee of experts in chiropractic practice, education, and research drafted a set of recommendations based on the most current relevant clinical practice guidelines. Additional supportive literature was identified through targeted searches conducted by a health sciences librarian. A national panel of chiropractors representing expertise in practice, research, and teaching rated the recommendations using a modified Delphi process. The consensus process was conducted from August to November 2018. Fifty-six panelists rated the 50 statements and concepts and reached consensus on all statements within 3 rounds.
The statements and concepts covered aspects of the clinical encounter, ranging from informed consent through diagnosis, assessment, treatment planning and implementation, and concurrent management and referral for patients presenting with neck pain.
The authors concluded that these best-practice recommendations for chiropractic management of adults with neck pain are based on the best available scientific evidence. For uncomplicated neck pain, including neck pain with headache or radicular symptoms, chiropractic manipulation and multimodal care are recommended.
Let's be clear what this amounts to: a panel of highly selected chiropractors (sponsored by a chiropractic organisation) has reached a consensus (and published it in a chiropractic) which allows them to continue to treat patients with neck pain.
Isn't that just great?
Now let's think ahead – what next?
I suggest the following:
A panel of homeopaths recommending homeopathy.
A panel of faith healers recommending faith healing.
A panel of crystal healers recommending crystal healing.
A panel of colon therapists recommending colonic irrigation.
A panel of supplement manufacturers recommending to buy supplements.
I am sure you get the gist.
Posted in alternative medicine, alternative therapist, bias, charlatan, chiropractic, commercial interests, critical thinking, neck-pain, pain, pseudo-science, quackery, risk/benefit, satire, spinal manipulation, symptom-relief, systematic review | 5 Comments
French homeopaths seek disciplinary action against doctors for speaking out against homeopathy
Published Monday 23 December 2019
Guest post by Richard Rasker
Almost two years ago, in March 2018, a group of 124 doctors and other medical professionals published an article in the French newspaper 'Le Figaro', warning the general public for the false promises, unproven claims and dangers of alternative medicine.
Homeopathy in particular is denounced as an unscientific belief in magic, utterly lacking in plausibility as well as in evidence of efficacy for any condition. Subjecting people to these kinds of unproven treatments is unethical, and may result in serious harm by delaying proper medical treatment. Also, homeopaths and other alternative practitioners often express anti-vaccine sentiments, endangering children by dissuading their parents from vaccination.
For these and several other reasons, these 124 medical professionals made an appeal for alternative and esoteric treatments to be excluded from the field of science-based medicine, and to stop reimbursement of homeopathic and other alternative treatments under France's national health care insurance system.
In a somewhat belated response, French homeopaths are now filing no less than 63 disciplinary complaints with the French Medical Council against the signatories of the appeal in Le Figaro, apparently for "uncollegial behaviour" and "defiling medical ethics". The homeopaths are represented by homeopathic doctor Daniel Scimeca, president of the French Federation of Homeopathic Societies, who also has close relations with Boiron laboratories, the biggest manufacturer of homeopathic products in the world.
At the time of this writing, 11 complaints have been adjudicated, resulting in 7 warnings, and 4 releases or dismissals. It is unclear how serious such a 'warning' should be taken, but it is clear that homeopaths are trying to punish real doctors for supporting and expressing an overwhelming scientific consensus, i.e. that there is no evidence whatsoever that homeopathy is actually good for anything.
And even though these French homeopaths do not resort to the sort of vile, underhanded media smear campaign perpetrated by the late Claus Fritzsche against Dr. Ernst, there are certain parallels – the most important of which is that proponents of unproven 'medicine' attempt to silence science-based criticism by unscientific means, instead of open discourse about the merits (or more precisely: the lack thereof) of their chosen profession.
I personally find it rather worrying that almost two-thirds of the complaints resulted in a slap on the wrist for the medical professional involved. Especially in a field that is so strongly dependent on both science and trust, well-founded criticism should be encouraged and made public, not punished and silenced.
Posted in alternative therapist, bias, big pharma, bogus claims, charlatan, commercial interests, conflict of interest, critical thinking, doctors, legal action, medical ethics, quackery, regulation | 45 Comments
The anti-vaccination movement is financed by the dietary supplement industry
Published Saturday 21 December 2019
At the heart of this story is Joseph Mercola, a dietary supplement entrepreneur and osteopath.
His website states that:
EVERYONE can benefit from Dr Mercola's unparalleled knowledge. For expertise in alternative healthcare and high quality supplemental medicine, it's hard to beat visionary Dr Joseph Mercola. The Chicago-based health wizard has his own website, Mercola.com ('Take Control of Your Health'), but you can find so many of his health support products right here at Evolution Organics. Our customers swear by them. They love the diversity of the range, and that the products are priced affordably, meaning that everyone can benefit from Dr Mercola's vast experience and unmatched know-how. And it's not just men, women and children who can feel better 'the Dr Mercola way' – his brand includes health support products for pets, too.
However, an article in the Washington Post tells a different story; allow me to quote a few excerpts:
The Northern Virginia-based National Vaccine Information Center lists Mercola.com as a partner on its homepage and links to the website, where readers can learn about and purchase Mercola's merchandise. Last month, Mercola wrote on his website that measles "continues to be a Trojan Horse for increasing vaccine mandates." A page that was recently removed said that "vitamin C supplementation is a viable option for measles prevention." Elsewhere on the site, a page about vitamin D includes the headline, "Avoid Flu Shots With the One Vitamin that Will Stop Flu in Its Tracks."
Mercola … has also given at least $4 million to several groups that echo the anti-vaccine message… Mercola … offers "simple, inexpensive and safe alternatives to the conventional medical system, which is contributing to the premature death of millions and is causing needless pain and suffering in great part because multinational corporations want to increase their revenues." … Supplements containing those vitamins are among Mercola's "top products," his website says… Earlier this month, Samoan anti-vaccine activist Edwin Tamasese, who touted vitamins as an alternative to vaccination, was arrested for allegedly claiming on social media that measles vaccinations would result in mass deaths…
The National Vaccine Information Center was founded in 1982 by Barbara Loe Fisher, who has said that her son was injured by a vaccine. The group claimed credit this year for helping to defeat legislation in a dozen states that would have made it harder for parents to opt out of vaccinating their children. At the beginning of last year's flu season, Fisher and Mercola appeared in a YouTube video urging people to be skeptical about flu shots. Mercola claimed that vaccines have been associated with "deaths and permanent neurological complications," and he said vitamin D supplements were among "far more effective, less expensive and less risky alternatives." … Fisher said in an interview that Mercola has asked for nothing in exchange for his donations and that the National Vaccine Information Center does not sell or advertise Mercola's products on its site. "I do not take funding for a quid pro quo," she said. "When [Mercola] called me, he said, 'I admire your work. I'd like to help you.' " The center's homepage, which the group says was visited more than 1.2 million times last year, displays Mercola.com's logo. An affiliated website run by Fisher's group refers numerous times to Mercola.com as one of the most popular health and wellness websites…
In recent years, the center has been at the forefront of a movement that has led some parents to forgo or delay immunizing their children against vaccine-preventable diseases such as measles… The Northern Virginia-based National Vaccine Information Center lists Mercola.com as a partner on its homepage and links to the website, where readers can learn about and purchase Mercola's merchandise…Asked if his companies benefit from his donations to the anti-vaccine group, Mercola said in an email that "being an adversary to powerful industries is not a positive for a business like mine." …
The FDA has taken no enforcement action against Mercola over his vaccine claims. The agency said in a statement that it has no role in approving dietary supplements or in evaluating claims about them — unless those products are purported to treat, diagnose, prevent or cure diseases and are reported to the agency as unapproved drugs. Agency officials did not answer questions about Mercola's claims regarding vitamins C and D…
The resurgent movement found a handful of wealthy patrons, including hedge fund manager and philanthropist Bernard Selz and his wife, Lisa. The Selzes gave $200,000 to a legal fund for Wakefield in 2012, and they went on to give more than $3 million to anti-vaccine groups, including one that held forums this year in Brooklyn, the epicenter of the measles outbreak…
The $2.98 million Mercola has given to Fisher's group since 2009 came from the Natural Health Research Foundation, a private foundation that is entirely funded by his business and that he leads as president, tax records show. The foundation has also given more than $3.3 million to the Organic Consumers Association, a health and environmental advocacy group, tax records show. On its website, the organization advertises Mercola's products and reposts some of his content about vaccines and other topics, as well as articles by prominent anti-vaccine activist Robert F. Kennedy Jr. …
While Fisher emphasized that she does not promote any retailers' products, she told potential sponsors of an anti-vaccine conference her group held in 2009 that the event could help them gain "access to both national and international markets" and "increase sales and visibility," promotional material shows. Mercola attended the conference and received an "NVIC visionary award." Mercola did not respond to questions about whether he was a sponsor. He donated $20,000 that year to the National Vaccine Information Center through his foundation. Without elaborating, Fisher said the money "was not an earmarked donation." The following year, Fisher's group and Mercola.com launched a website that tracks vaccine-related legislation in every state. The site provides activists with detailed information, including how to sign up for public comment to support or oppose legislation in their state, where to park to attend a public hearing and what color T-shirt to wear to rallies.
In 2011, Mercola co-sponsored a 15-second video ad on a Jumbotron in Times Square. The ad featured an image of a woman holding a baby with the message "Vaccines: Know the Risks." Logos of both the National Vaccine Information Center and Mercola.com were prominently displayed…
In addition to the large contributions from Mercola, Fisher's group has received financial support from Focus for Health. That foundation, funded by wealthy New Jersey businessman Barry Segal, gave Fisher's group more than $400,000 from 2011 to 2017, according to tax records.
In September of this year, as flu season approached, Mercola and the National Vaccine Information Center co-sponsored their 10th annual "vaccine awareness week." Mercola offered to match all donations made to the center that week up to $100,000, according to a video posted to his YouTube channel. In a video posted the following day, Fisher described her group's recent successes in state legislatures across the country. Those states include Colorado, Minnesota, Oregon and Texas, Fisher said. "I look forward to another 30 years of working with you," she told Mercola.
On this blog, I have repeatedly warned that many so-called alternative medicine (SCAM) practitioners recommend against vaccinations. Specifically implicated are:
Physicians practising integrative medicine
Doctors of anthroposophical medicine
We knew about the 'ideology' and the misinformation pushing SCAM-related anti-vaccination sentiments. The article in the Washington Post is a stark reminder of the financial interests behind all this. As a result, SCAM-use is associated with low vaccination-uptake (as we have discussed ad nauseam – see for instance here, here, here and here). Anyone who needs more information will find it by searching this blog. Anyone claiming that this is all my exaggeration might look at papers which have nothing to do with me (there are plenty more for those who are willing to conduct a Medline search):
Lehrke P, Nuebling M, Hofmann F, Stoessel U. Attitudes of homeopathic physicians towards vaccination. Vaccine. 2001;19:4859–4864. doi: 10.1016/S0264-410X(01)00180-3. [PubMed]
Halper J, Berger LR. Naturopaths and childhood immunizations: Heterodoxy among the unorthodox. Pediatrics. 1981;68:407–410. [PubMed]
Colley F, Haas M. Attitudes on immunization: A survey of American chiropractors. Journal of Manipulative and Physiological Therapeutics. 1994;17:584–590. [PubMed]
Posted in alternative medicine, alternative therapist, anthroposophical medicine, bias, bogus claims, charlatan, chiropractic, commercial interests, conflict of interest, critical thinking, doctors, fraud, gullible consumer, homeopathy, immunisation, integrative medicine, malpractice, medical ethics, neglect, osteopathy, politics, prevention, risk, risk/benefit, vaccination, vitamin | 10 Comments
Chiropractic spinal manipulation for a newborn
'Homeopathic treatment … synergise the effect of antibiotics' – Really? Or is this a case of scientific misconduct or even fraud?
Yes, conventional medicine is often deplorably bad
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David P on 'Good clinical effects' of herbal remedies in paediatric patients?
Stephen Hicks on 'Good clinical effects' of herbal remedies in paediatric patients?
Michael Kenny on The extraordinary popularity of homeopathy = an extraordinary lie
Lenny on The extraordinary popularity of homeopathy = an extraordinary lie
Mike Grant on Live blood analysis, another SCAM to avoid
Ron Jette on 'Good clinical effects' of herbal remedies in paediatric patients?
Roger on The extraordinary popularity of homeopathy = an extraordinary lie
Björn Geir on We all have misungerstood good old Gwyneth Paltrow. At heart, she is a true sceptic!
Roger on 'Good clinical effects' of herbal remedies in paediatric patients?
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19 Mar Univers was designed by Adrian Frutiger on Swiss principles for Charles that was possible in the foundry type and photocomposition fonts. Univers Cyrillic 55 Roman font by Linotype, from $ Univers Cyrillic Complete Family Pack Font: Licensing Options and Technical Information.
Buy Univers Cyrillic Complete Family Pack desktop font from Linotype on Fonts. com. Buy Univers Cyrillic Basic Pack desktop font from Linotype on secretsdoll.com Contribute. Share your examples of Univers Cyrillic In Use. Learn more →. Fonts In Use is a collaborative project and our collaborators are visitors like you!.
Univers Cyrillic font. Font libraries on secretsdoll.com Samples and previews of Univers Cyrillic font. Univers is a typeface designed by Adrian Frutiger, and is available for Desktop, Web Basque, Icelandic, and Luxembourgian in Latin, Cyrillic, and other scripts. Univers is the name of a large sans-serif typeface family designed by Adrian Frutiger and released by. Univers Cyrillic 55 Roman Font from secretsdoll.com - Download Univers Cyrillic 55 Roman font. for Mac in TrueType, Mac in TrueType. 22 Apr Univers Cyrillic 85 Extra Black Oblique Font from MyFonts.c - Download Univers Cyrillic 85 Extra Black Oblique font. for TTO, Mac in TrueType.
Click to view Univers Cyrillic font, character set and sample text · Univers Cyrillic by Linotype | Category: Sans Serif · Purchase · Click to view Universal Math I. You are only a step away from downloading your font. We know you are a human but unfortunately our system does not:). So please spare a moment to verify. Univers CondensedBoldHewlett-Packard: Univers Condensed Bold: Version 1. Condensed. Categories, Russian. Files: 2 Univers Condensed font preview. Buy and download Univers Cyrillic 75 Black, and other high-quality fonts for Mac and Windows Publishing. Fonts are available in TrueType, OpenType and web.


Carly Escoto is a visual artist turned musician, Los Angeles native and worship leader. She always had a knack toward creativity, and had her heart set on pursuing a career in visual arts when music took her by surprise. Though she'd tinker on her guitar at home and sometimes help lead songs at her local Young Life club, she never imagined music could be her full time passion or career.
That all changed after she served on Summer Staff at Young Life's Woodleaf the summer of 2007. While working in the coffee shop, the camp musician at the time ( Brandon Heath) heard her singing along with the radio and asked her about her voice. Unaware that she had anything special, she tried to shrug it off while also mystified that someone so talented would take notice of her. She shared this information with her Summer Staff coordinator who encouraged her to "Pray about it". Having very little belief that it would come to anything, she started to pray about this potential gift in her, and it grew rapidly. She began to write and noticed something powerful occurring every time she'd share her voice and songs with people. It was impossible to ignore after one of her first ever written songs got placed on a Starbucks album, sold in every store in the US and Canada.
When this happened, she shifted from visual arts to pursuing music with more of herself and it has led to years of leading worship, serving as Camp Musician at Young Life camps and releasing and performing her own music.


Want a chance at winning a Founder's Pack for Gigantic, the winner of our award for "Best Graphics in an MMO" for 2016? Join Matt tonight as he plays the game and gives away five Founder's Packs live.
Each Gigantic Founder's Pack includes the following.
With Hellion's Early Access launch fast approaching, it's about time that we get some more gameplay footage, isn't it? Today, Zero Gravity released a new 4-minute trailer showing off some of the game's open world and survival elements. In it, we get to see some navigation, combat, and even floating around in open space.
You can find the trailer embedded below. Hellion is set to launch on Steam Early Access sometime next month.
To get a chance to win one of the five Founder's Packs we will be giving away, simply tune in to twitch.tv/mmosdotcom tonight at 7 PM EST / 4 PM PST / 12 AM GMT.


Leading Brussels figure says she's planning to kick off in a few months time.
May giving a speech on Great Britain, Europe and our place in the world before she became PM.
Theresa May has declared that she wants to begin the formal process of leaving the European Union early next year, according to one of Brussels' leading figures.
European Council president Donald Tusk said the Prime Minister told him during their meeting at Downing Street last week that she would be ready to trigger Article 50 to begin Brexit by February 2017.
Formal negotiations between the UK and the EU cannot begin until she starts the two year process, which Brexit Secretary David Davis has insisted will be triggered without a parliamentary vote.
May giving a speech on Great Britain, Europe and our place in the world before she became PM.
Meanwhile, Defence Secretary Micheal Fallon has promised to block any plans for an EU 'army'.
With Britain's withdrawal clouded in confusion and no clear signal on whether the country intends to stay in the single market or not, Europe's 27 other leaders gathered for an informal summit in the Slovakian capital, Bratislava, without the Prime Minister, The Press Association reported.
Speaking about his meeting with the PM, Mr Tusk told a summit press conference: "Prime Minister May was very open and honest with me.
Meanwhile, Defence Secretary Sir Michael Fallon vowed to block any proposals for an EU army while Britain remains a member of the union in a move likely to anger European leaders.
Fallon vowed to block plans for an EU army.
In his state of the union address on Wednesday, European Commission president Jean-Claude Juncker called for EU countries "to pool their defence capabilities in the form of a permanent structured co-operation", and proposed a European Defence Fund by the end of the year.
But Sir Michael said the UK would veto plans for any EU army that may rival Nato.
"That is not going to happen," he told The Times. "We are full members of the EU and we will go on resisting any attempt to set up a rival to Nato.
In Bratislava, Mr Juncker insisted Britain cannot get access to the European single market without accepting the free movement of workers.
The conundrum has become central to the Brexit debate and has caused friction within the Government as ministers weigh up how to maintain the benefits of the trading bloc while regaining full control of the UK's borders - a goal deemed by Mrs May as essential to properly implement the referendum result.
The PM slapped down Mr Davis for saying it was "very improbable" that the UK could be in the single market and end free movement, and then insisted the Government would not offer a "running commentary" on negotiations.
Commenting on the issue, Mr Juncker told the press conference: "There's a clear interlink as we made clear since the very beginning between the access to the internal market and the basic principles of the internal market, mainly the one of the freedom of movement of workers.
"We are sticking to that position and this is not a game between prime ministers leaving and prime ministers remaining, this is about people in Europe.


This week we look at a beautiful solo from the wonderful Walt Weiskopf on Arthur Schwartz's "You and the Night and the Music". In our analysis section, we examine some of the ways Walt uses sharp elevens over major seventh chords. To purchase the individual track, click here. For the full performance with John Fedchock's NY Sextet, click here. For more information about Walt, click here.


Crayons at the bottom of your purse? Kids bored in the car? Why not make a travel crayon roll today?
To develop your pattern - draw a 11" W x 10"H rectangle. Shave off at the side top flap corners to suit your design scheme. I chose to make my corners angled, but you could also round the corners. Add 1/2" seam allowances to all sides.
8 Easy Steps to sewing the crayon roll: 1. Cut out your pattern pieces - 1 for the self and 1 for the lining 2. Place right right sides together and pin 3. Measure 4 1/4" up from the bottom seam and insert ribbon. Make sure to insert so the ribbon length is facing inwards and square the ribbon with the side seam. As the image above, you want approx 1/2" SA sticking out 4. Place into sewing machine. Sew with a 1/2" SA around the outside. Leave a 2-3" opening at the bottom. Press. While pressing to set your seams, also turn the 2-3" bottom opening and press the seam upwards. This will help when you later sew the opening closed. 5. Pull the roll rightside out and press the seams again. Pin the bottom opening closed. Edgestitch along the entire bottom edge. Backstitch at each end 6. Fold bottom upwards to measure 2 3/4" in height. Press the fold. Now edgestitch along each side seam. This will make a little pouch. Backstitch at the top and bottom. At this time, you can also edgestitch along the top edge 7. Place a measuring tape along the bottom. Using your disappearing ink pen and a ruler, mark at 1" increments along the bottom seam. Place into your sewing machine and stitch following each ink line. You are now sewing the little spots for all the crayons. Make sure to backstitch at the top and bottom. Press 8. Button - turn over to the backside. Place the button in the centre back area/near the vertical stitches. However, before sewing the button down, double check placement by rolling up the crayon roll. Handstitch the button in place.


Cliff Robinson has made marijuana legalization his post-basketball career calling, joining the Connecticut Coalition to Regulate Marijuana.
Before any discussion of Uncle Spliffy, we've got to ask about Uncle Cliffy.
"Doing good," Cliff Robinson said, "and continuing to get better daily."
The UConn basketball great was hospitalized in Portland, Ore., in early March for what he had called "a minor brain hemorrhage."
"Any time you go through a stroke, and you go through some paralysis, we call it minor because I didn't lose my faculties; I didn't lose my ability to speak," Robinson said. "But I did have some paralysis on the left side."
Robinson, 50, said he is continuing to rehab.
"I've got all my movement back," Robinson said. "It's a matter of getting all my strength back now."
Robinson certainly has the strength to continue his push for the reform of medical and recreational marijuana laws. He has made its legalization his post-basketball career calling. Robinson recently joined the Connecticut Coalition to Regulate Marijuana, a group of community leaders calling for the state legislature to end cannabis prohibition.
And he has this message for Connecticut.
"Take the handcuffs off the plant," he said. "Free the plant."
NIT champion, member of UConn's All-Century team, the 36th pick in the 1989 NBA draft, Robinson stands 11th all time in NBA games played at 1,380. He won a Sixth Man of the Year Award. He was an All-Star. He twice was named to the All-Defensive NBA second team. He twice got to the NBA Finals. When he retired in 2007, after playing for five teams, the final numbers showed he had averaged 14.2 points and 4.6 rebounds.
His dance after Portland's Game 4 victory over Utah in the 1992 Western Conference finals, well, he called it "Uncle Cliffy." A nickname was born. And after he was three times suspended for violating the NBA marijuana policy, there was another nickname for Robinson: Uncle Spliffy. When he decided to enter the marijuana business in Oregon, Robinson had the ready-made brand name for his products.
Uncle Spliffy. Sorry. I can't help but chuckle every time I say or write those two words.
"Peter Vescey of the New York Post actually poked a shot at me with that name because I was suspended for cannabis use," Robinson said. "I've got to say, it does have a ring to it. So I figured I'd roll with it."
I long have been in favor of the legalization of marijuana for adults and have written so. You also won't find anybody more against driving under the influence than me and have written so. Responsibility. Moderation. Maturity. At a time when we should be more concerned about shots of tequila and turning the key to the ignition and the terrifying use of opiates, isn't it also time for the state legislature to find a way to regulate, tax and make pot available for recreational use for those who are 21 and older?
A 2015 Quinnipiac poll showed 63 percent of Connecticut voters favored legalization.
"As someone who's involved in the cannabis space, I want two things," Robinson said. "One, I'm on the right side of this social issue. Two, whatever state we're in, it is rolled out in a successful manner.
"I did play at Connecticut. Whatever little celebrity I have, I think it is the right fit for me to try and get involved and try to push the legislation."
"Look, I have six children ranging from 30 to twins who are 11, so it's very important to me that this continues to be done the right way," Robinson said. "My own life has been affected by this. I have been taken off the basketball court and suspended. The older kids had to endure the fact that their father was suspended while they were in school.
"There's a negative stigma out there that there are no positive medical qualities to cannabis and the fact that it makes people lazy. I don't know how you can become a professional athlete and be labeled as a 'pothead.'"
Robinson long has said he didn't smoke before games. He didn't play high. He said he had some anxiety, and marijuana helped him relax after games. He said he smoked on offdays or during the offseason. He has said he stayed away from pharmaceutical drugs for anxiety and other ailments because they upset his stomach. Question: How's pot looking vs. oxycodone these days, folks?
It cost him 11 games in suspensions, but only 10 players played more NBA games. He has said in the past the stigma of the suspensions may have cost him a shot at coaching jobs.
"Lazy. Pothead," Robinson said. "Those words still get under my skin a little bit."
Eight states and Washington, D.C., including Robinson's home state Oregon, have legalized cannabis for recreational use. Twenty-one more, including Connecticut, have approved it for medicinal use. Massachusetts and Maine have voted to end cannabis prohibition. Vermont and Rhode Island are moving in that direction. Some states, it's the vote. Other states, like Connecticut, the legislature must approve it. There are many nuances to its production, sale and distribution. When Massachusetts does get it squared away, watch the flow of traffic with Connecticut tax dollars driving north. While it will not solve the state budget crisis — and shouldn't be the reason for legalization — the state could be looking at $100 million a year in tax revenue, according to proponents. It makes sense to take the money out of the hands of drug lords and stop damaging young lives with needless arrests.
"Cannabis prohibition disproportionately harms minority communities wherever prohibition exists, and Connecticut is no exception. Legalization clearly works, and it's beyond time for the Connecticut legislature to step up and do what is right," Robinson wrote when he joined the Connecticut Coalition.
Robinson said, "Just the fact people are being arrested for this is ridiculous. I'm a firm believer that you keep it out of kids' hands until they are the proper age, but for someone who makes the mistake, partakes in cannabis, they shouldn't be labeled as criminals.
"Let's be honest. A lot of African-Americans have been affected by these encounters with law enforcement over the years with cannabis. We've got to move past this."
Even when approved for recreational use, there are all sorts of rules from state to state. Counties can decide if it's legally sold or if it can be consumed in public. There was Robinson recently joining Portland Mayor Ted Wheeler and Commissioner Chloe Eudaly supporting a bill that would allow social consumption of cannabis in Oregon outside their personal homes.
"I wouldn't be involved in this, if I wasn't going to put my all behind it," Robinson said.
Which brings us to Uncle Spliffy, the businessman.
The idea behind his product is sports cannabis, he says, neither strictly medicinal nor recreational. Robinson believes marijuana helps in stress relief and handling pain for people with active lifestyles, not only pro athletes.
"I was doing a company where we're going to have a processing facility, but the more I was out in Oregon, involved in the cannabis space, it just made more sense to go at it from a licensing angle.
"I partnered with a very nice indoor grow out in Oregon. We're in the development of product stage. Right now we have some pre-rolled stuff that's about to hit the market in Oregon in the next month, while we're developing other products that's going to be more of a sports line of things, sports creams and those type of things."
Robinson said he has gotten plenty of feedback from former NBA players.
"It has all been positive," Robinson said. "I'm sure there are people out there who are still against cannabis, but at the end of the day, if we continue to educate and show the research behind it, about what people put in their bodies, those numbers will continue to be knocked down.
"Early on, it took me a second to get involved. I was thinking about my NBA career and what people think. But the response has been all positive — even from my Hall of Fame UConn coach."
Uncle Spliffy laughed at his last line.


text:
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After warning and 'F' rating from BBB, electric scooter & e-bike company GoTrax responds
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Video: crypto-mining Daymak Spiritus EV takes its first test drive
Daymak revealed the first "production-look" prototype of its 85 mph, light-electric three-wheeler, the Daymak Spiritus, back in October. At the time, it was thought to be a static display piece – but now? It's a runner, and we've got video. The video was posted with the description "The Spiritus 3-Wheel All Electric Car first drive
Denise Van Outen splits from fiance after seven-year relationship
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Tesla announces Full Self-Driving package price increase to $12,000
Tesla announced today that it is going to increase the price of its Full Self-Driving package to $12,000 starting on January 17. The price bump should coincide with the release of an important new update. The Price of Tesla's Full Self-Driving (FSD) package has been somewhat controversial. CEO Elon Musk has made Tesla's pricing strategy
'Please be at peace': Sinead O'Connor pays tribute to teenage son who has died after going missing
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World's largest floating solar farm comes online with wind and storage
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From a holiday birth to changing Hollywood: Who was Sidney Poitier?
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With only 25 Bolts and one Hummer delivered in Q4, GM cedes #2 US EV maker podium space to Ford
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'Champion of cinema': Acclaimed 'New Hollywood' film director Peter Bogdanovich dies
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redpajama_set_name: RedPajamaCommonCrawl


Indy's Designs: Naughty or Nice?
For this card, I pulled out a Christmas set from Newton's Nook Designs. It's called Santa Paws Newton. I just love the fun sentiment!
Adorable card! Love the black border to the different layers. Thanks for playing along with us at CC&S!
Super cute image, beautifully colored, love the black frame on your design.
Thanks for playing at SHOPPING OUR STASH, hope you play again soon.
what a great sketch and love that stamp set too -thanks for joining us at HLS this month!
Super cute card, that kitty is adorable and great take on the sketch, thanks for getting Krafty with us at shopping Our Stash.
Adorable card and a terrific job combining challenges. Thanks for joining us this week at CC&S!
super cute! The kitty is so adorable on this layout!
Super cute and a great take on the sketch!!
Thanks for getting KRAFTY with the crew from SHOPPING OUR STASH!!
Hey there, thanks so much for joining us at Papercraft-Challenges. We have just picked our winner of the Christmas Challenge, so make sure to check back soon!


Classmate Spell Bee Results 2019 Season 11 Download Selection list. India's largest Spelling Competition has successfully handled for the students who are pursuing Class 5th to 9th in any recognized School. Every year a huge number of candidates participates this examination. This is year also a huge number of students and they all are looking for the release of Classmate Spell Bee Session 11 Result 2019. The Organization totally conducts 4 Selection rounds for selection of students. These are School Level, City Finals, Semifinals and National Finals. The Final round selection candidates will get Prize money Rs.2,00,000/- and Four National Finalists get Prize money Rs.50,000/-. The details of Classmate Spell Bee Results 2019 are available below.
All selection rounds will be conducted in an online MCQ model. The merit score gotten candidates will be shortlisted for next round. This post provides details of Classmate Spell Bee Results 2019 for Season 11 all Levels 1 2 3 & 4. Who are curious on this Classmate Spell Bee Session 11 Results 2019 check the Official web portal http://www.classmatespellbee.in/. To get more Competition exams and scholarship exams updates stay visit gyananetra.com.
This is India's Largest Spelling Competition 2019. The Organization successfully conducted 11th time Spelling Test in all Over India. The Final selected candidates will get Prize money 2 Lacks. So, Lacks of students applied for this examination. Immediately check Classmate Spell Bee Result 2019 after updated link in the Official website. The downloading information and Organization updated link is available at end of this post. More information and latest updates of Classmate Spell Bee Season 11 Result 2019 check Oficial web portal.
The Candidates approach the Official website www.classmatespellbee.in and search for the link of Classmate Spell Bee Session 11 Result 2019 link. Open the link and enter details of Hall Ticket number and date of Birth to get the Results.


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An Occupation
Adam Stumacher
Before coming to the West Bank, Nathan worked for years as piano tuner, which left him with a nervous tic: one more slight turn of the crank, one more gentle pull, and the pitch will be perfect. He has begun to see the world as an instrument of dense hardwood and heavy alloy, pulled into a state of constant tension, to see himself as the only person capable of getting the damn thing into equal temperament. But no matter how he coaxes the pin, the strings will never quite render. A waver remains in that octave, a twang in that unison. So he has taken to a constant puttering, an endless low-grade effort to fix everybody else's problems. He might let his own bills pile up unopened on his desk, but he keeps busy repairing the lives around him, like so many busted D-strings.
This tendency used to drive Julie nuts, and even though he knew it was pushing her away he couldn't help himself: he needed to tell her the right tone to use when talking to her mother on the phone, the right anecdotes to tell when trying to impress her boss, the right grad programs to consider in pursuit of a career that would, finally, make her happy. The more he advised, the less she listened. Not that she had ever paid much attention to begin with; she couldn't tell a Steinway from a Hamilton if her life depended on it, never seemed to really feel music. So they ran out of things to discuss, and by the end they just stopped talking. And they had been such good conversationalists in the beginning. They were that noisy couple on the next table over in the diner, interrupting each other's stories with laughter that sprayed root beer across the booth. Over the years, their voices quieted down, and by the end they hummed absently as they read different sections of the newspaper and passed the sugar across the table without looking up. If their fingertips accidentally brushed together, Julie shivered as if her body were fighting venom. Maybe if he had been in a different line of work, Nathan thought, maybe if he had developed a different set of habits, things might have worked out.
On the other hand, the habits of a piano technician seemed well suited to survival in a war zone. This place, he decided, is like a delicate old instrument: feather-light touchweight and rich sound quality, the whole contraption held together by thirty tons of pressure across rusty strings. All those years of manipulating the tuning crank have given him the patience to settle in for these more involved jobs, and patience is perhaps the most important quality in a human shield. Because he is finding life under occupation seems to consist of sitting and waiting. The most common danger here seems to be boredom.
And while you wait there are the cigarettes, the countless cups of coffee, the heaping platters of food. Resources may be scarce, but people always somehow manage to fill the table for guests. In fact, as Nathan picks his way between villages, he somehow finds himself putting on weight. So, when an old man in a kuffiya walks into the shop in Beit Furik holding his granddaughter by the hand, when Kumiko, his fellow volunteer, explains that this is the mayor of the village and he wants to talk to them, Nathan smiles because he is hungry, and he knows they will soon be sitting down to a feast. Sure enough, the shopkeeper disappears into the back for a time and emerges with plates of fresh figs and grapes and flatbread, bowls of olives, creamy hummus, savory mashed fuul.
The mayor settles down at the table across from the foreigners while the shopkeeper returns to his station behind the counter, chatting with the customers as they browse the barren shelves. The mayor pats his granddaughter on the head and talks for a while in Arabic while Nathan smiles, feigning understanding. Then Kumiko turns to him.
'He said his granddaughter was crying the whole time the tanks were here. Loud noises sometimes make her scream.'
Nathan bites into a fig, pretending not to notice the shopkeeper watching him over by the counter. The mayor begins speaking rapidly in Arabic and Kumiko's pen scratches along the page while Nathan tries to seem engaged without calling too much attention to himself. To pass the time, he tries making friends with the girl, but she just grips her grandfather's knee and stares vacantly out the door at the fading sunlight.
Nathan finishes his coffee and is unsure where to put down the empty cup, so he places it discreetly on the ground under his plastic chair. His hands may be precise enough to loop a faulty string around the hitch pin, but maneuvering these miniature dishes makes them feel clunky, like catcher's mitts. As he straightens back up, he catches the granddaughter looking at him. He decides he will find some way to make her smile.
'He says they're almost out of water.' Kumiko says. 'The soldiers have been stopping the tankers at the checkpoints on the way to Nablus.' She shakes her head. 'The farmers have to kill their livestock because there isn't enough water to keep them alive.'
Then the mayor is talking again, so Nathan nods vaguely, reaching for a grape. Over by the counter he sees a group of customers gathering together, laughing quietly, and he decides they are not talking about him. He has a plan: he will play peek-a-boo with the little girl, a move that never fails to get at least a giggle. So he ducks his head below the tabletop, then slowly peers over the edge at her. But her eyes seem to be focused six inches behind him, and her face is slack.
The mayor glances over and shakes his head. 'She does not play,' he says. Then he swivels back to Kumiko and starts speaking in Arabic again, gesturing out towards the door. Nathan notices he has barely touched the food on the table in front of him.
'Last night the tanks were here,' Kumiko translates. 'The loudspeakers said all men between fifteen and fifty had an hour to meet at the school. Any male who stayed inside would be shot.'
Nathan meets her eyes for a long moment, but her face is the same professional mask as ever. 'I think we should stay in Beit Furik tonight,' she says. 'The soldiers won't come if foreigners are here.'
Nathan nods. She puts down the pen and turns back around and says something in Arabic. The mayor remains silent for a time, sipping his coffee.
Nathan is determined to make this little girl smile. He pulls a fig off the platter and sits back, turning it deliberately over in his hand, one final adjustment to the tuning crank. Then he bites into the fruit and opens his mouth wide, his teeth sheathed in the purple skin, eyes rolling. He looks over at the girl and laughs, shaking his head side to side. And while she doesn't exactly grin, for a moment the corners of her eyes seem to crinkle, slightly.
The mayor puts down his cup and smiles, cobwebbing wrinkles around his own eyes. 'Please do stay in my home tonight,' he says. 'You are welcome.'
Then the voices over by the counter grow suddenly loud, and Nathan sees an old man standing in the centre of the group, smiling and passing something around. The man raises his arms towards the ceiling, and everyone reaches out to shake his hand, and then the crowd shouts and surges its way towards the back. When the man gets closer, Nathan sees he is missing several teeth in his wide grin, and that he has been passing around sesame candies. The man hands one to the mayor, and then one to each of the foreigners.
'Today I am a grandfather!' he says.
But at that moment, he lets the candies drop to the floor and shatter as faintly, the refrigerator doors begin to rattle once again. Quickly, someone shuts off the light, and the shop grows silent as the tanks rumble closer.
Photograph © Rowena
I had wondered about the signs of burning
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How to Write About Africa
The late Binyavanga Wainaina's iconic satire is one of Granta's best-loved essays.
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#TeamBaddiel vs #TeamBabel
David Baddiel
'Social media has allowed everyone in the world to raise their own little flag of self'
Letters from Prison
Basel Ghattas & Einat Weizman
Letters from Basel Ghattas, an Israeli-Arab member of parliament imprisoned for smuggling cell phones to Palestinian prisoners.
Hungerwinter and Liberation
Jan Vegter
Jan Vegter's remarkable visual and written record of the Nazi occupation of the Netherlands, translated from the Dutch by Theo de Feyter.
Man of Principle
Roy Chicky Arad
A novelette by Roy Chicky Arad, written after one of the wars of Israel in Gaza. Translated from the Hebrew by Maayan Eitan and Oded Even Or.


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Grant Hill, Steve Nash: Hall Of Famers Both On And Off The Court
Grant Hill was on his way to legendary status, averaging 25.8 points per game for the Detroit Pistons in 1999-2000, but injuries took away some of his best years.
We all saw what awaited for the son of former Dallas Cowboys running back Calvin Hill and Janet Hill. Hill was supposed to take the torch from Michael Jordan, with his clean-cut image and all-around skills, eventually propelling him to most complete player in the game status.
Ballislife.com on Twitter
Did you know Grant Hill… Was the leading All-Star vote-getter his 1st 2 seasons in the NBA (over MJ & Shaq)? Was 3rd in MVP votes during his 3rd season? Was only behind the Big O, Larry Bird & LeBron for most PTS, REB, AST after 6 seasons? https://t.co/KHiwAnFi3f
Through six seasons in Detroit, Hill was a Swiss-army knife, rim-rocker that averaged an elite 22 points, eight rebounds, six assists, and two steals per game. The former Duke star is part of the fabric of the evolution of the sport. A master in the transition game and the lost art of lockdown defense, capable of defending cats on the perimeter, pulling boards, setting a high-octane pace on the court and finishing with fervor above the rim.
SB Nation on Twitter
Grant Hill was a point forward in a world where the point forward didn't exist yet. Despite all the 'what ifs' that come with his career, he's still going to the Hall of Fame https://t.co/vRu0uJEJUu
A weak ankle ensured that he was never the same player after missing the 03-04 season. During his six-year stint in Orlando, during the prime years of his career, Hill averaged just 33 games a season as he struggled with his physical ailments, tried to play through them and only made it worse.
But his will to survive, his humility, his love for the game and a white Point God from Canada, helped Hill play another nine years, carve out a solid 19-year career and retire at the ripe old age 40.
Steve Nash to Grant Hill
With Steve Nash officially announcing his retirement, I've decided to publish this video. I made sure I had something on the back-burner for when this day happened so forgive the roughness of it. Steve Nash and Grant Hill only have two years that separate them, meaning that they were two of the oldest players in the NBA in their final years in Phoenix.
Its fitting that Hill will be entering the 2018 Hall of Fame class with former Phoenix Suns teammate Steve Nash, a player whose astute court awareness and ball distribution skills heavily influenced Hill's revival. Hill and Nash played together on the Suns for Hills entire five-year tenure in the Valley. With the Suns, Hills decreased minutes and offensive responsibilities led to three-straight seasons of 80 or more games played.
In five seasons with Phoenix (2007-12) , Hill started 343 of 362 games and averaged over 30 minutes and 12 points per night. He was an integral part of the team's run to the 2010 Western Conference Finals, starting every playoff game and averaging a solid 9.6 points and 5.8 rebounds per game.
The star of that team was two-time MVP Nash, a master craftsman from the North by way of South Africa. Nash was a magician with the pill who could also penetrate and drill the long-range bomb. Nash had two stints with the Suns. He balled out from 1996-98 and then was traded to the Dallas Mavericks where he teamed with Dirk Nowitzki and Michael Finley to form a "Big Three." Nash returned to The Valley and had a glorious run from 2004-2012, where he built a Hall of Fame career and culturally impacted the NBAs white fan base in a Larry Birdesque manner.
Steve Nash Passes Magic Johnson in Career Assists
Watch as Steve Nash throws a nice alley-oop pass to Dwight Howard to tie Magic Johnson, then breaks the Laker great's career record.
In total, Nash played 744 games in Phoenix and was the most important player on the legendary 7 Seconds or Less teams led by Mike D'Antoni. Nash is one of the last true point gods in the NBA. In the mold of Magic Johnson and Isaiah Thomas, he was known for making everyone around him better, averaging 17.2 points and 11 assists during his MVP campaigns.
Amar'e Stoudemire and a host of other players, including Hill were the beneficiaries of Nashs ability to make a basketball game his own personal chess match, and he was checkmating suckas from the door. Together Nash and Hill won 228 games together in five seasons, losing in the 2010 Western Conference Finals in six games to the Lakers and providing the Phoenix Suns with a taste of elite NBA living that the franchise hasnt recaptured since.
Steve Nash's Top 13 Plays on the Suns
Take a look at the top 13 plays of Steve Nash's Suns career. About the NBA: The NBA is the premier professional basketball league in the United States and Canada. The league is truly global, with games and programming in 215 countries and territories in 47 languages, as well as NBA rosters at the start of the 2015-16 season featuring 100 international players from 37 countries and territories.
Hills leadership, humility, grace, character, and resiliency won him three NBA Sportsmanship Awards in his career. Two of them came with the Suns and Nash was very similar to Hill in that he was universally respected for his character and being a strong, positive locker room presence. They were silent assassins. Both men continue to contribute to philanthropic causes and Nash has been vocal about his politics. In 2006, Nash he was named by Time as one of the 100 most influential people in the world. Hill continues to be the ultimate pro in his job as an NBA and college analyst for CBS/Turner Sports.
Social Ambassador on Twitter
New #SportsPhilanthropy Blog -Steve Nash: Sports Philanthropy Star http://t.co/yjO0CgtU0d via @SportsBlog @AllSportsU
In an era where athletes were routinely portrayed as thugs, Grant Hill and Steve Nash were the exceptions. Gentlemen on and off the court, easily marketable ambassadors of the sport of basketball and more than worthy additions to the Hall of Fame.


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Admission/Registrations
Pre-K / Kindergarten
Tours & Open Houses
Welcome to Little Thinkers Montessori!
"Children are human beings to whom respect is due, superior to us by reason of their innocence and of the greater possibilities of their future."
– Dr. Maria Montessori.
The Little Thinkers child learns through the academic and experiential process, developed by Dr. Maria Montessori, and influenced by the culturally diverse atmosphere of Brooklyn, students learn to care for and respect themselves, others and the earth.
Students in the early childhood program acquire tools for individual fulfillment, academic excellence, physical, social, and moral development, as well as confidence and independence for lifelong learning. The curriculum is focused on promoting world peace through diversity and also has a huge emphasis on healthy lifestyles and green living.
The first Montessori school—the Casa dei Bambini, or Children's House—was opened by Dr. Maria Montessori in Rome on January 6, 1907. There are now more than 22,000 Montessori schools in at least 110 countries worldwide. Little Thinkers Montessori was founded over a hundred years after Dr. Montessori's first school in 2012. We are currently the only Montessori school in the Fort Greene/Clinton Hill neighborhood of Brooklyn.
Serah Kaiel, the Directress, was educated in Montessori schools and raised by a mother who was a Montessori teacher. For her, Montessori has always felt like home. Creating an Montessori environment in Brooklyn where children can not only learn and grow, but thrive has been a priority from the beginning. Working in partnership with families and creating community around raising children to be active participants in creating a healthier, kinder world mirrors Dr. Montessori's goals and views towards world peace.
"The Aborbent Mind" is one of the most famous books Dr. Montessori wrote and goes into great detail about how children absorb information from the world around them and essentially teach themselves. Little Thinkers is proud to be a part of the Montessori community both locally and worldwide. Our Staff and students come from one of the most diverse neighborhoods in Brooklyn and are actively working towards building a brighter future one child at a time.
Our teachers are both AMS and AMI certified.
OUR HIGHLY TRAINED STAFF
Karen Banks
Teacher – Educator
Helen Bishop
Denise Hunt
Amber Tran
Administrator –
Amy Guzman
The greatest sign
of success for a teacher...
Is to be able to say,
'The children are now working as if I did not exist.'
- Dr. Maria Montessori
Copyright © 2023 Little Thinkers Montessori
Little Thinkers Montessori