Do Night Shifts Cause Breast Cancer?

According to this review article, the answer appears to lie somewhere between maybe and probably.  While there seems to be a correlation between the two, more research is needed to determine whether or not there is a causal link as other plausible reasons for the correlation haven't yet been ruled out.

...Shift work. Excess incidence of breast cancer has been observed consistently in studies of women with prolonged exposure to shift work involving exposure to light at night (Kolstad 2008; Stevens 2009). Research needs in this area include a) a better definition of what is meant by shift work and related exposure metrics; b) studies of markers of circadian disruption in non–day workers; c) better descriptions of controls and their exposure to light at night; and d) investigation of the effect of variations in expression of circadian genes on cancer in shift workers. An emerging area of interest is the relative toxicity of occupational chemical exposure depending on time of day of that exposure. The marked circadian variations in cell division and DNA repair during the daily cycle are controlled by the circadian genes (Haus and Smolensky 2006; Stevens et al. 2007). Therefore, non–day workers may have very different susceptibility to occupational exposures compared with day workers. Studies are also needed to determine if shift work is associated with other cancers, especially hormonally related cancers, and prostate cancer in particular. If further experimental and epidemiologic evidence confirms a causal association between exposure to light at night and breast cancer, it will be important to develop interventions to reduce the risk.

You can read more here. For details, see the article and relevant references.

Reference

1. Ward EM, Schulte PA, Straif K, Hopf NB, Caldwell JC, et al. 2010 Research Recommendations for Selected IARC-Classified Agents. Environ Health Perspect 118(10): doi:10.1289/ehp.0901828

Home birth death toll rising in Colorado?

Dr. Amy Tuteur, the Skeptical OB, has a blog post up entitled 'Inexcusable homebirth death toll keeps rising in Colorado.'  Now I'm a big fan of science-based medicine (and of Tuteur's blog), however I have to call foul when it comes to that "rising" part of her post.  Yes, I think it's pretty minor point since the real comparison to consider is the home birth vs. hospital birth mortality rates - but this is a nice opportunity to do some basic stats. Having left a few comments to that effect on her blog, I figured I would summarize them here.

Embryonic Stem Cell Injunction (Part II)

More of my thoughts (part I is here) on the recent ruling by judge Royce Lamberth halting embryonic stem cell research in the U.S. Here are my thoughts on the judges decision to go forward with the injunction.  In his ruling he lays out the criteria for the decision and why he thinks the plaintiffs case was sufficient to pull federal research funding.   

Part II: Did the judge meet the criteria for an injunction?

In his ruling, the judge lays out criteria for issuing an injunction by quoting from another case which asserts that (emphasis mine)...

Embryonic Stem Cell Research Halted... AGAIN

If you haven't heard, there's plenty in the news here, here and here.  I recommend reading judge Royce C. Lamberth's 15 page ruling for yourself, as it clarifies much of what the media are glossing over at the moment.

Below are my thoughts on the ruling.  I take issue with some of the judges arguments, and not because I have zero legal expertise - I think it's because he's gotten some things wrong.  I also think the judge didn't live up to his own standards, which I'll discuss in part two of this post which you can find here.

Part I: Does "Embryonic Stem Cell Research = Killing Embryos"?

The crucial legal language in this case is known as the Dickey-Wicker Amendment (also, see here). It's notable for (1) limiting how federal dollars are spent on embryonic stem cell (ESC) research, and (2) it includes an attempt at defining "human embryo." The definition seems overly broad in my opinion (e.g. if I culture some of my skin cells, they seem to fit this definition), but take a look and decide for yourself.

The language can be seen in H.R. 3010 (see pg 48 in this PDF) section 509(a)(2) which reads...

Antivaccine Rally in Chicago LIVE VIDEO ( 5pm Weds)

Here's live feed from the antivaccine rally going on in Chicago ... right now. So far, it's what I expected to see: a steady flow of misrepresented facts, rampant conspiracy theorizing and heaping piles of bullshit. Bon appetit.

Updated:  Show's over, so I've replaced the embedded video with Andrew Wakefield's recent appearance on the Today Show with Matt Lauer.  For a comic overview of the Wakefield controversy, click here for the "Facts in the Case of Andrew Wakefield".

I think I'll go get a flu vaccine tomorrow...

[Hat tip to Elyse @ Skepchick]

Summary of Cancer Research Facts

Over at the Respectful Insolence, Orac has shared a video produced by the American Association for Cancer Research which includes a wealth of information about the current state of cancer research.  You to read Orac's take on the video if you're interested in the topic (though do ignore his unappreciative take on the soundtrack!).

What a remake of this video will look like 5, 10 or 15 years from now is anyone's guess -- but one thing is certain: it'll take a whole lot of money, manpower, technological innovation, and sound science if we're to continue to make progress in treating and preventing cancer.

BCA Drops Libel Case Against Singh!!

Update:  According to Ben Goldacre, Singh may go after the BCA to recover his legal costs. You can read more on the case and the remaining need for British libel reform in Goldacre's article in the Guardian.

The British Chiropractic Association (BCA) has dropped is libel case against science journalist Simon Sigh following the recent ruling that Singh could appeal an earlier verdict against him.  Details can be found on the BCA's website here (PDF) via the Sense About Science site here or at the Libel Reform Campaign website here.

BCA V SIMON SINGH - PRESS STATEMENT – 15th APRIL 2010

Having carefully considered its position in the light of the judgment of the Court of Appeal (1st April 2010), the British Chiropractic Association (BCA) has decided to discontinue its libel action against Simon Singh.
...
The BCA takes seriously its duty and responsibilities to members and to chiropractic patients. The BCA has considered seeking leave to take this matter to the Supreme Court and has been advised there are strong grounds for appeal against the Court of Appeal judgment. However, while it was right to bring this claim at the outset, the BCA now feels that the time is right for the matter to draw to a close.

Despite this big victory for Singh, it's only a non-loss for free speech.  Libel laws in the UK still need reform to protect free speech and promote open dialog -- and not just in the UK, but world-wide.

I would have preferred the outcome where Simon won his case on appeal, setting legal grounds for future libel cases against journalists. To learn more about libel law reform in the UK, visit the Sense About Science and The Libel Reform Campaign websites.

Michael Specter on the Dangers of Science Denial

Small free speech victory: Singh wins right to appeal!

For details, jump on over to this BBC article. While you're there, definitely watch the video and listen to what Singh has to say on the need to reform libel laws in the U.K.

I couldn't find a way to embed that video here, but here's a little more from him after the ruling...

To learn more about what you can do to help reform libel laws in the U.K., visit the Sense About Science and The Libel Reform Campaign websites.

---

Update:

More from the BBC...

Thalidomide, 50 years later

You've probably heard of the drug Thalidomide, used to treat morning sickness in the 1950s which resulted in severe developmental defects (particularly phocomelia) in thousands of pregnancies.  Despite causing one of the largest medical tragedies in recent history, Thalidomide still has medical applications today and only recently have researchers started understanding the mechanisms by which it causes birth defects.

Carl Zimmer has a nice article out in the NY Times (which I'd encourage you to read) on what we're learning about how Thalidomide causes birth defects, and the gains to be made from such insights.

[Hat tip to Carl for the heads up via his blog, The Loom]

Homeopathy gets throat-punched then drop-kicked by British Parliment

Over in the UK, a big report was released today by the Parlimentary Committee on Science and Technology. In it, homeopathy is basically called out as being ineffective pseudoscience, and bad medicine.  Reading a few of the points made in the report totally made my morning while I was waiting for some computer simulations (and some laundry) to finish!

There's a nice commentary and list of highlights over at Gimpy's Blog:

The Evidence Check on Homeopathy – a merciless punch to its vitalist organs (despite attempts to water down report).

You can also check out the short press release from the Science and Technology Committee

MPS URGE GOVERNMENT TO WITHDRAW NHS FUNDING AND MHRA LICENSING OF HOMEOPATHY.

which also includes a link to the full report.

Behold... the human brain!

"...one of science's final frontiers ... the human brain."

Tonight, while sharing a late night bowl of ice cream, my wife and I happened upon the fourth episode of the Brain Series by Charlie Rose. It pretty much poked all my science-dork buttons, so I of course had to run right over to the computer and put up a post telling you to watch the series - it's cool stuff!!

You can see all available episodes of the series here. The discussions cover some interesting and important topics. I'm already excited for next episode on brain development and child learning.

I haven't watched them all yet, but the series seems to touch on a variety of topics related to what our brains do and how they do it. The format is the usual scene: a table full of experts moderated by Charlie Rose. If anything, it's a great chance to hear a handful of experts discussing some of the latest insights into common brain disorders like autism/ASD, schizophrenia, and depression. There is also a fair bit of discussion related to brain development during the first few years of life, which should be of interest to parents.

For more info, check the links above and your local PBS listings.

Why use animals for scientific research?

[Hat tip to Dr. Isis]

The American Physiological Society has a new FAQ up on using animals in scientific research (big emphasis on medical research).  If you've ever wondered...

• Why do researchers study animals?
• Why can’t they use computers instead?
• What types of animals are needed?
• Who makes sure that research animals are treated well?
• Why do some people say that animal research is wrong?
• Why do companies test cosmetics and other products on animals?
• Why do some new drugs that are tested in animals still have serious side effects?
• Is research painful?

... then hop on over to their website and have a look.

Want to learn more about H1N1 flu, seaonal flu, vaccines, and who's most at risk?

Today I caught part of a radio broadcast of a special edition of Second Opinion: H1N1 Special Edition. From what little I heard, it sounds like a fantastic discussion - one I hope you'll find the time to watch in it's entirety.

Looking at the Data on U.S. Health Care & Spending

Here's an article from newscientist.com taking a look at some of the data on cost and effectiveness of health care services both internationally and within the U.S.







The videos use data from the Dartmouth Atlas of Health Care, and from the Organization for Economic Cooperation and Development (OECD) and recently released data on the "Statistics and Indicators for 30 Countries"

Follow the link in the article to play with the per capita spending data shown in the first video above.

How does U.S. healthcare compare with other countries?

Many have already seen this nice article by T. R. Reid in the Washington Post, but it's such a worthwhile read I thought I'd give it some mention here.  The short answer to the question in the title above is summed up nicely near the end of the article:

In many ways, foreign health-care models are not really "foreign" to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we're Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we're Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we're Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we're Burundi or Burma: In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die.

More details on the proposed U.S. healthcare system changes - and the many myths and outright lies about those those changes - at:

• The White House - Health Care Reform
  
• 10 Health Care Reform Myths - CBS News
  
• Factcheck.org - search for "health care" and "3200"
  

Does therapy change sexual orientation?

Surprise, surprise - it most likely doesn't. At least according to a review of dozens of studies investigating such "therapies", conducted over the past 45+ years.

The group's Task Force on Appropriate Therapeutic Responses to Sexual Orientation reached its conclusion after its review of 87 studies conducted between 1960 and 2007 and finding "serious methodological problems" in the vast majority of them.

Those few studies that did have "high-quality" evidence "show that enduring change to an individual's sexual orientation is uncommon," it said.

In addition, the report cited evidence that efforts to switch a person's sexual orientation through aversive treatments might cause harm, including loss of sexual feeling, suicidality, depression and anxiety.

The full report can be read here at the American Psychological Association website.

This comes as no big surprise, really - you might have seen this documentary on the sad story of David Reimer: The boy who lived as a girl, or read the book version of his story: As Nature Made Him: The Boy Who Was Raised As A Girl.

Born as Bruce Reimer, he received gender reassignment surgery after a botched circumcision. Psychologist John Money coached "Brenda's" parents to try and raise "her" as a girl, and later used Brenda's case to support his pet hypothesis of Gender Neutrality... the notion that nurture could trump nature when it came to sexuality and gender identity. The result? Nature never gave way to nurture for Bruce/Brenda/David, and he suffered because of it. He died via self-inflicted gunshot wound when he was 38 years old.

Stem cells cure mankind's most devastating diseases!

A friend of mine recently brought my attention to the website for Medra Inc., ran by one William C. Rader, M.D. To sum it all up - the whole thing smells pretty darn fishy...

So what type of medical services does Medra provide?? How about human fetal stem cell treatment for, as stated on Medra's website: "many of mankind's most devastating diseases." What are those disease? The rest of the site suggests they include a menagerie of neurological diseases, autoimmune diseases, Down's Syndrome, arthritis, chronic pain, and others.

With a list like that, you might be wondering what exactly is this amazing new stem cell treatment? Well, nobody outside of Medra Inc. seems to know. According to this L.A. Times article, Dr. Rader "said he has not published anything about his therapy because that would open him to attack from a 'conspiracy' of scientists, government authorities, pharmaceutical companies and abortion opponents."

Er, wait a second. So, he's discovered a way to treat "many of mankind's most devastating diseases", but he can't tell even his own peers about how they might use the treatment to save countless other human lives? Hmmm... something seems just a little bit really strange here!

According to his website, this fetal stem cell treatment is

A medical procedure whereby Human Fetal Stem Cells are transplanted into a patient. These cellular building blocks are usually administered intravenously and subcutaneously (under the skin). It is a painless procedure, which takes place in approximately one hour, and has no negative side effects.

Wow! No negative side effects!? Now pretty much all of my BS detectors are going off! Is this guy for real!?! Don't get me wrong - I think stem cell research holds great potential for advancing both medicine and many areas of biology, but the treatment offered here seems too good to be true.

Unfortunately, Medra Inc. is for real - in fact, $25,000+ for real. Oh, and you also have to travel to one of Dr. Rader's out-of-country clinics in the Dominican Republic, the Bahamas, or the Ukraine to get this mysterious treatment. Seems completely legit, right? Riiiiight.

So, with my suspicions flying off the charts and no available scientific evidence to turn to in order to evaluate these claims, what's left to do?? How else might we evaluate his claims of curing all these ailments? Even if we could hear each and every patient's story, we'd still be hard pressed to see through any placebo effects. But what we can do is take a closer look and see if there's at least some anecdotal evidence consistent with his claims. This by no means proves anything, but if Medra Inc. can't even provide some compelling anecdotal evidence, we can feel comfortable looking elsewhere for medical treatment.

So, lets start with the obvious - his front page "success stories." Lets begin with a video about Hannah from Medra's own website:

http://www.medra.com/video/medra4.html

Adorable kid, horrible disease, and a heart wrenching video with a wonderful outcome - the stem cell treatment has cured her! Right? I mean, that's what the video suggests, and we should trust Medra, Inc. to be honest with us, right? Surely t would get taken down if she were still sick, right? Wrong.

Fortunately, her mother keeps a web journal with tons of details. You can read about her last treatment in March, 2009, back to what appears to be the first treatment in June, 2007, and other details back through October, 2006. I don't have the time to do it myself, but it would worth trying to piece together a time-line of her treatments and symptoms over this period - various drugs at various dosages, IVIG treatments, the stem cell procedures in question - all seem to have been at play at some point during the past couple of years. Indeed, such a history could be just the sort of thing that doctor could infer quite a bit from, were we actually shopping around for this sort of medical treatment.

In any case, as you can see from the 2009 entries, Hannah's struggles are not over. Returning to our original intent for dredging through all this information - can we infer anything about Medra's front-page success story? Well, for starters, it isn't at all the wonderful success that the video lead us to believe. Could the treatment have helped her? Perhaps, although she was also receiving multiple other forms of treatment over the past couple of years that might also be responsible for any improvements. Heck, for all we know trips to the Dominican Republic alone may have brought about changes in her symptoms! Who knows!?

While we can't say much conclusively about Dr. Rader's claims, we can say that Medra, Inc. looks to have pulled in at least $20,000 x 1,500 = $30,000,000 from the his patients' families for what appears to be, at best, only moderately effective treatment. So is this the quintessential case of the brilliant doctor who holds the key to curing mankind's most devastating diseases, or is Medra Inc. just a modern-day snake-oil salesmen? Unfortunately, we don't have the evidence to really answer that question.

Until I see some real evidence supporting Medra's claims - I for one won't be flying any of my family members down to the Dominican Republic any time soon.

Links to more information:

1. Barrett, S. The Shady Side of Embryonic Stem Cell Therapy. Quackwatch, February 17, 2009.
2. Wikipedia entry for William C. Rader.
3. Ripoff Report #466029 and the associated web journal mentioned above.

These look interesting, but I haven't read them yet:

1. Baker, Monya. 2005. Stem cell therapy or snake oil? Nature Biotechnology 23. doi:10.1038/nbt1205-1467
2. Enserink, Martin . 2006. Selling the Stem Cell Dream. Science, 313(5784). doi:10.1126/science.313.5784.160
3. Other articles through google scholar.

The Placebo Effect

Following up on my recent post about recent research into "alternative medicine", I just came across this nice article from skeptic.com about the placebo effect. I found it well worth the read!

What does science say about "alternative medicine"?

According to this AP article, it says that it largely doesn't work. Well, at least not any better than placebo. So if you think that herbal tea helps cure your colds, or that acupuncture can fix your intestinal problems, read no further!!!

While there have been some marginal successes, "it doesn't really work" is largely the take home message of the past decade of research findings coming out of the National Center for Complimentary and Alternative Medicine (NCCAM), an NIH program established in 1991 to investigate the claims of scientifically unproven methods for treating health problems - usually referred to as the more pleasant sounding "alternative medicine" - such as homeopathy, acupuncture, herbal remedies and other common alternatives to science-based medical treatment.

Some may argue that a lot of these efforts were (and continue to be) a waste of time and money. After all, I'm personally not all that thrilled to know that

...the government also is funding studies of purported energy fields, distance healing and other approaches that have little if any biological plausibility or scientific evidence.

Fortunately, not all of these studies dealt with claims that demanded such a stretch of the imagination. Other studies looked into more plausible claims,

Echinacea for colds. Ginkgo biloba for memory. Glucosamine and chondroitin for arthritis. Black cohosh for menopausal hot flashes. Saw palmetto for prostate problems. Shark cartilage for cancer.

and did so using methods that puts these "alternatives" on the same level of comparison with standard science-based medical treatments. Unfortunately (though not surprisingly), almost all of these "treatments" worked no better than placebos.

Whether or not these findings are worth the more than $2billion spent on the projects, I for one am glad to see some of these claims taken seriously, studied, and the findings shared with the public. To elaborate on comments made by NCCAM director Josephine Briggs at the end of the AP article, there's nothing wrong with building sound, science-based knowledge about these mostly ineffective alternatives, and sharing that information with the public so they can make well informed decisions about their health and the health of their families.

It does beg one question though... Can we "have our cake and eat it too" when it comes to reaping the benefits of the placebo effect while at the same time denouncing these treatments as ineffective? Seems like a slippery slope to promote some of these alternatives on this basis, but still an interesting question.