Decision time for doctors about placebos

Last week we were treated to the sight of hundreds of British doctors voting on whether homeopathy has a place in the NHS – a surreal spectacle on a par with watching a geologists’ union arguing what their position on the likelihood of a flat Earth should be. Naturally BMA members voted overwhelmingly in favour of the motion that homeopathy should not be provided on the NHS, but many among their ranks were sceptical of the move, and not all of them were believers in 18th century magic.

In fact their arguments weren’t really about homeopathy at all, but made a compelling case for a wider debate about British medicine’s elephant in the room – the placebo…

Before we continue, let’s be clear, an argument for placebos is in no way an argument for homeopathy. For one thing, homeopathy is a rip-off – why should the NHS pay a fiver a time for magic sugar pills when a tube of Smarties costs 50p, comes in lots of different colours and has pretty much the same evidence base?

And as happy as many people are to believe that medical training can be replaced by Google and a DVD box set of House MD, the fact is that homeopaths are not trained in the same way that doctors are to make diagnoses or give out prescriptions. Nobody claims that all real doctors are perfect either, but with the best will in the world, giving homeopaths responsibility for front-line medicine is like letting toddlers fix your car because they can drive a go-kart and make “vroom vroom” noises…

But the committee’s discussion of placebos focused on ethics rather than pragmatism, and in the real world the ethics may not be as clearcut…

“We do not require doctors to use only evidence-based treatments, in any form of medical care, but we do expect doctors to do their best to ensure that any treatment they offer is in the patient’s best interests. This will generally mean that any known risks of the treatment are outweighed by the potential benefits to the patient.”

There are no easy answers here, and with existing guidance as vague as this doctors are left to make their own judgement calls about the use of placebos.

I believe homeopathy should be consigned to the history books, so I’m happy to see doctors standing up to ignorance and calling for a ban. But a bigger debate should be had about the role of placebos in healthcare, because at the moment they’re being used anyway, and simply banning them one by one on an ad hoc basis probably doesn’t constitute an effective health policy.

Good discussion about placebos. Doctors both sides of the pond pretty much agree – although I have to admit I get extra chuckles living in one of the better known Southwest Spa towns offering every treatment specialist from Wiccan to Space Alien intervention.

Civil servant exposes five-hours-a-week culture

A French civil servant who lifted the lid on the wastefulness of the country’s state sector in a book describing where people competed to take the longest coffee breaks – has been suspended.

Zoé Shepard, her pen name, confirmed France’s worst fears about its “fonctionnaires” – its 5.2 million civil servants – in a book recounting how they compete to see who will hover longest at the coffee machine, draw up sick notes to stay weeks away from the office or while away the day on Facebook.

In Absolument Dé-bor-dé (Absolutely Snowed Under), subtitled How to Make 35 hours Last a Month, nepotism is rife and taxpayer’s money wasted, with one local civil servant even signing off his visit to a prostitute as “travel expenses”.

After eight years studying in France’s top administrative schools, Miss Shepard was taken on as a high-grade civil servant in French local government. She said she was raring to put her knowledge to public use but soon realised her remit was to do as little as possible in the greatest amount of time

She said she was working five-hour weeks for a $45,000 annual salary…

Her book sparked fury from the Regional Council, which said it put “the entire credibility and honour of the region at stake”. On Thursday its disciplinary committee decided to ban her from holding a civil service job for two years – one step short of a dismissal.

“I find it totally absurd as the committee members hadn’t even read the book,” she told The Daily Telegraph, adding that she intended to appeal the decision.

But she remained defiant. “The image you have of the French civil service is not a caricature. There is an enormous amount of waste. It’s scandalous. But when you denounce this waste you lose your job,” she said.

National and local government spending = 56 per cent of France’s total budget – the third highest ratio in Europe.

By comparison – for all the teabaggers in the audience – the same number for the United States = 44.5%.

Turkey asserts new economic power

For decades, Turkey has been told it was not ready to join the European Union — that it was too backward economically to qualify for membership in the now 27-nation club. That argument may no longer hold.

Today, Turkey is a fast-rising economic power, with a core of internationally competitive companies that are turning the youthful nation into an entrepreneurial hub, tapping cash-rich export markets in Russia and the Middle East while attracting billions of investment dollars in return.

For many in aging and debt-weary Europe, which will be lucky to eke out a little more than 1 percent growth this year, Turkey’s economic renaissance — last week it reported a stunning 11.4 percent expansion for the first quarter, second only to China — poses a completely new question: who needs the other one more — Europe or Turkey?

The old powers are losing power, both economically and intellectually,” said Vural Ak, 42, the founder and chief executive of Intercity, the largest car leasing company in Turkey. “And Turkey is now strong enough to stand by itself.”

It is an astonishing transformation for an economy that just 10 years ago had a budget deficit of 16 percent of gross domestic product and inflation of 72 percent. It is one that lies at the root of the rise to power of Prime Minister Recep Tayyip Erdogan, who has combined social conservatism with fiscally cautious economic policies to make his Justice and Development Party, or A.K.P., the most dominant political movement in Turkey since the early days of the republic.

Indeed, so complete has this evolution been, that Turkey is now closer to fulfilling the criteria for adopting the euro — if it ever does get into the European Union — than most of the troubled economies already in the euro zone. It is well under the 60-percent ceiling on government debt, at 49 percent of G.D.P., and could well get its annual budget deficit below the 3 percent benchmark next year. That leaves reducing inflation, now running at 8 percent, as the only remaining major policy goal…

Whether it be embracing Islam as a set of principles to govern his life or Israeli irrigation technology for his sideline almond and walnut growing business, Mr. Ak represents the flexible dynamism — both social and economic — that has allowed Turkey to expand the commercial ties with Israel, Russia, Saudi Arabia, Iran and Syria that now underpin its ambition to become the dominant political actor in the region…

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Planck space telescope brings us primordial cosmic light

The picture is the first full-sky image from Europe’s Planck telescope which was sent into space last year to survey the “oldest light” in the cosmos.

It took the 600m-euro observatory just over six months to assemble the map. It shows what is visible beyond the Earth to instruments that are sensitive to light at very long wavelengths – much longer than what we can sense with our eyes.

Researchers say it is a remarkable dataset that will help them understand better how the Universe came to look the way it does now.

It’s a spectacular picture; it’s a thing of beauty,” Dr Jan Tauber, the European Space Agency’s (Esa) Planck project scientist, told BBC News.

Dominating the foreground are large segments of our Milky Way Galaxy.

The bright horizontal line running the full length of the image is the galaxy’s main disc – the plane in which the Sun and the Earth also reside.

RTFA. Learn something of modern astronomy and our understanding of the universe.

No gods, No angels. No holy ghost. Dust in the wind.

Warned of murder – coppers turned it over to a committee – UPDATED

Raoul Moat

Police today admitted receiving a warning that Raoul Moat may have been planning to harm his former girlfriend the day before he allegedly shot her and killed her boyfriend.

The disclosure of the warning from Durham prison prompted Northumbria police to refer the issue to the Independent Police Complaints Commission.

You see how much good that accomplished.

Despite an intense search, Moat has evaded officers since allegedly shooting his former girlfriend, Samantha Stobbart, and killing her partner early on Saturday.

Northumbria police said today they had received a long letter purporting to come from Moat setting out a number of grievances. He also made two 999 calls, the first of which included a threat that he was about to shoot a police officer. Twelve minutes after the call yesterday Moat is believed to have shot an officer through the passenger window of his patrol car.

On Thursday Moat posted an update on his Facebook page which read: “Just got out of jail, I’ve lost everything, my business, my property and to top it all off my lass of six years has gone off with someone else. I’m not 21 and I can’t rebuild my life. Watch and see what happens.” Later he reportedly used the site to taunt police, writing: “Ha, Ha! You can come but you can’t catch me!”

Speaking at a press conference today, Detective Chief Superintendent Neil Adamson confirmed that police were investigating Moat’s Facebook page

RTFA. Follow the chronology of Moat’s release from prison, assorted shootings – and a police department that seems only to have competent control of their public relations office.

UPDATE: Moat has killed himself while police attempted to negotiate his surrender.

The world’s most expensive vuvuzela

A Russian businessman has paid almost £20,000 to have a £2 plastic Vuvuzela covered in expensive white gold and encrusted with precious stones.

Linz-based jeweller Klemens Pointner who specialises in providing tailor-made items for Russian clients said he met the businessmen at a trade fair in Moscow.

“He asked me about the possibility of modifying one of the Vuvuzelas for a football mad business contact and I said it would be possible,” he said.

Pointner refused to reveal his customer’s identity – but said the white gold-clad Vuvuzela also features a one-carat diamond…

“I had to work fast because the Russian businessmen wanted it to be used during the World Cup final which his business partner has got tickets for. I sent it off this week and it should arrive this weekend in plenty of time for the final.

I hate vuvuzelas. Probably 99.9% of all season-long football fans hate the damned things and that bloody-awful sound.

There should be a watch list kept of people who’ve been attending the World Cup who attempt to bring them back into the country.

Now, there’s someone who should be interned at Guantanamo Bay without appeal.

Sadistic Catholic priest gets 20 years for abusing boys

An Australian Catholic priest has been jailed for almost 20 years for “sadistic” sex attacks on young boys that spanned more than 18 years.

John Sidney Denham, 67, was sentenced to 19 years and 10 months after pleading guilty to a range of charges, including multiple counts of indecent assault against boys aged five to 16.

Denham was found guilty of abusing 39 boys at schools in Sydney and elsewhere in New South Wales between 1968 and 1986.

In sentencing, judge Helen Syme said that the abuse had been ignored by school authorities for many years, allowing it to continue.

“The indecent assaults involved multiple children, often significant planning, were frequently sadistic and overall persistent, objectively serious, criminal courses of conduct,” Judge Syme said. “The offender’s actions contributed to a culture of fear and depravity, especially at the school, which allowed these disturbing offences to occur and then remain unpunished for years.”

The public gallery applauded when the sentenced was announced.

Throw away the key!