MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

education

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I recently came across the ‘Sutherland Cranial College of Osteopathy’.

Sutherland Cranial College of Osteopathy?

Really?

I know what osteopathy is but what exactly is a ‘cranial college’?

Perhaps they mean ‘Sutherland College of Cranial Osteopathy’?

Anyway, they explain on their website that:

Cranial Osteopathy uses the same osteopathic principles that were described by Andrew Taylor Still, the founder of Osteopathy. Cranial osteopaths develop a very highly developed sense of palpation that enables them to feel subtle movements and imbalances in body tissues and to very gently support the body to release and re-balance itself. Treatment is so gentle that often patients are quite unaware that anything is happening. But the results of this subtle treatment can be dramatic, and it can benefit whole body health.

Sounds good?

I am sure you are now keen to become an expert in cranial osteopathy. The good news is that the college offers a course where this can be achieved in just 2 days! Here are the details:

This will be a spacious exploration of the nervous system.  Neurological dysfunction and conditions feature greatly in our clinical work and this is especially the case in paediatric practice. The focus of this course is how to approach the nervous system in a fundamental way with reference to both current and historical ideas of neurological function.  The following areas will be considered: 

    1. Attaining stillness and grounding during palpation of the nervous system. It is within stillness that potency resides and when the treatment happens. The placement of attention.  
    2. The pineal and its relationship to the tent, the pineal shift.
    3. The relations of the clivus and the central importance of the SBS, How do we assess and treat compression?
    4. The electromagnetic field and potency.
    5. The suspension of the cord within the spinal canal, the cervical and lumbar expansions.
    6. Listening posts for the central autonomic network.
Hawkwood College accommodation

Please be aware that accommodation at Hawkwood will be in shared rooms (single sex). Some single rooms are available on a first-come-first-served basis and will carry a supplement. Requesting a single room is not a guarantee that one will be provided.

£390.00 – £490.00

29 – 30 APRIL 2023 STROUD, UK
This will be a spacious exploration of the nervous system. Neurological dysfunction and conditions feature greatly in our clinical work and this is especially the case in pediatric practice.

_________________________

You see, not even expensive!

Go for it!!!

Oh, I see, you want to know what evidence there is that cranial osteopathy does more good than harm?

Right! Here is what I wrote in my recent book about it:

Craniosacral therapy (or craniosacral osteopathy) is a manual treatment developed by the US osteopath William Sutherland (1873–1953) and further refined by the US osteopath John Upledger (1932–2012) in the 1970s. The treatment consists of gentle touch and palpation of the synarthrodial joints of the skull and sacrum. Practitioners believe that these joints allow enough movement to regulate the pulsation of the cerebrospinal fluid which, in turn, improves what they call ‘primary respiration’. The notion of ‘primary respiration’ is based on the following 5 assumptions:

  • inherent motility of the central nervous system
  • fluctuation of the cerebrospinal fluid
  • mobility of the intracranial and intraspinal dural membranes
  • mobility of the cranial bones
  • involuntary motion of the sacral bones.

A further assumption is that palpation of the cranium can detect a rhythmic movement of the cranial bones. Gentle pressure is used by the therapist to manipulate the cranial bones to achieve a therapeutic result. The degree of mobility and compliance of the cranial bones is minimal, and therefore, most of these assumptions lack plausibility.

The therapeutic claims made for craniosacral therapy are not supported by sound evidence. A systematic review of all 6 trials of craniosacral therapy concluded that “the notion that CST is associated with more than non‐specific effects is not based on evidence from rigorous RCTs.” Some studies seem to indicate otherwise, but they are of lamentable methodological quality and thus not reliable.

Being such a gentle treatment, craniosacral therapy is particularly popular for infants. But here too, the evidence fails to show effectiveness. A study concluded that “healthy preterm infants undergoing an intervention with craniosacral therapy showed no significant changes in general movements compared to preterm infants without intervention.”

The costs for craniosacral therapy are usually modest but, if the treatment is employed regularly, they can be substantial.

______________________________

As the college states “often patients are quite unaware that anything is happening”. Is it because nothing is happening? According to the evidence, the answer is YES.

So, on second thought, maybe you give the above course a miss?

Have you ever wondered how good or bad the education of chiropractors and osteopaths is? Well, I have – and this new paper promises to provide an answer.

The aim of this study was to explore Australian chiropractic and osteopathic new graduates’ readiness for transition to practice concerning their clinical skills, professional behaviors, and interprofessional abilities. Phase 1 explored final-year students’ self-perceptions, and this part uncovered their opinions after 6 months or more in practice.

Interviews were conducted with a self-selecting sample of phase 1 participant graduates from 2 Australian chiropractic and 2 osteopathic programs. Results of the thematic content analysis of responses were compared to the Australian Chiropractic Standards and Osteopathic Capabilities, the authority documents at the time of the study.

Interviews from graduates of 2 chiropractic courses (n = 6) and 2 osteopathic courses (n = 8) revealed that the majority had positive comments about their readiness for practice. Most were satisfied with their level of clinical skills, verbal communication skills, and manual therapy skills. Gaps in competence were identified in written communications such as case notes and referrals to enable interprofessional practice, understanding of professional behaviors, and business skills. These identified gaps suggest that these graduates are not fully cognizant of what it means to manage their business practices in a manner expected of a health professional.

The authors concluded that this small study into clinical training for chiropractic and osteopathy suggests that graduates lack some necessary skills and that it is possible that the ideals and goals for clinical education, to prepare for the transition to practice, may not be fully realized or deliver all the desired prerequisites for graduate practice.

Their conclusions in the actual paper finish with these sentences, in the main, graduate participants and the final year students were unable to articulate what professional behaviors were expected of them. The identified gaps suggest these graduates are not fully cognizant of what it means to manage their business practices in a manner expected of a health professional.

In several ways, this is a remarkable paper – remarkably poor, I hasten to add. Apart from the fact that its sample size was tiny and the response rate was low, it has many further limitations. Most notably, the clinical skills, professional behaviors, and interprofessional abilities were not assessed. All the researchers did was ask the participants how good or bad they were at these skills. Is this method going to generate reliable evidence? I very much doubt it!

Imagine, these guys have just paid tidy sums for their ‘education’ and they have no experience to speak of. Are they going to be in a good position to critically evaluate their abilities? No, I fear not!

Considering these flaws and the fact that chiropractors and osteopaths are not exactly known for their skills of critical thinking, I find it amazing that important deficits in their abilities nevertheless emerge. If I had to formulate a conclusion from all this, I might therefore suggest this:

A dismal study seems to suggest that chiropractic and osteopathic schooling is dismal. 

PS

Come to think of it, there might be another fitting option:

Yet another team of chiro- and osteos demonstrate that they don’t know how to do science.

Pancoast tumors, also called superior sulcus tumors, are a rare type of cancer affecting the lung apex. These tumors can spread to the brachial plexus and spine and present with symptoms that appear to be of musculoskeletal origin. Patients with an advanced Pancoast tumor may thus feel intense, constant, or radiating pain in their arms, around their chest wall, between their shoulder blades, or traveling into their upper back or armpit. In addition, a Pancoast tumor may cause the following symptoms:

  • Swelling in the upper arm
  • Chest tightness
  • Weakness or loss of coordination in the hand muscles
  • Numbness or tingling sensations in the hand
  • Loss of muscle tissue in the arm or hand
  • Fatigue
  • Unexplained weight loss

This case report details the story of a 59-year-old Asian man who presented to a chiropractor in Hong Kong with a 1-month history of neck and shoulder pain and numbness. His symptoms had been treated unsuccessfully with exercise, medications, and acupuncture. He had a history of tuberculosis currently treated with antibiotics and a 50-pack-year history of smoking.

Cervical magnetic resonance imaging (MRI) revealed a small cervical disc herniation thought to correspond with radicular symptoms. However, when the patient did not respond to a brief trial of chiropractic treatment, the chiropractor referred the patient back to the chest hospital for further testing, which confirmed the diagnosis of a Pancoast tumor. The patient was then referred for medical care and received radiotherapy and chemotherapy. At 2 months’ follow-up, the patient noted feeling lighter with less severe neck and shoulder pain and numbness. He also reported that he could sleep longer but still had severe pain upon waking for 2–3 hours, which subsided through the day.

A literature review identified six previously published cases in which a patient presented to a chiropractor with an undiagnosed Pancoast tumor. All patients had shoulder, spine, and/or upper extremity pain.

The authors concluded that patients with a previously undiagnosed Pancoast tumor can present to chiropractors given that these tumors may invade the brachial plexus and spine, causing shoulder, spine, and/or upper extremity pain. Chiropractors should be aware of the clinical features and risk factors of Pancoast tumors to readily identify them and refer such patients for medical care.

This is an important case report, in my view. It demonstrates that symptoms treated by chiropractors, osteopaths, and physiotherapists on a daily basis can easily be diagnosed wrongly. It also shows how vital it is that the therapist reacts responsibly to the fact that his/her treatments are unsuccessful. Far too often, the therapist has an undeniable conflict of interest and will say: “Give it more time, and, in my experience, symptoms will respond.”

The chiropractor in this story was brilliant and did the unusual thing of not continuing to treat his patient. However, I do wonder: might he be the exception rather than the rule?

One of my previous posts was about a press release announcing a ‘WORLDWIDE DECLARATION’, and I promised to comment about the actual declaration. This post firstly reproduces this document and secondly provides a few comments on it. Here is the document:

DEFINITIONS

Traditional, complementary and integrative healthcare (TCIH) refers to the respectful collaboration between various systems of healthcare and their health professionals with the aim of offering a person-centred and holistic approach to health.

ABOUT US

We represent a worldwide community of users and health professionals of TCIH with a large diversity of backgrounds and experiences with a common commitment to the advancement and
promotion of TCIH.

THE HEALTHCARE WE DESIRE

• Focuses on the whole person, including physical, mental, social and spiritual dimensions
• Is patient-centred and supports self-healing and health creation
• Is participative and respects individual choices
• Is evidence-based by integrating clinical experience and patient values with the best available research information
• Respects cultural diversity and regional differences
• Is an integral part of community and planetary health
• Uses natural and sustainable resources that are respectful of the health of our planet
• Integrates traditional, complementary and biomedical practices in a supportive and collaborative manner

We appreciate the benefits of conventional / biomedicine. At the same time we recognize its limitations, including:

• The insufficient therapeutic options that biomedicine provides, especially for chronic / non-communicable diseases (NCDs)
• Frequent side effects of biomedical treatments and rising antimicrobial resistance
• Fragmentation of care from increased specialization and the limits of a disease-based model

We are inspired by countries that are successfully integrating TCIH into their healthcare systems. However, we are concerned about:

• Countries that prevent, limit or undervalue the practice of TCIH
• Uninformed or unbalanced media reporting of TCIH
• Insufficient public funding of TCIH research
• Risk of reduced availability of TCIH and unregulated practices in some countries

OUR CALL TO ACTION

All countries

• Ensure full access to TCIH as part of the right to health for all
• Include TCIH into national health systems
• Provide accreditation of TCIH healthcare professionals in accordance with international training standards to ensure high quality care
• Ensure access and safety of TCIH medicines through specific regulatory pathways
• Fund research on TCIH and disseminate reliable information on TCIH to the public

All healthcare professionals

• Foster respectful collaboration between all healthcare professions towards achieving a person-centred and holistic approach to healthcare

_____________________________

And here are my comments.

  • “TCIH”: in the realm of so-called alternative medicine it seems popular to create a new name for the subject at hand; this one is yet another one in a long line of innovations – sadly, it is as nonsensical as most of the previous ones.
  • Person-centred and holistic approach to health: all good healthcare has these qualities.
  • We represent a worldwide community: really? Who exactly are you then, and what is your ligitimization?
  • Whole person, including physical, mental, social and spiritual dimensions: all good healthcare has these qualities.
  • Patient-centred and supports self-healing and health creation: all good healthcare has these qualities.
  • Respects individual choices: all good healthcare has these qualities.
  • Evidence-based: either they do not know what this term means or they are deliberately misleading the public.
  • Integral part of community and planetary health: all good healthcare has these qualities.
  • Natural and sustainable resources that are respectful of the health of our planet: like Rhino horn and similar ingredients of TCM products?
  • Insufficient therapeutic options that biomedicine provides: yes, conventional medicine is far from perfect, but adding something even less perfect to it cannot improve it.
  • Frequent side effects of biomedical treatments and rising antimicrobial resistance: yes, conventional medicine is far from perfect, but adding something even less perfect to it cannot improve it.
  • Full access to TCIH as part of the right to health for all: the ‘right to health for all’ means the right to the most effective therapies not the right to the most bizarre quackery.
  • Accreditation of TCIH healthcare professionals: giving respectability to every quack would not render healthcare better or safer but worse and more dangerous.
  • Access and safety of TCIH medicines through specific regulatory pathways: regulating access to unproven treatments is nothing less than a recipe for disaster.
  • Research on TCIH: yes in some areas, research might be worthwhile, but it must be rigorously testing TCIH and not promoting it uncritically.
  • Disseminate reliable information on TCIH to the public: thank you! This is my main aim in writing the ~2500 posts on this blog. Yet I do often get the impression that this gets disappointingly little support – and frequently the exact opposite – from enthusiasts of TCIH.

All healthcare professionals have an ethical obligation to be truthful and act in the best interest of the patient by adhering to the best available evidence. Providing false or misleading information to patients or consumers is thus a breach of medical ethics. In Canada, the authorities have started taking action against nurses that violate these ethical principles.

Now it has been reported that a former registered nurse in West Kelowna has been suspended for four weeks after giving a vulnerable client anti-vaccine information and recommending “alternative pseudoscience” treatments.

According to the terms of a consent agreement posted on the B.C. College of Nurses and Midwives site, Carole Garfield was under investigation for actions that happened in September 2021. The college claims that Garfield contacted the client when she was off duty, using her personal mobile phone and email to give information against the COVID-19 vaccine and recommending so-called alternative medicine (SCAM). The exact nature of the “pseudoscience modalities” Garfield recommended to the client was not listed in the college’s notice.

Garfield’s nursing licence was cancelled back in April, according to the college’s registry. It’s unclear how exactly the four-week suspension will be applied. In addition to her month-long suspension and a public reprimand, Garfield is not allowed to be the sole nurse on duty for six months. She will also be given education about ethics, boundaries, and client confidentiality, as well as the province’s professional nursing standards. “The inquiry committee is satisfied that the terms will protect the public,” read a statement from the college.

In my view, it is high time for professional bodies to act against healthcare professionals who issue misleading information to their patients. In the realm of so-called alternative medicine (SCAM), issuing false or misleading information is extremely common and causes untold harm. Such harm would be largely preventable if the professional bodies in charge would start acting responsibly in the best interest of patients. It is high time that they follow the Canadian example!

The Center for Inquiry (CFI) is a charitable nonprofit organization dedicated to defending science and critical thinking. CFI’s vision is a world in which evidence, science, and compassion—rather than superstition, pseudoscience, or prejudice—guide public policy.

It has been reported that the CFI, through its Office of Consumer Protection from Pseudoscience, warned Amazon.com that the marketing and sale of unapproved homeopathic drugs betrays consumers’ trust and runs afoul of federal law. In a letter sent to the world’s largest online retailer, attorneys for CFI charged that Amazon has legal and moral obligations to end its trade in the prohibited items and urged the company to immediately cease the sale of unapproved drugs marketed as medicine for babies, infants, and children.

In Amazon’s Health Care Products department, a search for “homeopathic” returns more than 10,000 product results–each claiming to treat a host of health issues, ranging from “nerve pain” and “fever” to “surgical wounds” and “fibroids and ovarian cysts.” Marketed with names such as “Boiron RhinAllergy Kids” and “Hyland’s 4Kids Pain Relief,” many items are explicitly sold as medicine for children. However, not one homeopathic drug has been approved by the Food and Drug Administration (FDA) as required by the federal Food, Drug & Cosmetic Act.

“Amazon built its business and public reputation on assurances it prioritizes consumer trust above all else,” says CFI Vice President and General Counsel Nick Little. “It’s impossible to be ‘Earth’s most customer-centric company’ while aggressively promoting thousands of snake oil products to parents. If Amazon truly wants to put its customers first, the company should be protecting them from sellers of sham treatments and faux medicine, not profiting from it.”

The FDA recently issued a warning letter to Amazon over the platform’s prohibited sale of mole and skin tag removal products that lack FDA approval. CFI makes clear that the same prohibitions apply to homeopathic drugs sold on Amazon.com. The letter also highlights deceptive marketing practices used to sell the products, noting that the industry’s own figures found 85 percent of those who purchased a brand of homeopathic product were not aware the item was actually homeopathic.

“Amazon recently announced partnerships to help crack-down on phony wrestling memorabilia,” Little notes. “We think protecting children against harmful homeopathic drugs is a bit more deserving of the company’s attention and hope Amazon accepts our offer to help identify these particularly problematic products for removal.”

You can read CFI’s letter to Amazon here.

Why are we here?

Who am I?

What is my life’s purpose?

These are BIG questions indeed.

And here are the answers:

The spiritually transformative work of Life Between Lives (LBL) hypnotherapy began with one man’s dedication and curiosity to search for answers to the great questions about life and beyond. Today, the Michael Newton Institute (MNI), founded by Dr. Michael Newton, and our global network of over 200 LBL Facilitators hold his vision for humanity and carry on his passion for researching the Afterlife and bringing the evolving modality of LBL hypnotherapy to humanity.

Our Vision

For humanity to live the unconditional love and wisdom of Spiritual Consciousness.

Our Mission

To raise personal and collective consciousness, by bringing the healing and wisdom of Life Between Lives to individuals around the globe, reawakening their immortal identity and integrating Spiritual Consciousness.

Who We Are

The Michael Newton Institute is a not-for-profit organization, bringing together a worldwide collective of trained Facilitators to offer Life Between Lives hypnotherapy, as pioneered by Dr. Michael Newton.Dr Michael Newton. We are committed to providing opportunities globally for people to experience their soul state and a reconnection to the wisdom of the After-life / Inter-life.

What We Offer the World

We advocate for the Spiritual Realm, sharing the wisdom received by individuals around the globe through the exploration of their existence between lives by offering:

  • Life Between Lives Sessions – Access to LBL sessions for individuals all around the world through our network of members.
  • LBL Facilitator Network – Our MNI members are a diverse group of over 200 individuals who offer LBL to clients all around the world in 40 countries and over 25 languages within their own practices.
  • LBL Training – Empowering new generations to learn LBL and continue this important work for their own clients. We create and nurture a community of Life Between Lives Facilitators to connect, learn and grow, so they may support their clients.
  • Stories of the Afterlife – Our quarterly journal shares the latest LBL cases and information about LBL (public subscriptions welcome).
  • Publications – Continued publication of Dr Michael Newtons and the Institutes own books ensure the wisdom of LBL work is accessible to all people. Over 1 million people have enjoyed these books and learnt from others, Life Between Lives spiritually transformative experience, applying the wisdom to bring new insight, awareness and healing to their own lives.
  • Research – We continue to explore the afterlife and conduct studies into the therapeutic benefits of LBL.
  • Facebook Community – Our thriving social media discussion group has over 8,000 members who discuss the work of Dr Michael Newton, MNI and LBL every day.

You can read about Dr. Newton and the development of the Michael Newton Institute over the last 20 years at History of MNI. The Michael Newton Institute is overseen by a Board of Directors and Volunteer Teams.

Our LBL Facilitator Community

MNI is an organisation of like-minded, yet diverse individuals who are called to help others expand their awareness of their immortal identity furthering Dr Michael Newton’s legacy. Individuals in our LBL facilitator member community can be found in 40 countries around the world.

We understand more than anyone that our higher guidance draws us together for a common purpose. Many feel the call to join the Michael Newton Institute, often inspired by reading our publications, or through a life changing experience in their own Life Between Lives session. MNI is always seeking to grow the community, if you feel drawn you may consider LBL training.

After completing LBL training and certification requirements, certified LBL facilitators join our global membership community offering LBL to their own clients in their independent practices. LBL work can be a spiritually transformative experience for many clients and MNI LBL Facilitators consider the offering of LBL work to others an honour.

Values and Ethics

As LBL Facilitators, and Members of the Michael Newton Institute (MNI) we are:

  • Dedicated and passionate about reawakening humanity’s connection to the unconditional love and wisdom of Spiritual Consciousness for healing and personal growth.
  • Trusting in the innate wisdom within everyone and All That Is.
  • Compassionate to those we serve and each other, seeking to transcend the human condition.

We are a Spiritual based organization. The Michael Newton Institute is committed to maintaining the highest standard of human and spiritual Values and Ethics in delivering our Mission for humanity. Our LBL Facilitators and those in many volunteers in roles throughout our organization commit to following the MNI Code of Ethics in their own practices, or working on behalf of MNI. Our Alliance Hypnotherapy and Alliance Past Life Regression Program partners also commit to these ethical standards, to support our Vision and Mission.

_____________________________

So:

Why are we here?

Who am I?

What is my life’s purpose?

I found one therapist offering these services, and it was her website that provided some plausible answers:

We are here to be exploited by charlatans.

We are considered to be gullible morons.

Our purpose in life is to support quacks.

The costs for the sessions range from 90 to 795 Euros!

As numerous of my posts have demonstrated, chiropractic manipulations can cause severe adverse effects, including deaths. Several hundred have been documented in the medical literature. When discussing this fact with chiropractors, we either see denial or we hear the argument that such events are but extreme rarities. To the latter, I usually respond that, in the absence of a monitoring system, nobody can tell how often serious adverse events happen. The resply often is this:

You are mistaken because the Royal College of Chiropractors’ UK-based Chiropractic Patient Incident Reporting and Learning System (CPiRLS) monitors such events adequately. 

I have heard this so often that it is time, I feel, to have a look at CPiRLS. Here is what it says on the website:

CPiRLS is a secure website which allows chiropractors to view, submit and comment on patient safety incidents.

Access to CPiRLS

CPiRLS is currently open to all UK-based chiropractors, all ECU members and members of the Chiropractic and Osteopathic College of Australasia. To access the secure area of the CPiRLS website, please click the icon below and insert the relevant CPiRLS username and password when prompted.

In the UK, these can normally be found on your Royal College of Chiropractors’ membership card unless the details are changed mid-year. Alternatively, email admin@rcc-uk.org from your usual email address and we will forward the details.

Alternatively, in the UK and overseas, secure access details can be obtained from your professional association.

National associations and organisations wishing to use CPiRLS, or obtain trial access to the full site for evaluation purposes, should contact The Royal College of Chiropractors at chiefexec@rcc-uk.org

Please click the icon below to visit the CPiRLS site.

Yes, you understood correctly. The public cannot access CPiRLS! When I click on the icon, I get this:

Welcome to CPiRLS

CPiRLS, The Chiropractic Patient Incident Reporting and Learning System – is an online reporting and learning forum that enables chiropractors to share and comment on patient safety incidents.

The essential details of submitted reports are published on this website for all chiropractors to view and add comments. A CPiRLS team identifies trends among submitted reports in order to provide feedback for the profession. Sharing information in this way helps to ensure the whole profession learns from the collective experience in the interests of patients.

All chiropractors are encouraged to adopt incident reporting as part of a blame-free culture of safety, and a routine risk management tool.

CPiRLS is secure and anonymous. There is no known way that anyone reporting can be identified, nor do those running the system seek to identify you. For this security to be effective, you require a password to participate.

Please note that reporting to CPiRLS is NOT a substitute for the reporting of patient safety incidents to your professional association and/or indemnity insurers.

So, how useful is CPiRLS?

Can we get any information from CPiRLS about the incidence of adverse effects?

No!

Do we know how many strokes or deaths have been reported?

No!

Can chiropractors get reliable information from CPiRLS about the incidence of adverse effects?

No, because reporting is not mandatory and the number of reports cannot relate to incidence.

Are chiropractors likely to report adverse effects?

No, because they have no incentive and might even feel that it would give their profession a bad name.

Is CPiRLS transparent?

No!

Is CPiRLS akin to postmarketing surveillance as it exists in conventional medicine?

No!

How useful is CPiRLS?

I think I let my readers answer this question.

 

This study aimed to evaluate the efficacy of Persian barley water in controlling the clinical outcomes of hospitalized COVID-19 patients. It was designed as a single-blind, add-on therapy, randomized controlled clinical trial and conducted in Shiraz, Iran, from January to March 2021. One hundred hospitalized COVID-19 patients with moderate disease severity were randomly allocated to receive routine treatment (per local protocols) with or without 250 ml of Persian barley water (PBW) daily for two weeks. Clinical outcomes and blood tests were recorded before and after the study period. Multivariable modeling was applied using Stata software for data analysis.

The length of hospital stay (LHS) was 4.5 days shorter in the intervention group than the control group regardless of history of cigarette smoking (95% confidence interval: -7.22, -1.79 days). Also, body temperature, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and creatinine significantly dropped in the intervention group compared to the control group. No adverse events related to PBW occurred.

The authors from the Department of Traditional Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, concluded that this clinical trial demonstrated the efficacy of PBW in minimizing the LHS, fever, and levels of ESR, CRP, and creatinine among hospitalized COVID-19 patients with moderate disease severity. More robust trials can help find safe and effective herbal formulations as treatments for COVID-19.

I must admit, I did not know about PBW. The authors explain that PBW is manufactured from Hordeum vulgare via a specific procedure. According to recent studies, barley is rich in constituents such as selenium, tocotrienols, phytic acid, catechin, lutein, vitamin E, and vitamin C; these compounds are responsible for their antioxidant and anti-inflammatory properties. Barley grains also have immune-stimulating effects, antioxidant properties, protective effects on the liver and digestive systems, anti-cancer effects, and act to reduce uric acid levels.

But even if these effects would constitute a plausible mechanism for explaining the observed effects (which I do not think they do), the study itself is more than flimsy.

I do not understand why researchers investigating an important issue do not make sure that their study is as rigorous as possible.

  • Why not use an adequately large sample size?
  • Why not employ a placebo?
  • Why not double-blind?
  • Why not report the most important outcome, i.e. mortality?

As it stands, nobody will take this study seriously. Perhaps this is a good thing – but perhaps PBW does have positive effects (I know it’s a long shot) and, in this case, a poor-quality study would only prevent an effective therapy come to light.

There is a broad, growing, international consensus that homeopathy is a placebo therapy. Even the Germans who have been notoriously fond of their homeopathic remedies are now slowly beginning to accept this fact. But now, a dispute has started to smolder in Germany’s southwest about further training for doctors in homeopathy. In July, the representative assembly of the Baden-Württemberg Medical Association decided to remove the additional title of homeopathy from the further training regulations of doctors. However, the local health ministry has legal control over the medical association and must therefore review the decision, and the minister (Manne Lucha), a member of the Green Party, has stated that he considers the deletion to be wrong.

In a further deepening of the conflict, it has been reported that the chairwoman of the Green Party, Lena Schwelling, considers the ongoing controversy over homeopathy to be exaggerated and wants to preserve people’s freedom of choice. She said she agrees with Health Minister Manne Lucha that naturopathy and homeopathy are important issues for many people. “There is freedom of choice of doctor and therapy in this country. And if people want to choose it, I think they should be allowed to do so.” She also said continuing education for homeopathy for physicians should remain.

Schwelling spoke out against omitting homeopathy from the benefits catalog of the statutory health insurance funds, as demanded by the German Liberal Party, for example: “We are talking about about 0.003 percent of the total costs of the statutory health insurance funds, which flow into homeopathic medicines and treatments. If you saw that as a homeopathic medicine, that would also be at the detection limit, that’s how little money it is. It’s so diluted and so little in this overall budget that it’s not worth arguing about. That’s why I’m very surprised at the crusade some are waging against the issue of homeopathy.”

Recently, a dispute has been smoldering in the southwest about continuing education for homeopathy. The representative assembly of the Baden-Württemberg Medical Association decided in July to remove the additional title of homeopathy from the continuing education regulations. The local health minister, Lucha, has legal oversight of the medical association and must review the amendment statute. However, the minister has already stated that he believes the deletion is wrong.

In response, Schwelling stated it is a “normal process” for the ministry to review what the medical association has proposed. He added that it was perfectly clear that “further training in homeopathy is additional training and does not replace medical studies. Of course, homeopathic doctors also prescribe antibiotics when indicated. An important point why homeopathy should remain in the canon is that you then have the established control mechanisms, for example, in further education.”

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