Your Health Feeds
Is There Such a Thing as “Created” COI?
Our friend Dr. Roy Poses, over at Health Care Renewal blog, has coined a new term, “created” conflict of interest:
http://hcrenewal.blogspot.com/2012/02/texas-tmap-trials-as-illustration-of.html
http://hcrenewal.blogspot.com/2012/02/logical-fallacies-in-defense-of.html
Here’s the basic idea: “We have repeatedly discussed the adverse effects of conflicts of interest on health care. Recently, I argued that the most pernicious are conflicts of interest created as an incentive for trusted health care leaders, usually respected health care professionals or academics, to promote the vested interests of those who pay them, in the guise of the leaders' professional roles. In this capacity, the leaders are often dubbed "key opinion leaders" by those who employ them, but may be regarded as mere "salesmen" by the corporate personnel who recruit them. (See posts here and here) These relationships may be hidden, often behind confidentiality agreements, unless revealed by litigation. Documents revealed by discovery in legal actions showed how companies planned other organized stealth marketing efforts for drugs that included activities by KOLs (e.g., see post here about marketing of Lexapro, and here about Neurontin).”
So let me see if I can dissect this a bit. Some COIs simply appear or emerge. An example: A case comes before a judge. At first glance there is nothing suggestive of a COI, the judge does not know of any special relationship he might have with any of the parties to the case. But as the facts unfold, the judge comes to realize that one of the parties to the case has a close relationship with Company X, and a close relative of the judge is an executive with company X. The judge now decides to recuse himself because of possible bias. If we call this COI and not simply “bias” then it would seems a good example of non-created COI. No one set out to create a situation in which this judge would be biased; it simply seemed to happen.
I take it that the contrast then is with a drug company bribing a KOL. The company deliberately set out to create the COI. Now, is that quite an accurate description? In one sense the company did not set out to create a conflict of interest; they merely wished to create a strong interest in the KOL shilling for them loyally and enthusiastically. But in another sense they did create the conflict quite deliberately. The KOL has to have interest #2 (supposedly being a neutral and unbiased scientific authority) in order for the company to regard him as a KOL and so worth tempting with interest #1.
One could further quibble: just who “created” the conflict? One could of course say the drug company did; they set out to corrupt this person to be used as a marketing tool. But one could also say that the would-be KOL could have said no to the company and so by agreeing it was the individual and not the company that “created” the COI.
So I end up with the skeptical stance that once we explain (ethically) just what is worrisome about COI, I am not sure that we say a heck of a lot more by adding the modifier “created.” Some COIs are in fact innocent and others are problematic but relatively easily managed. So COI lies along a spectrum of severity.
Of all COIs, I agree with Dr. Poses that instances where the industry deliberately corrupts KOLs so as to use their supposed scientific objectivity for marketing purposes are among the most severe. The reason for this (as I discussed in HOOKED, citing the work of my colleague Len Weber) is the way in which medical professionalism is deliberately dragged into the gutter for profit. This is a form of COI even more to be ethically deplored for that reason.
I cannot in the end dispute the use of the modifier “created” for come COIs. So why am I resisting? I guess my only reason is that I see COI, as noted, lying along a spectrum of severity. I think a spectrum metaphor is a more useful way to approach the COI question that a dichotomy, “created” vs. “not created.” But let’s let Dr. Poses run with his idea and I’ll see if he’ll convince me of its utility.
60 Minutes Weighs In on Antidepressants
I was just checking out on line yesterday's "60 Minutes" segment--
http://www.cbsnews.com/video/watch/?id=7399362n&tag=contentBody;storyMediaBox
--that features a friend, Dr. Irving Kirsch of Harvard, a psychologist whose work on placebo effect and expectancy I have long admired. But the segment is only peripherally about placebo effect; it's rather about Kirsch's now oft-repeated finding that except for severe depression, the difference between antidepressants and placebos in clinical trials is negligible.
As seems typical, the news program featured as "gosh golly gee whiz" news stuff that we've been over in this blog many times before:
- The serotonin theory of depression, on which most antidepressant therapy is based, is either only a part of the story or else dead wrong
- The drug companies selectively publish the drug trials that show benefit and selectively hide the trials that don't
- Several independent investigations have agreed with Kirsch's original work that in mild to moderate depression, there is hardly any difference between drug and placebo effects
If I had any major quibble with the program, it was that the magic words "side effects" were first mentioned at around 11:30 of the 13:40 segment (by the British psychiatrist). Those words tell the whole story. Placebos might be equivalent to drug in regards to benefits--but certainly not with regard to adverse reactions. We have been incredibly slow (aided by aggressive drug company marketing) to realize in medicine that most of these "nonaddictive" drugs actually have serious withdrawal syndromes, such that the worsening symptoms when patients go off their antidepressants--interpreted by the drug companies as sure proof that they work--might just as well be drug withdrawal symptoms as recurrence-of-depression symptoms.
The other fun part of the program was watching the US psychiatrist (and of course, consultant for several drug firms) who was put on to defend the track record of these drugs. He naturally made no mention of side effects whatever, but he did insist that in his own independent studies, 14% of moderately depressed patients do better on drug than on placebo. (He admitted that it was a wash in mild depression.) In his mind this justified current practice. Can you believe it--14%??? For a condition where the drugs have serious side effects and where talk therapy or exercise work as well? And that's apparently the best rebuttal the drug industry can come up with?
I must here repeat the usual disclaimer--don't try this at home--if you're depressed see your doctor and do what the doctor says, and above all don't discontinue any drug without the doctor's advice.
The Difference Between Essential Oils and Flower Essences
This article, The Difference Between Essential Oils and Flower Essences, was originally published at Natural Health Ezine.
People often confuse essential oils and flower essences. Although both essential oils and flower essences have therapeutic benefits they are, in fact, different commodities. They are extracted in different ways and are also used in different ways. This article outlines the differences and similarities between these two popular natural products – and when you should each one.
Essential Oils
Essential oils are natural oils that are extracted from plants. They are used in aromatherapy for therapeutic purposes for common conditions such as asthma, arthritis, back pain and stress. Essential oils are extracted from the hairs, glands or sacs of plants and plant parts such as bark, roots, leaves, flowers, grasses and seeds. The two most common extraction methods for essential oils are distillation and cold expression. Most citrus essential oils are cold expressed in comparison to other types of oils. Examples of essential oils include lemon, lavender, orange, rose, peppermint, rosemary, cypress, clary sage and eucalyptus.
Flower Essences
Dr. Edward Bach (1886 – 1936) is the most well known name accredited with the discovery of the therapeutic benefits of flower essences. However, in addition to The Bach Flower Remedies
Plant material is collected from the plant, placed in a bowl of water and allowed to infuse the natural elements of the sun (or other heat source) and air. Once the plants have been infused for a period of time, the water infusion is bottled and stored, ready for use. Flower essences also contain alcohol (usually brandy) as a natural preservative for the infusion. Flower essences contain the vibration, or energy, of the plant which is used to heal the imbalances in your body.
Therapeutic Benefits of Essential Oils
Essential oils are used to treat both physical and emotional ailments. However, essential oils are predominately applied to the outside of the body and are not recommended for internal use without a comprehensive and lengthy training and understanding of the oils from a qualified and experienced practitioner. Use essential oils in skin care, for muscle pain, digestive problems, respiratory problems, nervous system disorders, for circulatory problems, and to boost your immune system. Essential oils possess many different therapeutic properties, depending upon the oil; common properties of essential oils are analgesic, anti-inflammatory, calming, digestive, anti-viral and bactericidal (source: The Illustrated Encyclopedia of Essential Oils
Therapeutic Benefits of Flower Essences
Use flower essences to treat emotional problems such as fear, loneliness, uncertainty, despair, insufficient interest in present circumstances, over-sensitivity and over-care (source: The Essential Writings of Dr Edward Bach.
Use of Essential Oils and Flower Essences
Always dilute an essential oil in a carrier oil or lotion before use before applying it externally to your body. In addition, pay attention to any contra-indications for certain groups of people such as in pregnancy or with the elderly or children. Be aware that some essential oils might interact with certain types of medication or other therapies, such as homeopathy or high blood pressure. Consult a trained aromatherapist for advice on how to use essential oils for a specific problem.
In general, you can use flower essences with other medications and other types of therapies such as homeopathy. You usually use flower essences internally via the mouth. Consult a qualified professional, trained in the use of flower essences, for advice on how to use for a specific problem.
Essential Oil or Flower Essence?
Both flower essences and essential oils are suitable for both people and animals (but be aware of any different reactions). They both have similar uses but there are differences in the way that they are administered, the safety issues regarding use and the types of plants (and methods) that they are extracted from. If you understand the basic differences between flower essences and essential oils, you can use both products to the best of your ability and knowledge.
Author is a trained and certified clinical aromatherapist with level 1 training in Bach Flower Remedies
Photo by Mike Gilbert Photography
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Baby, Bathwater, and Prescribing for Chronic Pain
John Fauber, the indefatigable investigative reporter from Milwaukee, has a new article out on how the current overuse of opiate narcotics for treating chronic pain was spurred by heavy industry funding of major pain organizations, including one at University of Wisconsin:
http://www.jsonline.com/watchdog/watchdogreports/painkiller-boom-fueled-by-networking-dp3p2rn-139609053.html
I have blogged on this topic before: http://brodyhooked.blogspot.com/2011/12/painful-to-report-propublica-skewers.html--and also got out a little bit ahead of it back in HOOKED when I sympathized with the pain organizations but also criticized them for taking industry money and leaving themselves open to these charges.
I agree therefore with Fauber that these organizations issued tainted statements and guidelines due to their willingness to take funding from industry--which at the time might have seemed understandable because no one else was willing to put funding into pain issues, despite the estimated 75-100 million Americans who live with undertreated chronic pain. It is important that we don't lose sight of this critical public health need for better pain management while getting on the latest bandwagon deploring the overprescription of narcotics.
Where I would take Fauber's article somewhat to task is for 20-20 hindsight. Today we have some reasonable evidence to urge caution in prescribing opiates for chronic pain, especially in higher dose ranges. This evidence was not generally available 10-15 years ago when many of the ideas about improved treatment of chronic pain were first formulated. While it is true that these pain guidelines were unfortunately influenced by money from Pharma, it is also true that there were reasons to believe in the older style of pain therapy that was willing to go to higher doses of narcotics, and the evidence then available did not clearly indicate its hazards or limits.
As a family physician I never was a pain "specialist" but cared for a number of patients with severe chronic pain before I ceased patient care in 2006. If I knew then what I now believe to be the case, I would have managed some of them differently. But at the time I could point to apparently authoritative guidelines to support what I did, and I had all too few real options available--another point ignored by Fauber's article. What do you do with chronic pain that's not responsive to lower-dose opiates? The ideal answer, so far as I now know, is to refer the patient to a multidisciplinary pain clinic with a team approach that includes pain psychology, physical and occupational therapy, and so on along side pain medicine--and that's also willing to prescribe narcotics if that's justified in any individual case. Such clinics are few and far between--and if your patient is Medicaid, which is very commonly the case, then it's even harder to find such help for treating them adequately.
I would also disagree with one rather sweeping conclusion Fauber offers, that "pseudoaddiction" is a concept promoted by industry marketing, now known to be invalid. Pseudoaddiction refers to the fact that patients with untreated severe pain will in fact be "drug seekers"--they will display behavior which health providers often interpret as that of an addict just trying to get a fix, when the underlying problem is pain and not addiction, and if you gave enough drug to eliminate the pain, all the "drug seeking" behavior would disappear. As a clinician I would argue that this concept remains valid. Fauber seems to dismiss it because it's obviously invalid if one assumes that any patient showing such behavior is not an addict but has undertreated pain. I don't know any pain expert who has ever recommended this perspective; the suggestion as I have always understood it is that pseudoaddiction should be considered as a possibility alongside other explanations for the patient's behavior.
The sad news from a public health perspective is that if high-dose opiates are not the way to properly treat chronic pain, simply saying so, and ceasing to prescibe opiates that way, does nothing to diminish the serious problem of undertreated pain in our society. One of the wisest things I ever hard about this problem came from a colleague who had training in both palliative care and addiction medicine. She said that there are three kinds of patients who suffer from serious diseases and that deserve our sympathy as well as the best treatment we can come up with. The first group has severe pain. The second group has addiction. The third group has both of the above. While all three deserve our sympathy and care, what's the right type of care depends critically on locating each patient withyin the correct category out of the three. Sadly many practitioners in the US today don't have the sort of help they ideally need to make that determination, let alone administer the correct therapy.
More on Bioethicists and COI
I've had considerable feedback both in the form of blog comments and off-line e-mail regarding the previous post on bioethicists and conflicts of interest. One e-mail raised a factual issue which I have tried to correct in an addendum to the original post.
However a couple of writers have raised a response which I need to identify and challenge. The claim is that Dr. Glenn McGee may have done something ethically questionable, if not actually shameful, by becoming an exceutive and spokesperson for a for-profit company that markets unapproved stem cell therapy. But this is of no interest to the field of bioethics. If there is shame, it falls solely on his own head.
Sorry, in my view, this won't wash. When I do our course on "professionalism" for our medical students, if one of them says, "Look, if I want to have sex with my patients, I will go ahead and do it; if somebody objects, the responsibility is solely my own and has nothing to do with the professional of medicine as a whole," then I would gently try to set him or her straight on what professionalism means. (OK, maybe not quite so gently.) The idea that becoming a part of a profession constitutes a sort of collective promise of ethical behavior to society at large is a concept that many of our students, imbued with good ol' American individualism, resist mightily. I would argue that nonetheless it is the only way to think coherently about the concept of professionalism as an ethical or normative (not as a sociological or desrciptive) notion.
Now, just what bioethics is has been debated for decades, and many assert for good reasons that it is not a profession as such. (There is, for instance, no standard licensing exam.) That said, and not boring you with that debate, I would assert that bioethicists should regard themselves as professionals, and most are in fact professionals of one stripe or another--physicians, nurses, attorneys, university professors. So I think bioethics cannot evade the implication that bad behavior by one of us reflects badly on the entire "profession" or field or whatever; and without that assumption I would have had no grounds for calling attention to Dr. McGee's behavior or offering my opinion of it.
One writer suggested in an e-mail that Dr. McGee has now left the field of bioethics, so presumably if he wants to make a bundle of money doing something questionable (to put it as kindly as I can), so be it. If that were true, I wish he would have said so, instead of accepting a position that has "ethics" in its official title.
The Basic Ingredients For Homemade Lip Balm
This article, The Basic Ingredients For Homemade Lip Balm, was originally published at Natural Health Ezine.
Lip balm (or gloss!) is one of the easiest natural beauty products that you can make for yourself. Many of the ingredients used to make a natural lip balm have therapeutic properties, unlike a regular store bought lip balm or lip salve. Look closely at the ingredients of many regular lip balms and you might find a few surprising chemicals in there! Natural lip balms both heal and protect your lips from dry, winter conditions – and hot summer sun. Here is a list of the basic ingredients that you will find in a true natural lip balm product.
Cocoa Butter
Cocoa butter (Theobroma cacao) is extracted from the seeds of the cacao tree. The cacao tree is also the source of another well know commodity – chocolate. Although you can use several natural butters to make lip balm, cocoa butter is probably the most well known of the butters.
Cocoa butter is moisturizing in its properties; it is a solid fat that is cream-yellow in color. It is brittle at room temperature but melts to liquid form when it is heated up (above 85 degrees F) , which makes it is easy to blend it with other butters and oils to make lip balm. It has a slight chocolaty aroma.
Beeswax
Beeswax is obtained from the secretions of the honey bee (genus Apis). Beeswax turns from a white to colorless liquid to a solid, waxy substance which is yellow in color. There are variations in the color of beeswax because of geographical differences.
Beeswax has several therapeutic properties; it is moisturizing, antiseptic and a skin softener. It also helps to thicken, absorb water and bind together the other ingredients in a product. Again, although beeswax is solid at room temperature, you can melt it via a heat source so that you can blend it with other ingredients to make cosmetic products. It has a flowery, honey aroma.
Vegetable Oils
There are many different vegetable oils that you can use and add to a natural lip balm. However, if you want your lip balm to be therapeutic and free of any additives, you should only choose a cold pressed, unrefined vegetable oil; if high heat is used in the extraction process, the resulting vegetable oil may not possess many of the therapeutic properties which the plant had. Most reputable aromatherapy suppliers carry unrefined, quality vegetable oils.
Vegetable oils are obtained from various types of plants; these include sunflower (Helanthius annuus), almond (Prunis dulcis), apricot kernel (Prunus armeniaca) and olive (Olea europaea). Vegetable oils add both further therapeutic properties (depending on the vegetable oil) and softness to the texture of your lip balm.
Essential Oils
Essential oils are not an essential ingredient for a natural lip balm but they also contain therapeutic properties, in addition to adding “flavor” to the lip balm. Essential oils are extracted from plants in various ways and from various parts of the plant. Many flowers, trees and grasses contain essential oils. Essential oils range in price, texture and aroma, depending on the essential oil.
Essential oils which are suitable for adding to lip balms include sweet orange (Citrus sinensis), distilled lime (Citrus aurantifolia), peppermint (Mentha piperita) and lavender (Lavandula angustifolia). Take an aromatherapy course or read a good aromatherapy book to understand how much and which essential oils you can safely add to your lip balm.
Lip Balm Recipes
There are many different recipes available for making your own lip balm in aromatherapy books, on the internet and on aromatherapy courses. However, the above basic ingredients usually feature in most lip balm recipes, so understanding your ingredients will help you understand more easily how to combine these various ingredients for an effective and natural lip balm!
References:
- Carrier Oils for Aromatherapy and Massage, Len Price
- The Illustrated Encyclopedia of Essential Oils, Julia Lawless
- Author’s own experience and training
Photo by reway2007
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- Natural Lip Gloss Recipe
- What is the Difference Between Cocoa Butter and Shea Butter?
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- Differences Between Vegetable Oils and Essential Oils
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Bioethicists and Conflicts of Interest
I write this post with some trepidation because the issue is still evolving. However, I have been committed to the idea that those of us in bioethics should be willing to subject ourselves to the same scrutiny that we apply to others, and so feel a need to walk the walk even at risk of being premature. Plus I invite comments from my fellow bioethicists to this post and maybe the comments will prove more illuminating than the post.
The latest flap in our bioethics neck of the woods has to do with the editorship of the American Journal of Bioethics and the doings of the recent editor-in-chief, Glenn McGee, PhD. According to various of my colleagues, Dr. McGee is either a) an unethical bioethicist and should be roundly condemned or b) the victim of scurrilous character assassination.
Here is some of the anti-McGee background:
http://loathingbioethics.blogspot.com/2012/02/reporters-guide-to-american-journal-of.html
http://www.healthintheglobalvillage.com/?p=616&utm_source=rss&utm_medium=rss&utm_campaign=glenn-mcgee-and-the-internet-adjustment-bureau
Briefly, Dr. McGee was originally on the faculty at Art Caplan's prestigious bioethics program at Penn, but left when he failed to get tenure there--not necessarily a black mark as I doubt Aristotle would be granted tenure at Penn. He then became director of the bioethics institute at Albany Medical College, but left there under a cloud--lest I be accused of more character assassination I'll let the Scientific American do it instead:
http://www.scientificamerican.com/article.cfm?id=glenn-mcgee
The above-cited article quotes Dr. McGee as saying, "I am going to be entering a new phase of my career in which I am a dartboard." Dartboard or no, he next landed at the Center for Practical Bioethics in Kansas City where he held the John B. Francis Chair--not a terribly severe demotion, it would seem. All this time he continued to act as editor of AJOB, which he founded, and spun off two new AJOB journals, including one called AJOB Primary Research.
The controversy gets going sometime late in 2011 when Dr. McGee apparently left the Center in Kansas City to take up a position with a firm called Celltex in Sugar Land, outside Houston. Celltex is a very controversial outfit down in these parts, storing and injecting adult stem cells taken from a person's fat cells, a process which has not been FDA approved but endorsed by legislation that Gov. Rick Perry pushed through the Texas Legislature after he reportedly had a dramatic response to these injections for his back pain. Celltex is run by Gov. Perry's physician and a former Perry political ally. Dr. McGee was first listed as President of Strategic Initiatives at Celltex while a more recent news release (http://www.scribd.com/doc/81588050/February-10-2012-Celltex-Press-Release) has him as President of Ethics and Strategic Initiatives.
Now, I have to add a prequel here--a Korean firm, RNL Bio, involved in the stem cell tourism industry, had two patients die after receiving their stem cell infusions. A US group called the International Cellular Medicine Society investigated in November 2010. Dr. McGee was then on the ICMS board of directors and conducted a bioethics inquiry, which, according to Carl Elliott in one of the above posts, "found little fault with RNL Bio; he recommended better informed consent procedures and more ethics training." Now, Celltex has a close relationship with RNL Bio, having paid them a reported $30M to license their stem cell procedure. If I were to issue an "ethics" report that said Firm X was on the up and up, and then shortly after took a job with Firm Y which relies on a relationship with Firm X to be able to market its main product, then you would have reasons to be suspicious of biasin my "ethics" report, it would appear to me.
After complaints surfaced that it was inappropriate for Dr. McGee to remain as editor while working for a for-profit stem cell firm, he stepped down as editor while apparently remaining as head of the "AJOB family of journals" for the publisher, Taylor and Francis. The new co-editors of AJOB are Dr. David Magnus of Stanford, an old colleague of Dr. McGee's from Penn days, and Dr. Summer Johnson McGee, formerly managing editor of the journal, and incidentally, Mrs. Glenn McGee.
The fact that Dr. McGee retains his position as head of all the AJOB journals is significant because the Primary Research journal is now edited by Robert Nelson, a bioethicist and pediatrician. Dr. Nelson works at the FDA and is in the division that would review any application for approval of the adult stem cell treatments that Celltex promotes. So you could say that Dr. McGee is the boss of the guy at the FDA who might end up approving or disapproving his company's product.
That'a the anti-McGee case and critics are calling for the remainder of the editorial board of AJOB to at least meet and demand an acocunting of these measures if not resign en masse in protest.
On the other side, it's been pointed out (mostly on listservs where I don't have permission to copy the entries) that the editorial board is supposed to advise the editor on editorial policy, not advise the publisher on hiring and firing of editors, so it's not the job of the editorial board to decide who should or should not be editor of AJOB. Dr. McGee, it has been said, noted a potential conflict of interest and managed it appropriately by resigning as editor. His wife, as a long-time central figure in the day-to-day running of the journal, is very well qualified to assume a role as co-editor, and it's sexist and patronizing to view her as a mere appendage of her husband for this purpose.
Dr. Leigh Turner of U-Minnesota, in the post cited at the beginning, accuses Dr. McGee of scrubbing the Internet to alter the records of when he was in what position, to obfuscate the fact that he was involved in these conflicts of interest. As I review the instances he cites, the majority of these look more like updating rather than "scrubbing." But the one instance where this charge seems to hold water is with the most recent Celltex news release. That makes it seem that Dr. McGee had left his previous posts before assuming his role with Celltex, whereas it appears that there was at least a few months' overlap. As Dr. Turner alleges, the intent of the news release seems to be to appear to backdate his resignation as editor of the journal.
If anyone is still reading after all this, I will hesitantly offer some opinions.
I am not sure that the charge of conflict of interest can stick at this point with regard to the editorship of AJOB. The argument that there was a conflict, and Dr. McGee resolved same by resigning, seems reasonable. Normally when one transfers ownership of something to one's spouse, it's a transparent mechanism of trying to remain within a conflict while pretending to resolve the conflict; but the argument that Dr. Summer McGee has valid reasons to assume editorship in her own right seems plausible. The charge of COI seems to stick however with regard to Dr. McGee's role in naming Dr. Nelson to be editor of the other journal, and remaining in a position to oversee him as editor, when Dr. Nelson has a role at the FDA that could involve Celltex's interests.
I wonder if my bioethics colleagues, who are ordinarily very good at making fine ethical distinctions, are actually conflating two separate issues:
- Is it a COI for Dr. McGee to edit AJOB?
- Is it seemly for a bioethicist to work for Celltex?
My personal opinion is that it is highly unseemly and embarrassing for the field of bioethics to have one of our own working for this sort of firm, and giving ethical "cover" to their activities. It appears that contrary to the claim that their activities are highly ethical and are fully disclosed as experimental only, Celltex is seeking to make profits by presenting what it does to the public as effective therapy. There seems ton be a conflict of interest within the firm if the news release is to be taken seriously and Dr. McGee is actually charged with creating a true ethics program within the company. If he were to succeed in fully informing all patients that this is an unproven, experimental "treatment," it would seem to seriously cut into any chance of the company recouping the $30M they paid RNL Bio for the stem cell license. So one has reason to doubt that the firm is serious about their "ethicist" and his activities.
I explained in HOOKED that I agree with Ed Erde that the core ethical issue at the heart of conflict of interest is trust in a social role. "Bioethicist" is a social role and all of us have a stake in making the role as trustworthy as possible in the public eye. It seems to me that what Dr. McGee is doing with Celltex is predictably going to diminish trust in our field. (For evidence that this is already happening see http://leiterreports.typepad.com/blog/2012/02/american-journal-of-bioethics-redux-is-this-for-real.html).
So my current advice to my bioethics colleagues, based on what I have learned so far, is: if you think that Dr. McGee is a discredit to bioethics, talk about his role with Celltex. If on the other hand you think he's a fine fellow unfairly besmirched, then defend his role with Celltex. But forget about the side issue of the AJOB editorship which is just a distraction in my view. Now, bioethicists, have at me and send your comments.
Where To Buy Bulk Spices And Herbs – A Comparison of Bulk Herb Suppliers
This article, Where To Buy Bulk Spices And Herbs – A Comparison of Bulk Herb Suppliers, was originally published at Natural Health Ezine.
I have studied herbal medicine for almost 20 years. In the beginning, I purchased small quantities of herbs at the local health food store. That is great if you just want a teaspoon of something; but not so cost effective if you want a pound. After further learning and wanting to use more herbal preparations for our family, I started buying our herbs in bulk through the mail.
An online search proves there are a lot of herb suppliers out there. How is one to know which are the best? I did a comparison of four companies to help you decide for yourself. For this project I chose:
- Mountain Rose Herbs in Eugene, Oregon
- San Francisco Herb Company in San Francisco, California
- The Bulk Herb Store in Lobelville, Tennessee and
- Blessed Herbs in Massachusetts
I chose these four for their popularity and their location. Two are on the west coast and two are on the east coast.
The Order
To compare these companies fairly, I made up an imaginary order before looking at any of their catalogs. This order would be typical for me. In fact, it includes two things I currently need plus what I would order if I were to make a batch of healing salve. I then shopped each one’s online store and proceeded to checkout to get a total cost, including shipping. I did each one three times—one with an east coast delivery zip code, one with a west coast zip, and one in between. When available, I chose organic or wildcrafted herbs. Here is my order:
- 2 pounds of nettle leaf
- 1 pound of green tea
- ½ pound plantain leaf
- ½ pound calendula flower
- ½ pound comfrey leaf
- ½ pound of beeswax
The Results
My findings were not what I expected. But I will discuss each company individually so you can see for yourself.
The Bulk Herb Store–was out of nettles. I’m sure that happens from time to time with any company but they offer to email a customer when a product is available, so that is nice. If nettles were available, the sub-total for my order would be $86.75. To make things easier, the Bulk Herb store has a flat rate for shipping to the 48 contiguous United States of $6.50. That brought my total to $93.25. Many of the herbs in the catalog were labeled as organic. Also, the store offers herbal formulas, tinctures, water purifiers, books, and other educational materials, as well as supplies for making your own home remedies. Their site is easy to use and includes educational articles and tidbits of information on every page. A print catalog is also available.
Mountain Rose Herbs–The only thing I had to alter on my order with Mountain Rose was the amount of beeswax. They only sell it in one-pound increments. The sub-total for my order (including the extra ½ pound of wax) was $63. To have it shipped to my home on the east coast would cost me an extra $18.02 for a total of $81.02. This surprised me. After paying three times the amount for shipping, the prices were so much lower than the Bulk Herb Store that my total was still $12.23 less. The shipping for a west coast zip was $12.35 and for a central location, $14.51. I have ordered herbs from Mountain Rose for many years and have always been happy with the quality of the products. Their catalog, which is also available in print, lists whether the product is organic, wildcrafted, and fair trade certified. They not only offer bulk herbs but herbal extracts, formulas, teas, accessories and supplies. They are also one of the few suppliers that sell containers like dropper bottles and tins. Mountain Rose’s site is easy to navigate and even sports a floating cart that is always in view so that you can keep track of how much you are spending.
Blessed Herbs–I could not submit an order with Blessed Herbs. They did not carry 3 of the 5 herbs I wanted. This disappointed me as I thought they were all pretty common. The green tea came only in a box of 16 teabags for $12.50. Also, the one pound of beeswax cost $29.50. I found Blessed Herbs’ website difficult to use. Rather than listing all of the bulk herbs on one page, they were listed 12 to a page and you had to flip back and forth to find what you wanted. Also, most of the herbs were sold in one-pound increments. Blessed Herbs does not sell any accessories for those of us that like to make our own herbal preparations or any books or educational materials. I could not find a paper catalog available for order on the site.
San Francisco Herb Company–A friend recommended this company for their prices. However, I could not complete my order with them, either. The comfrey was out of stock, and they do not carry plantain or beeswax. In fact, they carry few supplies for the home apothecary. I did find their prices very reasonable but they do not mention anywhere in the listings if the herbs are organic or wildcrafted. A thorough search of the site found this statement in the frequently asked questions, “We are not certified as a warehouse to offer organic products. However, much of what we offer is grown in the wild (wildcrafted) or cultivated without the use of commercial pesticides and fertilizers.” To obtain a print catalog from San Francisco herbs you must download a PDF file and print it for yourself.
I hope you find this information helpful. I know I did, as I had not yet taken the time to compare herb suppliers for myself. If you have any other companies you’d like me to take a peek at, please let me know in the comments.
Photo by Chrissy Olson
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The Health Benefits Of Keeping A Dream Journal
This article, The Health Benefits Of Keeping A Dream Journal, was originally published at Natural Health Ezine.
Journaling is good for your health in more ways than one – but what about a dream journal? Research into what our dreams mean has been contested by significant names in history such as Sigmund Freud (1856-1939) and Carl Jung (1875-1961) for centuries and, although in many ways we are no scientifically nearer the truth than before, keeping a dream journal can be good for your health.
The Benefits of Keeping A Dream Journal
Many people find it difficult to recall their dreams on waking. However, with a little bit of practice, it can become easier to recall your dreams. Dreams can be a chaotic mess when recalled in fragments and sometimes there doesn’t seem to be any sense or order to our dreams. However, a few of the benefits of keeping a dream journal include:
- you might learn a little bit more about yourself
- good for your psychological and emotional health – dreams may help you to work through unprocessed material of your waking life and help you to come to terms with a situation. Psychologists believe that there is a scientific link between our minds and our behavior; dream journaling can give insight into our mind during sleep
- increases your creativity – several people have claimed that their idea for a book, song or other project came to them in a dream. Paul McCartney of The Beatles claims to heard the song Yesterday in a dream
- you might begin to notice a pattern in your dreams when, written down, begin to make more sense to you
- as with every day journaling, writing is therapeutic; studies have shown that journaling can increase emotional health which in turn leads to increased physical health and decrease in disabling conditions such as arthritis and asthma (source).
How to Keep a Dream Journal
There is no right or wrong way to keep a dream journal but the following tips might help you to get the most out of dream journaling:
- keep a pen and notepaper handy next to your bed so that you can begin to write down your dreams as soon as you wake up
- when you first wake up, lie still for a few minutes; this helps you recall more details of your dream before it starts to fade away
- write down as much detail as you can about the dream and then later assess the more important points of the dream; take special note of numbers, colors and events.
(source: The Complete Book of Dreams and Dreaming
Types of Dreams
People experience different types of dreams. In 1953, the discovery of REM (rapid eye movement) sleep showed that this is the period of time when you experience the most vivid dreams; REM sleep showed a link between eye movement and the electrical activity of the brain. Dream recall and imagery was most accurate immediately after waking from this particular period of sleep (source: The Secret Language of Dreams
Some people are also capable of lucid dreaming. Lucid dreaming is when the dreamer is able to “control” what is going to happen in the dream. However, this type of dreaming takes practice.
How to Interpret Your Dream Journal
There are many different books written on the subject of dreams, including several dream dictionaries. Dream dictionaries interpret various images, numbers and colors that appear in your dream. However, meanings can vary from book to book and there is no scientific proof as to what each element of a dream means, only theories.
Despite the lack of scientific evidence, you can still learn a lot from your dreams using a dream dictionary. You might begin to notice a pattern in your dreams, for example a specific color or event, that relates to your waking life. Or, it might help you to work through a particularly stressful period of your life, such as when coping with the death of a loved one.
Dream Journaling
Although science has barely touched the surface on the link between brain activity and the dream state, keeping a dream journal is therapeutic to your health. It might help you to work through various emotional and psychological problems, learn to be more creative, empty your head of “clutter” and help you to lead a more effective waking life. Dream journaling can be just as therapeutic as regular journaling – whether you get the answer to your dreams or not.
Photo by pixelspin
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Health Benefits of A Rocking Chair
This article, Health Benefits of A Rocking Chair, was originally published at Natural Health Ezine.
We acquired our first rocking chair
Learning Disabilities
Sensory Integration is the neurological course the brain uses to process multiple sensory input and utilize it to perform a response. Sometimes problems exist in the process and that condition is referred to as Sensory Integration Dysfunction. SID may be found in individuals with autism, traumatic brain injury, those with cochlear implants, and various other learning disabilities. The act of rocking has shown to improve SID. In fact, studies have shown that rocking chairs placed in classrooms help to calm children with Attention Deficit Hyperactivity Disorder, thereby facilitating their concentration and focus on the subject at hand.
Treating Varicose Veins
Because of the stimulation to the circulatory system, and exercise to the leg muscles, rocking in a rocking chair is recommended to prevent and treat varicose veins. This is especially helpful for the elderly or shut-in who cannot walk or swim.
Dementia
A study published in the American Journal of Alzheimer’s Disease and Other Dementia discussed the use of rocking chairs with nursing home residents with dementia. This study found that “there were improvements in depression/anxiety and reductions in PRN pain medication significantly related to amount of rocking.” Those residents that enjoyed the program and wanted to continue rocking past the six weeks of the study “demonstrated significant improvements in balance as measured by center of gravity.”
Postoperative Healing
Typically, after any abdominal surgery there is a certain degree of decreased motor activity of the gastro-intestinal tract. This condition, referred to as postoperative ileus or POI, causes the patient pain. According to a dissertation by Dr. Robert Lee Massey, “rocking chair motion is effective in postoperative abdominal surgery cancer patients reducing the duration of postoperative ileus.
Childbirth Recovery
According to an article at Mothering.com, a rocking chair is a must for any new mother. It not only soothes a fussy baby and sleep deprived mommy, but “rocking assists an infant’s biological development and promotes the baby’s ability to be alert and attentive.” Since rocking reduces the amount of postoperative ileus, it promotes healing after a cesarean section. And, since the act of rocking burns about 150 calories an hour, it helps mom to lose her pregnancy weight gain faster.
Have you ever used a rocking chair for therapeutic purposes? We’d love to hear about it in the comments.
References:
AM J ALZHEIMERS DIS OTHER DEMEN November/December 1998 vol. 13 no. 6 296-308
http://etd.utmb.edu/theses/available/etd-06292007-111418/unrestricted/DissertationMasseyFinal07.pdf
Photo by 1Sock
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