In today’s New York Times, the first story I’ve seen wherethe universities reply:

Macquarie University, which is in Sydney and offers bachelor’s and master’s degrees in chiropractic science, said it offered rigorous, high-quality courses.

“Our chiropractic science students are well trained in the fundamental relevant sciences (physiology, anatomy, biochemistry, biophysics, radiology, etc.) together with units in chiropractic methods and clinical practice,” the university said in a statement. “Our students are taught to understand that science proceeds only on the basis of evidence. We are confident that our graduates have been taught those techniques that are known through science to be beneficial.”

Nick Klomp, dean of the science faculty at Charles Sturt University, in Wagga Wagga, New South Wales, said while Friends in Science in Medicine made some valid points, the degree offered at his university, a bachelor of health science (complementary medicine), was based on science.

He said the course was designed to impart evidence-based science to people who already had a qualification, like a diploma, in alternative health care. The course includes such subjects as biology and physiology.

“They’re all subjects that are already mainstream, hard health science subjects,” Mr. Klomp said.

He said that thousands of practitioners were already providing alternative medicine and that there was much demand for their services.

“I could ignore them or I could train them better,” Mr. Klomp said, adding that a majority of the university’s students were already practicing. “We actually create graduates who are much better health care providers. It’s all about evidence based, science based.”

A new diet study just out from the American Journal of Clinical Nutrition went to a lot of trouble to prove the obvious.  When it comes to weight loss, how much you eat matters more than the proportion of fat, carbohydrate, and protein in your foods.

Researchers at the Pennington Biomedical Research Center got volunteers to eat diets that were supposed to differ in proportions of fat (40% vs 20%), carbohydrates (35% vs. 65%), and protein (25% vs. 15%).

The results of the study are consistent with the findings from many previous studies:

• The major predictor for weight loss was adherence to the diet.
• People on all of the diets lost weight by six months, but regained some of it by two years.
• The study had a high drop-out rate (hence the importance of adherence).
• It was hard for people to stick to the diets, especially those at the extremes of one dietary component or another.

Age-related delays in neural timing are not inevitable and can be avoided or offset with musical training, according to a new study from Northwestern University. The study is the first to provide biological evidence that lifelong musical experience has an impact on the aging process.

Measuring the automatic brain responses of younger and older musicians and non-musicians to speech sounds, researchers in the Auditory Neuroscience Laboratory discovered that older musicians had a distinct neural timing advantage.

“The older musicians not only outperformed their older non-musician counterparts, they encoded the sound stimuli as quickly and accurately as the younger non-musicians,” said Northwestern neuroscientist Nina Kraus. “This reinforces the idea that how we actively experience sound over the course of our lives has a profound effect on how our nervous system functions.”

Here’s the story, as described by John Weeks in a new article at the Huffington Post.

Integrative health care had never seen such bandwidth. The report, titled The Affordable Care Act and Beyond: A Stakeholder Conference on Integrated Healthcare Reform, reflects it. The editors are Daniel Redwood, D.C., Michael Traub, N.D., DHANP, and Kahn. Snider oversaw final publication.

The document’s heart is a series of recommendations from each of six well-integrated work groups: Access and Non-Discrimination, Integration in Practice, Comparative Effectiveness Research and the Patient-Centered Outcomes Research Institute, The Healthcare Workforce Prevention and Wellness, and Current Procedural Technology (CPT) Codes.

The work wasn’t blue sky. All but one of the work groups was linked to a relevant portion of the Affordable Care Act (ACA). The outlier, CPT, included two members of the American Medical Association’s advisory panel.

Jonas, who headed the NIH Office of Alternative Medicine in the mid-1990s, offers this appraisal: “The IHPC policy report is the product of one of the most collaborative, multi-stakeholder processes in the entire integrative medicine industry. It should be carefully attended to by practitioners and policy makers alike.”

Drug research, even from clinical trials sponsored by the federal government, routinely is suppressed, harming patients and increasing health care costs, according to new data highlighting an ethical controversy that continues to plague the field of medicine.

“The current situation is a disservice to research participants, patients, health systems and the whole endeavor of clinical medicine,” according to an editorial accompanying the papers published in the British Medical Journal.

Turning up the heat, the journal, in an editorial, posed a remedy that is likely to get the attention of doctors who take part in clinical trial research.

“Concealment of data should be regarded as the serious ethical breach that it is, and clinical researchers who fail to disclose data should be subject to disciplinary action by professional organizations,” wrote Richard Lehman of the University of Oxford, and Elizabeth Loder, a BMJ editor.

The BMJ papers are the latest thunderbolts in a gathering storm that has swirled around medicine in recent years. The revelations add to the calls for reform in the field.

“It is grossly unethical and an insult to the integrity of medicine when this is allowed to occur and go unpunished,” said orthopedic surgeon Chuck Rosen, president of the Association for Medical Ethics.

It’s easy enough to round up the usual suspects, which is what a story in the Daily Livestock Report did last month. It blames the decline on growing exports, which make less meat available for Americans to buy. It blames it on ethanol, which has caused feed costs to rise, production to drop and prices to go up so producers can cover their increasing costs. It blames drought. It doesn’t blame recession, which is surprising, because that’s a factor also.

All of which makes some sense. The report then goes on to blame the federal government for “wag[ing] war on meat protein consumption” over the last 30-40 years.

Is this like the war on drugs? The war in Afghanistan? The war against cancer? Because what I see here is:

• a history of subsidies for the corn and soy that’s fed to livestock
• a nearly free pass on environmental degradation and animal abuse
• an unwillingness to meaningfully limit the use of antibioticsin animal feed
• a failure to curb the stifling power that corporate meatpackerswield over smaller ranchers
• and what amounts to a refusal — despite the advice of real, disinterested experts, true scientists in fact —  to unequivocally tell American consumers that they should be eating less meat

Seeing a chiropractor or engaging in light exercise relieves neck pain more effectively than relying on pain medication, new research shows.

The new study is one of the few head-to-head comparisons of various treatments for neck pain, a problem that affects three quarters of Americans at some point in their lives but has no proven, first-line treatment. While many people seek out spinal manipulation by chiropractors, the evidence supporting its usefulness has been limited at best.

But the new research, published in The Annals of Internal Medicine, found that chiropractic care or simple exercises done at home were better at reducing pain than taking medications like aspirin, ibuprofen or narcotics.

“These changes were diminished over time, but they were still present,” said Dr. Gert Bronfort, an author of the study and research professor at Northwestern Health Sciences University in Minnesota. “Even a year later, there were differences between the spinal manipulation and medication groups.”

An intervention aimed at helping patients accept the pain and disability associated with rheumatoid arthritis, while at the same time blocking negative thoughts and anxiety about their condition, reduced patients’ depression and improved coping skills, researchers in Norway reported.

…

The researchers noted that the increase in emotional processing, by which they meant recognition and understanding of one’s own emotions, was of particular note because patient avoidance of disease-related emotions has increasingly been linked with negative outcomes in chronic disease.

They also pointed out that emotional expression improved in the control group at 12 months.

Although the control patients did not attend sessions, they received telephone calls from the researchers 12 times during the year’s follow-up, in which they were invited to discuss any emotional concerns. This may have increased their psychological awareness, according to Zangi and colleagues.

Many other psychological interventions for patients with chronic disease such as arthritis have found only short-term benefits, but in this study the benefits persisted for a year after the program.

“These lasting improvements indicate that the participants may have incorporated some mindfulness strategies into their daily lives and that these strategies have strengthened their ability to respond to their stressful experiences in a more flexible way,” the researchers observed.

A week of wound debridement using maggots cleared necrotic tissue more effectively than conventional debridement in patients with chronic venous ulcers, a randomized French study showed.

At day eight of treatment, the percentage of the wound area covered by slough was 54.5% in patients given maggot therapy compared with 66.5% (P=0.04) of the wound area in a control group, according to Anne Dompmartin, MD, PhD, of Centre Hospitalier Universitaire de Caen, and colleagues.

However, there was no difference between the groups in percentage of the necrotic tissue on the wound at day 15 (55.4% versus 53.8%, P=0.78), which was the study’s primary endpoint.

Bottom line: your wound can heal with either type of therapy, but it should heal somewhat more quickly with the maggots. This would seem to be a good example of the need to consider patient preference in the decision on therapeutic strategy.

How can this be? The idea that prevention saves money feels intuitive. “When we think of prevention, we tend to think of the individual who benefited,” Russell writes. We conjure up an image of the woman who caught breast cancer early, averting expensive treatments, or the man who brought his weight down and lived a long, healthy life. That, however, discounts all the mammograms that didn’t detect cancer and didn’t prevent anything and all the individuals for whom weight management programs didn’t work. All those costs add up to the point that most preventive interventions cost more than they save.

…

In her chapter, Russell also runs through what $1 million invested in a given treatment buys us in Quality Life Years. Investing $1 million in screening men over 55 for colon cancer would, according to the research, translate into a gain of 577 quality life years. Investing the same amount in cholesterol-lowering medications for high-risk, middle aged men would only translate into 12 additional quality life years. Not all preventive interventions, it turns out, are created equal.