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Acupuncture stings

In most of medicine, and in Health Protection in particular, one occasionally comes across people who have made questionable decisions which have had severe consequences. When people decline routine vaccinations or fail to use a condom for specious reasons, it can be both depressing and frustrating to be picking up the pieces.

It’s easy to rationalise that health is not at the top of everyone’s personal agenda and that sources of misinformation are common and commonly believed. At these times, it feels like the most productive outcome is to channel the frustration into improving the information on offer and trying to reach the people who have missed it.


A friend once told me to think of ‘health’, a topic which most of my life is dedicated to, in terms of ‘transport’, a topic with which I’m intimately engaged as a ‘user’ but in which I’m completely non-expert:

I might get frustrated that people don’t take obvious preventative health measures, but when was the last time I checked my tyre pressure, an obvious ‘preventative measure’ in the ‘transport’ world? (I’ve done it once in the nine years I’ve owned my car.)

I might get annoyed that people don’t have any idea of the true cost of their healthcare, but what’s the true cost of the public transport I take to work each day? (I’ve no idea.)

I might think that’s it’s patently obvious that homeopathic remedies contain no active ingredients and are a total waste of money, but what’s the evidence of benefit for the ‘premium’ grades of petrol? (I often buy them, even though there’s probably no benefit.)


And then, just occasionally, I come across something that seems so appalling unappealing that I’m baffled that anyone, medical knowledge or not, could possibly want to engage with it, let alone risk harm by doing so:

One type of apitherapy is live bee acupuncture, which involves applying the stinging bee directly to the relevant sites according to the specific disease.

Live bee acupuncture. Wowzers trousers. This paper by Vazquez-Revuelta and Madrigal-Burgaleta in the Journal of Investigational Allergology and Clinical Immunology, from which the above quote is taken, reports a terribly sad case of a 55-year-old woman who died from live bee acupuncture.

The paper reports that she’d been attending four-weekly for two years for the procedure, with the aim of treating

muscular contractures and stress.

As one might expect,

the risks of undergoing apitherapy may exceed the presumed benefits, leading us to conclude that this practice is both unsafe and unadvisable.

There is little about this paper which isn’t at least mildly astonishing. But then I wonder… I don’t know what the transport equivalent of intentional bee stings might be, but perhaps I engage in that too.


The alarmingly cute picture of a bee at the top of this post was posted on Flickr by Ozzy Delaney. I’m reusing it here under its Creative Commons licence.

This 2,441st post was filed under: Health, Posts delayed by 12 months, , , , , .

What I’ve been reading this month

Like the first two books in the series, it felt like a privilege to be read Ali Smith’s Spring, which are sure to become a classic, at the moment in time in which they’re set. Smith captures the voice of an age. I’ve found the writing in this series dizzyingly brilliant—the language and the fascinating ways in which Smith manipulates it are somehow more important than the plot. The raw anger in this volume in particular was something else. This was astounding.

There are lots of different editions of Italo Clavino’s Difficult Loves: mine had the classic collection of “Difficult Loves” short stories written in the 1950s, followed by the slightly longer stories “Smog” and “A Plunge Into Real Estate”. The overarching themes were love (in its broadest sense) and loneliness. I don’t usually get on with short stories, but this collection was an exception. The everyday tales which beautifully captured universal emotions; the dry humour; the hint of craziness that made me look at the world slightly differently; all allowed Calvino’s prose to take flight. It’s been years since I last read any Calvino, but I won’t let it be so long next time!

Let’s Explore Diabetes With Owls was a collection of amusing autobiographical short stories or ramblings about travel, writing, and life in general. As you probably know, Sedaris is an American living in rural England and he draws a lot on differences in US and British culture in this volume. This is the first time I’ve read any of his work, and it made me laugh out loud a few times, which books rarely do – and it was pleasantly cosy and inconsequential. I’ll certainly read more of Sedaris’s collections. 

I found Sarah Moss’s Ghost Wall utterly gripping, and finished it in a day. It was a book about a group of undergraduates, guided by an amateur historian (and his wife and child) plus a university professor, going on a camping trip in Northumberland and trying to recreate Iron Age life. There were some beautiful descriptions of the expansive scenery of Northumberland, which meant all the more to me for being local, and some very carefully observed descriptions of the lack of recognition of domestic abuse among victims. This left me with a lot of food for thought.

Thanks for the Feedback by Douglas Stone and Sheila Heen was a book about how to receive feedback effectively. I found the book baggy and over-long, with rather too many repetitive examples. That said, there was more useful stuff in here than I expected. It shifted my understanding of feedback conversations from being one-way (i.e. passively receiving feedback) to being two-way (i.e. working together to understand the intention behind the feedback and reach a mutual understanding on the next steps). This is an obvious point, but I confess that it’s not one that’s occurred to me in those terms before—perhaps fed by a lifetime of written feedback and evaluative assessment where there’s no opportunity to engage in further discussion.

Heartburn was a short and funny autobiographical novel about the breakdown of Nora Ephron’s marriage to Carl Bernstein. It used a series of relatively frothy vignettes (interspersed with the occasional recipe) to reveal rather deep reflections on life, pain and betrayal. I think I perhaps prefer Ephron’s shorter essays than this longer book, but I found the book so cleverly put together that I might come to think differently about that as I reflect further.

Women and Power was a book based on two speeches by Mary Beard about the way in which women have been systematically denied a public voice. The first took a historical, longitudinal and structural approach to that question, while the second focused more on contemporary examples. I found Beard’s historical account interesting and compelling, but I wish it had gone further. In particular, I would have liked to better understand Beard’s views on how things can change, and what the future may hold – but perhaps that’s not the point of a history book.

This 2,440th post was filed under: What I've Been Reading, , , , , , , , , .

‘Broadcasting’ rules need to keep up with streaming services to protect health

A couple of news stories I’ve read lately have made me think about our approach to regulation of advertising.


First, there was this story by Travis M Andrews in The Washington Post about the portrayal of smoking in shows made for streaming services:

Among the vices often embraced by streaming services and avoided by broadcast television is tobacco in all in its forms … A study compared seven popular Netflix shows to seven popular broadcast shows. In this sample, it found Netflix’s shows featured characters smoking almost three times as often as those produced by broadcast networks like NBC, ABC and CBS.

Now, we could spend all day poking holes in this ‘study’, but the thought is still going to fester: it does seem like there might be more smoking in these shows than in those on broadcast TV.


Second, there was this BBC Trending story by Branwen Jeffreys and Edward Main about YouTube stars being paid to encourage kids to cheat on school assignments:

YouTube stars are being paid to sell academic cheating, a BBC investigation has found. The BBC Trending investigation uncovered more than 1,400 videos with a total of more than 700 million views containing EduBirdie adverts selling cheating to students and school pupils. In some of the videos YouTubers say if you cannot be bothered to do the work, EduBirdie has a “super smart nerd” who will do it for you.

This isn’t so obviously related to health but does highlight an issue with inappropriate advertising within online streams which are typically seen by children and young people.


Both of these stories made me reflect on the work that has gone into restricting advertising of harmful products such as cigarettes and energy dense foods, and how the fruit of that work might be lost if legislation doesn’t keep up with changing media consumption habits.

For example, there are no regulations around the portrayal of smokers on streaming shows, whereas broadcast shows must comply with Ofcom’s rules, including Rule 1.10:

Smoking must generally be avoided … unless there is editorial justification.

There seems to be non-stop debate in the media press about whether TV ads or online ads are more ‘impactful’, with the conclusion usually predictable according to who has funded or published the work. But it does seem increasingly clear that many people (including me) are now watching more streamed content than broadcast content, and that this is more common among younger people.

It’s hard not to worry that the slow pace of legislative change might cause us to unintentionally slide back to an era of lesser regulation of what is actually seen despite strong evidence of harm. We really mustn’t let that happen.


The photo at the top was posted on Unsplash by Tina Rataj-Berard and is used here under the Unsplash licence.

This 2,439th post was filed under: Health, Media, Posts delayed by 12 months, , , , , , .

The credulity of most Apple coverage

Over my cornflakes this morning, I read Ben Hoyle’s interview with Tim Cook, CEO of Apple, in The Times Magazine.


This was one of those interviews which is sort of interesting but doesn’t really say much. Though I was quite taken with this description of Apple’s canteen where the cutlery is hidden from view in an illuminating example of form over function:

You can’t tell what the chefs are cooking because there are no menus on display (the options are on your phone if you’re an employee). You don’t seem to be able to pay cash for anything and there are no sauce sachets or eating utensils to be seen unless you know where to look (they’re with the other unsightly essentials like bottled drinks and napkins, sunk out of sight in smooth, curved central islands reminiscent of giant iPods).


What really struck me about this interview was the weird cognitive dissonance in the tenth paragraph. In this paragraph, Hoyle points out that:

Apple’s App Store is “curated” to the extent that you (and your children) won’t find hate speech or pornography on there.

That is, Apple – for better or worse – prioritises its values over the freedom of its customers to easily use the platform for activities which meet with disapproval from Apple. I wish this (puritanical?) attitude had been used to challenge in this bit of the same paragraph:

Apple has regarded privacy as “a basic human right” for a long time and “built the company around” that belief. The sprawling, intimate personal data profiles that companies like Facebook and Google compile “shouldn’t exist”, Cook thinks.

Cook claims that Apple is built around privacy. Yet, while Apple is happy preventing access to hate speech on the App Store, it actively promotes the Facebook app despite it asking for user permission to build data profiles which Cook says are antithetical to everything Apple stands for.

This seems a really odd moral position to me: if your company is reputedly built around one “basic human right”, why allow apps which violate that fundamental belief and ban apps which contravene less dearly held standards? The answer seems fairly obvious to me: the Facebook and Google apps are among the most popular, and are core to the iPhone experience. But can you really claim something is a cornerstone value if you ignore it to sell more phones?


I was also a bit riled up by this ludicrous comparison:

On cybersecurity … the company also protects its FaceTime and Messages apps with end-to-end encryption unlike, say, Google’s standard Gmail.

Why compare a closed messaging system, where end-to-end encryption is easy, with an open standard like email? That reads like a line supplied by Apple. It should have been challenged by asking if Apple’s iCloud email service protects messages with end-to-end encryption, which of course it does not.


There are a lot of things that Apple does extraordinarily well. It is evidently one of the corporate success stories of our time and has inspired phenomenol brand loyalty among a huge population of users. But it isn’t perfect.

Much of the media, and Hoyle’s article is no exception, seems far too credulous when it comes to Apple. Coverage of Apple would be much more satisfying if it showed a degree of balance or at least an attempt at challenging some of the more outlandish media lines rather than simply repeating them verbatim.


The picture of Tim Cook at the top of this post was uploaded to Flickr by Fabio Bini, and is used here under its Creative Commons licence.

This 2,438th post was filed under: Media, News and Comment, Posts delayed by 12 months, Technology, , , , .

How much would you pay to keep using Google?

The Economist’s data team has today published a blog post called “How much would you pay to keep using Google?” Unusually for The Economist, the headline isn’t really an accurate representation of the contents, which actually discuss research findings related to the amount people would have to be paid to give up using search engines in general.

But the original question got me thinking. A couple of years ago, I’d have responded with a fairly substantial sum. These days, I’m not so sure. I wonder what that says about the state of the company?

Google used to be the only decent search engine. That is no longer true. A couple of years ago, I decided to see if it was possible to go all-in on Bing. Ironically, this was somewhat inspired by Matt Cutts, formerly of Google, who gives himself 28-day challenges to test assumptions and better himself. Surely, I reasoned, it can’t be as bad as people make out, nor as bad in daily use as an occasional search to try it out makes it seem. I switched my default search engine to Bing in Chrome and on my mobile.

And do you know what? The vast majority of the time, it is perfectly competent. On very rare occasions when I’m struggling to find something I also try searching on Google: I’d say 75% of the time, I also fail to find what I’m looking for there. I’d also say, without any proper data to back up the assertion, that Bing’s results seem less replete with spammy useless links than Google’s. And Bing’s rewards scheme buys me an occasional coffee. I don’t think I’d pay for Google search.

But of course, Google provides more than just search. Would I pay for other components of their offer?

Would I pay for Gmail? There are perfectly decent alternatives to Gmail, and I rarely use my actual Gmail address but forward stuff to it from elsewhere, so redirecting future mail wouldn’t be a problem. Moving the archive would be a pain. I’d probably pay a small fee—a pound a month?—just to avoid the hassle.

One service I would definitely pay for is Google Maps. I use Google Maps every day and have not found anything that can even begin to compete. Back in December, Justin O’Beirne wrote a great essay on Google Maps’s moat—the content and time barrier which keeps it well ahead of competitors. On these terms, I guess Google Maps is probably the most “valuable” bit of Google to me.

Google Drive is great, but OneDrive is pretty great too. Chrome is my current default browser, but I’d happily switch to Firefox. Google Calendar is actually quite irritating (especially since ‘quick add’ was removed) and I use it only because it’s handy. I like my Android phone, but I’d get by on iOS. I’d be sad to lose my Chromebook, but Windows laptops aren’t quite the horror shows they used to be.

I enjoy watching occasional Youtube videos, but I wouldn’t really miss them if I couldn’t watch them any more. I use Google Photos, but I also upload all of my photos to other cloud services, at least in part because I don’t trust Google not to shut down Photos when it turns its attention elsewhere (à la Google Reader or Google Notebook, both of which closed while I was an active user).

More recent Google developments (Home, Assistant, Allo, Duo, Now) have totally passed me by.

Jeff Jarvis used to talk about “livin’ la vida Google” to describe his complete immersion in the Google universe. A couple of years ago, I’d have put myself in a similar category, but no longer. I am only one person, and I’ve no idea how ‘typical’ I am in this context, but I wonder if my change in behaviour represents a wider portentous shift for Google’s fortunes?


The photo at the top was posted on Flickr by Sigurd Magnusson, and is reproduced here under its Creative Commons licence.

This 2,437th post was filed under: News and Comment, Posts delayed by 12 months, Technology, , , , , , .

The next calling point for this service will be…

I usually try to avoid ‘grumpy’ columns in magazines. As a general rule, they are not very interesting and are not nearly as funny as the author intends. Turning a ‘moan’ into interesting writing is a tricky skill to pull off.

All of that aside: In 1843 magazine, Adrian Wooldridge recently wrote about irritating announcements on public transport:

Some companies seem to revel in redundancy. In the railway world Amtrak is the champion of verbosity. Recorded announce­ments on its trains proclaim the arrival of each station with a peroration ending in a request to “please take this time to look about you and collect your bags”, as though the majority of passengers were otherwise likely to canter off the train in a spiritual ecstasy, leaving their material possessions in their wake.

This complaint touched a nerve. When I was commuting to London on a weekly basis a few years ago, there was one particular train guard whose name became lodged in my memory, so annoying were his announcements. His tone tended to convey a weary sense of superiority: it was with some mild irritation that he reminded passengers to check that their tickets were valid for this particular service, as though only a moron could be confused. He spoke extremely slowly, as though he had been told in training not to speak too fast and had overcorrected. And, most irritatingly of all, he seeemed intent on lengthening every announcement to the greatest possible extent by including superfluous words.

Peterborough would never be the ‘next stop’; it would inevitably be ‘the next station stop at which our service will be calling this morning’. Passengers should not merely content themselves with ‘reading the displayed safety instructions’; rather they should ‘be sure to fully familiarise themselves with the safety information cards displayed on the walls of the vestibules at the end of every carriage on board this service’. Customers should not simply ‘have tickets ready for inspection’; they should ‘be aware that a full ticket check will now take place in all coaches, starting from Coach B at the front of the train, and ensure that they have all tickets, travel documents and railcards to hand both at their seat and when moving around the train.’

The verbosity was almost too much to bear. So while I disagree with Adrian’s preference for not knowing the names of service workers and wearing headphones through safety demonstrations on aircraft, I find it hard not to have a little sympathy with his complaints about excessively loquacious train guards.


As an aside, on a recent train journey, the guard issued the typical reminder that passengers should “take all of their personal belongings with them”. Somebody loudly responded that this wasn’t practical, as most of their personal belongings were at home rather than on a train. I’ll laughed quite loudly, despite myself.


The image at the top is of a Virgin train at Brighton station. The full version was posted on Flickr by Matt Davis, and I’ve reproduced a cropped version here under its Creative Commons Licence.

This 2,436th post was filed under: Posts delayed by 12 months, Travel, , , , , .

Espresso and tonic

The latest thing at Caffè Nero… and very refreshing it is, too.

This 2,435th post was filed under: Photo-a-day 2019.

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