“European manifesto against pseudo-therapies”

Let’s be clear: pseudoscience kills. And they are being employed with total impunity thanks to European laws that protect them.

They kill thousands of people, with names and family. People such as Francesco Bonifaz, a 7-year-old boy whose doctor prescribed homeopathy instead of antibiotics. He died in Italy [1]. People like Mario Rodríguez, who was 21 years old and was told to use vitamins to treat his cancer. He died in Spain [2]. People like Jacqueline Alderslade, a 55-year-old woman whose homeopath told her to stop taking her asthma medication. She died in Ireland [3]. People like Cameron Ayres, a 6-month-old baby, whose parents did not want to give their child “scientific medicine” [4]. He died in England. People like Victoria Waymouth, a 57-year-old woman who was prescribed a homeopathic medication to treat her heart problem. She died in France [5]. People like Sofia Balyaykina, a 25-year-old woman, who had a cancer that was curable with chemotherapy but was recommended an “alternative treatment”, a mosquito bite treatment.  She died in Russia [6]. People like Erling Møllehave, a 71-year-old man whose acupuncturist pierced and damaged his lung with a needle. He died in Denmark [7]. People like Michaela Jakubczyk-Eckert, a 40-year-old-woman whose therapist recommended the German New Medicine to treat her breast cancer. She died in Germany [8]. People like Sylvia Millecam, a 45-year-old woman whose New Age healer promised to cure her cancer. She died in Netherlands [9].

European directive 2001/83/CE has made –and still makes— possible the daily deceiving of thousands of hundreds of European citizens [10]. Influential lobbies have been given the opportunity to redefine what a medicine is, and now they are selling sugar to sick people and making them believe it can cure them or improve their health. This has caused deaths and will continue to do so until Europe admits an undeniable truth: scientific knowledge cannot yield under economic interests, especially when it means deceiving patients and violating their rights.

Europe is facing very serious problems regarding public health. Over-medicalization, multiresistant bacteria or the financial issues of the public systems are already grave enough, and there is no need to add to that gurus, fake doctors or even qualified doctors who claim they can cure any disease by manipulating chakras, making people eat sugar or employing “quantic frequencies”. Europe must not only stop the promotion of homeopathy but also actively fight to eradicate public health scams, which implicate more than 150 pseudo-therapies in our territory. Thousands of citizens lives depend on that. In fact, according to recent research, 25.9 % of Europeans have used pseudo-therapies last year. In other words, 192 million patients have been deceived [11].

Some believe there is a conflict between freedom of choice for a treatment and the removal of pseudo-therapies, but this is not true. According to article 25 of the Universal Declaration of Human Rights, every person has a right to medical care. Lying to patients in order to sell them useless products that could kill them breaks the right to true information about their health. This way, even if a citizen has a right to refuse medical treatment when properly informed, it is also true that nobody has the right to lie to obtain profit at the expense of someone else’s life. Only in a world in which lying to a sick person would be considered ethical, could we allow homeopathy—or any other pseudo-therapy—to continue to be sold to citizens.

Effective treatments being replaced by false ones is not the only danger of pseudo-therapies. Obvious delays in therapeutic care occur when a person gets false products instead of medication at the early stages of a disease. Many times, it is already too late by the time they get treated with proper medicine. Moreover, several of these practices have serious effects on their own and may cause damage or even death because of their side effects.

Many pseudo-therapists argue that “the other medicine” comes with side effects as well, which is true indeed. However, the difference resides in that pseudo-therapies cannot cure a disease or improve your health, and because of that patients assume risks in exchange of promises that are a scam, according to the full weight of the scientific evidence available. Lying to a sick person is not another type of medicine, it is simply lying to a sick person.

Every country has to face the issue with pseudo-therapies in its own ways. Yet it is not acceptable that European laws protect the distortion of scientific facts so that thousands of citizens can be deceived or even lead to their deaths.

We, the signatories of this manifest, therefore declare that:

  1. Scientific knowledge is incompatible with what pseudo-therapies postulate, as in the case of homeopathy.
  2. European laws that protect homeopathy are not admissible in a scientific and technological society that respects the right of the patients not to be deceived.
  3. Homeopathy is the most known pseudo-therapy, but it is not the only one nor the most dangerous one. Others, such as acupuncture, reiki, German New Medicine, iridology, biomagnetism, orthomolecular therapy and many more, are gaining ground and causing victims.
  4. Measures must be taken to stop pseudo-therapies, since they are not harmless and result in thousands of people affected.
  5. Europe needs to work towards creating legislation that will help stop this problem.

Europe being concerned about the misinformation phenomena but at the same time protecting one the most dangerous types of it, health misinformation, is just not coherent. This is why the people signing this manifesto urge the governments of European countries to end a problem in which the name of science is being used falsely and has already costed the life of too many.

Sign the manifesto

[This manifesto was reproduced with permission. Scientists in other countries who take healthcare and science serious should put more pressure on their politicians and regulators to, uhmm, wake up, because this is by no means a European problem, it is a global problem – please sign the manifesto]

 

References:

[1] Homeopathy boy died of encephalitis. Redazione ANSA, 2017.http://www.ansa.it/english/news/general_news/2017/05/29/homeopathy-boy-died-of-encephalitis-3_13e02493-4e62-4787-9162-12d831121ef6.html

[2] Grieving dad sues over ‘cure cancer with vitamins’ therapy, The local. Emma Anderson, 2016.

https://www.thelocal.es/20160412/grieving-father-sues-naturopath-over-son-cure-cancer-vitamins-leukaemia

[3] Asthmatic ‘told to give up drugs’. The Irish News, 2001.

https://www.independent.ie/irish-news/asthmatic-told-to-give-up-drugs-26063764.html

[4] Homeopaths warn of further tragèdies. BBC News, 2000.

http://news.bbc.co.uk/2/hi/health/702699.stm

[5] Alternative cure doctor suspended. BBC News, 2007. http://news.bbc.co.uk/2/hi/uk_news/england/london/6255356.stm

[6] Футболист рассказал трагичную историю жены. Она умерла от рака в 25 лет. Sport24, 2018.

https://sport24.ru/news/football/2018-08-28-futbolist-rasskazal-tragichnuyu-istoriyu-zheny-ona-umerla-ot-raka-v-25-let

[7] Mand døde efter akupunktur – enke vil nu lægge sag an mod behandleren, TV2, 2018.

http://nyheder.tv2.dk/samfund/2018-01-23-mand-doede-efter-akupunktur-enke-vil-nu-laegge-sag-an-mod-behandleren

[8] The price of refusing science-based medical and surgical therapy in breast càncer, Science Blogs, 2012. https://scienceblogs.com/insolence/2012/08/30/the-price-of-refusing-science-based-medical-and-surgical-therapy-in-breast-cancer

[9] Psychic ‘misled actress to hopeless cancer death’. Expatica. 2004

http://web.archive.org/web/20070208144309/http://www.expatica.com/actual/article.asp?subchannel_id=19&story_id=4821

[10] Directiva 2001/83/CE del parlamento europeo y del consejo:6 de noviembre de 2001

https://www.boe.es/doue/2001/311/L00067-00128.pdf

[11] Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants. Scandinavian Journal of Public Health. Laura M. Kemppainen et al. 2018.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989251/

 

Trio cleared over diabetic boy’s death after Chinese slapping therapy

Is this justice? I just don’t think so. When you read about the horrific circumstances in which this poor boy died, then this is a terrible judgement. Furthermore, this verdict now provides a safety net for parents who consider themselves ‘open-minded’, ‘making use of their freedom of choice’ and ‘being in charge of their children’s health’. And this in an environment with a rapidly increasing number of utter ridiculous and dangerous quackery being peddled to defenceless children (the anti-vaxx movement is also a case in point).

In short; slapping therapy involves slapping yourself or being slapped by someone else until (severe) bruising occurs, which is claimed to be ‘toxins’ that’s being released by your body (it is in fact nothing more than a very cruel form of child abuse). So, this poor child was taken of his insulin which caused him to start vomiting and eventually faint, which prompted his parents and the slapping therapist, Hongchi Xiao, to employ ‘emergency slapping’ to revive the child. Quite predictably and unfortunately, he died.

child abuse
An unrelated photo regarding ‘slapping therapy’ that I found on internet. This is child abuse!!!

This level of delusion is very hard to comprehend, and with this verdict the chances are very good that this sort of incident will become more common. For some background on this case, detailing all those involved in this tragedy you can find here and here. Below is the very short newspaper article reporting on the outcome of this court case. I do not know if the parents will now face lesser charges or if this is it. The slapping therapist is yet to be sentenced.

Start of article

“Three relatives have been found not guilty of the manslaughter of a diabetic six-year-old boy who died after attending a Chinese slapping and stretching therapy workshop in Sydney.

The boy’s mother, father and grandmother, who were accused of breaching the duty of care they owed the boy through gross negligence, had pleaded not guilty to his manslaughter in April 2015.

A NSW District Court jury, which was told the boy’s last insulin injection to treat his type 1 diabetes came on the first day of the week-long “radical” workshop, on Friday found the trio not guilty of manslaughter.”

End of article

Will keep you posted on any future developments.

‘My story and my vision of China’ – ‘Prof’ Alan Bensoussan, cheerleader of the World Hoaxers Organisation (WHO)

Just thought I’ll share this rather interesting interview with my more scientifically inclined followers. For me the message is rather clear; never make a quack a Prof otherwise healthcare might just suddenly find itself all the way back in the dark ages. Below you can find the unedited interview that appeared in the People’s Daily Online a couple of weeks ago. Because I am so tired of highlighting how people are being BSed by the NICM, regarding Traditional Chinese Medicine (and a lot of other rubbish), I am not even going to comment on the multiple issues (my less scientifically inclined followers should maybe first read these background articles here, here and here)

Start of interview:

“China is the only nation in the world to have systematically and conscientiously protected and invested in its traditional medicine. Professor Alan Bensoussan, who has been researching Chinese medicine for more than 30 years, is the only foreigner in 2013 who had received the prestigious International Award for Contribution to Chinese Medicine.

Professor Bensoussan is the Director of the National Institute of Complementary Medicine (NICM) at the University of Western Sydney, the largest institute in Australia that does research in traditional Chinese medicine. The institute focuses on four areas; neuro cognitional dementia and mental health in general, cancer, womens’ health and cardiovascular and metabolic disease.

“We have regulated the practice so that practitioners are recognised now so I think China continuing this interaction, engagement with the West, will only lead to greater improvements in the science of Chinese medicine,” Professor Bensoussan said.

Professor Bensoussan emphasised the importance of conducting clinical trials on Western patients in order to find ways to approve traditional medicine in Western countries.

“What we have to do is translate those medicines, develop the science, translate them for the use in the West,” he said.

“So the opportunities, you’ve got a field of medicine that is being used that has been the main form of medicine for all over the world for centuries. There are going to be endless opportunities.”

Professor Bensoussan believes that the advantage of Chinese medicine is that it provides a number of compounds in a mixture and lower dosage levels that will gradually readjust the body’s physiology.

“I think for me personally, the magic doesn’t lie in the purification of the medicine to identify a single compound … but the magic in Chinese medicine for me is actually the interface between foods and purified drugs,” Professor Bensoussan said.

It was learning about the science of acupuncture back in the 70s that triggered his curiosity to delve deeper.

“Chinese medicine offered a different perspective of the patients’ health, a different perspective of their health and illness because the theory is different. It offers different ways of viewing how symptoms and signs are connected and so this was interesting.”

His best experience regarding Chinese medicine was in 1984 and 1985 when he studied at Nanjing University of Chinese Medicine. Since then, Professor Bensoussan has been back 30 to 40 times for various research collaborations and different study periods.

Professor Bensoussan has high expectations for the future of traditional Chinese medicine such as treating chronic diseases in the West.

“It [Chinese medicine] was the system of healthcare in China for a quarter of the world for centuries so the field is very fertile, very rich with opportunities … We have the infrastructure, we have the resources, we have the enthusiasm, we need the partnerships with China to accelerate this.” Professor Bensoussan is also fundraising for NICM to further support their research.

Professor Bensoussan has been the Chair of the Advisory Committee for Complementary Medicines of the Australian Therapeutic Goods Administration from 2011 to 2014 and has also served frequently as a consultant in traditional medicine to the World Health Organisation.

He has also published over 160 scientific papers and two books, including a review of acupuncture research in 1990 and a government report on the practice of traditional Chinese medicine in Australia in 1996.”

End of interview.

And to think that the World Health Organisation is now planning on endorsing TCM in all its shapes and sizes is just ridiculous and truly a step backwards. I think the title says it all: “WHO endorses traditional Chinese medicine. Expect deaths to rise”. These bastards!! Because it is not only people dying but endangered wildlife and those trying to protect them, against this tsunami of ‘enlightened’ people.

rhino poaching

The Hogwarts School of Magic is actually in Australia! They even teach you how to ‘fly’ a broom (they really do).

And we thought that the ‘Hogwarts School of Magic’ only existed on the big screen. But, this type of school is actually real. There are quite a number of them currently operating in Australia, where bright-eyed, impressionable teenagers are taught how to manipulate energy fields in order to banish ‘evil spirits’ (or disease), and how to elevate out of their despondent earthly existence into an enchanted state of eternal health and happiness –  like flying for the first time on a broomstick (or smoking a joint). It will therefore come as no surprise, that the game of Quidditch, from the Harry Potter movies, is indeed being played at some of these modern schools of magic. The Tri-wizard cup was even won by Western Sydney University in 2013.  A real-life fantasy world.

Quidditch game

(Quiddich players ‘flying’ in attack formation on their Nimbus 2000 broomsticks)

But there is a problem!

To run around on a field with a broomstick between your legs is, I guess, okay, and not strange at all. It is good exercise, but you are not suddenly going to take off (at least not without a joint), because ‘strangely’ enough this only happens in the movies (or if you are completely stoned). So, for the rest of it, none of it is real – it is all a hoax. And this is now problematic, because all parents would agree that we want the best education for our children. But this is also where we tend to stop our involvement and we do not always ask the important question of; what is actually being taught at these schools? There are many reasons for this, one of them being that we tend to trust that government will protect us from fraudsters. So, when these schools are government funded and regulated, and especially, when they provide them with a stamp of approval via various accreditation schemes, this is usually enough to put our minds at ease – we  trust the system!

Unfortunately, some of these schools provide government accredited courses in magic. For example; children are being taught to manipulate ‘energy’, yes, without a wand (although I am not always so sure), but with the use of needles, crystals and various herbs such as the screaming mandrake (oh no wait, that was in the movie).

 

Specific examples of these courses include; Bachelor in Chinese medicine, chiropractic and osteopathy at RMIT University, Bachelor of Health Science (Naturopathy – includes homeopathy) at Endeavour College, Bachelor of traditional Chinese medicine at Western Sydney University and Bachelor of Health Science in traditional Chinese medicine at the University of Technology Sydney. The Southern School of Natural Therapies explains that their accredited course in Chinese Medicine; “is an ancient, holistic form of medicine that connects the mind, body, spirit. Chinese medicine believes that the body is made up of Qi – energy which permeates the whole body and flows through our meridians. Chinese medicine aims to stimulate the meridians, producing effects on different organs and systems within the body to restore balance and harmony” – this is pure magic!

This is what our kids are being taught at these schools, and unfortunately, this is pure fantasy because this ‘energy’, which is at the foundation of all of these pseudoscientific healthcare systems, simply do not exist. But, this ‘energy’ do indeed attract large numbers of students, because all of us are fascinated by magic. Regrettably, those students who actually believe in the magic show, tends to pay a significant amount of money to learn ‘magic’, and once they realise that it’s an elaborate government supported hoax, many simply tend to continue practicing magic. Because, by now, they have incurred a lot of debt, they have lost a lot of time, and they don’t want to be branded a drop-out or loser (sure, there will also be true believers amongst them). Hence, the problem of modern day ‘medical magicians’ will continue to be with us and might even surge, if the government continue to legitimise it via their various accreditation schemes.

And this brings me to accreditation, which is arguably a big part of the problem. The Council of Australian Governments (COAG) recently invited submissions for their “Independent Review of Accreditation Systems within the National Registration and Accreditation Scheme for health professions”. The ‘Friends of Science in Medicine’ (FSM) organisation did submit a detailed report highlighting their many concerns when accreditation is given to these schools of magic. This report was unfortunately deemed ‘out of scope’ by the COAG Health Council which implies that they are quite happy to continue to mislead students and their parents (and this can destroy families), as well as the patients who are on the receiving end of these completely ineffective magical treatments. Many patients do indeed get hurt and some even die, as was tragically illustrated by a practitioner whose magical ‘Slapping Therapy’ did not cure a 6yo boy from his type-1 diabetes.

Below you will find the Executive Summary of FSMs submission (with permission), and here you can find the full submission.  But the question remains; why do the government continue to bestow undue credibility and continue to legitimise ‘medical magic’ by providing accreditation to these courses in Australia?

“Executive Summary

Accreditation is antecedent to, and inextricably bound together with, practitioner registration. This submission raises concerns about registered alternative medicine (AltMed) practitioners, accusing the present accreditation system of failing to protect the public through its legitimising poor quality, belief-based, rather than evidence-based, education and on-going training of chiropractors, osteopaths and Chinese medicine/acupuncturists.

FSM is aware that some higher education institutes and continuing professional development courses give credibility to pseudoscience. Examples of pseudoscience include chiropractic (subluxation theory, Kinesiology, Retained Neonatal Reflex and Webster Technique, osteopathy (Osteopathy of the Cranial Field and Visceral Manipulation) and Chinese Medicine (Acupuncture and the teaching of “Qi”, energy blockages that cause disease, as a fact).

FSM also remains concerned with the accreditation process supervised by AHPRA and its Boards.

FSM alleges that:

A. the training of registered AltMed practitioners:

  1. is of low quality;
  2. is based on pseudo-scientific concepts that reject germ theory as the cause of disease;
  3. teach invalid diagnostic technique;
  4. includes potentially dangerous interventions, continued in the ongoing training of practitioners;
  5. wastes considerable public funding allocated to universities which teach these unscientific courses; and
  6. compromises our universities’ reputation within Australia and internationally.

B. thousands of false and misleading claims on AltMed websites breach the National Law. This report demonstrates that registered AltMed practitioners:

  1. are poorly trained;
  2. are not competent to treat patients;
  3. delay correct diagnosis and evidence-based therapies thereby allowing progression of disorders;
  4. may cause harm;
  5. waste millions of health dollars;
  6. undermine the efforts of evidence-based practitioners in their communities;
  7. do not, in respect of exaggerated claims and advertising, behave in an ethical manner;
  8. create considerable confusion for patients with chronic ailments; and
  9. focus their ongoing training on building their practices rather than on the needs of patients.
  10. This report also raises concerns about pseudoscience-based courses, that may attract VET-help fees, such as reflexology, homeopathy, aromatherapy and reiki, that are advertised on Government websites.

C. Government websites are providing undeserved credibility for discredited AltMed.

Underserved credibility is given to discredited AltMed courses including Reflexology, Aromatherapy, Homeopathy, Naturopathy and Reiki that may attract VET-help fees and are advertised on Government training websites.

Using acupuncture as an example, along with valid research findings, informed opinions and advice from medical experts, this report investigates the teachings in one high-profile accredited course and the impact and costs of this intervention on health care. While this report focuses on acupuncture, the same concerns can be extrapolated to other domains of pseudo-science, which is in both accredited university and continuing professional development courses. It also recommends that the scope of practice of AltMed practitioners should be limited to what they can advertise, to further protect patients from invalid diagnosis and belief-based interventions.

While ALL unregistered AltMed practitioners are NOT practicing any form of evidence-based medicine, (reflexology, iridology etc), there are thousands of registered practitioners, bound by the National Law to practice care that is evidence-based, who are practicing pseudoscience. The scope of the recent NHMRC review of natural therapies EXCLUDED interventions offered by registered practitioners on the basis that consumer protection was available through the AHPRA scheme.

This report highlights the millions of health dollars wasted by the Government funding of AltMed teachings and practices. Nearly $220 million was spent on acupuncture, chiropractic and osteopathy through Medicare from July 2011 to June 2016.

AltMed practitioners, who reject evidence-based medicine and over-service patient with placebo interventions are not the ‘right people’ to address patient needs, now and in the future.”

‘Celebrity’ endorsements! The NICM seeking Royal endorsement using their ‘faked’ ERA ranking!

Nooo waaay!! If Gwyneth Paltrow can promote that, then surely, I can promote some of my very own quackery! Don’t call me a snake oil salesman, look at Gwyneth, she is selling ‘psychic vampire repellent’ and ‘jade eggs’ – my quackery is not nearly as crackpot as that, and, she gets away with it!

And off they go, endorsing and promoting everything from water as effective medicine, to jade eggs to be; “used by women…. [to be inserted, you know where] ….to help connect the second chakra (the heart) and yoni for optimal self-love and well-being.” And, yes, psychic vampire repellent to ‘banish bad vibes and shield you from the people who may be causing them.’ Celebrity endorsements, using social status to (un)intentionally mislead the public, and in some cases, enrich themselves even further!

Pure quackery, but whatever these Demi-gods endorse, usually result in a large number of worshippers to blindly follow. Their faith is so blind, that they will even give their own children water as medicine. Unfortunately, but also predictably, some children die as a result, but apparently, this is a small price to pay in order to appease these Demi-gods. But luckily, there are a number of brave warriors (or scientists) who are standing up for science, understands social responsibility, and openly question the validity and motives of these apostles of quackery.  And you need to be brave, because this can backfire depending on the unique powers and influence of the Demi-god in question. As was illustrated by Prof Edzard Ernst, after he publicly, but fairly, called a Demi-god a snake oil salesman.

As for Gwyneth Paltrow, she is merrily continuing to promote the most bizarre healthcare rubbish via her company Goop. Her beauty, apparently,  has a hypnotic effect on her followers because they just continue to buy whatever she conjures up. At least, she won this year’s inaugural Rusty Razor award for “the ‘best’ promoter of the ‘worst pseudoscience of the year.” Well done, Gwyneth, although this will probably only strengthen the resolve of her followers.

In the picture above there is also a banner that seemingly does not fit the ‘bigger’ picture; “Excellence in Research for Australia” (ERA). The reason for this is because celebrity endorsement of quackery tends to attract the attention of a very ‘special’ kind of person – the promotional ‘scientist’. It is, in fact, a vicious circle. Quackery generates a lot of money, which partly flows into the coffers of ‘willing’ universities who provides further ‘scientific’ endorsement of quackery (much appreciated by the celebrities), and this, in turn, leads to an increase in sales – and round we go.  These promotional scientists actively seek endorsements from celebrities or royalty such as Prince Charles, and they pursue any opportunity to make this reality – an excellent way of spending public money! Endorsements gives them, and the quackery that they peddle, (undue) credibility and legitimacy, but at least it leads to increased sales – and that is what it is all about.

And this brings me to the National Institute of Complementary Medicine (NICM), Australia, who actively sought the endorsement of the Prince of Wales to become their patron. Here is an excerpt of the NICMs attempts, written by Prof Alan Bensoussan;

“I understand that HRH The Prince of Wales is a keen advocate of integrated healthcare and of proven complementary treatments and therapies.  His goals align substantially with those of NICM, which seeks to build an evidence-based complementary medicines sector in Australia and more broadly. Subject to the approval of HRH The Prince of Wales, I envisage that the role of patron would be to officially endorse NICM, for example, by the inclusion of letters written by HRH The Prince of Wales on the NICM website and in seminal publications.”

The words ‘proven’ and ‘evidence-based’ is somewhat out of place, because both the NICM and Prince Charles continue to promote debunked homeopathy (water as medicine against malaria etc.) and a lot of other crackpot treatments, so, these words are meaningless coming from the NICM.

But there is another type of endorsement that they actively pursue. And that is being endorsed by a respected organisation, such as the World Health Organisation (WHO), or in this case, the Australian Research Council (ARC), which manages the ERA scheme (the NICM does have a man on the inside at the WHO, but more about this at a later stage). Under the ERA scheme, universities submit their research outputs and based on this data they receive a ranking out of 5 for a specific field of research. In the NICMs case, they were ranked in the “Complementary and Alternative medicine” field of research in both the 2012 and 2015 rounds, and they are currently submitting data for the 2018 round.  This is what the NICM told Prince Charles;

“We are the only Australian complementary medicine research centre to receive a ranking of 5 in the Commonwealth Excellence in Research for Australia exercise – signalling research well above world standard.”

So, clearly the NICM has been endorsed by the ARC under their ERA scheme, and indeed they did receive the highest ranking of 5, in both the 2012 and 2015 rounds, which they now use to lobby for further recognition and endorsement from celebrities or royalty. They even managed to legitimise traditional Chinese medicine (TCM) in Australia using this ARC endorsement, and they are currently building a TCM hospital in the heart of Sydney. This is dangerous, because many people will get hurt, or might even die, because of ineffective fake healthcare systems such as TCM. Here is one example, where the NICM was indirectly involved in the death of a 6yo boy.

But there is a problem with the ERA endorsement. Having first-hand knowledge of the promotional research that the NICM conducts, there is no way in this world that they can or should receive a ranking of 5, so, clearly there is a discrepancy somewhere. For example; below is an abstract of one of their ‘scientific’ articles that was reviewed by the ARC, and you’ll be excused if you think that it was written by Gwyneth Paltrow;

This case report describes a 25-year-old woman who presented with nausea and vomiting (NVP) in her seventh week of pregnancy. The treatment was not successful overall and resulted in both patient and practitioner losing confidence. The following reflective questions challenged my practice and led to an examination of what makes acupuncture work. – Why, after a course of acupuncture, did the nausea and vomiting continue? – What led to a loss of confidence in the effectiveness of acupuncture to treat this ailment? Multiple traditional Chinese medicine (TCM) research reviews show some benefit for nausea and dry retching using acupressure and acupuncture, and limited results for vomiting. Despite this, I found that my confidence was undermined by being out of touch with my own inner knowing or Yi. I needed to encourage the patient (‘Laura’) to take more responsibility for her own health and we both needed clarity around the treatment result expected.

This is not something that you’ll expect from a university in Australia – especially not if they are ranked ‘well above world standard’. The fact that case reports (there is more than one) are ineligible to be submitted as a scientific article is an issue (ERA guidelines section 5.4.8.5 page 41), but I believe the contents of their work is a far bigger problem – it is pure and unadulterated pseudoscience! But this isn’t even the biggest problem. The NICM submitted 89 scientific articles for review in the 2012 round, and 151 articles in the 2015 round. Of the 89 articles, close to 50% was not produced by the NICM and in the 2015 round, close to 25% of articles was produced by other universities. This is not only completely unethical, this, in my view, is fraud. You cannot take the work of others and claim it as your own – just imagine what will happen if you do something like this on your CV! (here is a full list of the NICMs articles – interesting stuff).

But what does the ERA guidelines say about this? Well, to be honest, nothing. I could not find any information in the guidelines, clearly stating that they were allowed to do this. The ARC, and the expert committee members who reviewed the NICMs application, was contacted for clarification, but unfortunately only the ARC responded, and none of the 25 committee members. The answer from the ARC was also somewhat vague;

“Therefore if you review the individual outputs of a specific unit of evaluation within a university they may not all have a publication association listed but could still be within the submission guidelines.”

So, there appears to be an unwritten rule which ‘allowed’ the NICM to submit the work of others as their own – a typical loophole? And what better way to identify these loopholes than to serve on the expert committee reviewing these applications? As expected, the director of the NICM, Alan Bensoussan did indeed serve on the expert committee in 2010, where he, as an expert promotional scientist, identified the loopholes which they exploited in full, during the 2012/2015 rounds. But, this is only true if this is indeed a loophole, otherwise, it is plain and simple fraud! But, to be honest, I could not care less what the ERA guidelines say, it is never okay to take another person’s work! Because what example do you give students, and what about the international universities who have now unwittingly contributed to the legitimisation of dangerous pseudoscientific healthcare systems in Australia?

For example. Leiden University has ‘contributed’ 7 scientific articles towards WSU’s scientific output – obviously without them knowing about it. The authors of these articles worked at Leiden university while being paid by the Dutch taxpayer! And at the time, they were completely unaware even of the existence of the NICM or WSU. But, unfortunately, without them knowing about it, they have now assisted these ‘scientists’ at WSU to promote quackery. I am convinced that Leiden University, and the many other universities who are involved, will not appreciate this.

Although this issue is still unfolding, and there are still a lot of questions to be answered, it just again shows that almost everything that pseudoscientists do, is misleading or false. They will even mislead celebrities or royalty from whom they seek their highly valuable endorsements. And this does not bode well, because the NICM who has extensively used their ERA ranking to lobby the Australian and Chinese governments, has managed to strike a deal with China and, in effect, has legitimised TCM in Australia.

So, if you suspect that this practice is widespread at Australian universities, you can always request the information from the ARC under a Freedom of Information Act (section 6.4, page 69). And if you are an academic considering taking up a job at an Australian university, be careful, because they might just stick you in a dark hole and use your extensive publication record as part of their own scientific outputs – this might be the only reason why the hired you! But let’s hope that this fraud is limited to the NICM, and not a widespread phenomenon.

Much more to come on this issue.

 

Death by ‘Slapping Therapy’. The role of the NICM, and others, in this tragedy.

It is always a terrible day when children die at the hands of fake medical practitioners or pseudoscientists. It is so unnecessary and preventable, and yet, it happens every day everywhere around the world. The proverbial snake-oil salesman is not a new phenomenon, it has always been with us, but it is becoming a global epidemic since some universities decided to elevate this type of quackery, to become state-funded and university-supported quackery. This turn of events lends undue credibility and legitimacy to these ineffective and dangerous ‘treatments’ and this translates into more people being fooled, while the snake-oil salesmen and those universities stand to make more money. It is always about money! But let’s have a look at how it works with the following tragic example, followed by some suggestions as to what you can do to help prevent these things from happening.

The controversial ‘Slapping Therapy’

This example involves a complementary therapy within the realm of Traditional Chinese Medicine (TCM), called ‘slapping therapy’ or ‘Paidalajin’. A 6yo boy suffering from type-1 diabetes attended a slapping therapy workshop in Sydney with his parents, but sadly, the boy died in his hotel room shortly afterwards. Although the case is still before the courts, it is believed that he was deprived of medication and food during the workshop. The parents and grandmother have been arrested and faces manslaughter charges while the TCM practitioner, Hongchi Xiao, was only quite recently extradited from the UK, where another person died at one of his workshops. He was not granted bail and faces a maximum sentence of 25 years imprisonment.

But what is this ‘slapping therapy’, and why is it called controversial? It involves the flow of ‘energy’ or a ‘life force’ (chi) through channels (meridians) and by slapping yourself, or being slapped by someone else, you restore the flow of chi and your body starts to expel ‘toxins’. These toxins become visible when your skin turns red, and I guess, purple and blue, depending on how hard you are being hit. The theory was, therefore, that by slapping this boy he would be cured from diabetes, and this belief is so strong, that he was also taken off his medication – a life threatening scenario. But what does science say? Chi does not exist, meridians do not exist, diabetes cannot be cured and especially not by slapping, and the so-called toxins that your body expel are called bruising (the slapping injury causes tiny blood vessels to burst and the blood gets trapped below the skin’s surface, which causes a bruise). Just imagine how many people get hurt or die, due to TCM practitioners using chi, meridians etc. to diagnose and treat disease. Because it does not exist, they cannot really diagnose anything, and hence cannot effectively treat anything!

Here is a photo of the type of bruising that you can expect, posted as a testimonial from a cancer sufferer and devout follower of Master Xiao (I always wonder how many of these testimonials are real). In addition, if you hit a young child to a point of severe bruising it is called child abuse, but in the pseudoscientific world it is apparently called ‘self-healing’.

All of TCM is controversial, or none of it is!

If you promote TCM, in whatever shape or form, you also promote its underlying pseudoscientific principles. Let’s look at acupuncture; You insert needles at specific points (acupoints) that supposedly manipulate the flow of chi through meridians – and this, according to practitioners, cures disease! This acupuncturist (at Western Sydney University – WSU) recently published a case study where she reported that her patient did not recover after receiving an acupuncture treatment. What was her conclusion? “Despite this, I found that my confidence was undermined by being out of touch with my own inner knowing or Yi.” So, what is Yi? It is your intent (yi 意 ), and when your intentions (to cure disease) becomes permanent, then it becomes your will (zhi 志 ). In other words, acupuncture works and nobody should argue with that, the problem, this time, was that her intention for it to work were insufficient. Solution: believe more deeply!  And to think that this was part of the ‘science’ that was reviewed by the Australian Research Council in their Excellence of Research for Australia scheme, which they rewarded with the highest possible ranking (5) “evidence of outstanding performance well above world standard (something is rotten, but more about this in a next article).

But the same goes for herbal TCM, which also aims to manipulate the flow of chi through meridians. As described by ‘Prof’ Alan Bensoussan (director of the NICM at WSU) in a radio interview; “The first patient would receive acupunctural herbs that disperse the accumulation of energy, the second patient would receive acupunctural herbs that strengthen and tonify the low back. It’s a tool like this concept of circulation of energy, that actually allows the Chinese Medicine practitioner to distinguish these patients, and allows the Chinese Medicine practitioner to treat the patients in a way that the patient themselves may understand better,”.

Disease is therefore seen as an imbalance of a non-existent energy that flows through non-existent meridians, and the ‘slapping therapist’ makes use of these ‘fake’ principles to mislead people. In their strange world, bacteria, viruses, pancreatic cells secreting insulin etc. do not exist, but rather disease is caused by your chi clogging your meridians and hence slapping yourself, or inserting needles, or taking herbs, will unclog your meridians and you will be cured of whatever ailment you might suffer from. They are continuing, to this day, to promote these false and dangerous ideas to the Australian public. And again, it is dangerous because if you cannot diagnose a disease, you cannot effectively treat it. Any successful TCM treatment (some herbs might be effective) is therefore purely based on luck. Ever wondered why a TCM practitioner will prescribe a patient a combination of 10-20 different herbs? Because it improves their chances of getting lucky, but also amplifies the many risks, 20-fold.

This is why scientists call TCM, and the many other forms of complementary medicine, belief-based healthcare systems. You only have to believe hard enough that it works and that’s it, there are more than enough gullible people who will fall for your trickery. Sure, you get true believers (delusional) and unscrupulous people (criminals) that only make as if they belief, for the sake of misleading you and to make money out of you. If you fall for them, then, unfortunately, you are on your own. Master Xiao’s comments after his arrest? “This has nothing to do with the workshop. This boy had a lot of diseases, more than we ever know.” It is never their fault.

But now a very unfortunate death has occurred, which means that many of the important role players in this tragedy will disavow the slapping therapy ‘treatment’ in order to absolve themselves of responsibility and to stay out of the news. They do not accept any negative reports because it tends to clash with their Yi and Zhi. And hence they continue to promote acupuncture and TCM, even though many deaths have occurred as a direct result of acupuncture and even more due to herbal TCM remedies. And to think that most deaths, by far, occur as an indirect result after using these pseudoscientific therapies by neglecting a treatable or manageable medical condition, such as malaria or diabetes. The total number of deaths? Nobody knows.

Either all of the above therapies and treatments are controversial and should be stopped, or none of it is. I am fully supportive of the former, but those ‘open-minded’ people whose brains have fallen out, albeit delusional or criminal people, will obviously choose the latter and they will continue to make money out of the misfortunes of others. And with the current support of some universities, this problem will only get bigger.

Who is now really to blame for these tragic events? The role of Tasly Healthpac and the NICM.

No real doctor or scientist or any decent person with ethics and morals would allow a slapping therapist to give a workshop on their premises. Especially not to children suffering from serious medical conditions. What you should do, especially if you are an evidence-based healthcare practitioner, is to explain to this person that what he does is dangerous and that he should please stop doing it. And then you report him to the police. But this did not happen. So, the workshop was held at the ‘Tasly Healthpac Centre of Excellence in Integrative Medicine’. According to a Tasly spokesperson, the slapping therapist “Mr Xiao rented a room from our centre to conduct what was described to us as a series of health seminars. The boy and his mother were participants in the seminar.” Apparently, they did not know about the slapping therapy, but is this true?

It is telling that Tasly have deleted their website or they have changed their name to Medicentral, where they continue to provide TCM and acupuncture alongside conventional treatments. No information can be found on their new website regarding the workshop, but from internet archives, it is clear that they themselves advertised this workshop. Their old website received up to 538 daily visitors, and hence their marketing efforts via their website reached many people in Australia (I would not be surprised if the parents of the deceased became aware of this workshop via Tasly’s website). On Master Xiao’s website he also states that his workshop was co-organised by an Australian medical institution. Therefore, Tasly’s statement is false. Slapping, acupuncture, herbal TCM – it is all the same thing, and that is why they allowed this workshop to be held on their premises.

A key person at Tasly is the founder, Dr Ven Tan, who started the practice more than 20 years ago and ‘through his own practice he has come to realise the limitations of conventional Western medicine and to worship the merit of Traditional Chinese Medicine’. Having a well-established practice and making statements such as above will draw the attention of pseudoscientists at some Australian Universities. WSU in Sydney (and they are by no means the only Australian university who have decided to put money before science and ethics) used public money to convert TCM practitioners into ‘Professors’ and hence, it is to be expected that they will seek funding from, or collaborate with Tasly in exchange for providing extra credibility and legitimacy for Tasly’s pseudoscientific services. ‘Integrating’ TCM with conventional therapies, with the involvement of WSU, creates trust and a sense of security in patients that all of the provided services at Tasly’s are underpinned by science, and thus more and more people will be misled.

Here (second photo on the left) is the signing of a Memorandum of Understanding between the Chinese and Australian governments ‘aimed at promoting TCM in Australia through a collaborative initiative’ witnessed by Dr Ven Tan (Tasly) and Prof Alan Bensoussan (NICM at WSU). Another MoU was signed between Tasly and the NICM in 2011 which states that the NICM will provide “Assistance in the development of an Integrative Care Model: to assist the Tasly Healthpac Centre of Excellence in Integrative medicine so that its structure aims to integrate TCM and western medical diagnostics and treatments in an integrated, patient centred way.” The result of doing just that, speaks tragically for itself.

It is well known that the Chinese government wants to internationalise TCM, it is, after all, a $170 billion industry. An excellent article about this issue, a real eye-opener, was recently published in the Economist “State-funded Quackery. China is ramping up its promotion of its ancient medical arts. That is dangerous for humans as well as rhinos.” The NICM has played a crucial role in the national registration of TCM practitioners in 2012, which elevated TCM to the same level as conventional healthcare, lending undue credibility to TCM. This extra legitimacy was used by the NICM to facilitate China’s plans for internationalisation of TCM via Australia. They lobbied various Ministers and managed to get TCM into the Australia-China Free Trade Agreement in 2015, shortly after the boy’s death from slapping. In 2016 a trade delegation of the Minister of Health (Jillian Skinner – now retired) visited China, accompanied by Dr Ven Tan and Prof Alan Bensoussan. Part of the mission was “To assist the University of Western Sydney’s National Institute of Complementary Medicine (NICM) secure investor and donor support for the NICM’s integrative Chinese medicine facility medicine/treatment on the Westmead Campus“.

Yes, they are building a large integrative TCM facility in Sydney, which will open in 2018. They will obviously sell this as a ‘research’ facility, but in truth, it will be operated like a commercial facility. All of this is good news for China, Tasly and the NICM, but it is definitely not good news for the Australian public.

Tasly and NICM should therefore also be held responsible for these tragic events.

The role of the regulator, the TGA, and the NICM’s influence

In Australia, this very important function to protect the public against the sort of quackery described above, is being done by the Therapeutic Goods Administration (TGA). Pseudoscientists also know that the TGA is a potential key hurdle that must be overcome. They therefore lobby intensely, and some infiltrate the TGA (Alan Bensoussan has served many years on the TGA panel for complementary medicines), where they actually managed to get the job done. Even though the golden rule is that you really do not need to be a pseudoscientist in order to know what pseudoscience is, or to adequately regulate it. And yet, there are a number of TCM practitioners currently involved with regulating TCM at the TGA.

The NICM, and others, have managed to convince the TGA that almost all of these products and services are ‘low risk’, meaning low direct risk. Unfortunately, the high indirect risk is being ignored. You are probably not going to die after being slapped, but if you stop taking your real medicine it can lead to your death (the possible cause of the boy’s death). And this is exactly what this slapping therapist says. Medicine is poison so let’s slap your medical condition out of you.  What is my evidence for the bold statement regarding the TGA? They recently published their draft list of ‘permitted indications’, or the ‘medical’ claim that manufacturers can make for their products. Included in this list is 140 TCM indications. For example: “Harmonise middle burner (Spleen and Stomach)”, “Unblock/open/relax meridians”, “Balance Yin and Yang”. When a regulator allows pseudoscientists a foot in the door, then the above is the only logical outcome and now the TGA accepts the notion that meridians, chi, Yin and Yang etc. is real. And here again, the NICM is assisting Chinese companies to help them get past the TGA bureaucracy in order for them to register and sell their products in Australia. Having a partner such as the NICM in Australia, obviously makes a lot of Chinese companies very happy. Shouldn’t the TGA also be blamed when people get hurt after using these pseudoscientific healthcare treatments?

In a nutshell. The bereaved parents of the deceased are in trouble, while the slapping therapist is in jail where he will hopefully stay for a long time. But what about Tasly’s which promoted and hosted this workshop as part of their integrative medicine approach, or the NICM who collaborated with this clinic and facilitated their ‘integrative’ approach and who promoted TCM for decades and probably have misled thousands of people over the years, or the regulators who have opened their doors for pseudoscientists and who are continuing to allow this to happen? (I’ve actually volunteered my services to the TGA, but they were not interested.) Not even to speak about the politicians who could actually do something about this, but apparently have little interest to go in against the zhi (will) of the industry.

I can only hope that the courts will also look at the other players in this scenario who are partly responsible for this boy’s death, because it is time that the underlying problems be addressed, otherwise more and more people, including children, will get hurt.

What can you do about all of this?

Unfortunately, if you fall for their trickery and you get hurt, then you will be all alone. The bureaucracy involved is extremely complex so the best thing to do is prevention. Stop buying complementary, alternative, traditional or integrative ‘medicines’ and stop  using their ‘treatments’. Inform yourself and your family and friends about how these people play their game and what the dangers are, regarding these ‘treatments’. ‘Friends of Science in Medicine’ provides valuable healthcare information as well as the website of Prof Edzard Ernst, where he discusses everything complementary medicine (what works and what doesn’t). If you are interested in receiving automatic updates regarding the NICM and how they continue to promote these ‘medicines’ and ‘treatments’, you can always follow my Blog,  Twitter or connect on LinkedIn. Will keep you posted regarding the outcome of the 2017 Bent Spoon Awards, for which the NICM has again been nominated. Please, ‘Like’ and share this article via FaceBook etc. – options below.

Stopping your support of these products and services, by informing yourself and by creating awareness about these issues, are pretty much the only things you can do in order to prevent these needless deaths. It is just such a pity that the VC’s, regulators and politicians (all funded by the taxpayer!) don’t have much interest in this, or just can’t seem to get the job done because of vested interests.  I’ll end with the wise, but somewhat empty, words of Prof Barney Glover (VC of WSU) “universities must stand up for facts and the truth – if we don’t, who will!” – Clearly Prof. Glover will not stand up for the truth, hopefully, the public will!

Conflicts of Interest: Is there a difference between Doctors and Acupuncturists turned researchers?

Some serious flaws in two acupuncture clinical trials, for the treatment of infertility and allergic rhinitis, were recently published on Prof Edzard Ernst’s blog. The overly positive way in which the researchers made their mostly negative results public was also of concern. Both these studies were published by the researcher of the year, Prof Caroline Smith, of the National Institute of Complementary Medicine (NICM), Australia. The stream of comments and discussions that followed made me think of another commonly overlooked aspect when it comes to acupuncture clinical trials. Conflict of interest! In both these studies the authors declared to have no conflicts of interest and in other similar studies by this author this also seems to be the case. The question can be asked; If you are a practicing acupuncturist conducting a clinical trial in acupuncture, isn’t that, by default, a serious conflict of interest? The intention of this article is not an in-depth discussion of what a conflict of interest is, but rather to compare medical doctors with acupuncturists turned researchers. Let me explain.

Some medical doctors (GPs, surgeons etc.) decide to leave their practice after practicing 10-20 years to become full time researchers (and visa versa). Universities accept these people with open arms because they bring with them a wealth of knowledge regarding the practical side of medicine and healthcare in general. They are thus seen as an asset to any medical research project including clinical trials. Can the same be said about an acupuncturist? They also bring with them years of experience and thus they should also be a major asset to any acupuncture clinical trial. But I am afraid not!

Why? Medical doctors have a multitude of tools (drugs, surgical procedures, diagnostic kits etc.) at their disposal to diagnose and treat all types of medical conditions. Yes, there is medical conditions that cannot be treated and to say nothing about the issue of misdiagnosis. But when will it now be a conflict of interest? When they publish a positive clinical trial of a specific medical intervention in which they have a vested interest. e.g owning shares in the company producing the medical intervention (financial interest) or if they have been staunch supporters of this intervention during their years of practice (emotional interest). Just imagine that you have been prescribing a specific intervention to hundreds of patients over a long period of time, and now you have to face them with a negative clinical trial result – that will be difficult. The former is easy to declare whilst the latter might be slightly more difficult.

Doctors also tend to focus on a specific disease e.g. cancer and will perform research with the existing tools at their disposal but also try to find new tools in order to improve the risk-benefit profile of the disease treatment. Thus, for a doctor there is the possibility that they might run into a conflict of interest but due to the multitude of medical interventions this is by no means a given.

What about acupuncture practitioners turned researchers? An acupuncturist only has one tool at their disposal to treat all medical conditions. I can hear them say; but we stick needles in different places and depths etc. depending on the medical condition! Yes, but the fact remains that they can only stick needles into people – and that is a single intervention. So is this a conflict of interest by default? I would argue, yes, it is like having a single drug, packaged differently or in different doses, to treat all medical conditions. If you have treated hundreds of patients for various medical conditions and now suddenly you publish a negative clinical trial, you will not only be red faced when you run into your former (current) patients – who paid for their treatment – they might even sue you for misleading them. As an acupuncturist you cannot allow acupuncture to be ineffective for a specific medical condition otherwise people might start to query the effectiveness, in general, of the only tool you have. And not only that, they might start to question the unscientific principles that acupuncture is based on! And this, no acupuncturist want and hence they will have a conflict of interest by default – no matter what medical condition they aim to treat.

Likewise, if you have been emotionally and financially invested in acupuncture as a cure-all for 10-20 years it will be very difficult, if not impossible, to publish a negative result. In addition, the acupuncture fraternity is a very tight knit community, where negative results are frowned upon because of vested interests – surely they will expel you from this community if you publish negative results and thereby question the only tool that they have?

Keeping the above in mind, how do acupuncture researchers go about conducting clinical trials? An example: Prof Smith and Bensoussan, both at the NICM, are currently registered as practicing acupuncturists. This means that they can legally practice acupuncture and because they have been active for decades they are also well known and respected in the acupuncture fraternity. It is unknown if they’re still actively practicing or maybe practicing part-time in someone else’s practice, or if they have a financial stake in their former or someone else’s practice. Based on the fact that they are still registered it can be expected that they have a current emotional and/or financial interest in the positive outcome of their acupuncture clinical trials.

Because of this inherent conflict of interest and due to the current strict clinical trial regulations, which makes it quite difficult (although not impossible) to fabricate or falsify data, they target the next best thing which is the design of their clinical trial e.g. the A+B versus B design. But it doesn’t stop there. As soon as the clinical trial give a neutral (and thus negative) result, which in their books doesn’t happen very often, the results will be inflated to make it sound positive (another example here). Why? because they must protect the single tool that they have, they must keep the acupuncture fraternity happy and they must protect themselves against potential lawsuits from former (current) patients or a decrease in patient numbers (and thus financial income). On top of that – how would the media and the public react to an acupuncture clinical trial if the lead researcher declare that they have their own acupuncture clinic?  Surely this is a conflict of interest and it must be declared as such?

So what is the main difference between a doctor and an acupuncturist? A doctor has a multitude of medical interventions and might have a conflict of interest – but this is not a given. An acupuncturist has one intervention only and therefore they have a conflict of interest by default –  this is a given and one which they never seem to declare!

Forthcoming attractions: Currently the biggest ever complementary medicine clinical trial in Australia is being conducted by Prof Smith. This large trial is looking at the effectiveness of acupuncture on IVF outcomes and was branded a waste of money in the media when the NHMRC announced that they granted $600k for this project. Question is; when they publish the (inevitably positive) results will they also declare to have a conflict of interest? For some reason, I strongly doubt it.

What can you do about all of this?

Unfortunately, if you fall for their trickery and you get hurt, then you will be all alone. The bureaucracy involved is extremely complex so the best thing to do is prevention. Stop buying their products or using their treatments, and inform yourself and your family and friends about how these people play their game and what the dangers are, regarding these ‘treatments’. ‘Friends of Science in Medicine’ provides valuable healthcare information as well as the website of Prof Edzard Ernst, where he discusses everything complementary medicine (what works and what doesn’t). If you are interested in receiving automatic updates regarding the NICM and what they are up to, you can always follow my Blog,  Twitter or connect on LinkedIn. Will keep you posted regarding the outcome of the 2017 Bent Spoon awards (the NICM has obviously been nominated), and please, ‘Like’ and share this article via FaceBook etc. – options below.