Why Settle for a House When You Can Buy an Island

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australia_lakeland_island_sand_barThe Brisbane Times recently published an interesting article about what is happening in there private islands market. The article notes that there are currently more than a dozen islands on the market in Australia right now.  Here is what the article has to say.

Julia Roberts tried to get a slice of Queensland when she tried to buy Turtle Island, off Rockhampton, over a decade ago.  She offered about $3 million then and missed out by a few hundred thousand.  The island has just sold again for close to $5.5 million.

The article also discussings how one goes about selling an island in Australia, noting…

“Private islands, despite their undeniable romantic appeal, are difficult to sell, and tend to remain on the market longer than other types of residential or recreational property” according to Private Islands Online – a website dedicated to selling exotic islands.

Read more: http://www.brisbanetimes.com.au/business/property/why-settle-for-a-house-when-you-can-buy-an-island-20110609-1fun1.html#ixzz1PAoKhS2s

Kia Ora Island

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kia-ora-1Although not a true private island Kia Ora is a unique peninsular property located in Point au Baril in Ontario Canada. This picturesque 2.8 acre private peninsula is surrounded by 1,650 feet of water and boasts an abundance of granite shoreline.

Kia Ora is situated on the back of the revered Ojibway Club Island. This immaculately kept pine covered property offers panoramic, open southerly exposure. The 2,000 square foot main cottage is perched on the edge of a large granite rock face and offers every modern amenity including a 1,500 square foot wrap around deck, stone fireplace and screened in sitting room.

The private two bedroom guest cottage is a jewel and makes this an enviable family compound. It also offers panoramic views from its wrap around deck and comes complete with its own kitchen, living room, stone fireplace and two generous bedrooms.

For more information on this property visit Private Islands Online.

How the Billionaire Vacations

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cannes-festival-palace-boatsNow that the recession is over the world’s wealthiest individuals are once again starting to indulge in luxurios vacations and according to Fox business news the destination that is at the top of their list are Private Islands. Here is what Fox News had to say.

According to the American Affluence Research Center, 35% of America’s wealthiest households plan to spend more on domestic vacations this year, and 31% plan to spend more on vacations abroad. That means the rich are planning to do some serious spending on everything from private jets to private islands. 

Read more: http://www.foxbusiness.com/personal-finance/2011/06/10/adventures-in-affluence-how-billionaire-vacations/#ixzz1PAucGRdI

Keck Foundation gives $150 million to USC medical school – Los Angeles Times

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USC News
Keck Foundation gives $150 million to USC medical school
Los Angeles Times
The funds, aimed at improving the school's medical research ranking, will help recruit faculty in fields of stem cells, cancer, liver disease and preventative health. It is USC's third large donation since March. Surgery at USC University Hospital in ...
USC's medical school receives $150M giftabc7.com
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USC Gets a $150 Million Donation From Keck Foundation for Medical ResearchBloomberg
89.3 KPCC -San Jose Mercury News
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University of Alberta medical school dean resigns after plagiarizing speech – National Post (blog)

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Globe and Mail
University of Alberta medical school dean resigns after plagiarizing speech
National Post (blog)
Almost a week after admitting to having plagiarized large parts of a graduation speech, Philip Baker has resigned from his position as dean of the University of Alberta's medical school, effective immediately, the university president announced Friday. ...
Plagiarist resigns as dean, stays on as profWinnipeg Free Press
Dear class of 2011: Wear sunscreenToronto Star
A 65-year murder mystery solved, Bieber takes a beating, and Danny Williams ...Macleans.ca
CTV.ca -Globe and Mail -CBC.ca
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The Dow of Accutane

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At home the kids current TV show of choice is How I Met Your Mother, supplanting Scrubs as the veg out show in the evening. Both shows are always on a cable channel somewhere and are often broadcast late at night. Late night commercials can be curious, and as I work on projects, I watch the shows and commercials out of the corner of my eye.

Law firms trolling for business seem common. If you or a family member has had a serious stroke, heart attack or death from Avandia, call now. The non-serious deaths? I suppose do not bother. One ad in particular caught my eye: anyone who developed ulcerative colitis or Crohn’s disease (collectively referred to inflammatory bowel disease, or IBD) after using Accutane, call now. Millions have been awarded.

My eye may have been caught because of my new progressive lenses, but I will admit to an interest in inflammatory bowel disease, having had ulcerative colitis for years until I took the steel cure. It also piqued my interest as these were three conditions among which I could not seen any connections. Accutane, ulcerative colitis, and Crohn’s. One of these is not like the other.

Accutane (its generic name is isotretinoin) is an anti-acne medication, released long after my puberty. The drug is chemically related to retinoic acid, a natural vitamin A derivative, and works in part by decreasing the production of sebum, not an issue with IBD.

Ulcerative colitis (UC) and Crohn’s have the same clinical presentation: lots of bloody diarrhea. Any resemblance stops there. Pathologically they are completely different diseases. Crohn’s can affect the entire GI tract, from the mouth to the rectum, and its hallmark is noncaseating granulomas. While considered an autoimmune disease, I have, for uncertain reasons, been drawn to the data that suggests the disease may be due to atypical mycobacteria. Wherever there are granulomas, some sort of infectious disease is often not far behind.

UC is limited to the colon, has a high risk of leading to colonic cancer, and its etiology is even more uncertain, perhaps also an autoimmune disease. The two illnesses have different rates of extraintestinal manifestations as well.  Besides the bloody diarrhea and abdominal pain, the two diseases have little in common except they can wax and wane for no damn good reason and when active are a compelling reason to know where every public toilet in the city is.

The Wikipedia pages for both diseases have nice ‘compare and contrast’ tables, and it is obvious the illnesses have little in common. UC and Crohn’s are as different as pulmonary tuberculosis and bronchiolitis obliterans with organizing pneumonia, so it would be most curious if an anti-acne medication could be cause either one, much less both.

Ulcerative colitis occurs in 35–100 people for every 100,000 in the United States, and Crohn’s in 6 to 7.1 per 100,000, and there have been over 13 million prescriptions given for Accutane, more if you add in the other brands of isotretinoin. So there are bound to be, by coincidence, some people who will get IBD around the time they get their Accutane. Like Guillain Barré and flu vaccine, the question is whether or not the risk is increased.

As one review pointed out:

Assuming 1) a background incidence of IBD in the US of approximately 45,000 cases per year, 2) the number of persons taking isotretinoin is approximately 400,000 per year, and 3) the total US population is approximately 306 million, the expected number of cases of IBD among isotretinoin users would be 59 cases per year (if there were no association between isotretinoin and IBD), or 0.01% of Accutane users. If more than 59 cases per year were observed in isotretinoin users, this would suggest a positive relationship between isotretinoin use and IBD. However FDA MedWatch reports include an average of only 14 cases per year.

There are a smattering of case reports on the pubmeds of people developing IBD around the time they started isotretinoin. A few cases of IBD waxed on the medication and waned when isotretinoin was stopped. Interesting, but given the variability of the disease, causality is suspect.

Is there a basic mechanism whereby isotretinoin would lead to IBD?

The mechanism by which (endogenous and exogenous) retinoids cause or exacerbate intestinal inflammation is not understood. Retinoic acid affects intestinal epithelial growth and is involved in cell repair and apoptosis. Retinoids also impair neutrophil chemotaxis, a mechanism involved in Crohn’s disease. The production of induced regulatory T cells (iTreg) and T helper 17 (Th17) cells is also controlled by retinoic acid — these also being involved in gut epithelial homeostasis.

But there is also basic science to suggest that retinoic acid has the potential to be protective for IBD.

Retinoic acid, a form of vitamin A, has been shown to enhance barrier function by increasing expression of numerous tight junction proteins such as occludin, claudin-1, claudin-4, and zonula occludens-1. Furthermore, from the standpoint of immune function, retinoic acid has been shown to be capable of inhibiting pro-inflammatory interleukin-17-producing T helper cell (Th17) responses, while augmenting anti-inflammatory regulatory T cell induction. Such responses would be more likely to prevent the development of IBD, as opposed to trigger it.

So maybe there is a supporting mechanism, and maybe there isn’t. The putative mechanisms can go either way, although since there is perhaps less IBD than expected in patients on isotretinoin, the sparse data suggests a protective effect. Whether any of the basic science is clinically applicable is unknown and doesn’t really explain why it could be associated with two such widely divergent illnesses. Still, there may be unknown mechanisms that would be hinted at by epidemiology.

There really is a paucity of data with a grand total of about 49 references on Pubmed. One study found a relationship with UC, but not Crohn’s (which, given the etiology and pathology, perhaps makes more sense):

Isotretinoin use and the risk of inflammatory bowel disease: a case-control study.
OBJECTIVES:
Isotretinoin is commonly prescribed for the treatment of severe acne. Although cases of inflammatory bowel disease (IBD) have been reported in isotretinoin users, a causal association remains unproven.
METHODS:
We performed a case-control study using a large insurance claims database. Incident cases of IBD were identified and matched to three controls on the basis of age, gender, geographical region, health plan, and length of enrollment. Isotretinoin exposure was assessed in a 12-month period before case ascertainment. Conditional logistic regression was used to adjust for matching variables.
RESULTS:
The study population comprised 8,189 cases (3,664 Crohn’s disease (CD), 4,428 ulcerative colitis (UC), and 97 IBD unspecified) and 21,832 controls. A total of 60 subjects (24 cases and 36 controls) were exposed to isotretinoin. UC was strongly associated with previous isotretinoin exposure (odds ratio (OR) 4.36, 95% confidence interval (CI): 1.97, 9.66). However, there was no apparent association between isotretinoin and CD (OR 0.68, 95% CI: 0.28, 1.68). Increasing dose of isotretinoin was associated with elevated risk of UC (OR per 20 mg increase in dose: 1.50, 95% CI: 1.08, 2.09). Compared with non-users, the risk of UC was highest in those exposed to isotretinoin for more than 2 months (OR 5.63, 95% CI: 2.10, 15.03).
CONCLUSIONS:
UC but not CD is associated with previous isotretinoin exposure. Higher dose of isotretinoin seems to augment this risk. Although the absolute risk of developing UC after taking isotretinoin is likely quite small, clinicians prescribing isotretinoin as well as prospective patients should be aware of this possible association.

and another study found no relationship:

Isotretinoin is not associated with inflammatory bowel disease: a population-based case-control study.
OBJECTIVES:
There is anecdotal evidence that isotretinoin use is associated with development of colitis. We aimed at determining whether there is an association between isotretinoin use and development of inflammatory bowel disease (IBD).
METHODS:
The population-based University of Manitoba IBD Epidemiology Database and a control group matched by age, sex, and geographical residence were linked to the provincial prescription drug registry, a registry that was initiated in 1995. The number of users and duration of isotretinoin use were identified in both IBD cases and controls.
RESULTS:
We found that 1.2% of IBD cases used isotretinoin before IBD diagnosis, which was statistically similar to controls (1.1% users). This was also similar to the number of IBD patients who used isotretinoin after a diagnosis of IBD (1.1%). There was no difference between isotretinoin use before Crohn’s disease compared with its use before ulcerative colitis.
CONCLUSIONS:
Patients with IBD were no more likely to have used isotretinoin before diagnosis than were sex-, age-, and geography-matched controls. Although there may be anecdotes of isotretinoin causing acute colitis, our data suggest that isotretinoin is not likely to cause chronic IBD.

One for, one against. Crockett et. al. reviewed all the data, such as it is, and applied the nine Bradford Hill criteria to the data. The conclusions were underwhelming for causality

In conclusion, the only evidence to support a causal association between Accutane and IBD consists of isolated case reports. These reports support a possible temporal association between isotretinoin and the development of IBD, though such observations may have resulted from chance, confounding, bias, and misrepresentation of the natural history of IBD. A causal relationship remains biologically plausible, but beneficial effects of vitamin A derivatives on intestinal injury have been reported as well. None of the other commonly accepted causal criteria are met. The lack of evidence does not necessarily indicate lack of a causal connection.

Doesn’t seem to be the kind of data that warrants millions to plaintiffs. To double check, I asked some drug company shills, er, I mean gastroenterologists, what they thought of the data. They were equally underwhelmed.

Dow Corning was in bankruptcy protection for years stemming from multibillion dollar lawsuits in the 1980’s and 90’s over the assertion that silicone breast implants lead to breast cancer and autoimmune diseases. Subsequently, after billions were spent and the company was bankrupt, it was then determined that silicone breast implants are associated with neither cancer nor autoimmune diseases. Oh. That’s different. Never mind.

Does isotretinoin lead to inflammatory bowel disease? Maybe. Maybe not. The facts to prove or disprove the association lean against, the odds are “Five to one against and rising…Anything you still can’t cope with is therefore your own problem.” It is hard to prove a negative, and money is being spent and awarded, independent of a reasonable set of confirming facts. Hopefully this will not be like the Dow cases, where “a tort system that allowed a few lawyers to extort billions of dollars using a dollop of junk science.” Although as is often the case with corporations, Dow Corning apparently did not act as the model of integrity. No one acts their best when there is money to be made.

As one reference on the topic noted

In most policy matters, scientific evidence is only one among a complex assortment of factors that interact to produce particular decisions.” A careful reading of the events, stakeholders, and outcomes in the silicone breast implant controversy reveals the social, economic, legal, political, and scientific factors involved “the practice of Federal regulation, the relationship between science and courts, the lack of consistently enforced professional standards in law, medicine and journalism.” A major lesson from this case also involves the role of the plaintiffs. The Houston lawyers’ relentless pressure with inconclusive medical facts on Dow Corning, along with their courtroom successes, demonstrates that “facts” alone are insufficient factors in determining truth.

He could have been writing about SCAMs in general: the facts, in quotes, are insufficient factors in determining truth indeed.

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Exorcism and Sorcery as Health Benefits?!

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Luis Fernando Verissimo, a Brazilian writer, once proposed “voodoopuncture”. Instead of going to the acupuncturist, you would be treated without leaving home. The voodoopuncturist would stick acupuncture needles in the voodoo dolls of you! I add that voodoopuncture could be outsourced to Haiti and/or China. It is a win-win-win situation!

– Leonardo Monasteri, Brazilian economist

As unbelievable as this might sound, “voodoopuncture” is no fiction at all.

The practice is called “Tong Ren healing,” and involves needling or hammering an acupuncture mannequin, as if it were a voodoo doll. The main Tong Ren “Master” in the US is an acupuncturist in the Boston area by the name of Tom Tam. He treats groups of terminally ill and debilitated patients in a deliverance ceremony that is noting but a revamped Taoist exorcism — only the clay or straw doll is replaced by a plastic mannequin:

Unfortunately, Tom Tam is not the only licensed healthcare provider who is treating patients with hocus pocus and crackpottery. There are over 30,000 other adepts of Traditional Chinese Medicine (TCM) in the US who practice medicine based on notions of health and disease that are rooted in paranormal and magical beliefs. Some of these practitioners take their delusions to the outer limits of absurdity: consider, for instance, “acutonics” and “colorpuncture” as described in these videos:

In anthropology of religion, the principles that underline the above practices are called “imitation” (e.g. using a doll to affect a person), and “correspondence” (e.g. using a sound to affect an object). They are the hallmarks of what is called “sympathetic magic,” meaning the belief that a person, or a thing, can be affected through something that represents it, or that has similar attributes.1 The principle of magical correspondence in TCM is called wu xing (??) in Chinese, and is known as the Five Phases/Elements Theory in English. It can be summarized as follows:

1. Everything (including our organs) is ruled by one of 5 entities: Water (?), Wood (?), Fire (?), Earth (?), and Metal (?) — which are also the Chinese names for the planets Mercury, Jupiter, Mars, Saturn, and Venus.2 For instance, the heart is ruled by Fire (Mars), the liver by Wood (Jupiter), etc.

2. There is a sympathetic connection (or resonance) between things that are ruled by the same entity (or planet). For example, the heart is connected with the color red, the direction south, the summer season, a bitter taste, and the feeling of joy — because all of these are ruled by Fire (Mars).

3. All 5 entities are interconnected and act on each other. Disease is understood as a result of either the over-, or under-influence of one entity on another. For example, digestive disruptions can be attributed to “Wood overacting on Earth.”3

The concept map (pictogram) of wu xing is often drawn by placing the 5 entities in a circle, and then connecting them according to the lines of influence. The connecting lines create a “pentacle,” or a pentagram within a circle (Image 1).

Image 1. The pictogram of wu xing. Image Source: acupuncture.com

This pictogram, unbeknownst to most TCM practitioners, is nearly identical to a sigil (magical or religious symbol) found in the Old Religion of Northern Europe, also known as “Wicca” (from the Old English word wicca, meaning a male sorcerer). The only difference between the Chinese and the Wiccan pictograms is that Wicca uses Air instead of Wood, and Spirit instead of Metal. The assignment of attributes (color, sound, taste, etc.) to each entity also varies slightly (Image 2).

Image 2. The Five Elements of Wicca.

According to the historian Cornelia J. de Vogel, this sigil was commonly used by the druids in the context of spell casting, and protection against evil and malevolence.4 It was likewise used in ancient Greece among Pythagoreans in the context of the cult of Hygieia (?????, Salus in Latin), the Greek patron of well-being, sanitation, and the prevention of disease (Image 3). Notably, their brotherhood (an esoteric cult based on numerology) also believed in resonance between numbers, tastes, colors, sounds, and the classical elements.5

Pythagoras

Image 3. Pythagorean pentagram in Three Books of Occult Philosophy (Libri Tres de Occulta Philosophia) by Heinrich Cornelius Agrippa (1486 – 1535). The word ????? (Hygieia) is inscribed on the outer circle.

In Christian Europe, some of these pagan beliefs and symbols were culturally assimilated. For instance, the pentacle became the symbol of the five wounds of Jesus Christ.6 But with the advent of science and modernity, magical thinking, its symbolism, and all the rituals that accompanied it were discredited as superstition and ignorance.

Paganism and magic, however, weren’t so easily done away with — and they experienced a renaissance with the American Counterculture of the 1960s. Vietnam-era demonstrations with large hippie contingents famously mixed politics with occultism, magic, and witchcraft. For example, at the mammoth antiwar protest near Washington DC, in October 1967, demonstrators performed a mock-exorcism to levitate the Pentagon and cast out its demons.7

The magical notions of occult resonance and interconnectedness now find their zealots in the growing Neo-pagan and New Age movements. These revamped notions provide the conceptual basis for energy or vibrational medicine, which includes not only colorpuncture and acutonics, but also herbalism, reiki, reflexology, crystal therapy, magnet therapy, aromatherapy, acupuncture, and many other methods to channel putative “energy fields.”

A 2006 publication reported that in 2004, the annual spending on various channeling methods and alternative healthcare in the US was about $10 to $14 billion. It also estimated the number of Americans involved with New Age activities to be around 12 million.8

The popularity of these unscientific ideas and practices in the last decades has had a terrible impact on the public health policy in the US. One consequence is the licensing of non-physician acupuncturists in over 40 states. As George Ulett wrote in 2003, “is a travesty that in this time of scientific evidence-based medicine, acupuncture treatments are given to unsuspecting US patients by some 20,000 acupuncturists, posing as primary care doctors.”9 Be noted that their number has now increased to over 30,000.

Another consequence is the attempt to mainstream TCM and energy medicine by means of lobbying and political pressure. This leads to national and regional healthcare policies that are not based on science and evidence, but on consumerism and financial interest. As Steven Novella writes in Politics and Science at the HHS, this tends to “contaminate” science, and change the rules so that a popular modality can get a free pass. Novella adds that “modalities that require political pressure to force them into our health care system are those that are not backed by good science.”

An example of politically-motivated healthcare policy is the Federal Acupuncture Coverage Act of 2011 (H.R.1328), which is sponsored by House Representatives Maurice Hinchey (D-NY), Judy Chu (D-CA). It intends to “… provide for coverage of qualified acupuncturist services under part B of the Medicare Program, and to amend title 5, United States Code, to provide for coverage of such services under the Federal Employees Health Benefits Program.”

Yet another example is the current pressure put on the US Department of Health and Human Services by Judy Chu (a Representative for a district with a heavy concentration of acupuncturists and apothecaries) to make TCM and acupuncture part of the “Essential Health Benefits.” These benefits are a set of federally-mandated services under the Patient Protection and Affordable Care Act (PPACA).

This comes at a time when California State Senator Leeland Yee is trying to expand the scope of acupuncturists’ practice in his state to include the performance of “Chinese traumatology” — whatever that means.

If Maurice Hinchey, Judy Chu, Leeland Yee, and the TCM syndicate get their way, then revamped exorcism and sorcery will further infest the American healthcare system.

And if they don’t, I can already imagine voodoopuncturists in their cubicals in China, just like Leonardo Monasteri predicted: “…tap, tap, tap, can you feel me now?”

REFERENCES:

1. Frazer JG (Author), Fraser R (Editor). The Golden Bough: A Study in Magic and Religion: A New Abridgement from the Second and Third Editions. Oxford University Press, USA; Abridged edition. 1998.
2. Walters D. Chinese Astrology. Aquarian Press. 1987.
3. Maciocia G. The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. Churchill Livingstone. 1989.
4. de Vogel CJ. Pythagoras and Early Pythagoreanism. Assen: Van Gorcum; 1966.
5. Burkert W. Lore and Science in Ancient Pythagoreanism. Cambridge, MA: Harvard University Press; 1972.
6. Ferguson G. Signs and Symbols in Christian Art. New York: Oxford University Press, 1959.
7. Paglia C. Cults and Cosmic Consciousness: Religious Vision in the American 1960s, Arion, Winter 2003.
8. Pike SM. New Age and Neopagan Religions in America. Columbia University Press. 2006.
9. Ulett GA. Acupuncture: archaic or biologic? Am J Public Health. 2003;93(7):1037; author reply 1037-1038.

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Autism and Prenatal Vitamins

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Science has found no evidence that vaccines cause autism; but the true cause(s) of autism have not yet been determined. So far the available evidence has pointed towards a largely genetic cause with possible interaction with environmental factors. A new study supports that interpretation. It also supports previous evidence that autism is triggered prior to birth, rather than at the time of vaccinations.

Schmidt et al. published a study in Epidemiology on May 23, 2011, entitled “Prenatal Vitamins, One-carbon Metabolism Gene Variants, and Risk for Autism.” It was a population-based case control study of 566 subjects comparing a group of autistic children to a matched control group of children with normal development. They looked at maternal intake of prenatal vitamins in the 3 months before conception and the first month of pregnancy, and they looked for genotypes associated with autism. They found that mothers who didn’t take prenatal vitamins were at greater risk of having an autistic child, and certain genetic markers markedly increased the risk. There was a dose/response relationship: the more prenatal vitamins a woman took, the less likely she would have an autistic child. There was no association with other types of multivitamins, and no association with prenatal vitamin intake during months 2-9 of pregnancy.

They had a large sample size, and they tried to eliminate confounders. They looked for these potential confounders of the association between prenatal vitamin intake and autism: child’s sex, birth year, parent-reported race/ethnicity, family history of mental health conditions, paternal age at child’s birth, maternal age at child’s birth, education, prepregnancy body mass index (BMI) category, cereal intake from 3 months before through the first month of pregnancy, cigarette smoking, alcohol consumption, and residence with a smoker during the period 3 months before pregnancy to delivery. Only maternal education and the child’s year of birth proved to be confounders. They adjusted for these two factors in their analyses. A weakness of their study is that it depends on patient recall long after the fact. Also, it did not attempt to gather any diet information.

Mothers of children with autism were less likely to report taking prenatal vitamins (odds ratio 0.62). Having certain genotypes increased the odds that a vitamin-omitting woman would have an autistic child. Children with the COMT 472 AA gene were at increased risk of autism. If their mothers took prenatal vitamins, the odds ratio for the risk of autism was 1.8; if their mothers didn’t, the odds ratio jumped to 7.2.  This suggests that the maternal-fetal environment can magnify the effects of a child susceptibility gene. There was an association with certain maternal genes as well: those odds ratios went as high as 4.5.

The association was robust. The authors think there are plausible biological explanations. Folate and other B vitamins are critical to neurodevelopment. Iron could be involved.  The gene variants were within one-carbon metabolism pathways; methylation mechanisms may be responsible.

The authors speculate as to why multivitamins did not have the same effect. Prenatal vitamins typically contain more iron, vitamins B6 and B12, and twice as much folic acid (800 mcg) as multivitamins (400 mcg).

In their summary, the authors say:

Our data suggest that supplementation with prenatal vitamins before pregnancy and during the first month of pregnancy might protect against autism, particularly in genetically susceptible individuals. Additionally, COMT genotype may contribute to an elevated risk for autism, especially in offspring of unsupplemented mothers. This evidence for gene-by- environment interaction effects in autism etiology could help explain variations in previous findings across genetic studies. Whether similar interactions exist for susceptibility genes in other pathways, particularly those epigenetically regulated through methylation, remains to be explored. More research is warranted to replicate the findings, explicate potential mechanisms, and explore interactions with other autism candidate genes.

This is fascinating stuff. It confirms that certain genotypes are associated with autism and that environmental factors can interact with genetics to increase risk. We still need to pin down what it is about prenatal vitamins that prevents autism better than other multivitamins. Is it the folic acid? Is it a subset of the ingredients, or the whole mixture?

We should never blindly accept the results of a first study. These findings will have to be confirmed by other studies. Meanwhile, should we take action? We already recommend folic acid supplements for women who might become pregnant, and we recommend prenatal vitamins during pregnancy. I can’t see any downside to recommending prenatal vitamins in the pre-conception period for any woman who is likely to become pregnant. Some advisors (for instance the Mayo Clinic) were already recommending this practice even before the new study came out.

How will the anti-vaccine contingent react to this new study? It was convenient and satisfying for parents to be able to blame vaccines and accuse the evil medical establishment of causing their children’s autism. Now will those parents accept that at least part of the responsibility lies with their own genetic contributions and the mother’s actions prior to pregnancy? That’s not as palatable a thought, but it’s more realistic.

 

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The Value of Replication

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Daryl Bem is a respected psychology researcher who decided to try his hand at parapsychology. Last year he published a series of studies in which he claimed evidence for precognition — for test subjects being influenced in their choices by future events. The studies were published in a peer-reviewed psychology journal, the Journal of Personality and Social Psychology. This created somewhat of a controversy, and was deemed by some to be a failure of peer-review.

While the study designs were clever (he simply reversed the direction of some standard psychology experiments, putting the influencing factor after the effect it was supposed to have), and the studies looked fine on paper, the research raised many red flags — particularly in Bem’s conclusions.

The episode has created the opportunity to debate some important aspects of the scientific literature. Eric-Jan Wagenmakers and others questioned the p-value approach to statistical analysis, arguing that it tends to over-call a positive result. They argue for a Bayesian analysis, and in their re-analysis of the Bem data they found the evidence for psi to be “weak to non-existent.” This is essentially the same approach to the data that we support as science-based medicine, and the Bem study is a good example of why. If the standard techniques are finding evidence for the impossible, then it is more likely that the techniques are flawed rather than the entire body of physical science is wrong.

Now another debate has been spawned by the same Bem research — that involving the role and value of exact replication. There have already been several attempts to replicate Bem’s research, with negative results: Galak and Nelson, Hadlaczky, and Circee, for example. Others, such as psychologist Richard Wiseman, have also replicated Bem’s research with negative results, but are running into trouble getting their studies published — and this is the crux of the new debate.

According to Wiseman, (as reported by The Psychologist, and discussed by Ben Goldacre) the Journal of Personality and Social Psychology turned down Wiseman’s submission on the grounds that they don’t publish replications, only “theory-advancing research.” In other words — strict replications are not of sufficient scientific value and interest to warrant space in their journal. Meanwhile other journals are reluctant to publish the replication because they feel the study should go in the journal that published the original research, which makes sense.

This episode illustrates potential problems with the  scientific literature. We often advocate at SBM that individual studies can never be that reliable — rather, we need to look at the pattern of research in the entire literature. That means, however, understanding how the scientific literature operates and how that may create spurious artifactual patterns.

For example, I recently wrote about the so-called “decline effect” — a tendency for effect sizes to shrink or “decline” as research on a phenomenon progresses. In fact, this was first observed in the psi research, as the effect is very dramatic there — so far, all psi effects have declined to non-existence. The decline effect is likely a result of artifacts in the literature. Journals are more inclined to publish dramatic positive studies (“theory-advancing research”), and are less interested in boring replications, or in initially negative research. A journal is unlikely to put out a press release that says, “We had this idea, and it turned out to be wrong, so never-mind.” Also, as research techniques and questions are honed, research results are likely to become closer to actual effect sizes, which means the effect of researcher bias will be diminished.

If the literature itself is biased toward positive studies, and dramatic studies, then this would further tend to exaggerate apparent phenomena — whether it is the effectiveness of a new drug or the existence of anomalous cognition. If journals are reluctant to publish replications, that might “hide the decline” (to borrow an inflammatory phrase) — meaning that perhaps there is even more of a decline effect if we consider unpublished negative replications. In medicine this would be critical to know — are we basing some treatments on a spurious signal in the noise of research.

There have already been proposals to create a registry of studies, before they are even conducted (specifically for human research), so that the totality of evidence will be transparent and known — not just the headline-grabbing positive studies, or the ones that meet the desires of the researchers or those funding the research. This proposal is primarily to deal with the issue of publication bias — the tendency not to publish negative studies.

Wiseman now makes the same call for a registry of trials before they even begin to avoid the bias of not publishing replications. In fact, he has taken it upon himself to create a registry of attempted replications of Bem’s research.

While this may be a specific fix for replications for Bem’s psi research — the bigger issues remain. Goldacre argues that there are systemic problems with how information filters down to professionals and the public. Reporting is highly biased toward dramatic positive studies, while retractions, corrections, and failed replications are quiet voices lost in the wilderness of information.

Most readers will already understand the critical value of replication to the process of science. Individual studies are plagued by flaws and biases. Most preliminary studies turn out to be wrong in the long run. We can really only arrive at a confident conclusion when a research paradigm produces reliable results in different labs with different researchers. Replication allows for biases and systematic errors to average out. Only if a phenomenon is real should it reliably replicate.

Further — the excuse by journals that they don’t have the space now seems quaint and obsolete, in the age of digital publishing. The scientific publishing industry needs a bit of an overhaul, to fully adapt to the possibilities of the digital age and to use this as an opportunity to fix some endemic problems. For example, journals can publish just abstracts of certain papers with the full articles available only online. Journals can use the extra space made available by online publishing (whether online only or partially in print) to make dedicated room for negative studies and for exact replications (replications that also expand the research are easier to publish). Databases and reviews of such studies can also make it as easy to find and access negative studies and replications as it is the more dramatic studies that tend to grab headlines.

Conclusion

The scientific endeavor is now a victim of its own success, in that research is producing a tsunami of information. The modern challenge is to sort through this information in a systematic way so that we can find the real patterns in the evidence and reach reliable conclusions on specific questions. The present system has not fully adapted to this volume of information, and there remain obsolete practices that produce spurious apparent patterns in the research. These fake patterns of evidence tend to be biased toward the false positive — falsely concluding that there is an effect when there really isn’t — or at least in exaggerating effects.

These artifactual problems with the literature as a whole combine with the statistical flaws in relying on the p-value, which tends to over-call positive results as well. This problem can be fixed by moving to a more Bayesian approach (considering prior probability).

All of this is happening at a time when prior probability (scientific plausibility) is being given less attention than it should, in that highly implausible notions are being seriously entertained in the peer-reviewed literature. Bem’s psi research is an excellent example, but we deal with many other examples frequently at SBM, such as homeopathy and acupuncture. Current statistical methods and publication biases are not equipped to deal with the results of research into highly implausible claims. The result is an excess of false-positive studies in the literature — a residue that is then used to justify still more research into highly implausible ideas. These ideas can never quite reach the critical mass of evidence to be generally accepted as real, but they do generate enough noise to confuse the public and regulators, and to create an endless treadmill of still more research.

The bright spot is that highly implausible research has helped to highlight some of these flaws in the literature. Now all we have to do is fix them.

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Science-based medicine, skepticism, and the scientific consensus

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Editor’s note: This weekend was a big grant writing weekend for me. I’m resubmitting my R01, which means that between now and July 1 or so, my life is insanity, as I try to rewrite it into a form that has a fighting chance of being in the top 7%, which is about the level the NCI is funding at right now. This weekend, I buried myself in my Sanctum Sanctorum and tried like heck to try to pound the revision into a really good draft that I can distribute to my colleagues for feedback. Fortunately, I have some old posts that I can pull out, tart up (i.e., update a bit, as in correcting the parts that led me to groan as I reread them, thereby hopefully making them better). I think they’re quite good, if I do say so myself; so hopefully you will too.

There are some arguments made in blogs, articles, or books that strike me so hard that I remember them, even three and a half years later. Sometimes I even file them away for later use or response if the issue raised by them is interesting, relevant or compelling enough to me. Although this topic is a bit broader than many of the topics I write about for this blog, I think it also goes to the heart of science-based medicine and communicating scientific skepticism about medicine to the masses. A few years back, a Swedish blogger named Martin Rundkvist made a rather provocative observation about skepticism. Specifically, he argued that a “real skeptic always sides with scientific consensus.” Among his reasons was this one:

Science presupposes that all participants have a skeptical frame of mind and arrive at conclusions through rational deliberation. If a large group of knowledgeable people working in this way arrive at a consensus opinion, then there is really no good reason for anybody with less knowledge of the subject to question it. Informed consensus is how scientific truth is established. It’s always provisional and open to reevaluation, but as long as there’s informed consensus, then that’s our best knowledge. Humanity’s best knowledge.

Although at the time I saw where Martin was coming from, I found this viewpoint somewhat disturbing, leading me to echo Martin’s own words in response to his own rhetorical question asking whether accepting a scientific consensus is nothing more than “kowtowing to white-coated authority”: Well, yes and no.

For a skeptic and supporter of science-based medicine, in matters of science it is undoubtedly true that the scientific consensus is always the best place to start when evaluating unfamiliar issues. While it is certainly possible that a given scientific consensus regarding an issue can be wrong in almost any area, it nonetheless almost always represents the best current scientific understanding. It is also correct, as Martin argues, that legitimate authority matters. I emphasize the word “legitimate” because in pseudoscience arguments from authority are common, but rarely is the authority relevant to the point being argued. Often it’s not even legitimate, as in when anti-vaccine activists point to Andrew Wakefield’s work as justification for their claims that vaccines cause autism and other conditions. Like Martin, I’m more inclined to accept the pronouncements of someone who has actually dedicated his or her life to studying the issue systematically; i.e., an expert. If the topic is evolution, then that expert would be an evolutionary biologist. If the topic is the Holocaust, then a historian specializing in World War II and/or the Holocaust would represent an appropriate expert. For cancer, an appropriate expert would be an oncologist (or an surgical oncologist, such as myself). The list goes on.

Where I start to have a bit of a problem with Martin’s viewpoint is when I start to contemplate the nature of scientific consensus itself in many areas of science. Not all scientific consensuses are created equal because, in different fields the strength of scientific consensus can vary quite markedly depending upon the topic or even the subtopic within the topic. For example, the scientific consensus supporting the theory of evolution, particularly common descent, is exceedingly strong. It’s one of the strongest of all scientific consensuses, arguably the strongest. Similarly, the consensus that natural selection is a major driving force behind evolution is very nearly as strong. However, as the discussion devolves into more detailed areas, inevitably the consensus weakens. Eventually, subsidiary areas of a discipline are reached where the consensus is weak or where there is no consensus, such as what the function of “junk DNA” is, whether it is subject to natural selection, and if so how much. (Real evolutionary biologists could probably come up with a better example.) These sorts of questions are often at the cutting edge of scientific knowledge, and it is not always easy to recognize what they are. It is also these issues at the edge of our knowledge that are attacked as proxies for the much more strongly supported core theory. Creationists are notorious for this sort of tactic, often using new findings of molecular biology that appear peculiar or out of sync with specifics of evolution as wrecking balls to try to demolish the edifice of “Darwinism.” I can’t count the number of times I’ve seen supporters of “intelligent design” creationism point to either “junk DNA” or the findings of new genomic techniques as “evidence” that “Darwinism” is doomed. Never mind that some of the very strongest support for the theory of evolution, in particular common descent, comes from genetics and that new genomic techniques only keep confirming that.

The same is true of scientific consensuses in many other disciplines, including my own disciplines of medicine and surgery. However, scientific consensuses in medicine are almost never as strong as the theory of evolution. Germ theory of infectious disease probably comes close, but otherwise I’m hard-pressed to think of one. Usually, the strength of a consensus in medicine is proportional to the ratio of data supporting it that comes from randomized clinical trials to data from epidemiological studies, the latter of which are more prone to confounding factors. That does not, however, mean that there doesn’t exist strong consensus about many medical issues. For example, there is, for all intents and purposes, no doubt that HIV is the causative agent for AIDS, the claims of HIV/AIDS denialists notwithstanding. Similarly, there is in essence no doubt that smoking cigarettes vastly increases a person’s risk of lung cancer and heart disease, along with a host of other medical problems. Not even the tobacco companies try to argue against that anymore. When we come to subsidiary questions, however, the consensus is generally not as strong. For example, it has become increasingly appreciated that secondhand tobacco smoke increases the risk of heart disease and lung cancer in people chronically exposed to it. However, because the effect is considerably smaller than it is for people who actually smoke cigarettes, there is a lot more “noise” in the studies, giving more wiggle room for people who dislike the idea of the government banning smoking to claim that such bans are not scientifically supported, and it’s taken a long time for scientific and clinical studies to firm up the conclusion enough to the point that it is now a strong consensus.

Not surprisingly, given the difficulty doing controlled experiments and the nature of the material, which makes it more easily politicized or influenced by biases, a truly strong consensus is harder to come by in the humanities and social sciences. However, even so, it is not impossible. For example, one of my areas of interest is the Holocaust. There is overwhelming and incontrovertible evidence that the Nazi regime embarked on a systematic program to round up and exterminate the Jews in territories they controlled. Methods used included shooting, hanging, gas chambers, and a system of camps designed to literally work their inmates to death through a combination of grueling labor, insufficient food, and unsanitary and crowded conditions. However, this consensus becomes less clear when various issues surrounding the Holocaust are discussed. For example, there is the whole “intentionalism” versus “functionalism” debate. In a nutshell, this debate is over the question of whether the intent was there from the very beginning of the Nazi regime or even before the Nazis rose to power to exterminate the Jews or whether the Holocaust evolved “organically” or “functionally” from the persecution of Jews that began early in the Nazi regime and became increasingly radical and violent in the pre-war era, the radicalization of Nazis carrying out the program, and the question of what to do with the millions of Jews that suddenly fell under Nazi control after Hitler had invaded the Soviet Union. Holocaust deniers love to misrepresent and misuse this debate to claim that Hitler didn’t know about and didn’t order the Holocaust or to claim that there was never a plan to systematically exterminate European Jewry.

One thing that I’ve come to realize is that it’s not always obvious when skepticism devolves into denialism. In some cases it’s pretty easy, for example creationism, Holocaust denial, HIV/AIDS denialism, anti-vaccine activism and the germ theory denialism that often fuels it, and many sectarian belief systems that lead to the use of unscientific “alternative” medicine, such as homeopathy. Sometimes, appropriate skepticism about most scientific issues can exist side-by-side in a single person with credulity and pseudoskepticism about other scientific issues. For example, among skeptics who count themselves science-based, there is a disturbingly large contingent who do not accept the science behind anthropogenic global climate change, as Penn Jillette, for example, does not. Only recently does he appear to be grudgingly dragged towards accepting the scientific consensus in this area. His resistance to the idea appears to be due to his Libertarian beliefs.

One example that I used to use routinely before she shut down her blog was Sandy Szwarc at Junkfood Science. Most of her non-obesity-related posts were often actually not too bad. However, whenever she blogged about diet and obesity, there was usually a problem, sometimes a big problem like the one Steve Novella blogged about a couple of years ago. And it’s not the sort of thing that necessarily jumps right at you off of her blog, as it does from an obvious crank blog like Age of Autism. Certainly it didn’t for me. Rather, it’s the sort of thing you have to read her blog closely for a while (which I did) to start to realize. As I read her blog, more and more it bothered me that all of her “skepticism” was inevitably in the direction that being obese is not only not unhealthy but is actually at least as healthy as not being obese, that eating fatty foods is perfectly fine, and that virtually any study she looks at that says that eating fatty foods or too many calories predisposes to health problems is a pile of crap while any pile of crap study claiming otherwise is the latest and greatest. All of this led her to conclude that virtually every warning made by scientists and physicians about diet is fearmongering. Worse, she had a distressing tendency to use unscientific tactics, such as cherry picking data, attacking consensus, and alleging conspiracies. I also found it telling that, unlike most bloggers, myself included, Szwarc does not permit comments. If there’s one thing that skeptics usually encourage (as we do here on SBM), it’s spirited debate. That’s impossible in a blog that doesn’t permit comments.

In the end, I remain a bit uncomfortable with Martin’s blanket statement that “a real skeptic always sides with scientific consensus.” The reason is that what the scientific consensus actually says is not always that clear for many issues, even among those who work in the field. Indeed, there are comparatively few issues in science (evolution, for example) for which a strong consensus exists, and even fewer in the social sciences and history (the Holocaust, for example) for which an equally strong consensus exists. These are very strong consensuses, and to overturn them would require extraordinary evidence, evidence at least equal to the evidence supporting them. Consequently, when someone says that evolution is false or that the Holocaust didn’t happen (or the lessor form of Holocaust denial, that nowhere near 6 million Jews died), it’s fairly easy to recognize such person as a crank and denialist, and I usually do not hesitate to label them as such when appropriate.

But what about consensuses that are strong but not as bullet-proof, usually because, although there is a consensus, there are fairly wide error bars around the predictions or uncertainty regarding the importance of various factors? The prototypical example of this is anthropogenic global warming, for which there is a strong consensus among climate scientists but still a fair amount of uncertainty about the outcome. Another example, of course, is the scientific consensus about the link between obesity and adverse health outcomes. How do we differentiate legitimate skepticism about the consensus from denialism?

This is where I tend to agree with Mark Hoofnagle. It’s more about tactics and how evidence is used to support an argument. Scientific skepticism looks at the totality of evidence and evaluates each piece of it for its quality. Cranks are very selective about the data they choose to present, often vastly overselling its quality and vastly exaggerating flaws in current theory, in turn vastly overestimating their own knowledge of a subject and underestimating that of experts. In medicine in particular, denialists frequently emphasize anecdotes over epidemiology, clinical trials, and science. They also tend to leap to confuse correlation with causation. A great example that I just saw a week or two ago comes from our “friends” at the anti-vaccine group the International Council on Vaccination, a group that Mark Crislip and I had such fun deconstructing. There, Sherri Tenpenny posted an article entitled Vaccines and Blue Foot Syndrome (crossposted on her own blog). In the post, after citing anecdotes about “vaccine injury,” Tenpenny then segues into a story of a child who dropped a large frozen turkey on his foot, which became painful and blue within hours. The parents are then confronted with doctors who tell her that this is “Blue Foot Syndrome” and that they have shown by epidemiology that it is not linked to being struck by a frozen turkey. It’s an analogy obviously designed to mock scientists who quite correctly refer to the studies that have failed to find a link between vaccines and autism that ignores the fact that correlation does not necessarily equal causation and that the correlations reported by parents are not nearly as obvious as a blue foot after having a frozen turkey land on it. Anti-vaccine activists think they are, though.

In addition, because the mainstream rejects their ideas, there is often a strong sense of being underappreciated—persecuted, even—among cranks, leading them to view their failure to persuade the mainstream of the correctness of their views as being due to conspiracies or money. Global warming denialists, for example, tend to see the currently existing scientific consensus as being politically motivated by the desire of “liberals” to tell them how to live. Evolution deniers view evolution as the result of atheistic scientists wanting to deny God. People like Sandy Szwarc view the consensus that obesity leads to health problems as being due more to moralizing and bigotry against the obese, which, whether it is true or not, is an easy claim to make because there has been and is a lot of bigotry against the obese. Antivaccinationists view the rejection of their belief that mercury in vaccines or even vaccines themselves cause autism by mainstream medicine as evidence that we’re all in the pocket of big pharma. Practitioners of “complementary and alternative medicine” view the rejection of their beliefs in homeopathy, “energy healing,” and vitalism similarly: Science-based doctors must be in the pocket of big pharma! Or they’re close-minded! Or they’re threatened by the “success” of alternative medicine!

What a lot of this distinction boils down to is that crankery, denialism, pseudoskepticism, or whatever you want to call it tends, either intentionally through ideology or unintentionally through an ignorance of the scientific method, to conflate and/or confuse emotiona, nonscientific, and/or ideological arguments with scientific arguments. This is not to say that scientists and skeptics and supporters of SBM are free from their own biases, whether ideological or simply a desired result that they hope to find. Far from it. However, skepticism means applying the scientific method to claims, whatever its faults, scientific method is the best method thus far devised to minimize these biases. As scientists, the reason we use the scientific method is not because we consider ourselves superior to the cranks, but rather because we recognize that we are human too and thus just as prone to falling into the same traps as they. As Richard Feynman once famously said, “The first principle is that you must not fool yourself—and you are the easiest person to fool. So you have to be very careful about that. After you’ve not fooled yourself, it’s easy not to fool other scientists. You just have to be honest in a conventional way after that.” The scientific method is, above all, a methodology by which scientists try to avoid fooling themselves. Skeptics cross the line dividing skepticism and denialism and quacks the line between science and quackery when they forget that.

Moreover, skeptics and supporters of SBM know that science is a work in progress. What is considered correct today may well be modified tomorrow. This change, however, is not brought about by cranks cherry-picking data but by rather skeptical scientists probing for weak spots in our current understanding, making hypotheses, and then testing whether current theory or the new hypotheses make the better prediction. Thus, being skeptical of the consensus is not the mark of the crank. It’s how and why that skepticism exists that distinguishes crankery from genuine scientific skepticism.

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The impact of antivaccination lobbying

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Here’s an excellent news report from Australia on the human costs of the anti-vaccine movement:

The video features Viera Scheibner, who has nothing good to say about vaccines and thinks that vaccines are dangerous and infectious diseases in childhood are good. It also features the stories of children who caught vaccine-preventable diseases. This is how it’s done.

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Do You Have This in My Size?

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For many people (including myself), finding a job this summer was a challenge. Looking back, my classmates and I asked so many questions: Will I find an internship? Will it be paid? Will I have to move? Will they hire me after graduation? You know … those little details.

When I’m faced with uncertainty, I find myself asking tons of questions like those, and the night before starting my legal internship at SoftLayer, the “new question” machine went into overdrive. How early should I leave to get there on time? What projects will I have? How many hours will I work? Will I make a good impression?

Over the years, I notice that I tend to focus on that last question — “What impression will I make?” Time and time again, I’ve found myself answering that question by finding the perfect outfit.

What seems like ages ago (but was actually only four years ago), I began pursuing a career in fashion, so while the question, “What should I wear?” might be natural, when looking at any new job, it’s probably not the right question to be asking for this one. I’m not exactly required to strut down Fifth Avenue in designer shoes to enter the office of a luxury department store (which I did one summer) … I’m driving up to the SoftLayer headquarters in Dallas, Texas, where you’re more likely to see black T-shirts than suits and ties.

Feeling unsure about whether I can “WOW” some of the brightest people in Dallas in an industry where I am a rookie, I am pretty nervous, and I’m sure everyone has been in my shoes. Some of us ask too many questions, others ask too few, and some, like me, ask the wrong ones. My advice is to focus on one simple question: “Do we fit?” To unpack those three little words a little more, “Will this company value me as much as I value it, and will I enjoy being employed here as much as they enjoy employing me? Will our relationship be mutually beneficial?”

In today’s job market, some people can’t afford to ask these questions, especially considering the fact that “the right fit” tends to be the toughest aspect to quantify. Hiring and accepting an offer necessarily involves some risk, and the best choice might be decided by a gut feeling. After my first week at SoftLayer, I’m happy to say that I’m sure I made the right choice.

Walking through the office, the atmosphere is laid-back, but don’t be fooled. As relaxed and friendly as my coworkers are, they are also working hard, pouring themselves into the work they do. Coming from a business and a legal background, I thought this type of environment was only something I could read about in an article covering a cool new startup in BusinessWeek or the New York Times. Luckily I was wrong.

A company that values an employee’s autonomy is hard to find, and it takes the right employees to not abuse that privilege. From my one week of experience here, it’s clear SoftLayer has made it work, somehow finding the elusive combination of work, play, and success. That difficult important question is easy to answer: Yes, we fit … just as perfectly as a Christian Louboutin.

-Sarah

Technology Partner Spotlight: Relenta

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Welcome to the next installment in our blog series highlighting the companies in SoftLayer’s new Technology Partners Marketplace. These Partners have built their businesses on the SoftLayer Platform, and we’re excited for them to tell their stories.

We invite each of our featured SoftLayer Tech Marketplace Partners to contribute a guest post to the SoftLayer Blog, and this week, we’re happy to welcome Dmitri Eroshenko from Relenta. In his guest post, Dmitri explains Relenta’s inspiration and history to help you better understand how Relenta’s online app can benefit your business.
- Paul Ford, SoftLayer VP of Community Development

 

Relenta: Get Things Done with One Click

We’re all suffocating from information clutter. Our customer data and communications are scattered all over the place — multiple email accounts, social networks, CRMs and contact managers, instant messengers and chats, spreadsheets, various productivity and collaboration apps, calendars, and so on. We enter and re-enter data in different apps, which we endlessly cross-reference to reconcile discrepancies. We worry constantly that we’re missing something.

At some point, we reach the threshold where pain becomes unbearable, stop and say, “There must be a better way!”

Our small software development team started working on Relenta six years ago with these very words. The idea was to take several apps our team used regularly — including email, of course — and distill them into one single program. Soon after we started building the program, we realized that by storing different types of customer records in the same backend database, we’d actually only begun the process of consolidating the information … And that’s where we started building Relenta’s interface to truly streamline the process.

Instead of displaying various bits of customer information on separate screens, we created an interface that aggregated ALL data in one single activity stream. These “news feeds” provide at-a-glance views on the history of each of the customer relationships being tracked by the system. The feeds also put you in a one-click zone, from which no information is more than a single click away and no activity takes more than a single click to perform.

The rest is history. Today, Relenta is an elegant online application that lets you organize your entire customer-related life so that nothing is more than one click away.

The idea of building our platform around the one-click zone became our mantra and guiding principle. To put you into a one-click zone,
Relenta offers:

  • A unified inbox for all customer communications, including email and social network messages from LinkedIn, Facebook, and Twitter
  • A centralized platform for contact management, shared calendar, internal messaging, workflow management and document management
  • A built-in email marketing and email-autoresponder solution
  • A product philosophy that emphasizes disciplined process management and minimizes the number of steps it takes to get things done
  • A framework that enables asynchronous and geographically dispersed collaboration by keeping everyone and everything on the same page

As a result of this streamlined workflow, your data isn’t fragmented or unnecessarily duplicated across your systems and you can be more efficient in your operations. By interlinking all communication activity between our team and each customer, we found ourselves getting twice as much work done in half the time.

If you find yourself bouncing between platforms to manage your customer relationships, Relenta might be a great fit for you. While I can talk about the value Relenta can provide and send you as many customer testimonials as you want to read, what matters is whether the app meets your needs. Check out our Live Demo and sign up for a Free Trial to put us to the test.

-Dmitri Eroshenko, Relenta

Join the one-click revolution at http://www.relenta.com!

An Exercise in Innovation

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Some of the best ideas come from people who think “outside of the box.” SoftLayer was born in a living room six years ago when we decided to look at the staid hosting industry from a new perspective. We said, “We don’t want to build a company to meet customers’ current needs. We want to build a company to meet the needs our customers don’t even know they have yet,” and that’s one of the biggest reasons the SoftLayer platform has IPv6, KVM over IP, private network, out-of-band management and standardized pod-based data centers.

Only people with a certain level of “crazy” can recognize opportunities for innovation, and because SoftLayer’s motto is “Innovate or Die,” to incubate innovation, we have to create an environment that enables employees to take their “crazy” and run with it. Speaking of “crazy,” meet Phil.

Phil plays guitar, tests software in non-standard ways, and has a bobble-head of himself. Some would say he marches to the beat of a different drummer – a drummer that may or may not be overdosing on caffeine.

Phil was tasked with a 12-week project: If SoftLayer is built for what our customers are going to need tomorrow, figure out what customers will need after “tomorrow.” He’d have access to people and resources up and down the organization to build his idea, and the experiment is set up to incubate his innovation:

  1. Because there are no bad ideas in brainstorming, anyone helping Phil should do so without questioning the logic or “sanity” of what he asking for help with.
  2. Phil can spend up to 20% of his work hours building his idea.
  3. Anyone who helps Phil can spend up to 10% of his/her work hours to build his idea.
  4. Phil can have space in H2 to build his idea.
  5. Regardless of apparent success or failure, the project will conclude at the end of 12 weeks. From there, we’ll evaluate the “good” and “not as good” ideas from the experiment.

It’d be impossible to guarantee the success of any kind of project like this because it’s a little like catching lightning in a bottle, but I was interested to see what kinds of operational changes he came up with over the course of the three months. We might see the evolution of the next brilliant idea in hosting, or we’d see a lot of hilariously terrible ideas.

Then I saw his first installment:

By the time I got to “circumstantiate,” I had the phone in my hand to call off the project. What I didn’t expect was Phil’s tearful pleading to take the idea down a different path. They say you don’t get a second chance to make a first impression, and despite the fact that this first impression was pretty awful, I decided to give him another shot (with a much more limited scope):

  1. Apparently there are bad ideas in brainstorming, but anyone who helps Phil on his “new path” should try to be supportive.
  2. Phil can spend up to 5% of his work hours building his idea.
  3. Phil can’t take anyone else from SoftLayer away from their jobs during work hours.
  4. Phil can have space in the Houston office to build his idea.
  5. The project is scheduled to run for 12 weeks. There’s no guarantee that it’ll make it through next week.

If you have ideas for Phil, feel free to contribute. He’d probably appreciate the help.

-@lavosby

Presentation on Massachusetts Ocean Management Plan Use of Decision Support Tools by Nick Napoli and Stephanie Moura of the Massachusetts Ocean Partnership

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Date: 
Wednesday, October 5, 2011

The Massachusetts Ocean Partnership is developing and applying several tools to support decision making during the implementation of and updates to the Massachusetts Ocean Management Plan.  The tools include the Cumulative Impacts model and an ecosystem services tradeoff model developed by the University of California at Santa Barbara, the MIMES ecosystem service model developed by the University of Vermont and Boston University, and the MIDAS decision support interface developed by Boston University.  This webinar will provide an overview of these tools, why they were selected, a demonstration of draft and final products, and how they are being applied in Massachusetts.  We will also provide some lessons and recommendations for their continued development and potential application within the marine spatial planning context.  Learn more about the Massachusetts Ocean Partnership and its work at http://massoceanpartnership.org/.  Register for this webinar at https://www1.gotomeeting.com/register/400008192.