Flesh and Stone

Will Bill Gates solve the world’s energy crisis?

Mon, 15 Feb 2010 08:33:00 -0700

As we all know, a quick look at the history of the world demonstrates that someone always has the happy knack of turning up with a new invention just when we need it.

Take written communication for example. Just as we were inventing our first written languages and we needed something to write them down on, some soul somewhere invented papyrus. Then, at the very moment that there were too many people around to communicate the king’s news by using handwriting, which is an agreeable activity but it’s also one which begins to hurt your wrist after 500,000 A4 sheets, Gutenberg came up with the printing press. And more recently, just when we were getting fed up with typewriter ribbons, photocopier salesmen and licking stamps, up steps Bill Gates to launch a World Wide Web browser that became the most installed Web browser on the planet.

Well, we are now at a point in history where we desperately need to find a way, or ways, to ensure the future production of electrical power on Earth. And we need that capacity to be high enough to maintain our current living standards as well as creating headroom for future developments and our children.

And we want it all to be clean. No less.

Now that’s what you call a tall order, and it needs a lot of ideas, innovation and investment if it’s going to happen.

So, ladies and gentlemen, will you please welcome Bill Gates.

Bill Gates was a guest speaker on day two of the 2010 Technology, Entertainment and Design (TED) presentations in Long Beach, Calif., and he devoted some of his microphone time to the future of energy resources and the need for a viable zero-carbon option, about both of which he had some very interesting things to say.

He believes that we should be putting all our tech and technical resources to work on creating new power sources quickly and that “"What we're going to have to do at a global scale is create a new system, so we need energy miracles." So what’s his miracle?

Turning spent nuclear fuel into cheap, clean energy, using enormous advances in microprocessing and computers that must be rapidly developed according to “a pretty tight timeline."

But first, and by using an equation, he unveiled his method of illustrating how much carbon dioxide is released into the atmosphere due to human activity, adding that we need to drag one of the equation’s factors down to zero in order to solve our carbon dioxide pollution problems. Here it is;

Total CO₂= World population x Services x Energy of each service x CO₂ per unit of energy.

This theory holds that seeing as factors 1 and 2 will most certainly not reach zero and that 3 precludes zero because of the laws of physics, the only option left is 4, which is CO² output per unit of energy.

The best way of achieving a zero output for that factor in his view is by improving the efficiency of nuclear power by recycling all the leftover waste from reactors into fuel, claiming that the uranium used in just one plant could supply the United States with enough energy for the next two hundred years.

He says that the deadline for a zero carbon emission world is 2050 and that research activity should concentrate on inventing clean-energy technologies over the next twenty years and then move on to putting the theory into practice.

The energy supplied using those technologies would also have to be cheap in order that the whole planet benefit from them, and not just the richer nations, as is the case right now.

But, and because business is business, and because Bill Gates knows that very well, he is putting his money where his mouth is. Terrapower, the name for his idea for a revolutionary way of recycling nuclear waste and reusing it in a power plant, is his means of putting his research money where his mouth is.

One major research track concerns deciding which component of uranium to use to generate power, and he says that instead of burning the 1 percent of uranium-235 found in natural uranium and used in nuclear rods today, his reactor would burn the other 99 percent, called uranium-238. This means that today’s massive amounts of waste would be tomorrow’s fuel. And there’s a lot more of it around.

Gates considers that the potential exists to power the world indefinitely using nuclear power, and he also invoked a “traveling wave reactor” which would burn waste slowly in order to supply 60 years worth of energy to a single reactor and store it there if necessary.

He did mention a lot of other, more technical stuff, but it all went over my head. All I know is that he got a standing ovation at the end of his gig, so it must have convinced somebody.

Now I don’t care who thinks what about Bill Gates, or why. Nor am I an expert in nuclear power.

But the plain fact is that we need major solutions to massive problems, fast, and he is the only person I have heard of who is placing his energy into anything like a plausible idea of supplying massive amounts of power to the whole world at relatively little cost, both in terms of pollution and money.

And remember, wasn’t Gates’ worldwide web browser a means of supplying massive amounts of information to the whole world at relatively little cost, both in terms of pollution and money?

We haven’t heard the last of him yet. Not by a long chalk.

Countdown to extinction for polar bears?

Fri, 12 Feb 2010 06:33:00 -0700

Polar bears and their environment have been a major source of concern to nature-protection organizations and climatologists for many years, and this situation led the United States to demand on Thursday that the CITES (the Convention on International Trade in Endangered Species of Wild Fauna and Flora) moves them from Appendix II status, which allows limited commercial trade of species, to Appendix I, which forbids all trade and culling except for research purposes. The proposal is expected to be challenged by various interested parties and maybe even by some countries.

The current polar bear population is estimated to be around 20,000 to 25,000, and they are mostly to be found in the circumpolar Arctic sea ice environment and near land masses such as Canada, Denmark (Greenland), Norway, the Russian Federation, and the United States. Population decreases are not thought to be uniform, with some areas maintaining –- or even increasing –- their numbers, and others witnessing a decline. The overall impression however, is that of a slow decline.

Their natural habitat is sea ice, which they use for hunting, reproduction and migration, and it is now generally accepted that the annual sea ice area of the Arctic is decreasing, both during winter and in summer. The extent of the polar bear habitat is limited to the southern limit of the ice.

As the size of their habitat decreases along with the length of time the ice remains intact, they are increasingly forced to forage on land, and for longer periods of time. Food resources on land are scarcer and harder to catch and this results in polar bears using up the stored fat reserves they accumulated whilst on the ice, upon which they would normally feed all year round. It is this phenomena which is said to represent the biggest single threat to their existence.

However, the presence of polar bears on, or near, land masses also exposes them to other risks, many of which are related to human activities. They include trade, hunting for food, contaminants, disease and ecotourism.

The principal users of polar bears and their derivative products are the United States, Greenland, and, in particular, Canada. Some other countries, such as Norway and Russia, impose stricter limits on their hunting and commercialization.

The majority of polar bears are killed by indigenous people, some of whom have always done so for cultural as well as subsistence and commercial reasons. But the increase in the presence of polar bears on land has led to an increase in their trade, and the commercialisation of clothing articles such as boots, mittens and fur pants, as well as handicraft items.

The United States's demand to CITES is based on the following assumptions among others: sea ice changes are likely to result in a negative impact on polar bear populations; population redistribution will increase, along with polar bears’ vulnerability, due notably to hunting and scarcer food resources; and polar bears are already suffering from reduced physical conditions, increased nutritional and other stresses, increasing mortality rates and reduced reproduction success rates.

The CITES proposal also states: “As changes in habitat become more severe and seasonal rates of change more rapid, catastrophic mortality events that have yet to be realized on a large scale are expected to occur. The decrease in polar bear habitat –- sea ice -- exacerbates all other potential threats to polar bears….Therefore, a precautionary approach, which includes polar bears in CITES Appendix I, is necessary to ensure that primarily commercial trade does not compound the threats posed to the species by loss of habitat.”

The proposal will be considered at a CITES General Assembly meeting in Doha, Quatar, from March 13 to 25, and is expected to be contested by the wildlife trade monitoring network TRAFFIC, and the International Union for Conservation of Nature (IUCN), both of which argue that the biggest threat is polar ice melting and that it is not necessary to ban all trade and use of polar bears. The success or failure of the proposal will also be heavily influenced by the opinions and policies of other countries.

The Great Climate Debate commits suicide

Wed, 10 Feb 2010 15:58:00 -0700

I suppose that many of you are just as mystified as I am as to how the (albeit minimal) hopes of finally seeing some concrete action on the climate issue could possibly have been dashed just as the weight of scientific opinion and public opinion was beginning to put real pressure on the skeptics.

And I suppose that many of you are just as mystified as I am as to how it came to be that the debate became so totally discredited because of greedy, ego-driven and reckless actions carried out by some of the very people who were supposedly trying to help the planet.

We all know that governments and industrialists have had a tendency to minimise the problems –- all’s fair in love and war after all –- but what about the climate scientists? Are they any less corrupt than their opponents? What has happened since the run-up to Copenhagen and Climategate? How does it all fit together? Who loused the whole thing up? I have another question to ask, but I’ll save it for the end of this article.

Here are a few key dates from the sad and sorry saga of the untimely suicide of what was a young and promising debate.

November 19 2009 Hackers gain access to backup servers at the highly prestigious Climatic Research Unit (CRU) in England’s East Anglia University. Emails between several climate scientists are made public on a Russian website before spreading around the world like wildfire, the fans being flamed by climate skeptics. The emails are said to contain evidence that climate scientists do not agree on certain climate issues that are being presented to the world as facts, that a virulent campaign of denigration is underway vis-à-vis skeptics, that climate scientists rejected requests for information and have mounted a campaign to keep the work of skeptics out of scientific journals, and that efforts to dissimulate inconvenient facts have been made. Professor Phil Jones steps down from his post as head of the unit pending an independent inquiry into whether there is any evidence of scientific misconduct. He is not implicated in the hacking.

December 4 2009 Sarah Palin jumps into the fray and demands that the United States boycott Copenhagen, calling the work of climate scientists “junk science.” The email affair is now elevated to the status of “Climategate.”

December 7 2009 Influential Saudi Arabian Copenhagen delegate Mohammed Al-Sabban announces before the start of the summit that he wants to see an international inquiry into Climategate, claiming that it will have an impact on the summit and may even derail it.

December 20 2009 Rajendra Pachauri, the chairman of the UN’s Intergovernmental Panel on Climate Change (IPCC), is accused of gaining personal financial benefit from contracts signed with companies whose interests are not helped by those who propose stricter action on the climate to reduce pollution.

January 17 2010 The Sunday Times alleges that the world has been misled by exaggerated reports by the IPCC which claim that the Himalayan glaciers are in imminent danger. The research is said to be based on old and erroneous past research papers, with little effort having been made to update data. The IPCC subsequently apologizes and corrects the research findings.

January 24 2010 Rajendra Pachauri (him again) and his Energy and Resources Institute (TERI), based in New Delhi, is said to have been awarded hundreds of thousands of dollars by the Carnegie Corporation of New York and most of a £2.5m EU grant funded by European taxpayers. Both of these grants, and others, are alleged to have been obtained by the fraudulent use of the discredited Himalayan research in order to do more research into the same phenomena.

January 25 2010 Pachauri excludes any possibility of his resignation in an interview given to the BBC.

February 3 2010 The British government files an official protest in which it expresses its concern to the IPCC about lax scientific procedures used by the body which supplies the world with the facts about global warming.

February 3 2010 The Guardian claims that Phil Jones, the head of the CRU, may have attempted to cover up the fact that very old and false temperature data from Chinese collaborators was being submitted to American scientists before being published. The Guardian says that the documents containing the data no longer exist and that what data is available suggests that "the findings are fundamentally flawed." Jones and a Chinese-American colleague are also being accused of scientific fraud by an independent British researcher over the contents of a research paper published back in 1990.

February 3 2010 The IPCC announces that it is trying to verify figures in its 2007 report which claimed that more than half of the Netherlands is under sea level. That and other figures in the report are currently being hotly contested.

February 8 2010 Phil Jones tells the Sunday Times that he had contemplated suicide over the Copenhagen email leaks. He also expressed regret for attempting to block public access to scientific research, blaming his decision on “a campaign by foreign global warming sceptics.”

February 8 2010 Pachaori publishes a "partially autobiographical" novel
in a “raunchy” style which mixes reincarnation, sexual prowess and, of course, climate change. Frequent mentions are made of “voluptuous breasts.” What he doesn’t mention, though, is that it was released by Mukesh Ambani, India’s richest man and the head of the oil and gas conglomerate Reliance Industries, the largest private company in India. He also omits to say who financed the book’s launch bash and campaign. That’s not surprising, given that that company is the Indian subsidiary of British oil giant BP, which also just happens to be the principal source of funding for.....Pachouari’s Energy and Resources Institute.

And the list goes on.

All I can say about these events is that with friends like climate scientists to help us put the climate right, we certainly don’t need enemies.

I said I had another question to ask. Here it is.

Where are all those moralizing climate catastrophists who are normally so quick to screech and squeal about injustice and why aren’t they calling for the heads of those responsible for this mess instead of lamely bleating that none of the events described above ever happened or that they have all been manipulated?

The public expects rational answers from climate scientists and their supporters and not 9/11-style conspiracy theories. Moreover, if those answers and corollary actions are not forthcoming soon that same public should hit the delete button on the whole damn fraudulent bunch of them.

Global wind power sees large increases in investment

Mon, 08 Feb 2010 08:53:00 -0700

China and the United States are currently heading a worldwide upsurge in the installation of wind power capacity to the surprise of some analysts. The global wind power market generated $63 billion in 2009 and employed over half a million people, according to figures issued by the Global Wind Energy Council (GWEC). The report indicates that the sector is set to repeat its 2009 performance.

Steve Sawyer, the GWEC’s secretary general, offers an upbeat prediction. "The continued rapid growth of wind power despite the financial crisis and economic downturn is testament to the inherent attractiveness of the technology, which is clean, reliable and quick to install. Wind power has become the power technology of choice for a growing number of countries around the world," he said.

China led the pack last year in terms of installations by country, with 13 gigawatts (GW) of wind energy being put on line, thus almost doubling its capacity to 25.1 GW. This puts China in second place in the overall capacity stakes – just in front of Germany – but the United States remains top of the table with 22 percent of all wind power in the world being installed there and an increase in capacity of 40 percent in 2009. The total of installations by all countries represents a substantial 31 percent increase over the year, and world total capacity is now estimated to be just under 158 GW.

These are surprising figures in the triple-context of the world financial crisis, the fact that it is relatively investment-greedy per megawatt, and the meager results of the Copenhagen conference which hardly inspired investment confidence in the immediate future of alternative energy sources.

The figures are explained by national (as opposed to international) energy policies according to Sawyer, who said: "...wind energy continued to grow due to national energy policy in our main markets and also because many governments in prioritised renewable energy development in their economic recovery plans."

Asia, with recent investment in India, Japan, South Korea and Taiwan, is the largest regional investor, followed by North America and Europe.

Europe installed 10.5 GW of wind power capacity in 2009, with Spain’s total of 2.5 GW leading the way. France had a relatively bad 2009 due to an upsurge in court cases brought by opponents of wind power who claim that it results in aesthetic damage to the environment. This phenomenon has led to uncertainly concerning wind power’s future development there and the government is considering aesthetic damage legislation which wind power proponents say will act as a brake on wind power investment.

But the best performance was to be found in the USA, despite dire predictions by analysts in early 2009 who expected investments to fall by up to 50 percent. However, the U.S. Recovery Act, which encourages wind energy development, actually led to an increase of 39 percent of the country’s capacity to a grid-linked total of 35GW.

Sawyer is highly optimistic for the future. "Wind energy is already making a significant contribution to saving CO2 emissions," he concludes. "The 158 GW of global wind capacity in place at the end of 2009 will produce 340 TWh (terawatt-hour) of clean electricity and save 204 million tons of CO2 every year. As we see in Europe and the US, wind power is now often the most attractive option for new power generation, both in economic and environmental terms, and for improved supply security."

French face transplant specialist awaits go-ahead to help wounded GIs

Sat, 06 Feb 2010 11:48:00 -0700

Contacted last year by American authorities for his knowledge and experience in facial transplants, professor Laurent Lantieri, MD, transmitted their appeals to French authorities. Since that time he has not received permission to accede to the Americans’ request and he has the impression that France is ignoring his efforts and putting administrative obstacles in his way.

Lantieri, a plastic surgeon and pioneer in facial transplantation, recently sounded the alarm in an interview given to French daily L’Express, in which he vented his frustrations and explained the issues.

American armed forces in Iraq have repatriated thousands of seriously wounded personnel to the United States since 2001; about 2,500 of them with facial wounds. The face is the least protected part of a soldier’s body and in cases where they are caught in explosions, facial damage can be severe. About 200 victims are estimated to be in need of partial or total facial transplants.

The French possess extensive know-how in facial transplants, and the first-ever operation was carried out in France in 2005 on a young French woman. French specialists have carried out many more transplants since with a relatively high success rate, although the body’s rejection of the transplant remains a major risk. The French are generally acknowledged to be the world leaders in this field.

It is in this context that American military authorities invited Lantieri, who is a world-leading authority on facial transplants, to visit the United States and share French transplant techniques with American military personnel and to see how French and American surgeons could pool their resources in an efficient manner.

Lantieri informed the French health, research and foreign ministries -- and even the president’s health counsellor -- of the American request and his wish to help, but he has not received any positive responses from anyone. He says that the government is stalling by informing him that they didn’t understand what he wanted. He said the Health Ministry responded to repeated queries saying it had not received his demands and asked him to send another demand along with all the “relative explanations for your request.”

The response leaves Lantieri frustrated. “What are they waiting for?” he asked. “Both civil and military medical authorities in America are asking me to train their people here in France for a six-month period, but because their qualifications and diplomas are not recognised here I do not even have the right to discuss the matter with them. The Americans need specialist teams all over the United States and they do not exist at this time. Our specialists have a substantial lead in this field and the Americans know it. That’s why they are asking for our help. But here in France my demands are met with silence.”

Lantieri has visited the United States on several occasions over the last year and is scheduled to visit San Antonio, Texas, in March to meet senior members of American severe burns facilities there and elsewhere.

The challenges posed by facial injuries sustained by American soldiers are substantial in his view. Some of those injuries are of a ballistic nature – caused by bullets or shrapnel – but burning and searing caused by IED (Improvised Explosive Device) explosions are the most common, and they often present extensive lesions of a type and severity which push current operating techniques to their limits. Lantieri claims that this kind of injury would be better treated by transplants than by superficial reparation methods, which can take up to 15 years to complete. This can lead to victims’ lives being constantly disrupted by long and frequent interventions.

No facial transplants have yet been carried out on blast victims. The Americans have adequate personnel according to Lantieri, but he says they need to learn from the more extensive experience of French specialists who have more research and practical work to draw upon. He has been invited to several congresses on the subject, stressing that he is sharing “the character of transplants at this time, but the reality of this type of operation can be completely different.”

The Americans, meanwhile, are making efforts to try and move things forward. The Pentagon recently released $3.4 million (€2.5 million) to fund between six and eight transplants at the Brigham and Women’s Hospital in Boston over the coming year, but Lantieri considers this to be both an unrealistically high target and a drop in the ocean given the timescale and available resources. He adds: “...and even if those operations are carried out, there will still be a waiting list of around 190 patients.”

France bans sibutramine for obesity in advance of expected Europe-wide ban

Sat, 23 Jan 2010 13:46:00 -0700

The sibutramine ban may be received as very bad news for obese French and European citizens who, due to stringent health safeguards, already have a very limited range of legal drugs available to help them lose weight.

France’s Agency for the Sanitary Safety of Health Products (AFSSAPS) decided this week to take sibutramine –- sold in France since 2001 under the brand name Sibutral –- off the list of approved prescriptions in advance of an upcoming Europe-wide decision on its safety risks by the EU’s health commission. It is widely expected that the drug will be banned in European countries. Great Britain has already suspended its use.

Long-term studies carried out by the AFSSAPS claim that sibutramine can cause undesirable cardiovascular effects in almost half of patients who use it. Other side effects include blood pressure increase, stomach and muscle pain, nausea, and mental mood changes, including depression. There are also many contraindications associated with sibutramine which mean that prescribing it can be fraught with difficulty.

Examples of sibutramine poisoning in Europe have also been uncovered. They have been caused by illegal imports of dangerous dietary supplements principally imported from China, the Far East and Africa.

Another nail in the coffin for sibutramine comes in the form of a decision by the heavily influential London-based European Medicines Agency (EMA) which has also recommended the suspension of its use. The recommendation also includes other drugs containing sibutramine, such as Reductil, Reduxade and Zelium. Not only does the EMA say the drug presents risks which outweigh its benefits, but it also claims that it has a minimal weight-loss effect in most patients and that weight lost during sibutramine treatment is soon put on again when the patient stops using it. Both the AFSSAPS and the EMA are asking themselves how sibutramine -– produced by the American company Abbott –- was able to be legalised in Europe just a few years after other appetite-reducers such as dexfenfluramine and fenfluramine were banned for the same health concerns.

The only appetite-reducing drugs available legally in France at this time are the orlistat-based Xenical, which is produced by Roche, and Alli, another orlistat-based drug sold by GlaxoSmithKline. These drugs do not work in the same way as sibutramine. Sibutramine is a neurotransmitter reuptake inhibitor which gives the patient the impression of satiety, and orlistat works by preventing the absorption of fat. It also has many less secondary effects compared to sibutramine.

Sibutramine is also a controversial drug in the United States, where the FDA recently acknowledged concerns that it may increase the risk of heart attacks and strokes in patients with cardiovascular antecedents.

Study: Eating slower reduced obesity in children

Tue, 19 Jan 2010 16:42:00 -0700

The study’s objective was to determine whether or not the instrument modified eating behavior in overweight children. The study is published this month in the British Medical Journal.

Investigators at the Karolinska Instutute in Stockholm recruited 106 obese young people, aged 9-17, who had been referred to a hospital based obesity clinic in England for the study.

The study was carried out over 12 months and supervised by Professor Julian Hamilton-Shield. All of the children were encouraged to exercise for at least one hour a day and to follow a balanced diet defined by the British Food Standards Agency.Half of the children used a Mandometer whilst eating and the other half ate without one.

The Mandometer, a computerized weight scale placed under a plate, measures and provides real-time feedback on eating speed. It was developed by a research team at Karolinska Instutute, led by Professor Per Södersen, to help reduce eating speed, known to increase the likelihood of obesity, by indicating the correct speed at which meals should be eaten in order to minimize the risk of putting on weight.

It warns its users when they are eating too fast, or too slow, for food to be absorbed correctly.

Another of its key functions is to determine when the person eating has eaten enough for his or her nutritional needs based on information on specific eating habits provided to a nutritionist. That information is programmed into the Mandometer and appears as a calculated optimal norm on the accompanying screen.

“Childhood obesity is increasing almost universally with little evidence to support any specific treatment programme,” wrote the study authors.

Results showed that all children in the study were eating too quickly at the beginning of the study, but one year later those participants using the Mandometer were eating 11 percent more slowly, compared to 4 percent in the group not using the device. More importantly, it was noticed that body mass index (BMI), body fat, metabolic status and portion size parameters had all changed in a way which led to weight loss.

The improved eating patterns and continued weight loss were maintained for at least six months after the children had stopped using the Mandometer, suggesting that use of the device had a long-term effect on their eating habits. Another positive result was that those in the Mandometer group demonstrated amelioration in the concentration of their high density lipoprotein cholesterol levels.

The researchers conclude that “Retraining eating behaviour with a feedback deviceis a useful adjunct to standard lifestyle modification in treatingobesity among adolescents.”

A short video showing Mandometer training is availableat this web site .

Source:

Treatment of childhood obesity by retraining eating behaviour: randomised controlled trial, BMJ 2009;340:b5388

doi:10.1136/bmj.b5388

Online and telephone psychological consultations 24/7 begin in France

Mon, 18 Jan 2010 12:16:00 -0700

While it's common in the United States and Canada, telephone counseling of patients by psychologists has only recently become an option in France due to a mix of strict legislative controls and the public’s perception of how health care should be dispensed.

Jean-Pierre Camard is the founder of jeconsulteunpsy.com, an internet gateway created four months ago which aims to make psychological counseling more readily available to the general public. Once a client has subscribed to the site he or she has permanent access to any one of forty-five qualified psychologists who respond to a wide range of enquiries, ranging from teenage drug issues to marital and even more serious problems, around the clock. The cost of consultations is around $85 (€60) per half-hour.

M Camard has set up his service in a country in which most basic health care is free – that which is not the case for more specialised disciplines like psychology – and in which waiting lines for consultations can be relatively long. These conditions mean that he has had to adapt his service to these realities, as he explained in our interview.

What inspired you to set up your service in what is, after all, a country which is not used to online and telephone assistance in matters of health?

The idea came to me after I realised the large extent to which the French consult online personalised horoscope and future-telling sites. They consult these sites partially for the advantages that complete anonymity and relatively rapid access to results have to offer. I thought that those principles could be adapted to psychological consulting; even more so given that those who seek counseling often want immediate access to an interlocutor.

Did you take onboard any of the practices and experiences that have evolved over the years in the United States?

Not exactly. I did most of my research into how to organise things in Canada, which has been influenced by the pioneers of the discipline, who are of course to be found in the USA. My initial reaction was shock at the sheer number of online and telephone consultants available in Canada. Another revelation was that people over there find it normal to pay for access to psychological help, whereas in France people are not at all used to being obliged to pay for health care. That was a major element in deciding how to organise our services. The fact is that the French are not used to taking the financial initiative when it comes to health issues.

Are those who dispense consultations qualified as psychologists and within which deontological framework do they operate?

All psychological counseling is done by fully qualified personnel whose credentials and qualifications are verified. How does the caller know that? Because all personnel possess what in France is called “Adeli Code” affiliation. Only fully qualified and trained psychologists can be certified in this way and all the details of their Adeli affiliation and training can be consulted not only on the site but also by contacting the authorities who administer Adeli. Concerning their operational framework, their professional status obliges them to work within the ethical bounds and practices set out by the health authorities and their professional organisations. That means that they do not work according to criteria linked to other objectives because their professional peers – and most notably their syndicate – are there to make sure that standards are maintained.

Who contacts your organisation for telephone counseling and for which reasons?

The majority of private individuals who consult us are women and their average age is around 40 years old. The reasons for their calls are varied, and range from child-related schooling and drug problems, marital problems including violence, pressure in the work environment and, of course, depressive states with less-readily identifiable origins. A non-negligible factor here is the anonymity and spontaneity of the consultation. Our biggest source of calls, however, comes from companies wishing to offer psychological counseling to their employees. The recent spate of suicides at France Télécom and Rénault – both multinationals – and the suicide rate in France in general, have led the government to consider legislation which will oblige companies to offer counseling. Those companies who use our services are those who are organising themselves with that future legislation in mind.

Marketing efforts designed to attract business to telephone psychological services are quite common in the USA and Canada. Those efforts include billboard campaigns and leaving publicity in the waiting rooms of general practitioners. Do you use that kind of support?

No, we don’t. The press has been very interested in our work and has given us a lot of visibility, but apart from that we mostly use articles and ads in specialised health magazines like “Psychology Magazine” which is France’s biggest reference in this field. We have also been invited to do radio and TV interviews, but we don’t envisage using other means at this time.

Would your consultants call an ambulance or emergency services without the caller necessarily knowing if they considered it to be urgently necessary?

Again, this is down to deontological practice, and they surely would. That said, getting emergency services to come out to resolve family and other what could be termed as “daily life” issues is another matter and I do not consider that their response would always be positive.

Certain psychologists who are critical of telephone counseling in France have called it “fast-food therapy.” What would you say to them?

It doesn’t seem to be a viable comparison. For example, a mother who urgently needs to consult a psychologist about how to deal with a devastating discovery concerning their child’s drug abuse may feel that they need to speak to someone now, and not after waiting for weeks for an appointment with a psychologist in his office.

Finally, you are pioneers in this discipline, and as such the public’s reaction to your initiative must have been difficult to predict. Do you consider that the number of people availing themselves of telephone counseling is what you thought it might be?

We are quite surprised by the ease and frequency with which people are calling us, as well as the reaction of the press and other health care professionals. For things to really catch on here, however, we will have to wait for a change in people’s perception of how responsible they should be for their health without relying on traditional services.

Thank you very much M Camard for taking the time to talk to us.

Study: Antidepressants no better than a placebo for many patients

Thu, 07 Jan 2010 14:13:00 -0700

Many millions of people use antidepressants, but do they work, and if so, for whom? JAMA has just published the results of a recent study on the question.

Antidepressants most likely have little or no effect on the majority of those suffering from slight or non-severe forms of depression, and placebos were often observed to have just as much perceived beneficial affect.

Antidepressants are, however, very efficient in combating severe depression. Those are the conclusions of an analysis of six randomized placebo-controlled trials of antidepressants approved by the Food and Drug Administration in the treatment of major or minor depressive disorder. The analysis was carried out by a team of researchers from Pennsylvania University led by doctor Jay Fournier. The study was published Wednesday in the Journal of the American Medical Association (JAMA.)

Included in the analysis were the results of six therapeutic trials (involving a total of 718 patients) lasting six weeks each and designed to compare the relative effects of antidepressants and placebos.

Various drugs were used in the different studies, including Imipramine, which is a common trycyclic antidepressant from the dipenzazebine group, and Paroxetine, a drug from the selective serotonin reuptake inhibitor family which is used to treat severe depression. Prozac is a well-known example of that class of drugs.

Trial end results showed that whatever the drug used, the conclusions were the same -- in cases of severe depression, antidepressants were much more effective than placebos, but on the other hand, the beneficial effects of drug molecules was observed to be minimal, or even nonexistent, in patients treated with drugs adapted to conditions of mild depression, and placebos worked just as well.

In the complete version of the study, Fournier expressed his surprise at the severe levels of depression necessary to be able to observe superior results from drugs over placebos. Another conclusion by the research team is that it appears that neither patients or healthcare professionals are aware that most studies which claim to demonstrate the efficiency of various antidepressants only used patients suffering from severe forms of depression, which would spin the study conclusions.

It was also pointed out that that information is not included in marketing efforts employed by the drug producing companies concerned.

H1N1 vaccines available at rock bottom prices in Europe

Wed, 06 Jan 2010 12:51:00 -0700

In a scenario that would have been unimaginable just two months ago, European countries are now scrambling to sell off hundreds of millions of H1N1 vaccine doses to the highest bidders. The race is on to find clients and the competition may well become fierce.

Well, if the development of the H1N1 story in Europe was made into a film it would have the kind of tortuous and unpredictable plot of which even Quentin Tarentino would be proud.

Before looking at recent developments, let’s go over the storyline again and remind ourselves of how things have unfolded up until the last week or so.

It all began with a sinister virus whose first major offensive arguably took place in Mexico before spreading to the United States and, from there, winging its inevitable way around the world in the pressurised cabins of jetliners.

Initial reactions were measured, with governments and the WHO trying to work out the best possible counter-attack strategies. Public reaction was relatively measured. However, once the novelty of the situation had dissipated and things began to look less serious than was initially predicted, secretly relieved cynics, in a sudden twist to the tale, began to trot out the usual conspiracy theories which held that the Powers-That-Be were hiding things from us, that we were being deliberately poisoned, that it was all a pharma-scam, that our governments were scare-mongering, and that our basic civil rights were being menaced by the threat of forced mass vaccination by hordes of jackbooted establishment shocktroopers.

Then, just as all the hullabaloo was reaching its peak, it was suddenly noticed that H1N1 infection and death rates were reaching proportions which were becoming conducive to a worldwide pandemic. So the story took another, and this time unexpected and dramatic, turn.

Citizens in many countries suddenly changed their tune and instead of slamming the authorities for scaremongering they began lining up at vaccination centres clamouring for vaccination, governments were widely criticized for not doing enough in terms of preparation, the labs were laminated because they couldn’t develop and produce vaccines fast enough. There was violence in police-controlled waiting lines –- notably in France –- and face masks began making their sinister appearance on the streets of our threatened cities. Predictions abounded of millions of possible deaths and, to cap it all, drug-resistant H1N1 mutant viruses were said to be lurking in the shadows, waiting to pounce upon us.

Then Christmas came and everyone forgot all about it, preferring to take a break from the ambient fear and flood the streets and malls in search of presents in the kind of heavy and close-proximity numbers that would have been deemed irresponsible a couple of weeks before.

Which brings us up to today.

It is being announced in the European press that governments, far from scrambling to obtain vaccines at any price, are now actually cancelling orders right, left and center and are selling existing stock off at bargain basement prices. Worse, total average vaccination figures in Europe are estimated to be a very low 5 to 8 percent and stagnating.

The French government has just cancelled orders for 50 of the initial 90 million doses it had signed up for and other countries are said to be following suit. Several countries are said to be refusing to accept further deliveries. Pharmaceutical companies are predictably trying to limit the damage by evaluating the validity of cancellation claims on a case-by-case and contract-by-contract basis, which translates into: “We are not going to carry the financial can for your hysterical pressuring and over-ordering.”

A good measure of the fear of financial loss is the totally unrealistic statement made today by French Health Minister Roselyn Bachelot, who said, “These orders have neither been delivered nor paid for, and [the contracts] are thus resiliated.” She doesn’t have a legal leg to stand on of course, just like other countries who think they have too much vaccine in stock. She seems to have forgotten that France selfishly ordered double doses all for itself until the OMS decided that was unnecessary last November.

Countries already known to be rushing to off-load vaccines are Germany, Sweden, Belgium, Spain, Holland, Switzerland, Great Britain and Italy. Other countries are expected to join them. Lucky bargain-hunting countries so far (or should I say poorer countries that were cynically and mercilessly squeezed out of the buyers market by the richer and larger European countries during the “shortages”) include Egypt, Ukraine, Romania, Mexico, Bulgaria and various Middle Eastern countries including Quatar.

Other doses are being “offered” to the OMS by richer countries who are resorting to sordid methods designed to disguise their actions as being a heart-warming gesture of human and international solidarity.

And make no mistake about it, all this is being taken very seriously by our governments. The French government openly admits that its ambassadors and embassies have been instructed to try and sell excess vaccines to their host countries. The French Foreign Ministry issued a statement saying, “We are selling vaccines, in a case-by-case manner, to governments who wish to buy vaccines and who request that we sell them. All demands are sent to the Health Ministry, which is the competent authority for dealing with the requests.” Concerning the fact that other countries are doing the same thing, another ministry official said: “That is true, but this isn’t about commercial competition.”

The cherry on the cake is that they will have to move quickly to sell the product, because another complication is that many doses are only a few months away from the end of their shelf-life. It’s the same for masks, the more sophisticated of which are impregnated with degradable anti-infection compounds.

So here we are, in the middle of one of the biggest and most cynical international health scandals of the last hundred years. And we have no one to blame but ourselves. A fickle and spoilt public, overbearing profit motives, spineless politicians and a hysterical press. Oh, and as a confirmed blogger, I consider that this episode has also shown the very narrow limits of what is fast becoming no more than a platform for hysterical paranoia dressed in uninformed “free speech” and amateur journalists’ clothing.

At the end of the day, and given that yet another “pandemic” is being predicted when the warm spring weather kicks in, I really do wonder if even the great Quentin Tarentino would be capable of coming up with the kind of byzantine and as-yet-unimagined direction that the next episode in this ugly soap-opera is very likely to take.