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Mammography Screening: Truth, Lies and Controversy
On the face of it the case for increased breast cancer screening is clear. Cancers caught sooner are easier to excise or to treat with chemotherapy. Earlier diagnosis means a lower likelihood of metastases, which are the real killers in cancers of all kinds. So who could argue against increased screening? Unfortunately this simple picture, seductive though it is, is just too simplistic and obscures a bitter controversy that has raged across the medical literature but which barely registers in public consciousness. Peter Gøtzsche, a Danish medical researcher, Professor of Clinical Research Design and Analysis and the director of the Nordic Cochrane Centre, is a key player in the controversy and is highly sceptical of the value of breast screening in the general population. As an expert in clinical trial design and results analysis he came to the topic with no real experience of breast oncology, chemotherapy or surgery. But it was from this position of independence that he looked at the data from the studies that had been performed on breast screening and decided, based on the evidence that he and his colleagues uncovered, that far from being an unalloyed good, there were real and significant harms being perpetrated on women taking part in breast cancer screening programs. As Gøtzsche outlines in considerable detail in this book, his findings were not greeted with open arms by breast screening advocates, the medical establishment and numerous well-placed political and academic figures. In fact the reaction was extremely hostile and remains so to this day, many years after his initial research findings. Gøtzsche and his colleagues were attacked from all sides for straying from the 'consensus' view that screening saved lives. His results, methods and motives were all attacked and continue to be attacked, though few seem to actually dispute the core of what he has found. And what is it that makes Gøtzsche and a few others like him dispute the simple narrative that regular screening saves women's lives? The fly in the ointment is simple - over-diagnosis. [Continued] Watermelons
Just in case you're in any doubt about what you're getting - the subtitle of James Delingpole's latest book puts you firmly in the picture: How environmentalists are killing the planet, destroying the economy and stealing your children's future. And, if you're still wondering, watermelons are green on the outside and red on the inside - just like those nasty environmentalists. Except that real watermelons are sweet on the inside, which is the last thing one could say about the environmentalists in this book, who are of the type that tend to leave a lingering and bitter aftertaste. Delingpole's central thesis is that environmentalism is a misanthropic, authoritarian and dangerous creed that seeks to ultimately destroy industrial society in order to save Gaia. This means, among other things, having to cut back on population numbers, massively curtailing energy use and instituting a global centralised government to oversee the new world order. Environmentalism, Delingpole posits, is no longer about hugging trees and saving cuddly animals, it's about ridding the world of the cancer that is the human race. Of course this sounds like the ravings of a conspiracy-obsessed lunatic, it's a point that Delingpole himself makes. But he backs up his point with quotes from leading environmentalists, some of whom are positively raving when it comes to expressing their distaste for the human race. There is, without a doubt, a strong seam of self-hatred that animates many environmentalists. It's also darkly pessimistic, and it doesn't even start with Malthus and his visions of famine and disaster - visions revisited again and again and again. But it's the idea of anthropogenic global warming in which we see the disparate strands of environmental extremism coalesce and emerge as the dominant ideological force in global politics. Forget socialism, forget free market capitalism, forget even the idea of democracy, what unites the global political elites of today is the idea that they must save the world from ecological disaster brought on by global warming induced by human emissions of carbon dioxide. [Continued]The Information Diet
The central premise of this book is a simple one. Just as there is a glut of cheap and unhealthy junk food, so we are surrounded by cheap and unhealthy junk information. And, to continue the metaphor, just as we have rocketing levels of obesity, we have information obesity, and therefore what is required is an information diet to get us all back to health and steer us away from the perils of junk. While the metaphor gets stretched way too long, there are some valid points about that emerge from this idea. In an age of almost unlimited access to the web, how can we sort sense from nonsense? How can we detect bias? Are there ways of spotting when we're being spun a line? And how do we ensure that the plethora of personalisation engines don't algorithmically feed us only the message we want to hear? Unfortunately, despite raising some interesting questions, the author, Clay Johnson, ultimately disappoints by falling prey precisely to the ills he seeks to steer us away from. To be fair to him, Johnson makes no secret of where he's coming from. He's open about his liberal politics (that's liberal in the US sense of the description), and that he has spent a lot of time campaigning for various politicians and causes. He does a good job of describing the bubble that can end up enclosing campaigners - who can end up so wrapped up in what they're doing and who they're with that they can lose touch with reality. It's a danger that every campaigner should be aware, regardless of where they sit on the political spectrum or what cause they align too. A poor information diet is part of the syndrome, as he rightly points out. And, therefore, by carefully adopting the information diet that he recommends one can become immune from this. However, studded throughout the book are examples of where his bias comes through loud and clear. As a reader I can feel no confidence in his information diet when I see the blatant examples of misdirection and bias. It's like reading a book on weight loss and finding the author is clinically obese and lives on nothing but junk food. [Continued]Amazon Kindle
As a confirmed and fanatical bibliophile, the thought of using an e-reader has never been particularly attractive. They've always had a similar attraction to reading a book as a PDF on desktop or laptop. Sure, you'd do when you needed to, but it couldn't compare to the convenience, comfort and sheer pleasure of a book. And the early generation of specialist devices did little to change that view. Why spend time looking at a screen when you could look at a book? However, Alan Jacobs in his 'The Pleasures of Reading in an Age of Distraction', made a good case for the Amazon Kindle as the device that changes all of that. Here clearly was a man in love with reading and with books, who could outline a case that reading with the Kindle was decidedly not like reading off another screen. It was not just the technical details about e-ink technology or the comfort of reading the Kindle screen. It was not just the ability to store hundreds of books on one device. Nor even the chance to search the text. No, what made the Kindle different, according to Jacobs, was that it provided all of the functionality of electronic devices without the distractions. It's almost a perverse argument. The Kindle is good because it makes the things that act as distractions to reading - like surfing the web - difficult. Sure, the Kindle has got a primitive sort of web browser, but it's slow and not very functional. The screen is great for text - clear and legible - but it's black and white and less than ideal for web pages or full colour graphics. It's got lots of functionality, but the focus is on reading pure and simple. As an argument it's not one that would be appealing to most people, but to a reader it's about as compelling as you can get. Could the Kindle really be the device that entices hard-core readers to consider an electronic device? [Continued]Interview With Donna Laframboise
Donna Laframboise, author of The Delinquent Teenager Who Was Mistaken for the World's Top Climate Expert, responds to questions on the controversies surrounding her book, the responses to it and the politics of climate change. [Continued]
Interview With Denis Gingras
Denis Gingras, co-author of Foods to Fight Cancer, responds to questions on the food, life-style and the role of diet in preventing and treating cancer [Continued]
Interview With Christopher Booker
Christopher Booker, co-author of Scared To Death, responds to questions on global warming, health scares, the mass media and responses to his book in this interview with LondonBookReview.com [Continued]
Forthcoming Reviews
Future Babble by Dan Gardner; Integrative Oncology by Donald Abrams and Andrew Weil…
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Other Recent Reviews
The Pleasures of Reading in an Age of Distraction by Alan Jacobs The Emperor Of All Maladies by Siddhartha Mukherjee The Delinquent Teenager Who Was Mistaken for the World's Top Climate Expert by Donna Laframboise The Hockey Stick Illusion by A W Montford The Rational Optimist by Matt Ridley The Spirit Level Delusion by Christopher Snowdon The Manga Guide To Relativity by Hideo Nitta, Masafumi Yamamoto, Keita Takatsu and Trend-Pro Co, Ltd The Beautiful Tree by James Tooley Foods to Fight Cancer by Richard Beliveau and Denis Gingras Breaking The Law Of Averages by William M. Briggs The Cult Of Statistical Significance by Stephen Ziliak and Deidre McCloskey |
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