Click to view this issue of Critical Links as a webpage, or check out the CL archive .

In this Edition of Critical Links:

Dates of Interest

CFIC Branch Events

Contest!

Science Check

Secular Check

Think Check

Books and Authors

Dates of Interest

October 1 is the United Nations International Day of Older Persons. The theme for this year is “ Celebrating Older Human Rights Champions“

October 8 is Thanksgiving. Though some people consider this to be a religious holiday, we can also enjoy a secular celebration of a harvest festival, and for those of us who live with abundance of food, we can be thankful for that (and, as humanists, take the opportunity to share with those who are less fortunate).

October is also Sarcastic Awareness Month! (Just remember: Sarcasm works really well in print.)

If you celebrate any of these, please drop us a line or send us a picture to [email protected]

CFIC Branch Updates

Coming Events

Saskatoon: Blasphemy Rights Day Fundraiser

 

CFIC Saskatoon is hosting a Blasphemy Rights Day fundraiser! Please join us Saturday, September 29, from 6-10 pm. Feel free to dress as a deity: one taken seriously, one widely known to be mythical, or, heck, one you just made up! Best costume gets a free meal!

 

Entry fees will be $10 for members of the general public, and $5 for active CFIC members. For more information, check out the CFI Saskatoon Meetup

Ottawa: Screening Highway of Tears

 

CFIC Ottawa, in conjunction with the Humanist Association of Ottawa and the first Unitarian Congregation of Ottawa, is pleased to present a screening of the 2015 documentary Highway of Tears. The film examines the cases of missing and murdered [First Nations] women along a 724 kilometer stretch of highway in northern British Columbia known as Highway 16, between 1969 and 2011.



Date: Tuesday October 2 ^nd

Time:  7:30 pm

Location: First Unitarian Church, 30 Cleary Avenue (Westboro)

Free parking, free admission, refreshments provided .

Past Events

Ottawa: The upper room in a downtown pub was filled to capacity for the talk on "Inherent and Inherited issues for Women in Mormonism", presented by a member of CFI Ottawa's Living without Religion group. (For those who missed the talk, audio and text versions are available on the CFIC website.)

CONTEST!

CFI US has generously donated two tickets to the upcoming Pangburn Philosophy event “An evening with Richard Dawkins and Carolyn Porco” in Calgary on October 22.

If you are a member of CFIC and can make use of these tickets, we invite you to enter our draw by sending an email with your name and phone number to [email protected].

The winning entry will be drawn on 10 October, 2018.

Not yet a member of CFIC? Sign up here. (New members, please let us know the date you signed up for membership when you send your contest entry email.)

Science Check

Measles Outbreak 2018

Beverly Carter

Measles is highly infectious and spreads by droplets in coughs and sneezes. Measles is one of the most contagious human diseases. It is caused by the measles virus and occurs as a seasonal disease. In tropical zones, most cases of measles occur during the dry season, whereas in temperate zones, incidence peaks during late winter and early spring. The infection lasts seven to 10 days. But while most people recover completely, it can cause some serious complications, including encephalitis (infection and swelling of the brain), meningitis, febrile convulsions, pneumonia, or liver infection (hepatitis).

Cases of measles in Europe have hit a record high, according to the World Health Organization (WHO). Over 41,000 children and adults in the WHO European Region have been infected with measles in the first 6 months of 2018. The total number for this period far exceeds the 12-month totals reported for every other year this decade. The previous highest annual total for measles cases was 23,927 for 2017, and the lowest was 5,273 for 2016. This is a huge change.

Seven countries in the Region have seen over 1,000 infections in children and adults this year (France, Georgia, Greece, Italy, the Russian Federation, Serbia, and Ukraine). The majority of cases were in teenagers and young adults who missed out on their measles-mumps-rubella (MMR) vaccine when they were children.

Ukraine has been the hardest hit, with over 23,000 people affected; this accounts for over half of the Regional total. As recently as 2008, 95% of eligible children in Ukraine received their second recommended MMR dose on time. By 2016, this rate had fallen to 31%, the lowest coverage in the WHO European Region and among the lowest in the world.

Large-scale outbreak response measures have been undertaken by Ukrainian Health authorities since the start of the outbreak in 2017 to curb further spread of the disease and restore high routine immunization coverage. With WHO and UNICEF support, Ukraine has recovered huge ground in the fight against measles. Measles-related deaths have been reported in all of these countries, with Serbia reporting the highest number of 14. Monthly country reports indicate that at least 37 people have died in Europe due to measles so far this year. Experts blame this surge in infections in Europe on a drop in the number of people being vaccinated. The WHO is calling on European countries to take action.

Before the introduction of the measles vaccine in 1963, major epidemics occurred approximately every two to three years and it is estimated that 30 million cases of measles and more than 2 million deaths occurred globally each year, and that by the age of 15 years, more than 95% of individuals had been infected with the measles virus.

Measles is preventable and can be eliminated by vaccination. The MMR vaccine can prevent infection, but discredited research published 20 years ago that erroneously linked MMR to autism has stopped some people from trusting the vaccine. It is recommended that all children receive the MMR around their first birthday and then just before starting school.

There is no current measles outbreak in Canada or the United States. In Canada, 22 cases of measles and no cases of rubella have been reported in 2018.The number of cases in the United States in 2018 is also well within what's expected. So far, 124 individual cases of measles have been confirmed in 22 states and the District of Columbia. Some recent media reports misinterpreted data from the Centers for Disease Control and suggested there was an outbreak in North America. If all of those affected across 22 states were sick from a single outbreak, it might be more concerning, but the cases in different states do not appear to be from a single outbreak.

So, measles is still common in some parts of the world. And with global travel, cases are being spread. Make sure you and yours are up to date on the MMR vaccine.

Influenza Vaccine: Update for 2018-2019

Zack Dumont

Flu season is nigh, and the 2018-2019 vaccine may need you as much as you need it!

Despite society’s efforts, estimates attribute to influenza virus over 12,000 hospitalizations and as many as 3,500 deaths in Canadians, annually . The looming threat in 2018-2019 is that these numbers could grow, beyond normal variance, due to negatively framed media reports about vaccine effectiveness (VE) during and following the 2017-2018 season. Undoubtedly, VE did lessen last season. Some reports suggested effectiveness as low as 36-40%. That’s hardly anything to be considered a failure, but it's admittedly less than normal: VE rarely dips below 50%.

Nevertheless, VE is somewhat unpredictable, varies, and by rule isn't affected by the the preceding year’s VE. At present, there is no indication that 2018-2019 wouldn’t rebound, as all lower years have rebounded in the past. Still, the media reports do little to bolster the public’s collective confidence, and worse, provide fuel for the anti-vaccine movement.

In Canada, the National Advisory Committee on Immunization (NACI) is the authority on all matters of vaccine-preventable diseases, and the annual influenza fight certainly falls within their domain. As you may be aware, the work to combat influenza is one of dynamics, subtleties, and continuous quality improvement, with annual updates to the vaccine composition and roll-out. As such, NACI has long commissioned the Influenza Working Group (IWG) to help inform the provinces and healthcare providers with information needed to care for residents and patients. Their annual report preserves information that has stayed the same, and provides specific updates when applicable.

Despite the lower-than-normal VE rates in 2017-2018, the IWG’s recommendations have appropriately not wavered: The vaccine is recommended for everyone six months and older, unless contraindicated. Further, some specific recommendations have been bolstered; for example, NACI “reaffirms its recommendation that children and adults with neurologic and neurodevelopmental conditions are groups for whom influenza immunization is particularly recommended”; and “any of the four influenza vaccines available for use in adults 65 years of age and older should be used."

As influenza is primarily transmitted by droplets from coughing or sneezing, or through contact (direct or indirect) with infected respiratory secretions, getting vaccinated each autumn is the best way to help prevent influenza infection. In the northern hemisphere influenza activity can begin in November, and thus it is time for us all to take action. Vaccination before influenza season is strongly preferred, as it increases the likelihood that the vaccine has the opportunity to protect you and others. The additional benefit is that it mitigates the risk of fallout from false vaccine failures: when the individual comes in contact with the virus before receiving the vaccine or before vaccine activation, and then after experiencing illness, the sufferer incorrectly attributes the perceived ‘lack of effect’ as either vaccine failure, or, even more problematic, as the vaccine causing the illness.

Provincial public health offices have announced a late October launch. More specific details are imminent or have already begun dissemination. For example, the Saskatchewan Health Authority announced the influenza vaccination program will commence October 22. Plan when and where you will get yourself and loved ones vaccinated. Further, consider how you will provide leadership and support to those who need it – many doubters are not part of any anti-vax movement and may look to you for positive encouragement.

Science Tools

Zack Dumont

There's an app for that:

CANImmunize

Have you checked out CANImmunize ? It is available in app format for most mobile devices, or on the web for others. CANImmunize is a citizen-directed tool initially developed for Canadians to track their vaccination records, but has grown to include a wealth of information regarding immunization schedules, outbreak maps, answers to FAQs, and more. In preparation for the upcoming influenza season, download today and start to explore the many resources:

 

FluWatch

Are you ready to battle bugs and misinformation? Are you really into influenza-related information? FluWatch is Canada's national surveillance system that monitors the spread of influenza (and influenza-like illness) on a regular basis, with a newsletter posted every Friday. The aim to detect (influenza), inform (prevention programs), and enable (national and international pandemic responses). Want to know more? Check out the website.

Energy-based Devices and Vaginal Rejuvenation 

Beverly Carter

Editor's note: The following article was in the September issue of Critical Links, but due to a formatting error, it showed up as black text on a black background, so we are running it again this month.

In recent years, vaginal rejuvenation procedures have gained increasing popularity in Western countries, not only among healthcare providers but also among women. "Rejuvenation" is an ill-defined term used to describe non-surgical procedures intended to treat vaginal symptoms and/or conditions including vaginal laxity, vaginal atrophy, dryness or itching, pain during sexual intercourse, pain during urination, and decreased sexual sensation. Some approaches include the use of energy-based devices that usually use radio waves or lasers on the surface mucosa of the vagina and vulva.

On July 30, 2018, the Food and Drug Administration (FDA) of the United States unexpectedly issued a  Safety Communication for patients considering any vaginal "rejuvenation" or cosmetic vaginal procedures intended to treat vaginal conditions and symptoms related to menopause, urinary incontinence, or sexual function. The communication warned healthcare providers who perform said procedures using energy-based devices that those devices are not proven safe or effective for vaginal rejuvenation or vaginal cosmetic surgery. Rather than improving patient health, these products may cause harm, including “vaginal burns, scarring, pain during sexual intercourse, and recurring/chronic pain.” The FDA further recommended that any patients having undergone treatment for vaginal "rejuvenation" and have experienced a complication are encouraged to file a report through  MedWatch, the FDA Safety Information and Adverse Event Reporting program .

In addition, the FDA sent letters to seven marketing companies demanding information about the companies’ unproven health claims about these products. Though approved for sale by the FDA, the agency notes that companies marketed the devices for a wide variety of treatments that have no association with the ailments for which they were approved.

Health Canada has approved the usage of some laser devices for vaginal therapy, and clinics across Canada from Newfoundland and Labrador to British Columbia are advertising the use of energy-based devices for vaginal rejuvenation. Advertisements include claims that “a non-surgical, quick, safe and highly effective laser vaginal rejuvenation procedure effectively restores damaged tissue without anesthetic or numbing cream” and “treatment options for vaginal rejuvenation use radiofrequency energy to gently heat tissue to rejuvenate collagen, without discomfort or downtime.”

The Society of Obstetricians and Gynecologists of Canada (SOGC) has not specifically addressed this issue. However, in 2013 they released a policy statement prepared by their Clinical Practice Gynaecology and Ethics Committees, and approved by both the SOGC Executive and Council. They found that there is little evidence to support any of the female genital cosmetic surgeries or vaginal rejuvenation in terms of improvement to sexual satisfaction or self-image. They advised that physicians choosing to proceed with these cosmetic procedures should not promote surgeries for the enhancement of sexual function, and advertising of female genital cosmetic surgical procedures should be avoided. This position was echoed by the Royal College of Obstetricians and Gynaecologists (UK) and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists underlining that presenting female genital cosmetic surgery procedures as unproblematic was inappropriate because it misinforms women about the actual efficacy of these procedures.

More recently, in April 2018, the SOGC published a study out of Montreal entitled “No. 358 - Intravaginal Laser for Genitourinary Syndrome of Menopause and Stress Urinary Incontinence,” which offered multiple recommendations, one of which is that for patients declining or with apparent contraindication to local estrogen, intravaginal laser therapy may be considered for short-term relief of symptoms such as atrophy and sexual dysfunction. However, they strongly cautioned that there was insufficient evidence to offer intravaginal laser therapy as an equivalent form of therapy to estrogen. They also stated that long-term use of intravaginal laser therapy remains experimental and should remain within the protocols of well-executed clinical trials in attempts to establish its safety and efficacy.

 

CFIC supports science-based medicine in Canada and advocates for empirically supported medical services. Women considering this mode of therapy should be aware of the lack of evidence supporting its use, the real possibilities of side effects, and the lack of support for their use by multiple governing agencies.

Secular Check

Alberta Alliances Promote Welcoming, Caring, Respectful, and Safe Schools for LGBTQ Students and their Allies

Sandra Dunham

“GSAs and QSAs promote welcoming, caring, respectful and safe schools for LGBTQ students and their allies.” -- Alberta Education

Alberta's Bill 24 came into effect on June 30, 2018. This bill requires all schools to create gay-straight alliances (GSAs) or queer-straight alliances (QSAs) upon student request, and requires that teachers get student permission to notify parents that their child is a member of a GSA or QSA.

Catholic school boards in Alberta have come a long way since 2014, when some refused to allow students to form GSAs. However, they continue to express concerns about the legislation, especially its impact on “Catholic values.” The summer 2018 edition of The Catholic Dimension (page 3) outlines the Catholic school board’s concerns about Bill 24, which focus on:

Other publicly funded faith-based schools sought an injunction during which GSAs were described as “ideological sexual clubs that could expose young or otherwise vulnerable kids to explicit materials.” Justice Johnna Kubik, who heard the case, ruled against the injunction, stating that there was no risk of explicit material being disseminated through these alliances.

David Eggen, Alberta Minister of Education, has granted all schools an extension until early October to comply with the new law. Those that continue to defy the law could risk losing public funding. While Eggen indicates that the number of schools not in compliance is coming down, the exact numbers have not been released. He commits to reporting these numbers following the October deadline.

CFIC will monitor future developments.

Religion in Toronto Municipal Politics

Sandra Dunham

Municipal politics are clearly not immune to religious influence. Toronto incumbent councilor Giorgio Mammoliti is appealing to Christians and believers of other faiths to support candidates who believe in “a” god. Mammoliti is reported to have tweeted “The lack of religious values in politics is why our children are killing each other. Religion and politics DO MIX. Let’s drive the devil out of Toronto!”

He goes on to say “…anybody that is within a faith and believes in a faith would tend to make better choices and decisions in policy-making.”

Clearly there is a need to be vigilant about the insidious creep of religion into politics at all levels. Be sure you know where your politicians stand on secularism in government before you cast your ballot.

Building Community in Ottawa

Seanna Watson

CFI Ottawa's Secular Community Network is “an intentional community working cooperatively to build a fair, inclusive and cohesive society through gaining knowledge and serving others.” Recently, the local Community Voice newspaper published an interview with Ottawa SCN leader, Lyndee Wolf.

Interested in building secular community in your area? Contact [email protected] to get started.

Think Check

Twelve-Step Programs: A Work in Progress

Edan Tasca

Everyone has heard of Alcoholics Anonymous (AA). It’s that organization that holds meetings where people go when they’re trying to stop drinking. These are meetings with other problem drinkers, where people enjoy social support for what they’re going through. They can share their struggles with sympathetic people, and they can hear about the experiences of others, often benefitting from the insights they glean.

Less known is the term “12-step program.” AA is probably the most well known. Others you might have heard of: Narcotics Anonymous (NA), Gamblers Anonymous (GA), Sex Addicts Anonymous (SAA), Marijuana Anonymous (MA), and Al-Anon (for the family and friends of the one pursuing the problem behaviour). Such programs are widely encouraged by health professionals as legitimate forms of treatment for compulsive and addictive behaviour, and in the latter case (Al-Anon) for the risk of co-dependency (the state of being at risk for, say, covering up and even enabling the addiction or compulsion of a friend or family member).

The 12 steps were introduced in the 1930s by Bill Watson in a book called Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism, now known casually as “The Big Book”. Generally the 12 steps look something like this:

1. Admitted powerlessness in the face of the problem behavior

2. Acceptance of a higher power (often but not always God)

3. Turning over one’s life significantly to this greater power

4. Acknowledgment and acceptance of mistakes made during periods of pursuing the problem behaviour

5. Admitting such mistakes to the higher power and to another person

6. Willingness to allow the higher power to remove the character flaws that allow for these transgressions

7. Asking humbly for the higher power to remove such character flaws

8. Listing those who were harmed by such transgressions with the intent to make amends

9. Making amends to such people, unless this would harm them

10. Continuing to account for and amend transgressions

11. Prayer to continue and further the connection with the higher power

12. Spiritual awakening, which is shared with others struggling with the same problem

It isn’t hard to spot where, from a non-religious perspective, the wheels come flying off. Atheist and agnostic types are at risk of feeling alienated by all the talk of a higher power, and how important an aspect of the process it is. This feature makes it seem to many that AA and other 12-step programs are almost strictly a religious process. AA, in particular, has been flat-out called a cult, by many who’ve attempted it and ended up hating it.

I believe that for many secular types, there exists a hack for this problem. When discussing the possibility of adding a 12-step program into the treatment process, I will ask my patient if he or she is religious. If they are not, I will suggest that a) there is a lot of God talk involved in a 12-step program that might rub them the wrong way, and that b) they can perhaps replace the concept of God or the higher power with something else. Perhaps their "higher power" can simply be the truth of their condition. This “higher power”, in other words, would simply be the pathology itself (often called a disease, for what it’s worth) that they haven’t been able to alleviate on their own.

Fortunately, if a patient doesn’t feel that this take on a higher power is going to work for them, there are secular 12-step alternatives. For example, Rational Recovery is a process initially based on the 12-step model. Meetings for this group have been on the decline, however, after the founder began offering toolkits that folks can purchase and use on their own. Another secular program is Self-Management and Recovery Training (SMART) Recovery, which eschews not only the higher power, but also the concept of addiction as a disease. Such problem behaviors are seen instead as unhealthy habits.

Regardless of which 12-step program one chooses, do these programs actually help? There has been extensive controversy about the efficacy of 12-step programs in general, to the point where AA, in particular, has been accused of inflating its success rates. Among the skeptical community, a statistic that is widely cited is that AA, for example, has merely a 5-10% success rate.

Lance and Zachary Dodes, authors of The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, sum this problem up thusly: “We hear from the people who do well; we don't hear from the people who don't do well.” This is disconcerting given that many in such programs are not even there of their own volition. Rather, they might be in such a program because of a court order, for example, or the prescription of a physician.

It’s also disconcerting that, as the Dodeses fear, the other 90% aren’t merely wasting their time; they’re sometimes accused of being the reason their program hasn’t worked for them, because it's thought that the 12 steps should work for everyone engaging properly. This is a valid concern. When a patient is blamed for a treatment not working, it’s always worth looking closely for red flags.

On the other side of the debate, however, are medical and mental health professionals in the addictions field who have worked with thousands of patients struggling with compulsive behaviours. They have seen firsthand, over and over, how 12-step programs like AA can help guide a person though the process of transforming his or her life.

Yes, this is largely anecdotal. And further, we don’t even have a concrete mechanism for exactly how and why a 12-step program might be effective. What is it about the steps that works for many, but not for so many others? The structure? The change in conceiving of the problem (higher power, etc.)? A combination of factors? It’s likely different for everyone.

What does seem to be an inarguably huge benefit of a 12-step approach is something that is similarly huge for everyone else’s mental health: community and social support, which are essential for well being (and which, it’s worth mentioning, always seem to be an advantage for religious communities over their secular counterparts). Additionally, if someone sticks around long enough to become a sponsor (i.e., a mentor about the journey through the steps) for a newer member, they add altruism and being of service to what’s helping them in their recovery.

Twelve-step programs will never be flawless. We should never assume they can’t be improved. We should keep up the skepticism, the criticism, and the tweaking. Also, ideally, 12-step programs should be accompanied by other forms of treatment, such as a prior stay in rehab, regularly meeting with a psychotherapist, and meeting with a physician to discuss the possibility that medicine might help alleviate some of what’s fueling the unhealthy behaviour.

Despite their flaws, 12-step programs offer many people something essential that they don’t get anywhere else. And they’re free. And they’re widely available at many different times of the day and week. This offers options about when to attend, and the ability to attend more than once per week.

Yes, it might be that they help only 5-10% of the people who start. The numbers 5 and 10 might seem low, certainly lower than we would hope. But 5 and 10 are better — infinitely better, in fact — than zero.

Books and Authors

Fiction-loving atheists will enjoy the latest novel by the author of the best-selling The Da Vinci Code. Origin is a thriller involving a brilliant futurist, Kirsh, who has answered the age-old questions “Where do we come from?” and “Where are we going?” As the tale unfolds, we see murder and conspiracy.

Although a work of fiction, Brown lets us know that all of the art, architecture, locations, science, and religious organizations in the novel are real. The novel unfolds among the architecture and art of Spain. The unlikely cast of lead characters in addition to Kirsh include a computer (Winston), a university professor (Langdon), Catholic Bishop Valdespino, Prince Julián, and his fiancé Ambra.

The novel opens with Kirsh sharing his discovery with three religious leaders, one of Christian, one of Jewish, and one of Muslim faith. Although we do not learn what the discovery is until the final chapter, we know that Kirsh has proven, without a doubt, that the story of creation is false. (Where do we come from?) And we also know that there is a dark discovery that will shake the foundation of faith. (Where are we going?) Arguments against religion abound in this compelling read.

“By a show of hands,” Kirsch asks in one scene, ”how many of you believe in any of the following ancient gods: Apollo? Zeus? Vulcan?” He pauses and laughs. “Not a single one of you? Okay, so it appears we are all atheists with respect to those gods.” He pauses. “I simply choose to go one god further.”

Kirsh offers more non-religious wisdom: “To permit ignorance is to empower it. To do nothing as our leaders proclaim absurdities is a crime of complacency. As is letting our schools and churches teach outright untruths to our children. The time for action has come. Not until we purge our species of superstitious thinking can we embrace all that our minds have to offer.”

Origin also provides great descriptions of many of the architectural marvels of Spain, as well as provides an interesting look at the Spanish monarchy and changing role of the Catholic Church in Spain.

Centre for Inquiry fans who enjoy reading fiction might want to check this one out.

Have you read a good book lately? One that made you think more critically? One that changed your outlook? Something that used science to call into question misinformation? Critical Links is looking for book reviewers to share their thoughts on books that other members will enjoy.

If you would like more information on the type of book reviews we are interested in, please email: [email protected]