Orac's looking for some quackademic medicine

well Dr. Fombonne at the University of McGill is peddling woo in the form of very bad autism prevalence studies. But luckily the university is reviewing his breach of ethical guidelines.

Unfortunately, Brigham & Women's Hospital in Boston has gone over to the dark side by offering reiki. So far, no homeopathy that I've heard of... yet.

You have another blog??? How do you find the time??? I am flat out just reading your particular brand of Insolence.

Keep up the good work. I have nothing to offer (from Australia) - never really looked into whether our systems is teaching this crap, I hope not!

OHSU Family Medicine residency program offers an Integrative Medicine Fellowship, I do believe.

One place not to use as a reference [unless you are looking for a quackademic primary source], particularly because it categorizes modern medicine as "allopathic" believe it or not, is Princeton Review's "Best 168 Medical Schools 2010" (ISBN 0375429573).

It contains all the AANMC ND granting schools' propaganda.

It says things like:

"[an ND] curriculum is structured to provide a solid scientific understanding of the body [the science-based] while never losing the philosophies inherent to naturopathic medicine [the science-ejected sectarian]."

-r.c.

Hi,

This new "Science" trend of prescribing mag "OIL" (There doesnt exist a lipid magneisum species) for every possible ailment just boils my blood!

http://www.puremagoil.com/

As a toxicologist I know for a fact that ions do not readily cross human skin, so why in earth would this expensive mag "oil" product "easily and completely" absorb through topical application?

*Please DO notice I AM NOT saying a prolonged bath in magnesium chloride or magnesium sulfate solution will not absorb.

Theres this clown behind all this magnesium miracle craze, called "Doctor" MArk Sircus, who in fact is an acupuncturist. He purportedly treats everything from cancer to chronic fatigue with magnesium "oil" and "Nascent" (another epithet that is heavily favored by quakery practitioners!) Iodine.

He is the "Director" of a quack "International Medical Veritas Association".

Please take the time to look at his webpage:
http://imva.info/index.php/about/director/

Hi,

This new "Science" trend of prescribing mag "OIL" (There doesnt exist a lipid magnesium species) to cure every possible ailment just boils my blood!

http://www.puremagoil.com/

As a toxicologist I know for a fact that ions do not readily cross human skin, so why in earth would this expensive mag "oil" product "easily and completely" absorb through topical application as their sales pitch webpage states?

*Please DO notice I AM NOT saying a prolonged bath in magnesium chloride or magnesium sulfate solution will not absorb.

Theres this clown behind all this magnesium miracle craze, called "Doctor" MArk Sircus, who in fact is an acupuncturist. He purportedly treats everything from cancer to chronic fatigue with magnesium "oil" and "Nascent" (another epithet that is heavily favored by quakery practitioners!) Iodine.

He is the "Director" of a quack "International Medical Veritas Association".

Please take the time to look at his webpage:
http://imva.info/index.php/about/director/

I was going through some of the previous Woo Aggregateor links and some of them are now disabled or gone. The UC Irvine and Thomas Jefferson University links are 404. Maybe inclusion on the list did some good.

http://uanews.org/node/26234

U of A is particularly woo-friendly.
http://integrativemedicine.arizona.edu/about/directors.html

Dr Andrew Weil runs that.

Orac,

Now I know you wanted to leave europe for others, but it seems that it's always bad news for you with quackademic woo, so I thought I'd give you a little encouragement from over the pond. I'm a third year med student at Cambridge, and we have a course called "preparing for patients"
One of the things we have to do is visit an alternative medicine practitioner, then do some research to see if any of their claims are justified. To paraphrase the course organiser "In my experience, they never are. People only ever fail this coursework by believing what is told to them too easily". And in 3 years, that's all the exposure that alt-med has got.

So, Africa anyone?

The Durban Institute of Technology in South AFrica offers wonderous courses in homeopathy, chiropractic and somatology.
I always wonder if they ever have a throwdown in the cafeteria over which one is the one-true-woo-to-rule-them-all!
http://www.dut.ac.za/site/default.asp

Guys, I said North America. The world is too big for me to try to cover it all. A man (or even a Plexiglass box full of blinking lights) has got to know his limitations.

I was going through some of the previous Woo Aggregateor links and some of them are now disabled or gone. The UC Irvine and Thomas Jefferson University links are 404. Maybe inclusion on the list did some good.

I'm working on that. Of course, all that means is that they may have a spiffy new website and the old link doesn't redirect. For instance, Thomas Jefferson University still has a Center of Integrative Medicine:

http://www.jeffersonhospital.org/departments-and-services/myrna-brind-c…

It even offers homeopathic bee venom:

http://www.jeffersonhospital.org/Tests-and-Treatments/homeopathic-bee-v…

@jen: drop it. You lose every time.

@Bill: Orac's other blog is written by his "friend" at Science-Based Medicine. Lots of good posts there, too. Check it out.

amygdala: that's great. I wonder how they manage to get the woo-providers to participate. Or do you visit undercover?

Tying into Steve's comment about BWH, Spaulding Rehabilitation Hospital regularly offers classes (which I believe grant CMEs for nursing) on reiki. The Massachusetts General Hospital and Partners HealthCare also recently established the Benson-Henry Mind-Body Institute. I'll take a closer look to see exactly what they offer and claim. Also, I believe MGH offers some acupuncture as an adjunct to cancer treatments.

Two things, Orac.

(a) This guest post at Science Based Medicine contains a list of schools involved in quackademic medicine, including one that is not there in the original list.

(b) In the original list of quackademic woo, there was a mention of the Albert Einstein College of Medicine (which was my institution in NY for 5 years) of the Yeshiva University. I followed that hyperlink, and found that it leads to the 'Continuum Center for Health and Healing' which has nothing to do with AECOM/YU. Rather, it is a part of the Department of Integrative Medicine of the Beth Israel Medical Center (I wish I had seen the original list sooner; this needs to be corrected immediately).

Also in Boston, Simmons College has on its faculty a proponent of Therapeutic Touch.

A listing of woo-oriented folks at Massachusetts General Hospital's Nursing Doctoral Forum can be found here amongst some who apparently don't embrace the woo.

The MGH page on endometriosis suggests some women benefit from such things as Traditional Chinese Medicine and homeopathy.

Massachusetts General Hospital for Children has a page on sleep in adolescents, listing therapies to aid sleep such as herbs, acupuncture, and homeopathy.

I think that will do for now.

Columbia's already on the list for their "Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine", and now they have "The Integrative Therapies Program for Children with Cancer" in the Division of Pediatric Oncology at Columbia University Medical Center, Morgan Stanley Children's Hospital of New York-Presbyterian (http://integrativetherapies.columbia.edu/).

They're also very proud of and public about Dr Mehmet Oz. (http://www.columbiasurgery.org/news/oz.html)

and...
Until 2008, Columbia used to be affiliated with the "Institute for Integrative Nutrition" (http://www.integrativenutrition.com/), whose list of "experts" includes Deepak Chopra.

What's next?

Why only the U.S. and Canada? What about things like:

http://www.cam-research-group.co.uk/

http://health.tvu.ac.uk/chi/cam/

Etc?

In your original list, there was a mention of the Albert Einstein College of Medicine (which was my institution in NY for 5 years) of the Yeshiva University. I followed that hyperlink, and found that it leads to the âContinuum Center for Health and Healingâ by a woman who has nothing to do with AECOM/YU. Rather, she is associated with the Department of Integrative Medicine of the Beth Israel Medical Center.

I'm afraid you are incorrect. Beth Israel is a major teaching hospital of AECOM/YU:

http://www.bethisraelgme.org

And AECOM lists the Health and Healing website as its integrative medicine website. For instance, look at this ad for an integrative medicine conference in 2012:

http://www.imconsortium.org/prod/groups/ahc/@pub/@ahc/@cahcim/documents…

And here:

http://www.imconsortium.org/members/home.html#NewYork

Albert Einstein is a sponsor of several of the integrative medicine programs at Beth Israel:

http://www.healthandhealingny.com/center/center_give.html
http://www.healthandhealingny.com/professionals/medical.html
http://www.healthandhealingny.com/center/images/staff_ehrlich.html

I stand by my previous post. I'm not sure what the exact relationship between AECOM and the Continuum Center is, but there is clearly an academic affiliation; AECOM lists Continuum as its "integrative medicine" center; and Beth Israel is a major university hospital for AECOM/YU.

So I was pretty annoyed when I found out that the only medical school that has accepted me so far (NYCOM) teaches cranial osteopathy. STUPID!! At least it'll be an easy class because I can just pretend I'm actually doing something. As if some of the claims of OMM weren't dubious enough, I have to learn that garbage. But I guess it would probably be offered at every osteopathic school, so I'm not sure it really qualifies for the list if you haven't already added them.

An update for the Wisconsin link from the old list:

http://www.uwhealth.org/alternative-medicine/programs/11433

McMaster University Medical Acupuncture Program

http://fhs.mcmaster.ca/acupuncture/

"In 1998, the first McMaster University accelerated training program in Contemporary Medical Acupuncture for Health Professionals was launched. Since then, over 500 professionals from ten different countries have already profited from these high quality programs"

I tried checking my own school, UC Davis, and to my wonderful surprise, they approach CAM with excellent taste.

UCD provides one class (seminar) covering complimentary and alternative medicine.
Description: In recent years a wide range of unconventional therapies has appeared on the public scene. These are offered as âalternativeâ or âcomplementaryâ to mainstream medicine. They include everything from herbal medicines, homeopathy, and aromatherapy to the use of acupuncture, therapeutic touch, prayer at a distance, faith healing, chelation therapy, and âmiraculousâ cancer cures. We will explore the claims of these alternative therapies, the proposed mechanisms by which they work, and using scientific methods and reasonable criteria, attempt to determine if there is credible support for their safety and efficacy.

There was also a continuing education convention in 2009 for physicians hosted by UCD which employed CAM for pain relief. It focused on integrating specific CAM practices with conventional medicine, in order to harness the placebo effect for pain (and chronic pain), addiction/recovery, and certain emotional problems. I like how they show that many CAM practices are nothing more than placebos; but as we all know, the placebo effect can be a very real and very powerful tool when it comes to pain control.

Once again, I can walk away being proud of my school. :)

University of Bridgeport: https://www.bridgeport.edu/pages/2002.asp

I took a nutrition course there a couple of years ago as a prerequisite for entrance into a MS program elsewhere. I was horrified by some of the stuff that was presented in class and at one point I ended up in an email battle with the professor which, in retrospect, I can see could have landed me right out of that class. To his credit, he kept our disagreements out of the grade book.

I see they offer a degree in acupuncture now. [eye roll]

Orac @22: Some clarifications on my part are in order. After reading your message, I dug a little deeper. The only connections of AECOM with the CAM stuff that I could find were these:

1) One elective course in Family Medicine (FM5) - Complementary Therapies and Alternative Healing - offered by the Department of Family and Social Medicine (DFSM) at the Montefiore Medical Center: Tthe course description for this elective course does not inspire confidence, I admit.

This elective will provide the student with an introduction to the philosophy of integrative medicine and a supervised exposure to complementary therapies and alternative healing methods in primary care settings (e.g. community health center and small practice). Among the therapies to be covered are meditation, relaxation techniques, acupuncture, acupressure, biofeedback, shiatsu massage, chiropractic, energy and herbal medicine.

However, the course is administered by the Montefiore Residency Program in Social Medicine (Bronx, NY) which includes Beth Israel Family medicine Residency program (Manhattan, NY), Jamaica Hospital Family Medicine Residency Program (Jamaica, Queens), and Bronx Lebanon Medical Center (Bronx, NY).

The link that the Beth Israel website mentions (that you pointed to in your reply) has the same reason behind it.

The medical school is affiliated with five hospital centers: (a) Montefiore Medical Center, The Academic Medical Center and University Hospital of the Albert Einstein College of Medicine; (b) Beth Israel Medical Center, the University Hospital and Manhattan Campus for the Albert Einstein College of Medicine; (c) North Shore-Long Island Jewish Health System, the Manhasset and New Hyde Park campuses of the Albert Einstein College of Medicine; (d) Jacobi Medical Center; and the (e) Bronx-Lebanon Hospital Center. It is also affiliated with three mental health facilities and four long-term care facilities.

The hospital-associated programs, such as residency, mostly run themselves, and are just loosely academically associated with AECOM - though many faculties have dual appointments.

The IM Consortium link (that you pointed to) is really link-whoring for the Beth Israel woo center; it is just operating under the banner of AECOM for increased credibility, which we know to be an SOP for CAM groups.

2) In the person of one Dr. Ben Kligler: Dr. Kligler is the Vice Chair of the Department of Integrative Medicine at Beth Israel Medical Center. He is also an Associate Professor of FSM at AECOM, the Research Director of the Continuum Center for Health and Healing, and the Co-Director of the Beth Israel Fellowship Program in Integrative Medicine. Dr. Kligler is deeply immersed in woo; he is:

the author of Curriculum in Complementary Therapies: A Guide for the Medical Educator, and co-editor of Integrative Medicine: Principles for Practice, a textbook published by McGraw-Hill in 2004. He is also Co-Editor-in-Chief of the peer-reviewed journal Explore: The Journal of Science and Healing. Dr. Kligler is certified in Ericksonian Hypnotherapy and acupuncture, and incorporates these and the use of botanical medicines into his primary care practice at the Center for Health and Healing.

3) In the person of one Medina Byars: She is a Program Assistant, Einstein Enrichment Program, Office of Diversity Enhancement of the AECOM.

In addition to Medinaâs AECOM career, she became an Emergency Medical Technician and Certified Natural Health Professional. Medina graduated from the school of Integrative Medicine in 1993, earning Board Certification in Holistic Health Counseling. In 1994 she went to Everglades University in pursuit of a Bachelor of Science in Alternative Medicine. Since 1988 Medina Byars has owned Visions of Health, a consulting service that provides a holistic approach to wellness.

4) In the body of a student group called 'Students for Integrative Medicine':

As you see, AECOM - the College of Medicine involved in graduate and medical education - is not directly associated with any of the woo stuff. But I do admit, perhaps the spreading of woo ought to be better regulated.

Sorry, Kausik. I realize you hate the idea that AECOM is in any way affiliated with woo, but you can't separate Beth Israel and AECOM that easily. Beth Israel may not be owned by AECOM, and it may run some of its own independent residencies, but the link between it and AECOM is more than just "link whoring" and the academic affiliation does not appear to be as loose as you would like it to be. For one thing, Beth Israel is a primary teaching hospital of AECOM, its Manhattan university hospital. Moreover, in concert with AECOM offers an academic integrative medicine fellowship run by Raymond Teets, MD and Ben Kliger, MD, MPH:

http://www.bifp-residency.org/clinicsitedocuments/ACADEMIC%20IM%20FELLO…

I think this shows that AECOM is directly associated with some of the woo stuff. It's lending its good name and faculty to a woo fellowship, at the very minimum.

I'm also going to disagree, because Ben Kliger is full faculty at AECOM, and his NCCAM-funded grant in woo is featured on the AECOM webpage:

http://www.einstein.yu.edu/home//enewsletter/EnewsSection.asp?id=22&s=r…

You yourself point out that he is Vice Chair of the Department of Integrative Medicine at Beth Israel Medical Center. He is also an Associate Professor of Family and Social Medicine at AECOM, the Research Director of the Continuum Center for Health and Healing, and the Co-Director of the Beth Israel Fellowship Program in Integrative Medicine.

I'm sorry, but AECOM can't be dissociated from the woo that cleanly or easily. The connection may not be as direct as many other medical schools, but it is fairly prominent. My link still stands, as far as I'm concerned, unless AECOM formally dissociates itself from the woo at Beth Israel.

It's really disappointing to see Jefferson offering this shit. They're one of the top hospitals in Philadelphia, or so I thought.

What's interesting is that its main competitor, Penn, at first blush appears to eschew most CAM offerings. If you search for "CAM" on their site, you at least get this pdf: http://penncancer.org/pdf/education/CAM.pdf. It's a bit more skeptical in tone then some other literature hospitals seem to offer, although the end of the doc states it got its info from NIH's CAM center.

Damn, I was hoping against hope for a 'say it ain't so' moment. But you are right, it does appear that AECOM, even if by association, does lend its name to certain woo-ey stuff.

I am ashamed. I am very fond of AECOM, my first postdoc institution, and Bronx, NY, which I have called home for five long years.

One does notice that many of these people actively propagating pseudoscientific nonsense are actually trained MDs, and one wonders where it all went wrong, why their training did not include critical thinking and analysis skills, why these trained physicians succumbed to the allure of handwaving, magical practices of uncertain provenance, and even less certain effects.

What is it that motivates them? Is it the easy money? The lack of accountability? The power over the lives of vulnerable people?

Surely, the satisfaction of successfully treating a patient to recovery with defined scientific approaches is much greater than just handing hapless patients some vacuous and lofty-sounding promises, or taking them through voodoo practices that even they must know doesn't really work?

I know, I am naive, ain't I?

so I see this... and I decide to surf a little locally at my institution and it's many websites.

First the good news...
THE GENERAL APPROACH to C-A-M medicine is educational and
doesnt seem to reflect a huge academic department of Woo...
http://www.urmc.rochester.edu/encyclopedia/content.cfm?pageid=P00185

actually states "TALK TO YOUR DOCTOR, none of this is proven effective" (okay I paraphrased a bit)
then the bad news...
searching for specifics...

I find DR SEEMA KHANEJA listed for ROCHESTER and ALTERNATIVE MEDICINE. with her own fuzzy warm webpages.... Kumbaya
http://www.integrative-homeopathy.org/bio.html

and then I find she has a current faculty appointment
http://www.urmc.rochester.edu/directory/showProviderPage.cfm?prov_id=58…

But then.....thru the miracle of YAHOO/Google.
I Find this DISAPPOINTING, almost scary endorsement of Pediatric WOOOOOO. Mentions DAN! therapy, and 'upcoming' article about autism, .... yada yada....

http://www.aap.org/sections/chim/SOCIM_Newsletter.pdf

and I was so used to trusting the AAP...
BUT THIS IS, in the words of Harpo Marx... DUCKFEATHERS...

Looks like I was giving Penn too much credit:
http://www.med.upenn.edu/progdev/compmed/education.shtml

#13 - I'm afraid that, like Thomas Jefferson University, the only thing that has changed at UCI is the web site. It is now:

http://www.sscim.uci.edu/

And while they talk about being evidence based on their home page, just follow some of the links and you'll turn up stuff like:

"Live Longer, Live Better" consolidates what the clinic provides â acupuncture treatments, tai chi classes and naturopathic therapy - into a single, individualized program. Designed for those who struggle with obesity, high blood pressure, elevated cholesterol counts and metabolic diseases like diabetes, it can also benefit people who are chronically stressed, are often fatigued or just don't feel well.

The woo truly runs deep, although I have to say I'm a little surprised facilities in the LA area aren't better represented. I though this was supposed to be the woo capital of the world.

I can find nothing about sCAM being offered at my alma mater UBC. I recall that a couple of years ago, you could take an elective in your final year, but I can't find any mention of it on the website. I can hope it was cancelled for lack of interest.

Thad
Holy Crap! That link shows a video, at least partially shot in the same building where many nursing classes are taught.I'm a second year. I had no idea they were in there.If I had I would have sought them out. I shall have to complain about this. I don't want to share space with this garbage. Tomorrow instead of studying for exams I may be re-evaluating the "evidence based practice" I thought I was learning.Woo is sooo pervasive.

The College of Medicine in the University of Saskatchewan (Saskatoon) has a Centre for Integrative Medicine, apparently established in 2002. It is officially called a "unit", not a department or division Here is a brief write-up about it from On Campus News:

http://www.usask.ca/communications/ocn/09-may-08/12.php

A bright spot quote from one of the interviewees: âThere is still all kinds of garbage that goes on in the alternative medicine worldâ.

I skimmed through their website:
http://www.usask.ca/medicine/integrativemedicine/

Fortunately did not see a reference to the Boss Hogg of Big Placebo (homeopathy). They seem to concentrate on nutrition, meditation, yoga and a lot of relatively innocuous things, but I did see a ref to Reiki, and there is a lot of touchy-feely stuff.

You may have set yourself a mega-huge task to update your list though, because if they are correct, these integrative medicine units seem to cropping up at pretty much every university in Canada and the U.S.

Kaiser Permanente in Portland, Oregon has an "Integrative Medicine Clinic" which consists of a single MD practicing Ayurveda (the Maharishi variety). Appointments are made in the same way and co-pays are the same as any other clinic service in the system. The phone number for the "clinic" is listed on the KP web page, right there between "Imaging (X-ray)/EEG" and "Interpretation Services."

This really bugs me. In an age when everyone in health care is struggling with a shortage of resources, here we are devoting space and administrative dollars to some of the most ridiculous woo on the planet. Worse, we're giving our patients the idea that this is valid medical practice. No wonder people are confused.

I took a closer look at the Benson Henry Institute for Mind-Body Medicine at MGH and it appears that they eschew the woo. From their "What is Mind Body Medicine?" page:

Although mind/body medicine is also commonly referred to as complementary medicine or integrative medicine, it should never be described as alternative medicine. Mind/body interventions are scientifically proven, and have the same foundation in traditional medicine as surgery and pharmaceuticals. Alternative medicine, conversely, does not have scientific validation. As long as alternative medicine lacks this proof, it will not be practiced at the Benson-Henry Institute.

The focus seems to be primarily on stress-reduction as it relates to other illnesses. They use a lot of relaxation techniques.

Here is the link for The Center for Integrative Medicine at University of Colorado Hospital

Also you have left off your list all 26 American College of Osteopathic Medicine. We are all required to learn Osteopathic Manipulative Medicine, including 'Osteopathy in the Cranial Field' and Chapman Points.

American Association of Colleges of Osteopathic Medicine

⢠A.T. Still University of Health Sciences Kirksville College of Osteopathic Medicine
⢠A.T. Still University of Health Sciences School of Osteopathic Medicine in Arizona
⢠Arizona College of Osteopathic Medicine of Midwestern University
⢠Chicago College of Osteopathic Medicine of Midwestern University
⢠Des Moines University College of Osteopathic Medicine
⢠Georgia Campus Philadelphia College of Osteopathic Medicine
⢠Kansas City University of Medicine and Biosciences College of Osteopathic Medicine
⢠Lake Erie College of Osteopathic Medicine
⢠Lake Erie College of Osteopathic Medicine Bradenton Campus
⢠Lincoln Memorial University DeBusk College of Osteopathic Medicine
⢠Michigan State University College of Osteopathic Medicin
⢠Nova Southeastern University College of Osteopathic Medicine
⢠New York College of Osteopathic Medicine of New York Institute of Technology
⢠Oklahoma State University Center for Health Sciences College of Osteopathic Medicine
⢠Ohio University College of Osteopathic Medicine
⢠Pacific Northwest University of Health Sciences College of Osteopathic Medicine
⢠Philadelphia College of Osteopathic Medicine
⢠Pikeville College School of Osteopathic Medicine
⢠Rocky Vista University College of Osteopathic Medicine
⢠Touro College of Osteopathic Medicine - New York
⢠Touro University - California
⢠Touro University College of Osteopathic Medicine
⢠Touro University - Nevada
⢠Touro University Nevada College of Osteopathic Medicine
⢠University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine
⢠University of New England College of Osteopathic Medicine
⢠University of North Texas Health Science Center at Fort Worth Texas College of Osteopathic Medicine
⢠Edward Via College of Osteopathic Medicine - Carolinas Campus
⢠Edward Via College of Osteopathic Medicine - Virginia Campus
⢠Western University of Health Sciences College of Osteopathic Medicine of the Pacific
⢠West Virginia School of Osteopathic Medicine
⢠William Carey University College of Osteopathic Medicine

Northeaster University's undergrad program in pharmacy includes the following course:

PAH 1405 Alternative Medicine 4 QH
Presents an objective discussion of the alternative medical methods. Emphasizes theory of alternative methods, principles of treatment, and the effects of alternative methods. Discusses the complete theory of homeopathy and Chinese medicine and the possible physiological and biochemical explanations of the beneficial effects of alternative methods.

The Nursing courses seemed relatively clean of woo. At least no specific references were listed in the course descriptions.

I feel like a bit of a traitor, but the University of Calgary appears to have a CAM connection, though it looks like research rather than promotion? Sorry I can't give you a link, but there was an article about a Dr. Badri Rickhi here getting the Dr. Rogers Prize for Excellence in CAM for 2009.

Now, Harry...there's no need to discount all of OMM just because some crazies think it is useful for more than muscular skeletal problems (which it treats very well. I'm still trying to figure out how to do it on myself). But I agree that cranio-sacral is a joke. I also never bought into the idea that problems with my internal organs were reflected in my muscles. Though adjusting my 4th rib always made it easier to breathe. I wish they would all do away with the crap and focus on tx's that at least make some rational sense.

Willow, you do realize you're replying on threads nearly half a year old, right?