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Back pain costing UK one million lost years as GPs accused of signing patients off work too
easily
Henry Bodkin
21 MARCH 2018 • 5:00PM
Back pain is costing the UK one million years of lost productivity each year in part because GPs are signing
patients off work too easily, a major new study has found.
Medical leaders have condemned the “unconscionable” readiness of doctors to prescribe rest, painkillers and to
order intrusive tests when many patients should instead be advised to keep active.
The findings are published in a series of Lancet studies which names lower back pain as the leading cause of
disability in the world.
The global burden of disability it causes has risen by more than 50 per cent since 1990, the research found.
Most cases of lower back pain respond to simple physical and psychological therapies aimed at keeping people
active and able to stay in work.
However, medics routinely ignore their own guidelines and order surgery or scans instead of giving education
and advice, according to the research.
“Millions of people across the world are getting the wrong care for low back pain,” said lead author Professor
Jan Hartvigsen, from the University of Southern Denmark.
“Funders should pay only for high-value care - stop funding ineffective or harmful tests and treatments and,
importantly, intensify research into prevention, better tests and better treatments.”
UK figures show lower back pain accounts for 11 per cent of the entire disability burden from all disease,
costing the country more than £10.7 billion a year.
On Wednesday the Chartered Society of Physiotherapy said the new research should prompt “serious reflection”
among clinicians to improve the care of back pain patients.
‘That so many people start out with minor back pain and go on to suffer life-changing consequences is bad
enough; that healthcare professionals contribute to that journey is unconscionable,” said Steve Tolan, head of
practice at the organisation.
“It is absolutely essential that we cut through the noise with these messages and it is to be hoped that today’s
publication leads to a tangible difference in the way back pain is both talked about and treated.”
The Global Burden of Disease study (2017) found that low back pain is the leading cause of disability in almost
all high-income countries as well as central Europe, eastern Europe, North Africa and the Middle East, and parts
of Latin America.
Every year, a total of one million years of productive life is lost in the UK because of disability from low back
pain, three million in the USA and 300,000 in Australia
Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said family doctors were “mindful” of
clinical guidelines which “advocate an approach that combines physical, psychological and pharmacological
treatments”.
Merkel speaks out against Turkey and Russia in assertive speech on her return to parliament
Aweakened Angela Merkel sought to reclaim her place on the world stage on Wednesday as she spoke out
against Russian and Turkish aggression and warned President Donald Trump against protectionism.
Mrs Merkel tried to put damaging election losses and months of difficult coalition negotiations behind her as
she set out her new government’s programme to the German parliament.
She defended her controversial refugee policy and said it was time for Germany and Europe to do more to solve
the crisis “on the EU’s doorstep” in Syria.
“We have been too half-hearted for too long,” she said, as she spoke out against “the gruesome acts of the Assad
regime in eastern Ghouta while Russia looks on”.
She condemned the Turkish military offensive in Syria “in the strongest possible terms”, adding: “For all
Turkey's legitimate security interests, what has happened in Afrin, where thousands and thousands of civilians
are persecuted, killed or forced to flee, is unacceptable. This too we condemn in the strongest terms.”
On the poisoning of Sergei Skripal and his daughter in Salisbury, she said: “I wish I did not have to name
Russia today, but we cannot ignore the evidence”.
Germany “stands side by side with Britain” over the poisoning, she said, but she had a harsher message on
Brexit. “The relationship with Britain will not be as close as it is today after Brexit,” she said. “That's why we
need a detailed trade deal with Britain.”
She had tough words too for Mr Trump., threatening an EU trade war if the US presses ahead with plans to
impose protectionist tariffs on European imports. “We will talk intensively with the US, but if necessary we are
also ready for unmistakable countermeasures,” she said.
She made a passionate defence of the EU. In future no single European country will account for more than 1 per
cent of the world’s population, she said. “Our future lies in a united Europe,” she said. “Only together can we
achieve lasting peace and prosperity.”
It was a defiant performance from a German chancellor many are writing off as irretrievably damaged by her
election losses and the months of difficulty in forming a new government, and in her waning years of power.
She did not avoid mention of her “open-door” refugee policy, as she often did on last year’s campaign trail.
Instead she made it the centrepiece of her speech, insisting she had acted to avert a humanitarian crisis.
“The vast majority of the people who came to us couldn't help the fact that the international community had
abandoned them. We took them in as a humanitarian gesture. But it can never be allowed to happen again,” she
said.
“It was an incredible test of our country. None of our structures were properly prepared for this task, yet we
largely accomplished it.”
She accepted mistakes had been made, but insisted they were in allowing the Syrian refugee crisis to spiral out
of control before her 2015 decision to open Germany’s borders.
She waded into the row over the role of Islam in German society, and slapped down her new interior minister,
Horst Seehofer, who claimed last week that “Islam does not belong in Germany”.
“There is no doubt the history of our country is Christian and Jewish, but it also true that Islam has now become
a part of Germany,” she said as Mr Seehofer looked on.
She acknowledged her losses in last year’s elections and the difficult negotiations to form a new coalition,
describing them as a sign “something has changed in our country”.
“I want to do everything to ensure that at the end of this legislature people say: in Berlin they learned from the
election results of September 2017,” she said.
For the first time it fell to the nationalist Alternative for Germany party (AfD) to respond as the main opposition
in parliament.
Alexander Gauland, the AfD leader, accused Mrs Merkel of lacking empathy and vision.”There is no obligation
to diversity and colorfulness,” he said. “There is no obligation to share your own country with strangers."
Researcher at centre of Cambridge Analytica scandal: Facebook made me a scapegoat
The Facebook data scandal deepened today as a Cambridge academic who harvested 30 million people’s
private details from the site said “tens of thousands” of other apps had done the same thing.
Aleksandr Kogan, a psychologist, claimed he had been made a “scapegoat” in a row that has caused the social
media giant’s stocks to tumble by tens of millions of pounds.
Dr Kogan said he had not known that the personal information he obtained from Facebook users by paying
them to take a “personality test” might be used for micro-targeting people in election campaigns.
He told the BBC: “My view is that I’m being basically used as a scapegoat by both Facebook and Cambridge
Analytica.
"Honestly we thought we were acting perfectly appropriately, we thought we were doing something that was
really normal.”
He blamed any rule-breaking on Cambridge Analytica (CA), the firm at the centre of claims that it used
Facebook data to help secure the election of Donald Trump as US president and the Brexit victory in the
2016 referendum.
“We were assured by Cambridge Analytica that everything was perfectly legal and within the terms of service,”
he said.
Dr Kogan said the company, which is based in Oxford Street, assured him that social media platforms were rife
with similar activities designed to get hold of people’s data.
“It was communicated to me that thousands, maybe tens of thousands, of apps were doing the exact same thing
and that this was a normal usage of Facebook data,” he claimed.
Dr Kogan told the BBC he was unpaid but that CA paid up to £570,000 to cover the costs of obtaining the data
from Facebook users.
Alexander Nix, CA’s chief executive, was suspended last night after appearing to admit to an undercover
reporter that the company could entrap politicians. CA said Mr Nix’s comments, recorded by Channel 4 News,
“do not represent the values or operations of the firm”.
Today it was alleged that CA’s parent company, SCL, set up a Caribbean politician by offering him a bribe and
then putting a video online of him accepting the deal. Several wealthy people have invested in SCL, including
the former Tory treasurer Lord Marland. He was named as a shareholder in its annual return in 2006. His office
today said he no longer owns any shares.
The Information Commissioner, Elizabeth Denham, is waiting for a warrant to examine computers at CA’s
offices. Conservative MP Stephen Hammond, a leading Remain campaigner in the EU referendum, called for a
full inquiry into how data may have been used to sway the result. “The lack of transparency about who has what
data and how they manipulate it is concerning and should be checked,” he added.
Whistleblower Christopher Wylie, who worked with CA, has alleged that it mined Facebook data from tens of
million of people to create profiles of users, matched to names and addresses, that could be used for micro-
targeting. Data was obtained through a personality quiz, This is Your Digital Life, which sucked up the personal
details of about 270,000 people who took it, plus data belonging to their Facebook friends.
Dr Kogan said he found it “horrible” that his data may have helped get Mr Trump elected. The data he obtained
came from 30 million Americans. He said: “My motivation was to get a dataset I could do research on; I have
never profited from this in any way personally.”
Contradicting CA’s assertion that he approached it, Dr Kogan said: “What happened was they approached me.
In terms of the usage of Facebook data, they wrote the terms of service for the app, they provided the legal
advice that this was all appropriate.”
Dr Kogan said he would be prepared to appear before Parliament or the US Congress to give his version of
events.
Facebook shares fell 2.56 per cent yesterday. Early indications suggest another fall when New York opens for
business later. The social media giant, which was founded in 2004, is valued by the US stock market at $488
billion.
Facebook has tightened up security since the personality quiz was launched in 2014 so that the data belonging
to users’ friends is no longer obtainable. It said its policies were violated by the app used to remove the data and
it that had been assured that any information would not be passed on for commercial purposes.
The company’s woes deepened when the co-founder of WhatsApp, Brian Acton, appeared to add his voice to
critics. Mr Acton, who sold the messaging app to Facebook for about £11.4 billion in 2014, tweeted: “It is time”
with the #deletefacebook hashtag.
Mark Zuckerberg, the founder of Facebook, has been asked to come before a committee of MPs to explain its
data protection procedures. Damian Collins, chairman of the Commons digital, culture, media and sport
Committee, wrote to him yesterday requesting that the firm explain the “catastrophic” failure.
Facebook said it had made “significant improvements” in its ability to detect and prevent apps that obtain data
from users over the past five years.
In addition, users now have better privacy settings which can be set to stop data being obtained.
A spokesman said: “Now all apps requesting detailed user information go through our App Review process,
which requires developers to justify the data they’re looking to collect and how they’re going to use it – before
they’re allowed to even ask people for it.
“Before you decide to use an app, you can review the permissions the developer is requesting and choose which
information to share. You can manage or revoke those permissions at any time.”
A variety of manual and automated checks were used to ensure apps comply with Facebook policies, including
spotchecks of older apps and monitoring of newer ones.
Enforcement measures included working with developers to stop problems, suspending abusers and pursuing
litigation.
Cambridge Analytica LLC[1][3] (CA) is a privately held company that combines data mining, data brokerage,
and data analysis with strategic communication for the electoral process.[7] It was created in 2013 as an offshoot
of its British parent company SCL Group to participate in American politics.[8] In 2014, CA was involved in 44
US political races.[9] The company is partly owned by the family of Robert Mercer, an American hedge-fund
manager who supports many politically conservative causes.[8][10] The firm maintains offices in London, New
York City, and Washington, D.C.[11]
In 2015, it became known as the data analysis company working initially for Ted Cruz's presidential campaign.
[10]
In 2016, after Cruz's campaign had faltered, CA worked for Donald Trump's presidential campaign,[12] and on
the Leave.EU-campaign for the United Kingdom's withdrawal from the European Union. CA's role in those
campaigns has been controversial and is the subject of ongoing criminal investigations in both countries.[13][14]
[15]
Political scientists dispute CA's claims about the effectiveness of its methods of targeting voters.[16]
On March 17, 2018, The New York Times and The Observer reported on Cambridge Analytica's use of personal
information acquired from Facebook, without permission, by an external researcher who claimed to be
collecting it for academic purposes. In response, Facebook banned Cambridge Analytica from advertising on its
platform.[17][18] The Guardian further reported that Facebook had known about this security breach for two years,
but did nothing to protect its users.[19]
A series of undercover investigative videos released in March 2018, showed Cambridge Analytica's Chief
Executive Officer boasting about using prostitutes, bribery sting and "honey traps" to discredit politicians whom
it conducts opposition research on. Nix also claimed that the company "ran all of (Donald Trump's) digital
campaign", including possible illegal activities. The Information Commissioner of the UK has asked for a
warrant to search the company's servers.[20][21]