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Paths of Civilization

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[X][Main] Build Iron Mine
[X][Secondary] Study Health
[X][Secondary] War Mission - Northern Nomads
[X] Change Policy - Offense
 
10ebbor10 said:
No, it isn't.

I don't want to have a long derailing discussion here, so I'll answer this only once.

A systematic review of systematic reviews has found that it does not work for pain relief. The indications that it works sometimes are statistical artefacts. If you do sufficidnt studies, you will get false positives. Systematic review allows you to avoid those, and only get reproducable effects.

The conclusion from those is simple : No effect.

All of Accupuncture's supposed benefits can be attributed to the fact that patients are getting attention, not the treatment itself.

http://www.dcscience.net/Ernst-2011-AcupunctAlleviatePainRiskReview.pdf
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A placebo isn't a terrible thing to have for pain relief - as a purely mental effect, it basically does have the intended effect. Also, if Academia Nut thinks acupuncture works, then as far as the quest is concerned it works.

10ebbor10 said:
Placebo is dangerous, especially with our observance trait. Placebo will entrench itself, preventing the development of stuff that actually works.
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It's explicitly only being used for pain relief though.

veekie said:
Actually no. War missions stack. We're facing an even larger horde. A secondary alone won't be enough but:

Symphony
All have their part to play in this world, be it their interaction with each other or with the spirits. When all the parts of a group are moving in accord, the result is greater than the sum of the parts.
Pros: Bonus to collective action, spiritually and ecologically harmonious actions, and to concerted efforts
Cons: Disharmony is to be corrected, require casus belli to declare war

Based on the Megaproject, if the King and Provinces take the same action, we get a free Main action added.
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Oh wow, forgot about Symphony. Changing back to War Mission.

[X][Main] Build Iron Mine
[X][Secondary] Study Health
[X][Secondary] War Mission - Northern Nomads
[X] Change Policy - Offense
 
Tally? Tally.

Vote Tally : Paths of Civilization | Page 1480 | Sufficient Velocity
##### NetTally 1.9.0
[30] Change Policy - Offense
[4] Change Policy - Defense
——————————————————————————————————————————————Task: Main
[33][Main] Build Iron Mine
[5][Main] Proclaim Glory
——————————————————————————————————————————————Task: Secondary
[34][Secondary] Study Health
[25][Secondary] War Mission - Northern Nomads
[4][Secondary] Expand Economy
[2][Secondary] Proclaim Glory
[1][Secondary] Black Soil
[1][Secondary] Improve Annual Festival
[1][Secondary] Build Iron Mine
[1][Secondary] Build Iron Mine x2
[1][Secondary] Expand Boats
[1][Secondary] Proclaim Glory x2
[1][Secondary] Salt Gift
[1][Secondary] Salt Gift x2

Total No. of Voters: 38

Color me a bit surprised.
 
Candesce said:
Placebo actually works, as your own cite demonstrates.
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Which would be nice if we discovered and understood the placebo effect, but we don't.

Now our doctors will waste time trying to improve accupuncture, not knowing that they're stuck on a dead end because the accupuncture doesn't work and never will. And they will attempt to improve it, because everyone is voting for getting them to improve it.

Besides, it's not like it's new. We had doctors before, and they had placebo and real stuff too. So we didn't gain anything by inventing a new placebo, as it's not a new idea. We had a collection of real working medicine and placebo, and now we added more placebo to it.

So, if anything, we made everything worse

Umi-san said:
...?
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Humans are weird.

http://www.npr.org/sections/health-...cebo-when-it-works-and-you-know-its-a-placebo
 
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10ebbor10 said:
Placebo is dangerous, especially with our observance trait. Placebo will entrench itself, preventing the development of stuff that actually works.
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Getting orthopractic cruft that stands in the way of doing things better is a big downside of Observance, I agree with that. In this case I hope that we will have evolved Observance to reduce that downside before that happens.
Still placebo treatment > no treatment >>> actively harmful treatment.
 
Candesce said:
Placebo actually works, as your own cite demonstrates.
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Yeah, like the update itself says very clearly:
Academia Nut said:
The application of pressure, thin needles, or hot stones to the right places in the right combinations helps alter the flow of spiritual energy, which can be used to help calm the spirit and heal the body when done correctly. Add in the right herbal and aromatic treatments and great things can be achieved. I can't cure broken bones with my methods, but I can manage the pain so that the patient remains calmer and minimizes agitating the damage while it heals," Hygurtyn explained.
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1) On it's own, it 'calms the spirit'. In modern language, it provides psychological relief.
2) It reduces pain reliably enough that patients don't screw up their injuries more by their reaction to the pain.
3) It exists as a supplement to drug treatment, and is not used independently unless the problem is entirely rooted in psychological or untreatable pain. i.e. it works on cramps because what you need to do is sooth the symptoms so that you stop causing the actual problem.

This is actually better than opiates for minor pain relief, since it's not habit forming, nor judgment impairing, and thus suitable for chiefs and clerks dealing with.
It's well...cheap aside from shaman/carrion eater time allocation, so suitable for chronic pain.

"Safe" painkillers don't really exist until the modern era at least. And then we built a better idiot and people manage to overdose anyway.
 
10ebbor10 said:
Which woukd be nice if we discovered and understood the placebo effect, but we don't.

Now our doctors will waste time trying to improve accupuncture, not knowing that they're stuck on a dead end.

Besides, it's not like it's new. We had doctors before, and they had placebo and real stuff too. So we didn't gain anything by inventing a placebo, as it's not a new idea. We had a collection of real working medicine and placebo, and now we added more placebo to it.

So, if anything, we made everything worse



Humans are weird.

Does a placebo work if you know it's a placebo?
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We did not have doctors before... at least not for mental illness. We considered it a blessing or curse of the spirits that would either be ignored, stigmatized or at best haphazardly treated by the local shaman. We now have a dedicated, centrally placed institution with the backing of the martial elite which is accumulating a body of lore on the matter over the generations.
 
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[X] [Main] Build Iron Mine
[X] [Secondary] War Mission - Northern Nomads
[X] [Secondary] Study Health
[X] Change Policy - Offense
 
[X][Main] Build Iron Mine
[X][Secondary] Study Health
[X][Secondary] War Mission - Northern Nomads
[X] Change Policy - Offense
 
DragonParadox said:
We did not have doctors before... at least not for mental illness
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Actually, we do. They attempted primitive brain surgery, which is how we ended up with the madman in the first place.

DragonParadox said:
. We now have a dedicated, centrally placed institution with the backing of the martial elite which is accumulating a body of lore on the matter over the generations
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That is a benefit, but we don't need accupuncture to have an asylum.

And all the talk about placebo is irrelevant, because our doctors were not twiddling their thumbs before placebo was invented. They were doing other stuff, likely involving more placebo or primitive meducine.

Thus, because one can not add more hours in the day, the lengthy accupuncture therapies must be displacing other therapies, some of which might have actually done something real. The rest would have been equally good placebo.
 
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[X] [Main] Build Iron Mine
[X] [Secondary] Study Health
[X] [Secondary] War Mission - Northern Nomads
[X] Change Policy - Offense

I have been convinced that this plan is the best so far. I still worry that having the Iron mind turn dose not mean that it will be happen before the mid turn battle and we might not even make enough in time for all our heroes and elites to be equipped and be skilled at using them. The rewards out weigh the short term risks in the way I see it.
 
none of this matters

[X][Main] Build Iron Mine
[X][Secondary] Study Health
[X][Secondary] War Mission - Northern Nomads
[X] Change Policy - Offense
 
DragonParadox said:
True, but we are in the copper age. Some false starts and dead-ends are to be expected. It's certainly not a debilitating belief since it is not actively stooping other avenues of study. To put it another way its no worse than chanting prayers over the sick, which I'm sure our shamans do.
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It's not a delibating belief yet, but everyone here is voting to further study, further intrench the accupuncture.
 
[X][Main] Build Iron Mine
[X][Secondary] Study Health
[X][Secondary] War Mission - Northern Nomads
[X] Change Policy - Offense

Honestly acupuncture is not a debabtiling belief and is a good first step onto the path of finding pain relief. It may be a minor effect compared to Tylenol and Advill but it still helps and is a boon for us right now.
 
10ebbor10 said:
That is a benefit, but we don't need accupuncture to have an asylum.
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Actually, consider that Acupuncture is already on the tech list. It has already been adopted. Asylum/Sanatoriums/Hospitals do not appear on either tech list or projects list.

Therefore, Study Health is likely to copy the healthcare facility and propagate it. Acupuncture needs no assistance.
And all the talk about placebo is irrelevant, because our doctors were not twiddling their thumbs before placebo was invented. They were doing other stuff, likely involving more placebo or primitive meducine.

Thus, because one can not add more hours in the day, the lengthy accupuncture therapies must be displacing other therapies, some of which might have actually done something real. The rest would have been equally good placebo.
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False assertion.
Accupuncture requires about 5-10 minutes for the healer to set the needles, then going off to do other things before coming back in half an hour to take the needles out.

Secondly, we did not have a safe and reliable placebo before. Treatments listed were:
-Trepanation - Potentially makes things far worse. Risk of infection. Risk of doing nothing even if performed correctly. Only good for relieving concussion induced pressure buildup.

-Ingested unspecified herbs - Potentially makes things worse, potentially makes things better. Definite risks from drug interactions or poisonous plants.

-Brewed unspecified herbs - Potentially makes things worse, potentially makes things better. Definite risks from drug interactions or poisonous plants.

-Burnt unspecified herbs - Potentially makes things worse, potentially makes things better. Definite risks from drug interactions or poisonous plants.

-Prayer/chants/music - Oddly enough I don't notice this being used at any point. We seem to be using the soothing sounds of mini waterfalls as the closest thing. Generally unreliable placebo.

-Acupuncture/pressure/heat - Cannot make things worse. Some risk of needle induced infection...well if we weren't using the antibacterial copper needles and boiling water to disinfect them due to Sacred Warding techniques. Generally reliable placebo.

-Therapeutic dialogue - Used for the psychologically ill, where the shamans try communicate with them so they can try to understand the problem. Ineffective for pain, but effective on untangling psychological trauma.

-Exorcisms - Mentioned. Process unknown.

Being able to reliably do no harm to your patients while helping them with minor woes is rather important.
 
Duesal said:
I think we should take advantage of these. ESPECIALLY the free action to change policy. Defense is critical.

Academia Nut said: ↑
Special: Studying Health this turn may produce special results
Special: Changing Policy of Defence or Offence does not cost an action this turn​
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Just a question, but where did you see that health special effect? I cant find it anywhere in the turn.
 
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