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Of the one million It was in 1927 that Sister Hunt succumbed to disabled who are now registered in Great Britain 250 mg meldonium otc, the stimulation of Robert Jones and agreed that a high proportion have been trained to take their the problem was not yet solved order 500mg meldonium with visa. It was not enough place in the open labor market and have proved to search out cripples and arrange hospital and themselves to be no less efficient than their able- after-care treatment. Those few whose disabilities be taught not only the joys of normal recreation were so grave that they could not have been but also the responsibilities of normal work. A expected to compete in the open market have retraining scheme was necessary. She wrote: “I been engaged in the sheltered factories of the collected four boys, already training in the boot Disabled Persons’ Corporation, the trade name of and blacksmith’s shops, and two girls from which is “Remploy. Loyes’ College for informed them that they were ‘The Shropshire Training and Rehabilitation of the Disabled, Orthopedic Training School for Cripples. As this was more than Crafts’ School, Chailey; the Lord Roberts’ I could tell them the meeting adjourned. Institute for the Deaf; and the Duchess of Port- “Before you could say ‘knife’we had one hundred land’s Training College for the Disabled, Not- and fifty names on the waiting list: and not even tingham. Where were they to be realize, when they were appointed solemnly as a housed and fed? How would the hospital forerunners of a great reform in resettlement of committee take this new venture? With Miss Sankey, who is well remembered Cross in 1918, and was created a Dame of the as a superb after-care superintendent, Miss Hunt British Empire in 1926—the highest honor that moved into the Derwen, which was to become the can be awarded to any woman in this country— Cripples’ Training College. There was an early was responsible for important advances in pre- stage when, after being granted £50 by the com- ventive treatment, the creation of an orthopedic mittee, “we also annexed some unconsidered hospital, the organization of an after-care system, trifles from the hospital. Shortly before she died, she asked and wrote: “Ten shillings for leather and two days herself to name the essential qualities of a nurse of man’s time at three pounds ten shillings a week and replied: “Common sense, gentleness, kindli- plus 5 per cent profit equals—? Eventually I put ness, and the power of giving hope and joy to x which I had been told meant an unknown quan- those who are suffering. He cures most in whom William was diligent as a boy, and at the age most are confident”? Most were confident in of 14 went with a bursary to Glasgow University, Agnes Hunt. Afterwards he spent enjoy life despite disability; at the age of 81 she a short time in Edinburgh, and finished his died as she had always been—cheerful, brave, medical training at St. Later he started a school of anatomy in rather than by precept, and the decision of history Covent Garden, which soon acquired consider- may well be that the greatest of all her contribu- able reputation by reason of the facilities he tions was her own life. In 1770 he transferred the school to Great Windmill Street, where a building had been Reference erected with lecture theater, dissecting rooms, and museum. He had already been elected physi- The quotations in this appreciation are from This is my cian–accoucheur at the Middlesex Hospital and Life by Agnes Hunt (Blackie & Sons, Ltd. Rhaiadr Jones anatomy, and he lectured upon it to the end of his for access to many unpublished documents. He was elected a Fellow of the Royal Society, to whose transactions he contributed a paper “On the Structure and Diseases of Articulating Cartilages. In early life he had none of the studious habits of his elder brothers, both of whom went to a university, one studying medi- cine and the other law. Being the youngest, and favored by his mother, John was somewhat undis- ciplined. He was averse to schooling of any kind but gave early evidence of the thread of his pecu- liar genius when he rambled in the woods, watched ants, bees, birds, and tadpoles, and pestered country folk with simple questions on natural history. Until the age of 20 his mind remained fallow and untroubled, but on the verge of manhood he woke from slumber and for the next 45 years worked so prodigiously in the pro- duction and study of scientific material in medi- cine and biology that the like of him has not been seen again. He soon acquired such 1728–1793 patience and skill as a dissector, and such knowl- edge of anatomy, that within 12 months he was John Hunter was born on February 13, 1728, at appointed demonstrator. He studied surgery under Long Calderwood, a small estate in Lanarkshire Cheselden, and afterwards under Pott, the two about 7 miles from Glasgow. Later he enrolled as a name was also John, was one of the Hunters of pupil at St.

The restricted response form sets boundaries on the answer required and on its organisation order meldonium 500mg fast delivery. An advantage of the more restricted format is that it can decrease the scoring problems (and hence be more reliable) cheap meldonium 250 mg without prescription. If you intend to set and mark essay questions in an examination, then we suggest that you keep in mind the points in Figure 8. For essays, or other written assignments required during a course of study, you should take steps to improve the quality of feedback to students. Not only can such an attachment provide very useful individual feedback, but used early in a course with a model answer, it can show students the standards you expect fromthem, and also help you in awarding marks. SHORT-ANSWER AND SIMPLE COMPUTATION QUESTIONS Short-answer tests have been surprisingly little used in recent years, yet another casualty of the multiple-choice boom. However, we have found them increasingly useful as our concerns about the limitations of the objective type tests have become more apparent. Though easy to mark, it is essential that markers are provided with a well constructed marking key, especially if more than one correct answer is possible, or if several processes are involved in answering the question (See Figure8. Obviously more short-answer questions than essays can be fitted into a fixed time period. If one of the purposes of the assessment is to cover a wide content area, then short- answer questions have distinct advantages. Much of the same may be said about multiple-choice questions but short-answer questions have the advantage of avoiding cueing and requiring students to supply an answer, rather than to select or to guess from a fixed number of options. The major limitation of the short-answer test is that it is not suitable for testing complex learning outcomes. If you wish to employ short-answer questions you should take account of the point in Figure 8. STRUCTURED TESTS Broadly speaking there are two types of structured tests which are used in medical education – patient management problems (PMPs) and modified essay questions (MEQs). Patient management problems PMPs aim to represent, with varying degrees of fidelity, an interaction with a patient incorporating various amounts of data gathering, diagnosis and management. Written formats, using many ingenious technical devices, were quite widely used at one stage particularly in postgraduate education. However, difficulties with developing valid scoring systems have led to a marked reduction in their use and it seems unlikely that many medical school teachers will be called on to develop them. On the other hand the use of computer-based PMPs is a rapidly expanding field particularly in North America where they are increasingly being used in national certifying examinations. The levels of expertise required to construct these sophisticated simulations are beyond those expected of the average medical teacher so will not be considered further in this book. However, we strongly recommend looking at examples of such PMPs which are available on the Web, and consider incorporating them into teaching programmes. Modified essay questions This test was initially developed for the Royal College of General Practitioners in London. The term essay is perhaps a little misleading because the format more closely resembles a series of short-answer questions than an essay. The student is provided with a limited amount of patient data and then asked to write a brief answer to a question. Such questions may relate to history taking, examination findings, diagnosis, investigations and so on. Following one or more initial questions, further information may be provided and additional questions posed. The precautions to be taken in marking are the same as those described for marking short-answer questions. MEQs are very popular with students, particularly when used in formative assessment. Marked papers can be returned or the students can be given the model answer and mark their own.

Two canes offer better stability for the persistent imbalance that sends me veering erratically purchase meldonium 250mg with mastercard. Neither Reed nor I recall exactly how I de- cided to get the motorized scooter over a dozen years ago meldonium 250 mg. Maybe John first suggested it, but eventually it just seemed the logical thing to do. Initially, I opposed the idea, making all the usual arguments (chapter 12). Only sev- eral years later did I find out that when I got the scooter, my work col- leagues were frightened, thinking my health was deteriorating. Because I never talked about it, they could not know that nothing was further from Preface / xxi the truth. My physical functioning was unchanged, just my mind and world had finally opened up. Here, I was lucky too—the old adage that when one door closes, another opens up. I spent six years at Boston University, then moved to Beth Israel Hospital (now Beth Israel Deaconess Medical Center) at Har- vard Medical School, conducting research oriented toward health policy is- sues, particularly improving quality of care. Reed, an aca- demic hematologist and oncologist, does the physical chores around our house—the grocery shopping, the laundry, the lawn, the gardening, the kitty litter—and I work, sitting, writing (I still cook a little, although he appropriately distrusts me with knives). Reed’s help allows me to concen- trate on my work, at some cost to his own career. Although time restored my spirit lost in the gray hazes of diagnosis and medical school, my sub- conscious mind remembers my walking past: I still awake occasionally from dreams of running. Uncertainty about the future, John’s early warn- ing, is now part of my life’s fabric. And that is why, after all these years, MS is not a trouble, just the landscape I live in. In large measure, my equanimity came with restored mobility—I now go where I want to go in my scooter-wheelchair. This freedom is delicious after years of slowly inching forward, constantly afraid of falling and ex- hausted with effort. Nowadays, I sometimes grin with the sheer joy of in- dependent movement. On beautiful days, I can track the sun or shadows almost as I used to—a wonderfully freeing feeling, like spring after a housebound winter. For instance, I could have spared my caring col- leagues their fears about my health if I had told them why I had bought the scooter and how it thrilled me. Silence reinforces the stigmatization of dis- abling conditions, the sense that becoming less able to walk is something to hide—although, of course, we can’t. In my wheelchair I conduct a sort of “rolling focus group,” attracting unsolicited questions from strangers, remarks about themselves or their relatives and their difficulties walking. They describe bad knees, bad backs, heart and lung problems, and many other conditions slowing them down. They want advice about restor- ing mobility or compensating for its loss, getting back out into the world. The single, over- whelming statement on the pro side of that partitioned page was the op- portunity medicine offered to help people. Though my experience wends through this book, I concentrate primarily on the stories of other people whose walking is slowed by progressive chronic conditions. Using their words and those of health-care professionals, I describe both barriers to and opportunities for becoming independently mobile again. It is one of those stores where you feel scrutinized by security cameras even if you do not roll in on a battered old scooter held together by bright red airline baggage tape. The saleslady eyed us with barely veiled suspicion as we sorted through the tie rack. When we finally selected a tie and pulled out our credit card, she brightened up and began talking about her mother.

Medical Council on Alcoholism (1987) Hazardous Drinking: A Handbook for General Practitioners discount 500 mg meldonium with mastercard, London: MCA generic meldonium 250 mg without a prescription. Merrison (1975) Report of the Committee of Inquiry into the Regulation of the Medical Profession (Merrison Report), Cmnd 6018, London: HMSO. Nuffield Institute for Health, Welsh Institute for Health and Social Care, London School of Hygiene and Tropical Medicine (1998) The Health of the Nation— A Policy Assessed, London: Stationery Office. Public Health Alliance (1992) The Health of the Nation: Challenges for a New Government, Birmingham: PHA. Public Health Laboratory Service (2000) Aids/HIV Quarterly Surveillance Tables, 45 (99) 4 (March), London: PHLS. Royal College of General Practitioners (1988) Alcohol—a Balanced View, London: RCGP. Royal College of Physicians (1962) Smoking and Health, London: Royal College of Physicians. Royal College of Physicians, Royal College of Psychiatrists, Royal College of General Practitioners (1995) Alcohol and the Heart in Perspective, London: RCP, RCPsych, RCGP. Royal College of Psychiatrists (1986) Our Favourite Drug: New Report on Alcohol and Alcohol-Related Problems, London: Tavistock. McQueen (eds) Readings for a New Public Health, Edinburgh: Edinburgh University Press. Social Affairs Unit/Manhattan Institute (1991) Health, Lifestyle and the Environment, London / New York: SAU/Manhattan Institute. Starr, R (1982) The Social Transformation of American Medicine, New York: Basic Books. US Department of Health, Education and Welfare (1979) Healthy People, Washington, DC: US Government Printing Office. US Environmental Protection Agency (1992) Respiratory Health Effects of Passive Smoking, Washington, DC: EPA. US Surgeon-General (1986) The Health Consequences of Involuntary Smoking, Rockville, MD: US Department of Health and Human Services. Toronto Disclaimer: Some images in the printed version of this book are not available for inclusion in the eBook. Using Alternative Therapies: A Qualitative Analysis by Jacqueline Low First published in 2004 by Canadian Scholars’ Press Inc. No part of this publication may be photocopied, reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical or otherwise, without the written permission of Canadian Scholars’ Press Inc. In the case of photocopying, a licence from Access Copyright may be obtained: One Yonge Street, Suite 1900, Toronto, Ontario, M5E 1E5, (416) 868-1620, fax (416) 868-1621, toll-free 1-800-893-5777, www. Portions of chapter one, “What Are Alternative Therapies and Who Uses Them? A critical analysis of the use of the concept of complementary therapy,” Complementary Therapies in Medicine, 9(2):105–110. CSPI would be pleased to have any errors or omissions brought to its attention. Canadian Scholars’ Press gratefully acknowledges financial support for our publishing activities from the Government of Canada through the Book Publishing Industry Development Program (BPIDP) and the Government of Ontario through the Ontario Book Publishing Tax Credit Program. National Library of Canada Cataloguing in Publication Low, Jacqueline, 1964– Using alternative therapies : a qualitative analysis / Jacqueline Low. DEDICATION This book is dedicated, with love, to the memory of my brother, Douglas, who never failed to encourage me or tell me of the pride he took in my scholarly achievements. This page intentionally left blank Table of Contents PREFACE VIII ACKNOWLEDGEMENTS X INTRODUCTION 1 THE STUDY THE STRUCTURE OF THE BOOK CHAPTER ONE 12 What Are Alternative Therapies and Who Uses Them? CHAPTER TWO 26 How People Use Alternative Therapies ALTERNATIVE HEALTH CARE NETWORKS Friends The Media Family Commercial Outlets Public and Private Institutions Alternative Practitioners and Alternative Health Centres Allopaths Non-Mainstream Spiritual Groups The Work Place ENTRÉES INTO ALTERNATIVE HEALTH CARE RECONCEPTUALIZING THE HEALTH CARE SYSTEM CHAPTER THREE 42 Why People Turn to Alternative Therapies MOTIVATING FACTORS Control Holism Dissatisfaction INDIVIDUAL PROBLEMS, ALTERNATIVE SOLUTIONS Physical Problems Personal Problems THE WIDER SOCIO-CULTURAL CONTEXT CHAPTER FOUR 54 An Alternative Model of Healing THE FOCUS AND PURPOSE OF THERAPY Chronic vs. Invasive THE NATURE OF THE CLIENT/PRACTITIONER RELATIONSHIP Attitude Time Caring ALTERNATIVE HEALING TECHNIQUES Self-Healing Healing Energy CHAPTER FIVE 67 An Alternative Model of Health ALTERNATIVE HEALTH AS PROCESS Holism Balance Control THE IMPLICATIONS OF ALTERNATIVE HEALTH BELIEFS CHAPTER SIX 81 Alternative Healing and the Self ADOPTING A HEALER IDENTITY CHANGES IN SELF-PERCEPTION Changes in Personality Changes in Value Systems HEALING THE SELF CHAPTER SEVEN 95 Using Alternative Therapies: A Deviant Identity BIOGRAPHIES, ACCOUNTS, AND RETROSPECTIVE REINTERPRETATION ALTERNATIVE THERAPY USE AS DEVIANT BEHAVIOUR MANAGING THE STIGMA OF USING ALTERNATIVE THERAPIES Accounting for Stigma Stigma Management Via Retrospective Reinterpretation CONCLUSION 111 IMPLICATIONS FOR HEALTH POLICY SUGGESTIONS FOR FUTURE RESEARCH APPENDIX: THE THERAPIES 127 ACUPRESSURE ACUPUNCTURE AROMATHERAPY ASTROLOGICAL HEALING BAGUA CHINESE HERBAL MEDICINE CHIROPRACTIC CHRISTIAN SCIENCE MEDICINE CREATIVE VISUALISATION CRYSTAL HEALING EAR CANDLING FASTING FELDENKRAIS METHOD HERBAL MEDICINE HOMEOPATHY HYPNOTHERAPY IRIDOLOGY MASSAGE MEDITATION MIDWIFERY NATUROPATHY PSYCHIC HEALING REFLEXOLOGY REIKI THE RESULTS SYSTEM THERAPEUTIC TOUCH VITAMIN THERAPY YOGA REFERENCES 139 INDEX 152 Preface In this book I present a qualitative analysis of the experiences of twenty-one Canadians who use alternative therapies. My analysis is informed by a symbolic interactionist perspective that emphasizes the process by which people give meaning to reality, and how those meanings guide their actions. This research is a timely addition to the literature on alternative and complementary health care as it addresses significant gaps in this area of scholarship. For instance, dominant biomedical interests mean that there is considerable study of the therapies themselves, especially the issues of efficacy and safety (Ernst 1997, 1999, 2000a; Lewith et al. An equally pervasive concentration on the professions means that research is, more often than not, geared towards the study of the activities of alternative practitioners in their efforts to professionalize or achieve regulated status (Boon 1998; Bourgeault 2000; Coburn 1997; Saks 1995).

Constructed of suspension” remains of considerable value for gas piping discount meldonium 250 mg overnight delivery, the frame was shaped individually for the treatment of children with transient synovitis each child to produce the appropriate compensa- of the hip buy cheap meldonium 500 mg on line, Legg–Calvé–Perthes’ disease, coxa tory spinal curvatures. The child was secured to vara,11 and fractures of the femoral shaft, and pro- 282 Who’s Who in Orthopedics vides a memento of “Pugh of Carshalton,” who foreign editor of The Journal of Bone and Joint devoted his life to the care of crippled children. The Cathedral of San Pietro e San Paolo, built in part from the References Roman remains, was erected in the fourth century. D’Arcy Power, Le Fanu (1953) legends attribute the founding of the famous Uni- 2. Wastson-Jones (1952) student population has decreased, but the medical school of the university is still outstanding. The Istituto Ortopedico Rizzoli is situated on a hill on the outskirts of this fascinating old city and occupies the picturesque buildings of a Benedic- tine monastery known as San Michele in Bosco. The early years of this institute for crippled children were not noteworthy, until Alessandro Codivilla, modest and skillful master, became its director and surgeon-in-chief. This great general surgeon, after excelling in the surgery of the gastrointestinal tract and the brain, devoted his talents to orthopedic surgery, and the “Istituto” became world-famous. Codivilla made original and important contributions to the surgery of frac- tures and the methods of tendon transplantation, and to the development and standing of the specialty. At his death in 1912, Codivilla was succeeded by Vittorio Putti, the son of a well-known surgeon who was for many years professor of surgery in the University of Bologna. Putti had first become identified with the Istituto Ortopedico Rizzoli in 1903, when Codivilla had appointed him as an Vittorio PUTTI assistant. Following 2 years of study in European 1880–1940 clinics, he returned to the institution in 1909 as vice director, and in 1914 became director and Vittorio Putti was professor in the University surgeon-in-chief of the Istituto. He was also of Bologna, surgeon-in-chief of the Istituto professor of orthopedic surgery at the University Ortopedico Rizzoli, a founder of the Société of Bologna. Internationale de Chirurgie Orthopédique et In 1922 he opened the country branch, which de Traumatologie and president of its 1936 provided for the care of 100 cases of surgical Congress, Honorary Member of the British tuberculosis, and as director of this hospital (Isti- Orthopedic Association, the American Orthope- tuto dio terapico Codivilla di Corona d’Ampezzo) dic Association, Corresponding Member of the in the Dolomites, he found frequent escape from American Academy of Orthopedic Surgeons, and his very strenuous city life. He was a bib- A brilliant student, a wide reader, an able liographer, medical historian, orthopedic investi- administrator, a resourceful and skillful surgeon gator, and teacher of surgeons. He had been a with a mechanical bent, he enhanced the 283 Who’s Who in Orthopedics reputation of the Istituto Rizzoli, and like Surgeons held in Boston in 1934 and in Chicago Codivilla, made lasting contributions to the in 1937. He received medicine and the contributory sciences, to strive from the King the title of Grand Officiali of the for exactitude in thought and action, and to appre- Crown of Italy. His sanctum sanctorum, which he cians and surgeons throughout the world and was shared with his helpers, was the library (La Bib- an inspiration to them. On the walls of this dignified discovered a depth of feeling and a capacity for room are the same beautiful frescoes, executed by friendship that were the true attributes of his char- Canuti, that had given joy to the monks, and on acter. After the death of his professional ideal, Sir its shelves are books and manuscripts covering a Robert Jones, he wrote the following letter in period of over 400 years. Its exquisite By his numerous original contributions he diction suggests a faith and an affection that are became an international leader, a pioneer and an almost religious in nature. It is a forcible manipulation of adult club feet, the open great friend who has left us, and I think that all of us treatment of fractures and the use of skeletal trac- who loved him feel the need of uniting together in his memory. Let our friendship find in his memory tion and metal fixation, the equalization of leg strength of faith and reason of comfort. Do not forget lengths by bone lengthening, spinal anomalies, me and believe me cineplastic amputations and artificial limbs, and Affectionately yours, the surgical treatment of the residual effects of PUTTI poliomyelitis. He published many monographs, not only on strictly medical and surgical subjects, Vittorio Putti will rank among the great ortho- but also on nonmedical subjects; as well as trans- pedic surgeons of all time—great in heart as well lations of old medical works. His latest volume, pub- lished in 1940, is entitled “Cura operatoria delle fratture del collo del femore. He continued as the editor of this out- standing medical journal until his death. He was an accomplished linguist and lectured by invitation in practically every country, includ- ing the United States, England, France, Germany, and Russia.