Medical and professional homoeopathy in the UK: a study of tensions in a heterodox healthcare profession

Homoeopathic practitioners in the United Kingdom can be divided into two groups,those with medical qualifications and those without, professional homoeopaths. This study examines these two groups to discover how they practise homoeopathy and why. Also examined are any tensions that may exist, both between the two groups and within the groups. Collecting qualitative and quantitative data using questionnaires and interviews, a randomly selected sample of homoeopaths was studied. All subjects were members of either the Faculty of Homoeopathy or the Society of Homoeopaths. The study starts by examining the development of homoeopathy over its almost 200 year history. Following this section data regarding the practice of homoeopathy and the opinions of homoeopaths on this practice are discussed. The homoeopath's opinions regarding their opposite numbers are also discussed, that is professional homoeopath's opinions of medically qualified homoeopaths and vice versa. The data highlighted a number of tensions that exist between medically qualified homoeopaths and professional homoeopaths. Medically qualified homoeopaths questioned the wisdom of allowing non-medically qualified people to practice homoeopathy and the professional homoeopaths questioned the validity of the homoeopathic methods used by medically qualified homoeopaths. Tensions within professional homoeopathy were also identified between pro and anti professionalisation and registration subgroups. Another tension identified was between those professional homoeopaths who claim to use the original, 'classical' formulation of homoeopathy and those using a more eclectic therapeutic regime with changes to the original method incorporated into their practices.Finally, the utility of the concept of heresy when describing both medically qualified homoeopaths and professional homoeopaths in the United Kingdom was addressed. Although the labelling of heretics is properly reserved for those members of the orthodoxy, not for researchers, a small number of homoeopaths were identified as holding potentially heretical ideas. On the whole the medically qualified homoeopaths and the majority of professional homoeopaths could not be regarded as heretics or dissenters in any way. In the light of the tensions that were identified, and the policies being promoted by the professional bodies, the conclusion examines the possible future of homoeopathy in the United Kingdom in the first years of the new millennium. A thoroughly modernist medicine in a possibly postmodern era

‘I don't think I can catch it’: women, confidence and responsibility in football coach education

Whilst women’s participation in sport continues to increase, their presence remains ideologically challenging given the significance of sport for the construction of gendered identities. As a hegmonically masculine institution, leadership roles across sport remain male-dominated and the entry of women into positions of authority (such as coaching) routinely contested. But in powerful male-typed sports, like football, women’s participation remains particularly challenging. Consequently, constructions of gender inequity in coaching were explored at a regional division of the English Football Association through unstructured interviews and coaching course observation. Using critical discourse analysis we identified the consistent re/production of women as unconfident in their own skills and abilities, and the framing of women themselves as responsible for the gendered inequities in football coaching. Women were thereby strategically positioned as deservedly on the periphery of the football category,whilst the organization was positioned as progressive and liberal

‘We’re not all dangerous and crazy’. Negotiating the voice hearing identity: A critical discursive approach

A critical discursive approach examined how the voice hearing identity is negotiated. Conflicting constructions identified voice hearing not only as distressing but also as a normal experience. The discursive strategies reveal that when individuals who hear voices construct their identity, they must either disavow their own distress to avoid stigma or accept the stigmatising accounts of their identity imposed on them if they are to have their distress recognised. The study points to the value and importance of discursive approaches in uncovering unspoken distress in individuals and society, and towards the need to address identity issues in clinical and social interventions

Magazine and reader constructions of 'metrosexuality' and masculinity: a membership categorisation analysis

Since the launch of men's lifestyle magazines in the 1980s, academic literature has predominantly focused on them as a cultural phenomenon arising from entrepreneurial and commercial initiatives and/or as cultural texts that proffer representations of masculinity such as 'new lad' and 'new dad'. This paper steps aside from the focus on culture and, instead, treats magazine content as a discursive space in which gender and sexuality are oriented to, negotiated, and accomplished within and beyond the magazine itself (i.e. through readers' responses). Specifically, membership categorisation analysis is deployed to explore how the relatively new (and perhaps alternative) category for men - 'metrosexual' - is presented and received. Our analysis suggests that masculinity concerns are central in debates about 'metrosexuality', with self-identified 'metrosexuals' invoking heterosexual prowess and self-respect on the one hand, and critics (e.g. selfidentified 'real men') lamenting 'metrosexuality' for its perceived effeminacy and lack of authenticity on the other. Implications for understanding contemporary masculinities are discussed

Design and use of vignettes to investigate referral decision-making by optometrists

Purpose This study describes the design and application of a range of online clinical vignettes for measuring the impact of Continuing Education and Training (CET) and identifying unwarranted variation in optometric decision-making concerning referrals to secondary care. Methods Twenty computerised vignettes were developed to assess clinical and referral management decisions taken in primary care optometry. The online system was specifically designed to present vignettes (ten pre-CET and ten post-CET) that avoided prompting correct answers. The main study group was qualified optometrists (N = 31) who chose any CET options available to United Kingdom optometrists over six months. Participants submitted a record of the CET undertaken, which was compared with an anonymised General Optical Council (GOC) reference sample. The vignettes were also completed by newly-qualified (N = 18) and pre-registration (N = 11) groups. Results CET had no significant correlation (p = 0.37) with improvement in optometric clinical decision-making and referral practice (qualified group). Selection bias affected this group who had more CET points (p = 0.008) and peer discussion points (p = 0.003) than the GOC reference sample. Results were indicative due to small sample sizes. Newly-qualified practitioners were significantly more likely to refer than the qualified group (p = 0.004). Number of referrals decreased with time since qualification (p = 0.006). Conclusion Computerised vignettes are a useful tool for comparing referral decisions between groups. Recruiting clinicians for time-consuming vignette studies is challenging. Strategies to reduce unwarranted variation in optometry, including support for newly-qualified optometrists, require further investigation

Reliability of resting-state EEG modulation by continuous and intermittent theta burst stimulation of the primary motor cortex:a sham-controlled study

Theta burst stimulation (TBS) is a form of repetitive transcranial magnetic stimulation designed to induce changes of cortical excitability that outlast the period of TBS application. In this study, we explored the effects of continuous TBS (cTBS) and intermittent TBS (iTBS) versus sham TBS stimulation, applied to the left primary motor cortex, on modulation of resting state electroencephalography (rsEEG) power. We first conducted hypothesis-driven region-of-interest (ROI) analyses examining changes in alpha (8-12 Hz) and beta (13-21 Hz) bands over the left and right motor cortex. Additionally, we performed data-driven whole-brain analyses across a wide range of frequencies (1-50 Hz) and all electrodes. Finally, we assessed the reliability of TBS effects across two sessions approximately 1 month apart. None of the protocols produced significant group-level effects in the ROI. Whole-brain analysis revealed that cTBS significantly enhanced relative power between 19 and 43 Hz over multiple sites in both hemispheres. However, these results were not reliable across visits. There were no significant differences between EEG modulation by active and sham TBS protocols. Between-visit reliability of TBS-induced neuromodulatory effects was generally low-to-moderate. We discuss confounding factors and potential approaches for improving the reliability of TBS-induced rsEEG modulation.</p

Prime beef cuts : culinary images for thinking 'men'

The paper contributes to scholarship theorising the sociality of the brand in terms of subject positions it makes possible through drawing upon the generative context of circulating discourses, in this case of masculinity, cuisine and celebrity. Specifically, it discusses masculinity as a socially constructed gender practice (Bristor and Fischer, 1993), examining materialisations of such practice in the form of visualisations of social relations as resources for 'thinking gender' or 'doing gender'. The transformative potential of the visualisations is illuminated by exploring the narrative content choreographed within a series of photographic images positioning the market appeal of a celebrity chef through the medium of a contemporary lifestyle cookery book. We consider how images of men 'doing masculinity'are not only channelled into reproducing existing gender hierarchy and compulsory heterosexuality in the service of commercial ends, but also into disrupting such enduring stereotyping through subtle reframing. We acknowledge that masculinity is already inscribed within conventionalised representations of culinary culture. In this case we consider how traces of masculinity are exploited and reinscribed through contemporary images that generate resources for rethinking masculine roles and identities, especially when viewed through the lens of stereotypically feminised pursuits such as shopping, food preparation, cooking, and the communal intimacy of food sharing. We identify unsettling tensions within the compositions, arguing that they relate to discursive spaces between the gendered positions written into the images and the popular imagination they feed off. Set against landscapes of culinary culture, we argue that the images invoke a brand of naively roughish "laddishness" or "blokishness", rendering it in domesticated form not only as benign and containable, but fashionable, pliable and, importantly, desirable. We conclude that although the images draw on stereotypical premeditated notions of a feral, boisterous and untamed heterosexual masculinity, they also set in motion gender-blending narratives

Final design of the SLAC P2 Marx klystron modulator

The SLAC P2 Marx has been under development for two years, and follows on the P1 Marx as an alternative to the baseline klystron modulator for the International Linear Collider. The P2 Marx utilizes a redundant architecture, air-insulation, a control system with abundant diagnostic access, and a novel nested droop correction scheme. This paper is an overview of the design of this modulator. There are several points of emphasis for the P2 Marx design. First, the modulator must be compatible with the ILC two-tunnel design. In this scheme, the modulator and klystron are located within a service tunnel with limited access and available footprint for a modulator. Access to the modulator is only practical from one side. Second, the modulator must have high availability. Robust components are not sufficient alone to achieve availability much higher than 99%. Therefore, redundant architectures are necessary. Third, the modulator must be relatively low cost. Because of the large number of stations in the ILC, the investment needed for the modulator components is significant. High-volume construction techniques which take advantage of an economy of scale must be utilized. Fourth, the modulator must be simple and efficient to maintain. If a modulator does become inoperable, the MTTR must be small. Fifth, even though the present application for the modulator is for the ILC, future accelerators can also take advantage of this development effort. The hardware, software, and concepts developed in this project should be designed such that further development time necessary for other applications is minimal

Cooling effect in emissions of 103mRh excited by bremsstrahlung

Nonlinear characteristic emissions of K alpha, K beta and gamma with a significant triplet splitting at room temperature are observed from the long-lived nuclear state of 103mRh excited by bremsstrahlung irradiation. A pronounced phase-transition-like narrowing of the emission profiles occurs immediately after the sample is cooled down to 77 K. The room temperature profiles reappear again abruptly and almost reversibly as the temperature drifts freely back to approximately the ice point after the filling of liquid nitrogen is stopped. These emission properties at 300 K and at low temperature may indicate that the 103mRh nuclei are in collective states

Resting-state EEG signatures of Alzheimer's disease are driven by periodic but not aperiodic changes

Electroencephalography (EEG) has shown potential for identifying early-stage biomarkers of neurocognitive dysfunction associated with dementia due to Alzheimer's disease (AD). A large body of evidence shows that, compared to healthy controls (HC), AD is associated with power increases in lower EEG frequencies (delta and theta) and decreases in higher frequencies (alpha and beta), together with slowing of the peak alpha frequency. However, the pathophysiological processes underlying these changes remain unclear. For instance, recent studies have shown that apparent shifts in EEG power from high to low frequencies can be driven either by frequency specific periodic power changes or rather by non-oscillatory (aperiodic) changes in the underlying 1/f slope of the power spectrum. Hence, to clarify the mechanism(s) underlying the EEG alterations associated with AD, it is necessary to account for both periodic and aperiodic characteristics of the EEG signal. Across two independent datasets, we examined whether resting-state EEG changes linked to AD reflect true oscillatory (periodic) changes, changes in the aperiodic (non-oscillatory) signal, or a combination of both. We found strong evidence that the alterations are purely periodic in nature, with decreases in oscillatory power at alpha and beta frequencies (AD &lt; HC) leading to lower (alpha + beta) / (delta + theta) power ratios in AD. Aperiodic EEG features did not differ between AD and HC. By replicating the findings in two cohorts, we provide robust evidence for purely oscillatory pathophysiology in AD and against aperiodic EEG changes. We therefore clarify the alterations underlying the neural dynamics in AD and emphasize the robustness of oscillatory AD signatures, which may further be used as potential prognostic or interventional targets in future clinical investigations.</p