Homeopathy, Phenomenology and the Unprejudiced Observer. Letter in response to Swayne and Whitmarsh

The belief that ‘homeopathy works’, is effective and can demonstrate clinical efficacy, while encouraging, has little to do with the philosophy, practice or relevance of phenomenology to homeopathy. Jeremy Swayne’s editorial draws a spurious link between positive outcome studies and the capacity for homeopathy to ‘open up a rich vein of scientific enquiry and clinical opportunity’ (Swayne 2013). So too, Tom Whitmarsh’s understanding of phenomenology suggests that homeopathy and phenomenology are ‘pretty similar’ in terms of how they look at the world (Whitmarsh 2013). As long as the homeopath remains ‘untainted by what he knows’ and is ‘doing (his) best to avoid received opinion’ phenomenology is made to appear logical and easily applied in practice. Together, Swayne’s and Whitmarsh’s understanding diminish the complexity of phenomenology as a research methodology and as a method of clinical engagement. Their understanding misconstrues phenomenology as being ‘purely descriptive,’ ignoring the prospect that description and observation are actually based upon interpretation of patient phenomena, not objective and unprejudiced observations

Does the Weight of Evidence Signal the End of Homeopathy?

The National Health and Medical Research Council (NHMRC) recently completed a review of the evidence for homeopathy’s effectiveness and, after analysing systematic reviews of clinical trials, concluded there was “no reliable evidence for homeopathy and that it cannot demonstrate efficacy.” To judge the efficacy, and hence the value, of homeopathy on the basis of randomised controlled trials misses the point. Such trials are the gold standard for conventional drugs because they test a medication’s effect across a population, eliminating placebo effects and other forms of perception bias. But – and here’s the crux – homeopathic medicines are not drugs and homeopathy involves much more than the use of a particular therapy. People don’t visit a homeopath wanting a drug, in fact they often quite deliberately don’t want one; they want individualised treatment

Empirical and Evidence-based Homeopathy: Back to Basics.

That the theme of this issue is Back to Basics is a critical reminder of the problems faced by the Australian homœopathic community. This year, 2013, its practitioners may face political marginalisation and economic asphyxiation. The right of Australian consumers to choose and be rebated for homœopathy may be restricted by the National Health and Medical Research Council, a commission of the Australian Federal Government, as well as by the actions of the Friends of Science in Medicine . Practitioners at the coalface practice a combination of empirical and evidence-based homœopathy. The results presented in this paper are part of a qualitative research study exploring the reasoning and decision making practices of Australian homœopaths. After gaining ethical approval from the University of Sydney in 2009, I observed, interviewed and recorded 12 participants in urban and regional Australia (2009-2012). Using interpretative phenomenological analysis (IPA) to explore and understand the participants’ clinical reasoning behaviours and experiences, this paper asks why homœopathy needs to go back to basics. Their experiences strongly suggest the need for rigorous reproducible methods for the benefit of patients and for the sustainability of homœopathy. Keywords: homœopathy, clinical reasoning, empiricism, evidence, evidence-based medicine

Does the Weight of Evidence Signal the End of Homeopathy?

The National Health and Medical Research Council (NHMRC) recently completed a review of the evidence for homeopathy’s effectiveness and, after analysing systematic reviews of clinical trials, concluded there was “no reliable evidence for homeopathy and that it cannot demonstrate efficacy.” To judge the efficacy, and hence the value, of homeopathy on the basis of randomised controlled trials misses the point. Such trials are the gold standard for conventional drugs because they test a medication’s effect across a population, eliminating placebo effects and other forms of perception bias. But – and here’s the crux – homeopathic medicines are not drugs and homeopathy involves much more than the use of a particular therapy. People don’t visit a homeopath wanting a drug, in fact they often quite deliberately don’t want one; they want individualised treatment

2. Magnon spectra in layered samples: From NN exchange to dipolar coupling

International audienceThe dispersion relations of progressive spin waves and the stationary normal modes in thin films are derived according to a unified picture, by means of dynamical and transfer matrices. The full spectrum of stationary excitations and their localization properties are deduced. Numerical calculations confirm the increasing complexity of both dispersion relation and stationary mode localization when increasing interaction range. Recent experimental observations and micromagnetism simulations are confronted with these results. PACS numbers: 75.30.Ds; 72.15.R

Clinical Reasoning and Decision-Making in Homeopathy: an Interpretative Phenomenological Analysis

Aim: The aim of this study was to examine homeopathic practice as a lived phenomenon. This thesis explores the interior of clinical practice. Background: Homeopathy is a globally practiced discipline in the arena of complementary and alternative medicine. Despite sustained practice it is epistemically contentious, yet little is known about the reasoning and decision making practices of its practitioners, what actually happens in practice. Methods: Using interpretative phenomenological analysis, participants were extensively observed, recorded and interviewed. Data were coded, categorised and analysed. Results: Themes representing the sources and forms of reasoning were generated. Practice is underpinned by theory, core texts and clinical authority. Beyond these sources of authority, practice is guided by clinical experience, by praxis and professional wisdom. Clinical reasoning does not exclusively depend on knowledge; it is performed between practitioners and their patients, built upon a therapeutic relationship. Discussion: This thesis enhances knowledge and understanding of clinical reasoning practice. It raises pedagogical and philosophical questions about how clinical practice can be interpreted and understood. It also argues that questions about forms of evidence for disciplines including homeopathy need to consider the diverse goals and preferences of patients and health professionals alike. Conclusions: Research into the lived experience confirms that homeopathic clinical reasoning is highly complex, driven by multiple sources of evidence

Reported Job Satisfaction : What Does It Mean?

By reporting his satisfaction with his job or any other experience, an individual does not communicate the number of utils that he feels. Instead, he expresses his posterior preference over available alternatives conditional on acquired knowledge of the past. This new interpretation of reported job satisfaction restores the power of microeconomic theory without denying the essential role of discrepancies between one’s situation and available opportunities. Posterior human wealth discrepancies are found to be the best predictor of reported job satisfaction. Static models of relative utility and other subjective well-being assumptions are all unambiguously rejected by the data, as well as an \"economic\" model in which job satisfaction is a measure of posterior human wealth. The \"posterior choice\" model readily explains why so many people usually report themselves as happy or satisfied, why both younger and older age groups are insensitive to current earning discrepancies, and why the past weighs more heavily than the present and the future.En rapportant sa satisfaction vis-à-vis son travail ou toute autre expérience, un individu ne communique pas le nombre d’unités d’utilité qu’il ressent. Plutôt, conditionnellement à ses expériences antérieures, il exprime a posteriori sa préférence relativement à d’autres emplois ou situations alternatives. Cette nouvelle interprétation de la satisfaction révélée rend à la théorie microéconomique son pouvoir explicatif tout en reconnaissant le rôle essentiel joué par la différence entre la situation d’une personne et les opportunités. Les différences a posteriori dans la richesse humaine sont les meilleurs prédicteurs de la satisfaction révélée. Les modèles statiques de l’utilité relative et ceux d’utilité subjective sont tous rejetés par les données, de même que le modèle économique où la satisfaction de l’emploi est une mesure de la richesse humaine a posteriori. Le modèle de choix a posteriori explique pourquoi, dans les enquêtes, une grande majorité de personnes expriment leur bonheur ou leur satisfaction, pourquoi les jeunes et les vieux ne réagissent pas aux différentielles de revenus courants et pourquoi le passé joue davantage que la situation présente ou future

Conflicting Cultural Perspectives: Meanings and Experiences of Postnatal Depression Among Women in Indian Communities

A woman’s cultural and social context affects her experience of postnatal depression. In this literature review, the authors explore questions regarding the normal and a bnormal postnatal experiences of Indian women with consideration to cross cultural perspectives. Although postnatal distress or sadness is recognised among many cultures, it is constructed as a transient state in some cultures and as an illness in others. A major challenge for health care providers in Western countries like the UK and Australia is to develop culturally sensitive approaches to postnatal care for migrant mothers

Epistemology and the Ethics of Homeopathy: a Response to Freckelton

The death of two patients in the care of Australian homœopaths is undeniably tragic and reflects poorly on the homœopathic profession at large. While Freckelton admits that it is not fair to judge a profession by its worst practitioners, this is precisely what he has done. If the same argument were applied to all Australian hospitals, in which there are an estimated 18,000 deaths each year due to adverse events or medical errors, then the public could be expected to lose confidence in conventional medicine. Generalising risk by citing extreme examples does not facilitate healthy debate or consideration of the deeper epistemological and ethical issues. While addressing Freckelton's valid concerns, we believe that the appropriate practice of homœopathy is epistemologically robust, ethical and empirically sound. Furthermore, while debate continues on definitions of evidence and the appropriate delivery of health care, we argue that the deliberate exclusion of certain forms of evidence, including positive patient outcomes measured according to different quantitative and qualitative criteria, inappropriately constrains individuals' rights to select models and methods of health care according to their values and to the goals that they wish to achieve

Reverse engineering for industrial-environment cad models

International audienceIndustrial-environment CAD models are commonly represented by triangular meshes, which do not preserve original information about implicit surfaces used during design. The reverse-engineering algorithms presented in this paper focus on reconstructing implicit information, recovering original data. We propose two different approaches, a numerical one and an original topological approach. We explore specificities found in CAD meshes to achieve high effectiveness, reconstructing 90% of information from massive models (with millions of triangles) after few minutes of processing