By G. Nasib. Fairfield University.
Therefore discount super levitra 80mg with mastercard, while using alternative therapies can allow the individual to change their self-perceptions and transform their identities for the better discount super levitra 80mg with amex, these benefits to self can come at the price of acquiring a deviant identity purchase super levitra 80mg with visa. My intent here is not an in-depth examination of the components of the alternative healer identity discount 80 mg super levitra amex. Rather, I am concerned with what motivates these informants to begin, continue, or complete the process of adopting a healer identity. Interested readers should see Boon (1998); Cant and Calnan (1991); and Lowenberg (1992) for analyses of alter- native practitioner identity. Glik’s (1990) characterization of the changes to self experienced by her informants as imagined is problematic. As Thomas and Thomas (1970:154) made plain, “If [people] define situations as real they are real in their consequences. While Lindsey (1996:466) does not identify the source of the beliefs that allowed her informants to find “health within illness” as alternative healing ideology, much of the data she presents in illustrating how her informants describe health are analogous to many of the components which make up the alternative model of health espoused by the people who spoke with me. For example, one woman who took part in her research defined health as “being in control of myself and making my own decisions” (Lindsey 1996:468). CHAPTER SEVEN Using Alternative Therapies: A Deviant Identity The use of alternative therapies as deviant behaviour is neglected as an area of research, despite the fact that people who use so-called unortho- dox therapies have consistently been ridiculed (Johnson 1999; Leech 1999; Miller et al. For example, Hare (1993:40) equates a patient’s disclosure of her use of acupuncture to her doctor with the Catholic confessional, and the use of alternative therapies with a sin that must be absolved: “She is confessing to her physician who absolves her, even confessing his own foray into the domain of the ‘other. My focus here is on the means used by informants to reduce the stigma associated with their participation in alternative approaches to health and healing. In addition to describing the use of perennial methods of coping with stigma, such as managing disclosure and using humour (Davis 1961; Goffman 1963), I analyse informants’ use of accounts as a technique of stigma management (Scott and Lyman 1981). In particular, I reflect on their use of retrospective reinterpretation of biography employed in their accounts of their participation in alternative therapies. One’s self-defined biography is neither static nor fixed; rather, as Goffman (1963:62) points out, a salient feature of biographies is that they “are very subject to retrospective construction. As we remember the past, we reconstruct it in accordance with our present ideas of what is important and what is not. In Scott and Lyman’s (1981:357) words: “Every account is a manifestation of the under- lying negotiation of identities,” and is no less so in negotiating deviant identities (emphasis theirs). According to Scott and Lyman (1981:343–344), “An account is a linguistic device employed whenever an action is sub- jected to valuative inquiry.... A statement made by a social actor to explain unanticipated or untoward behavior. These categories differ in that justifications are accounts in which the actor “accepts responsibility for the act... For Scott and Lyman (1981:348) the crucial distinction between excuses and justifications is that in the former case the individual accepts that the behaviour in question is wrong, while in the latter case he or she “asserts its positive value in the face of a claim to the contrary. Self-fulfillment accounts justify behaviour through the rationale that the act is not wrong if it corresponds with the actor’s notion of what is necessary to his or her self-fulfillment, whereas “The sad tale is a selected (often distorted) arrangement of facts that highlight an extremely dismal past, and thus explain the individual’s present state” (Scott and Lyman 1981:349). Below, Using Alternative Therapies: A Deviant Identity | 97 I critically apply Scott and Lyman’s (1981) notions of justifications and excuses, as well as Sykes and Matza’s (1957) techniques of neutralization, in analysing informants’ accounts of their experiences with alternative therapies. Further, I argue that the concept of retrospective reinterpretation of biographies can also be used to shed new light on how people who use alternative therapies reduce the stigma associated with their participation in alternative forms of health care. ALTERNATIVE THERAPY USE AS DEVIANT BEHAVIOUR The language used in the literature to describe alternative therapies has been and remains largely derogatory and pejorative. For example, consistently and over time, alternative therapies have been styled unconventional, nonconventional, unorthodox (Dunfield 1996); unscientific and unproven (Feigen and Tiver 1986); “fuzzy stuff” (Monson 1995:170); or “deviant forms of health service” (Cassee 1970:391). One extreme example concerns Leech’s (1999:1) pronouncement that alternative therapies are “snake oil [which] belongs in the last century, not this or the next. For example, while she uses the term alternative medicine, Monson (1995:168) refers to allopathic health care as “proper orthodox medicine,” implying that alternative therapies are unorthodox and improper.
A rational buy super levitra 80 mg on line, tiered diagnostic approach order super levitra 80mg with mastercard, tailored to the individual patient and inﬂuenced by the presence of accompanying neurologic signs order 80mg super levitra free shipping, temporal course cheap super levitra 80mg online, family history, and other factors is recommended. Most, but not all, secondary dystonias have additional neurologic signs or symptoms. Perhaps the most important entity to diagnose is DRD because it is readily treated. SPECIFIC DISORDERS AND TREATMENT Treatment of dystonia varies depending on the etiology. In the following sections, treat- ment of DRD, primary dystonia, and secondary dystonia will be considered separately. SCA-3) Wilson disease Structural brain lesions Acute disseminated encephalomyelitis Infection Perinatal hypoxia-ischemia Stroke Tumor Drugs=toxins Dopamine blockers e. The DRD is also known as hereditary progressive dystonia with diurnal ﬂuctuations or Segawa syndrome. The DRD typically presents between 1 and 12 years of age with a gait disturbance involving foot dystonia. In untreated older children, there is devel- opment of diurnal ﬂuctuation with worsening of symptoms toward the end of the day and marked improvement in the morning. It is important to recognize the entity of DRD because it responds dramatically to low doses of levodopa. Thus, it is important to consider DRD in the child with abnormal movements that might otherwise appear to be cerebral palsy if there is prominent dystonia and a progressive rather than static course. With appropriate diagnosis and treatment, children with DRD can lead normal lives. A starting dose is 1 mg=kg=day of levodopa, which can be increased gradually until there is complete beneﬁt or dose-limiting side effects. Most individuals respond Dystonia 141 to 4–5 mg=kg=day in divided doses, but some authors have suggested doses up to 10 mg=kg=day. If there is no response to a dose of 600 mg=day, it is highly unlikely that DRD is the correct diagnosis. They can be crushed and dissolved in an ascorbic acid solution or in orange juice and used within 24 hr. The 10=100 tablets contain insufﬁcient car- bidopa to prevent nausea in most patients. The most common side effects are som- nolence, nausea and vomiting, decreased appetite, dyskinesia, and hallucinations. Nausea and vomiting can be reduced by given additional carbidopa, available in 25 mg tablets. Dyskinesia may occur upon initiation of treatment or in older indivi- duals who are treated with relatively higher doses of levodopa. Dyskinesia can be reduced or eliminated by reducing the dose of levodopa. If dyskinesia is present with the initiation of treatment, reduce the dose. If inadequate beneﬁt at the lower dose, it can usually be increased again slowly without recurrence of dyskinesia. Motor complications of levodopa therapy that are seen in Parkinson disease do not occur in DRD. The dosing of trihexyphenidyl for treatment of DRD is not well established. In DRD, there is beneﬁt from rela- tively low doses compared to those used to treat other forms of dystonia. Trihexy- phenidyl should be considered as second-line treatment in DRD because it does not reverse the biochemical defect of decreased dopamine synthesis in DRD. Tetrahydrobiopterin may be a useful treatment in DRD due to GTP-cyclohydrolase I deﬁciency, but it is not readily available and has not been well studied. Primary Dystonia The major form of primary dystonia in children is childhood onset, generalized, idio- pathic torsion dystonia, formerly known as dystonia musculorum deformans. This disorder is inherited as an autosomal dominant condition with incomplete (30%) penetrance. A GAG deletion at the DYT1 locus on chromosome 9 causes most auto- somal dominant, early-onset primary generalized dystonia in Ashkenazi Jewish families (90%) and also in non-Jewish populations (50–60%).
If cheap super levitra 80 mg on line, for detention rate and a school that has example order super levitra 80 mg visa, the list has been organised no detention policy discount 80 mg super levitra amex, all of which will alphabetically cheap 80mg super levitra with visa, the researcher needs help to explain diﬀering detention to be aware that some cultures and rates and attitudes towards them. The researcher has decided that he The researcher is a teacher himself wishes to concentrate on the and decides to interview colleagues, detention rates of pupils by GCSE as he has limited time and resources subject choice and so decides upon a available to him. Also, at a method the researcher stratiﬁes his conference he unexpectedly gets to sample by subject area and then interview other teachers. This might chooses a random sample of pupils be termed haphazard or accidental from each subject area. The ability to generalise he found that there were many more from this type of sample is not the pupils in the arts than the sciences, goal, and, as with other sampling he could decide to choose a procedures, the researcher has to be disproportionate stratiﬁed sample aware of bias which could enter the and increase the sample size of the process. However, the insider status science pupils to make sure that his of the teacher may help him to data are meaningful. The researcher obtain information or access which would have to plan this sample very might not be available to other carefully and would need accurate researchers. If you get it wrong it relevant literature suggested could invalidate your whole in this book. Discuss your proposed Ignore advice from those sampling procedure and size who know what they’re with your tutor, boss or talking about. Be realistic about the size of Take on more than you can sample possible on your cope with. A badly worked budget and within your time out, large sample may not scale. Use a combination of Stick rigorously to a sampling procedures if it is sampling technique that is appropriate for your work. Admit your mistakes, learn by them and change to something more appropriate HOW TO CHOOSE YOUR PARTICIPANTS / 53 as your sample to overcome this problem. If you’re inter- ested in large-scale quantitative research, statistical meth- ods can be used to choose the size of sample required for a given level of accuracy and the ability to make general- isations. These methods and procedures are described in the statistics books listed at the end of this chapter. If your research requires the use of purposive sampling techniques, it may be diﬃcult to specify at the beginning of your research how many people you intend to contact. Instead you continue using your chosen procedure such as snowballing or theoretical sampling until a ‘saturation point’ is reached. This was a term used by Glaser and Strauss (1967) to describe that time of your research when you really do think that everything is complete and that you’re not obtaining any new information by continuing. In your written report you can then describe your sam- pling procedure, including a description of how many people were contacted. SUMMARY X If it is not possible to contact everyone in the research population, researchers select a number of people to contact. X There are two main types of sampling category – prob- ability samples and purposive samples. X In probability samples, all people within the research population have a speciﬁable chance of being selected. Only within random samples do participants have an equal chance of being selected. X The size of sample will depend upon the type and pur- pose of the research. X Remember that with postal surveys it might be diﬃcult to control and know who has ﬁlled in a questionnaire. X In some purposive samples it is diﬃcult to specify at the beginning of the research how many people will be contacted. X It is possible to use a mixture of sampling techniques within one project which may help to overcome some of the disadvantages found within diﬀerent procedures. This is a document which sets out your ideas in an easily accessible way. Even if you have not been asked speciﬁcally to produce a research proposal by your boss or tutor, it is a good idea to do so, as it helps you to focus your ideas and provides a useful document for you to reference, should your research wander oﬀ track a little.