Complementary therapies: considerations for diabetes care

Complementary therapies (CTs) are receiving increasing attention in mainstream health care. Over 50% of the global population between 25% 30% of people with diabetes use CTs. In addition, health professionals are increasingly incorporating CT into their practice or referring patients to CT practitioners. This paper explores the philosophy underlying CT, gives an overview of the types of therapies used, outlines the reasons people use CTs the risks benefits for people with diabetes. Copyright © 2004 John Wiley & Sons, Ltd.

Psychopharmacology and pregnancy : treatment efficacy, risks, and guidelines

 This book examines the role of psychopharmacological treatment in a range of disorders that may be encountered during pregnancy, including major depressive disorders, anxiety disorders, bipolar affective disorder, schizophrenia, eating disorders, and substance abuse. The natural history of each condition pre- and post-partum is analyzed, and the evidence for the efficacy of drug treatments, evaluated. Special attention is paid to the potential dangers of different treatment options for both mother and fetus, covering risks of malformation, pregnancy and obstetric risks, neonatal risks, and possible long-term consequences. The risks of not treating a particular condition are also analyzed. On the basis of the available evidence, management guidelines are provided that additionally take into account non-pharmacological options. Closing chapters consider the value of complementary and alternative medicine and ECT and explore future research directions.

Children, adolescents and complementary and alternative therapies

Complementary and alternative therapies (CAM) are widely used in the general community and by people with diabetes, including children and adolescents; the latter usually use CAM on the advice of their parents. Children/parents use a range of CAM including herbal medicines, vitamins and minerals, essential oils (aromatherapy) as well as non-medicine CAM such as massage. The main reasons children/parents use CAM is to manage symptoms, improve metabolic control, prevent complications and as a supplement to insulin. There are benefits and risks to using CAM depending on the age of the child, the particular CAM used and their capacity to make an informed choice and understand the consequences of their choices. Health professionals need a broad understanding of CAM, to be aware that children/parents use CAM, to ask about CAM use and monitor potential beneficial and negative effects.

A risk analysis model to reduce computer security risks among healthcare organizations

The paper describes the on-going development of a new computer-based security risk analysis methodology that may be used to determine the computer security requirements of medical computer systems. The methodology has been developed for use within healthcare, with particular emphasis placed upon protecting medical information systems. The paper goes on to describe some of the problems with existing automated risk analysis systems, and how the ODESSA system may overcome the majority of these problems. Examples of security scenarios are also presented.

Bad sports : the risks associated with not 'fitting in'

This paper is about peer rejection and bullying in schools and the tragic consequences that it can have. The focus of the paper is in the ways schools interact with groups of young males and, more importantly, those who are left out of these groupings. My concern is that schools currently give too little attention to informing and/or shaping the peer group practices of young people. I argue that the current educational theory and practice focus too heavily on individuals and their potential to act independently and overlook the all-important socialization that takes place within and between groups. Drawing on two case-studies of young males who experience peer rejection, I seek to raise concerns about the contemporary socializing practices of young males and the burgeoning need for schools to play a role in bringing about change. Given the continued prominence of sport as a trajectory for defining the dominant masculinity, I believe that it is critical that physical educators engage with the discussions and debates that surround this topic.

Complementary therapies or 'luxury' therapies? A nurse's experience in the use of complementary therapies in nursing practice

Complementary therapies have an increasing popularity. This case study explores the experience of a nurse who practises complementary therapies within the health care system where there is a still a widespread of skepticism within the medical profession. It is considered by the nurse that it is a 'luxury' to include these therapies in nursing practice.

Growing Up as Risky Business? Risks, Surveillance and the Institutionalized Mistrust of Youth

This paper will argue that a major problem for young people today is that they increasingly cause adults anxiety. This anxiety translates into a raft of interventions and strategies and programmes that target young people. These imaginings reflect and constitute a range of anxieties about the dangers posed by some young people, or to some young people, and how these risks might be economically and prudently managed. These institutionalized relationships of mistrust can have a range of often negative consequences (intended or otherwise) for individuals and populations of young people. I argue that Foucault's work on disciplinary, sovereign and governmental forms of power provides a generative framework for analysing what I refer to as the institutionalized mistrust, surveillance and regulation of contemporary populations of young people.

Constructing detectors in schema complementary space for anomaly detection

This paper proposes an extended negative selection algorithm for anomaly detection. Unlike previously proposed negative selection algorithms which directly construct detectors in the complementary space of self-data space, our approach first evolves a number of common schemata through coevolutionary genetic algorithm in self-data space, and then constructs detectors in the complementary space of the schemata. These common schemata characterize self-data space and thus guide the generation of detection rules. By converting data space into schema space, we can efficiently generate an appropriate number of detectors with diversity for anomaly detection. The approach is tested for its effectiveness through experiment with the published data set iris.

Complementary therapies and diabetes

There is increasing recognition that people with diabetes use a range of complementary therapies (CT), for a number of conditions, but do not always inform their conventional health practitioners about their use. Controlling blood glucose levels in people with diabetes is important to reduce the consequent metabolic abnormalities and symptoms and the incidence of long-term complications. Conventional medical and nursing practitioners often incorrectly assume that they are used to control blood glucose levels, e.g. using herbal medicines to increase insulin production or reduce insulin resistance. CT can be beneficial for people with diabetes. They can also lead to adverse events. This paper describes the outcome of monitoring complementary therapy use in our diabetic outpatient services in 2001, the results of a focus group (n=10) to explore issues identified in the monitoring process and a survey undertaken with a convenience sample of diabetes educators (n=40).

Twenty percent of patients used CT and there were three adverse events in the monitoring phase. Eight of the 10 focus group participants used CT and 16 of the diabetes educators used CT in patient care. Only one had a complementary therapy qualification.

Complementary therapies in action - education and outcomes

A study investigated the use of aromatherapy hand and foot massage on 11 patients in a rural rehabilitation setting. An education programme for nurses, carers and family members was developed and implemented. Clinical outcomes - pain, anxiety, joint flexibility and skin condition were evaluated using Likert scales completed before, and after, treatment at three time points and open questions to ascertain patients' feelings about the treatments. Each patient had three treatments, making a total of 33 massages. A significant reduction in pain and anxiety was apparent after all three treatments (p=0.05). Changes in skin condition (softer and more resilient) were highly significant (p=0.01). However, there was no significant change in joint flexibility (p<0.05). The main themes emerging from patients' comments were that aromatherapy massage facilitated communication, allowed emotional release and aided relaxation. Nine people undertook the education programme. They indicated that it covered appropriate information and they felt confident to deliver the aromatherapy massages, but the non-nursing participants would have liked more practice before they entered the clinical setting.