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In Natalie’s words: “If the chakras4 are blocked for any reason cheap moduretic 50mg amex blood pressure palpation, due to stress generic 50mg moduretic visa hypertension medication drugs, illness, disease, these have to be opened before you can possibly Appendix: The Therapies | 137 help this person. If the fingers fly open as you pull your client’s fingers apart then you know that chakra needs to be opened. Once you open the chakra, then you come back and touch that part of the chakra with your hand just gently and then do the fingers of the client and see if they’re still open. In Natalie’s words: “Once those are all cleared you can go forth and try to heal this person with your hands. Natalie told me that the results system is based on the metaphysical belief that a higher power is guiding the healing. It could be spirits, it could be angels, but above all that there is one person, like a god. By moving his or her hands close to, or lightly touching, the client’s body, the practitioner enables the person to heal (field notes). According to Natalie: You put your hands above their head, about two, three inches away from them and you hold them there and then you go over the entire body. And you can feel different spots in their body where they have a problem. VITAMIN THERAPY Vitamin therapy is based on the belief that imbalances of nutrients in the body create ill health and that certain “vitamins... In the mid-1960s, Norman Cousins popularized the use of megadoses of vitamin C as a therapeutic approach. According to Hanna, Yoga, to our knowledge, is at least five thousand years old. It’s the union between body, mind, and spirit and physically it works on the endocrine system. When the endocrine system’s not functioning properly then the hormones aren’t secreting into the body, there’s an imbalance and that’s where ill health comes from. So the postures are designed to squeeze and release, increase blood flow and hormonal supply into the system to help the body get balanced, and then the body can help itself. Healing through yoga means building up and controlling bodily energy or life force. In Hanna’s words: “It’s energy and the more you do your yoga breathing, the more prana you get in there. And you build it and build it until it builds up a resistance against illnesses and diseases. What is common to many therapies involving energy as a therapeutic medium is that they rest on the notion that every living thing is imbued with energy or a life force and that total well-being depends on the balanced flow of this energy (Blate 1982). In addition, spiritual energy, universal energy, and/or the energy within the natural world can be harnessed to heal (Blate 1982). Body work is based in part on the belief that disease is caused by the build up of physical and emotional trauma that is stored in the musculature of the body. By manipulating the musculature, tension and “the chronically held traumas of a lifetime are removed,” allowing a return to health and well-being (Dychtwald, 1986:12). There are seven chakras, or spiritual centres, along the body which govern different aspects of mind, body, and spirit (Dychtwald 1986). For instance, the “root chakra [is] located at the base of the spine [and] relates to... In Health Canada, Perspectives on complementary and alternative health care, pp. Complementary and alternative health practices and therapies—A Canadian overview. Alternative medicine in Western countries: An agenda for medical geography. In Health Canada, Perspectives on complementary and alternative health care, pp.

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Late in 2001 buy 50mg moduretic visa blood pressure medication refills, the United States and its NATO (North To combat biological agents generic moduretic 50mg otc how quickly should blood pressure medication work, bioindustries are develop- Atlantic Treaty Organization) allies reaffirmed treaty com- ing a wide range of antibiotics and vaccines. In addition, mitments that stipulate the use of any weapon of mass advances in bioinformatics (i. At the tactical level, the United States possesses or virus), the major problem in developing effective counter a vast arsenal of weapons designed to detect and eliminate strategies to bioterrorist attacks involves the breadth of organ- potential biological weapons. For example, researchers are analyzing many pathogens in an effort to identify common options is the use of precision-guided conventional thermal genetic and cellular components. One strategy is to look for fuel-air bombs capable of destroying both biological research common areas or vulnerabilities in specific sites of DNA, facilities and biologic agents. Regardless of whether the pathogens evolve Because terrorist operations are elusive, these large- naturally or are engineered, the identification of common traits scale military responses offer protection against only the will assist in developing counter measures (i. When laboratories capable of producing Biological warfare; Contamination, bacterial and viral; Genetic low-grade weaponizable anthrax-causing spores can be estab- identification of microorganisms; Public health, current issues lished in the basement of a typical house for less than $10,000, 77 Bioterrorism, protective measures WORLD OF MICROBIOLOGY AND IMMUNOLOGY Bioterrorist attack on the U. The NPS stockpile is designed to be rapidly extreme of potential military responses, the formal resumption deployable to target areas. For example, in response to poten- of biological weapons programs—even with a limited goal of tial exposures to the Bacillus anthracis (the bacteria that enhancing understanding of potential biological agents and causes anthrax) during the 2001 terrorist attacks, the United weapons delivery mechanisms—is unneeded and possibly States government and some state agencies supplied Cipro, the detrimental to the development of effective protective meas- antibiotic treatment of choice, to those potentially exposed to ures. In addition to increasing funding for the NPS, Biological Weapons Convention to which the United States is additional funds have already been authorized to increase a signatory and which prohibits such research, opponents of funding to train medical personnel in the early identification such a resumption argue any such renewal of research on bio- and treatment of disease caused by the most likely pathogens. Nonethless, advocates of increased research capabilities develop protective measures against biological attack. Such argue that laboratory and hospital facilities must be expanded plans allow for the maximum flexibility in terms of effective and improved to provide maximum scientific flexibility in the response to a number of disease causing pathogens. For example, In addition to increased research, preparedness pro- the Centers for Disease Control and Prevention (CDC), based grams are designed to allow a rapid response to the terrorist in Atlanta, Georgia, has established a bioterrorism response use of biological weapons. One such program, the National program that includes increased testing and treatment capac- 78 WORLD OF MICROBIOLOGY AND IMMUNOLOGY Bioterrorism, protective measures ity. The CDC plan also calls for an increased emphasis on epi- ment facilities. Environmental Protection Agency demiological detection and surveillance, along with the devel- (EPA) has increased monitoring and working with local water opment of a public heath infrastructure capable of providing suppliers to develop emergency response plans. For example, the list of those biological agents most likely to be used on its web public has been specifically discouraged from buying often pages. As of July 2002, the CDC identified approximately 36 antiquated military surplus gas masks, because they can pro- microbes including Ebola virus variants and plague bacterium, vide a false sense of protection. In addition to issues of that might be potentially used in a bioterrorist attack potency decay, the hoarding of antibiotics has is also discour- Other protective and emergency response measures aged because inappropriate use can lead to the development of include the development of the CDC Rapid Response and Advanced Technology Laboratory, a Health Alert Network bacterial resistance and a consequential lowering of antibiotic (HAN), National Electronic Data Surveillance System effectiveness. Following the September 11, 2001 terrorist attacks on More specific response plans and protective measures the United States, additional funds were quickly allocated to are often based upon existing assessments of the danger posed enhance the United States Department of Health and Human by specific diseases and the organisms that produce the dis- Services 1999 Bioterrorism Initiative. For example, anthrax (Bacillus anthracis), botulism of the Bioterrorism Preparedness and Response Program (Clostridium botulinum toxin), plague (Yersinia pestis), small- (BPRP) increases the number and capacity of laboratory test pox (Variola major), tularemia (Francisella tularensis), and facilities designed to identify pathogens and find effective viral hemorrhagic fevers (e. Although these biogenic agents share the common previous funding for bioterrorism research. CDC has of experts to evaluate changes in research in order to effec- tively anticipate and counter potential terrorist threats. As a adopted a position that, in the absence of a confirmed case of result, research into smallpox, anthrax, botulism, plague, smallpox, the risks of resuming general smallpox vaccina- tularemia, and viral hemorrhagic fevers is now given greater tion far outweigh the potential benefits. CDC has also accelerated production of a biological weapon attack could overburden medical infra- smallpox vaccine. It is also possible days) convey at least some protection from the ravages of the that an effective biological weapon could have no immediate disease. A number of former agreements of an anthrax vaccine used primarily by military personnel. Bacteria and bacterial infection; Biological warfare; On a local level, cities and communities are encour- Epidemics and pandemics; Vaccine aged to develop specific response procedures in the event of bioterrorism. Most hospitals are now required to have response plans in place as part of their accreditation require- BLACK DEATH • see BUBONIC PLAGUE ments.

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For additional information on practical and laboratory teaching we recommend the following: A Handbook for Teaching and Learning in Universities and Colleges by R 50mg moduretic free shipping blood pressure medication overdose death. Baillie discount moduretic 50mg pulse pressure emedicine, HERDSA Gold Guide No 4, 1998 available from HERDSA, PO Box 51, Jamieson, ACT, 2614, Australia. Unfortunately, there is no straightfor- ward formula to guide you in this activity. First, curriculum planning is a complex business involving more than purely educational con- siderations. For example, you will find that full account must be taken of the political and economic context in which you teach. Much curriculum development is a matter of revising and adapting existing courses or materials. And third, there are important differences between individuals – especially between individuals working in different disciplines – in the ways in which they view a variety of educational issues. You may, for instance, see your main function as transmitting appropriate knowledge, skills and attitudes. On the other hand you may perceive your role as being primarily concerned with the personal and social development of your students as well as with their intellectual development. In a book of this kind it is not possible to provide a discussion which can fully take into account these various orientations. However, we believe that you should be aware of these differences and we would encourage you to read further on the matter to help develop your own particular orientation and your own approach to curriculum development. In our view, the key to good curriculum or course design is to forge educationally sound and logical links between planned intentions (expressed as objectives), course content, teaching and learning methods, and the assess- ment of student learning while taking account of student characteristics. In the past, too many courses started with vague intentions, consisted of teaching which had a tenuous relationship to these intentions and employed methods of assessment which bore little or no relationship to either. Such courses then placed students in the unfortunate situation of playing a guessing game, with their academic future as the stake! This pattern can be improved by adopting an approach which aligns the intentions with course content, teaching, and the assess- ment. Although we assume you have some responsibility for course planning, it is unlikely that this will be a solo affair. You will have additional resources on which to draw which may include colleagues in your own and related departments, staff of a university teaching unit, members of your discipline outside your immediate environment, and students. Whatever your situation, experience suggests that some form of consultation with others is very desirable. COURSE CONTENT Content is a broad concept meant to include all aspects of knowledge, skills and attitudes relevant to the course and to the intellectual experiences of students and their teachers in a course. While not always easy to achieve, we feel that course content should be made explicit and that this will then put you in a better position to make informed and coherent decisions in your planning. There are several different criteria for selecting content that may be more or less relevant to your work. Academic criteria These criteria focus attention on theoretical, methodologi- cal and value positions. For example: Content should be a means of enhancing the intellectual development of students, not an end in itself. Content that is solely concerned with technical matters has a limited place in university education; content must also involve moral and ethical considerations. Content should contribute to a deep rather than to a surface view of knowledge. Psychological criteria These criteria relate to the application of psychological principles – especially of learning theory – to teaching: Content should be carefully integrated to avoid fragmentation and consequential loss of opportunities for students to develop ‘deep’ approaches to learning (see Chapter 1). Content selection must provide opportunities to emphasise and to develop higher-level intellectual skills such as reasoning, problem-solving, critical thinking and creativity. Content should provide opportunities for the devel- opment of attitudes and values. Content should be selected to assist in the develop- ment of students as independent lifelong learners.

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If appropriate moduretic 50 mg on line blood pressure chart easy to read, can I combine less reliable methods with more reliable methods? Obviously buy discount moduretic 50 mg line blood pressure 90 over 50, there will be other considerations of a practical nature that are peculiar to your own circumstances and that you will have to consider before implementing any particular scheme. Norm-referenced versus criterion-referenced assessment Before we finish dealing with some of the basic principles of educational measurement, we wish to introduce the difference between norm- and criterion-referenced assessment. You are likely to be familiar with norm- referenced assessment, as this reflects the traditional approach to testing. Any assessment which uses the results of all the students to determine the standard is of this type. In such tests the pass level is often set by predetermining the proportion of students given each grade or ‘grading on the curve’ as it is often called. Some assumptions made are not appropriate to assessing learning in universities, and the approach can be shown to lack an educational justification. For example, do we seriously set out in our teaching to ensure that, no matter how well students achieve the objectives, because of our grading on the curve policy, some will fail? Surely, our task is to help all students to achieve the objectives and reduce gaps between them rather than getting a ‘spread of scores’. In medicine we are often more concerned to establish that the students achieve some minimal standard of compe- tence. In this case, the criterion-referenced approach is 132 more appropriate. Such an approach necessitates the determination of an absolute standard before administer- ing the assessment, rather than waiting to see the overall results before doing so. Though this can be difficult to implement, we have found that attempting to do so is a powerful way of improving the validity of the assessment. Everyone concerned is forced to consider each item in the assessment and ask themselves if it is relevant and set at the appropriate level of difficulty. Our own experiences with such an approach used to test clinical competence in the final year of the medical degree have been very revealing and rewarding. The issue of standard setting is one which is achieving growing attention as the focus of assessment moves from norm-referenced to criterion-referenced or competency based testing. Established procedures are available for setting absolute standards in objective-type tests but are less well developed for clinical examinations. This is too complex and too difficult an area to discuss in this book but reading the article by Norcini is strongly recommended if you have responsibility for a ‘high stakes’ examination. Positive impact on learning It is clear that how and what students learn is influenced more by our assessment practices than by any other factor in the curriculum. At a policy level, an over-emphasis on formal examinations and the implicit threat that this may carry will have a negative impact. At a methodological level, an emphasis on objective tests, such as true/false and multiple-choice, will almost certainly encourage and reward the use of surface learning strategies by students rather than approaches that demand higher-level intellectual processes such as reasoning and analysis. On the other hand, there are several assessment practices that can encourage and reward the kinds of learning that are more highly valued today. These approaches include direct assessments of performance, learning portfolios, research projects, self and peer assessment, and regular and constructive feedback on learning. In the criterion-referenced approach de- scribed above, the objectives are embedded in the assessment tasks, so if students focus on assessment, they will be learning what the objectives say they should be learning. This is a positive solution to the common problem of the negative impact of assessment. ASSESSMENT METHODS In planning your assessment, it is necessary to be aware of the variety of methods available to you. It is impossible to be comprehensive for reasons of space so we will restrict ourselves to some common methods. We will also include information about some innovative approaches developed recently, which may be of interest. We do this deliberately in an attempt to encourage you to become subversive! With your new-found knowledge of assessment you will soon be involved in situations where it is obvious that inappropriate methods are being used. The first two you may be able to influence by rational argument based on the type of information we provide in this book.

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