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A Once this anomaly had been demonstrated it was purchase lipitor discount grams of cholesterol in eggs, great void is left in the surgery of France 40 mg lipitor with visa cholesterol readings chart australia. Leveuf attended the annual meeting of the British Orthopedic Association in Manchester in October 1947 discount lipitor 40mg with amex low cholesterol eggs in india, and appeared to be full of vigor purchase lipitor visa cholesterol hypertension medication. In the early part of 1948 he attended the meeting of the American Academy of Orthopedic Surgeons in Chicago. After his return from the United States it became evident that he was a tired man, and very soon there were unmistakable signs of the grave malady that brought his life to an end. By the death of Professor Jacques Leveuf at the height of his powers, French orthopedic surgery has been deprived of an outstanding modern leader. His dynamic personality had become one of the features of recent meetings of the British Orthopedic Association, of which he was elected an honorary member in 1945. After the liberation of France, he was eager to establish contact with his British colleagues and to expound with char- acteristic vehemence and eloquence his views on congenital dislocation of the hip, on acute Erich LEXER osteomyelitis, and on many other subjects in which he appeared always to challenge orthodox 1867–1937 beliefs and practice. During his adolescence, the family suddenly at the age of 63 in the midst of a stren- moved to Würzburg, where Lexer attended the uous surgical and scientiﬁc life. Many cultural, university, graduating from the medical school in literary and artistic interests showed the breadth 1890. Above all, his character was study of anatomy in Göttingen, Lexer began his notable for a swiftness of comprehension. His surgical training in 1892 in the famous clinic of passion for surgery, and the ﬂame of his enthusi- Ernst von Bergmann in Berlin. He remained there asm, led him to express views with an ardor that for 12 years. During this period he established won furious opposition, or enthusiastic support, himself as an investigator and a surgeon. With this impetuosity he was appointed Professor of Surgery in nevertheless had the rare quality of being able to Königsberg in 1905. Freiburg in 1919, and ﬁnally to Munich in 1928, This agility of mind, enthusiasm, and direct where he was the successor to Sauerbruch. His reputation as a general and plastic surgeon He made of the Clinique des Enfants Malades continued to grow, with the years in Munich a complete service, directing a group of distin- marking the zenith of his career. His clinic was guished colleagues, and himself taking a leading crowded with patients, students, and visiting sur- part in the orthopedic surgery of children in geons from throughout the world. Unfortunately, which he was so interested, in traumatology, an acute coronary occlusion brought an abrupt neurosurgery, and plastic surgery. His pioneer work on the transplantation of tissues such as fat, fascia, tendons, nerves, and bone continues to inﬂuence orthopedic and plastic surgery procedures today. His use of whole joints from cadavers as trans- plants into patients was just a small part of this work. We are fortunate that one of his students has compiled a bibliography of these papers. His ego at times caused him to be abrasive and aggres- sive, but none of his contemporaries doubted his ability. His great artistic talent was sublimated in his surgical technique, which was of such a high level of virtuosity that it lent itself easily to show- manship. Lexer was a surgeon in a very broad Robert Korn LIPPMANN sense who made substantial and lasting contribu- tions to the development of the special areas of 1898–1969 plastic and orthopedic surgery. Lippmann was born and educated in New York, having been graduated from De Witt References Clinton High School in 1915 and Columbia Uni- versity in 1918, where he received a BS degree. Plast Reconstr Surg 29:141 Lippmann was an intern at Mount Sinai Hospital. Plast Reconstr Surg 30:670 His ﬁrst year in orthopedics was spent studying bone pathology in Vienna in the laboratory of Professor Erdheim, where he was introduced to a basic scientiﬁc approach to the specialty that remained the foundation of much of his future work. In 1925, he studied under Professor Putti at the Istituto Rizzoli in Bologna. He began investigating the pathology and etiology of osteochondritis of the hip in children. While Adjunct, then Associate Orthopedic Surgeon, and ﬁnally Chief of the Orthopedic Clinic at Mount Sinai Hospital, Dr. Lippmann also served as Adjunct Orthopedic Surgeon and Associate Orthopedic Surgeon at Monteﬁore Hospital. At Monteﬁore he became Chief of Service in 1938, but resigned in 1942, 3 years after he became Director of the Department of Orthopedic Surgery and Orthopedic Surgeon-in- Chief at Mount Sinai Hospital. Lippmann served as Orthopedic Surgeon-in-Chief for almost 30 years at Blythedale, a long-term children’s care hospital in Valhalla, New York, and at the 196 Who’s Who in Orthopedics time of his death was Director Emeritus of Ortho- his scientiﬁc inquiry and teaching, his sense of pedics, and Emeritus Professor of the Department humanity and the ethical code manifest in his of Orthopedics of Mount Sinai School of practice and in his approach to patients formed Medicine. Lippmann was a superb craftsman, capable great inﬂuence on the growth of the hospital as a of translating his mechanical concepts into reality. In his ofﬁce was a workshop with power tools and Until his untimely and sudden death on June 9, a lathe to work out the designs of devices that 1969, at the age of 70, Dr. Robert Korn Lippmann were later fabricated, or new instruments to was actively engaged in orthopedic practice. Among his many original Lippmann was survived by his wife, his daugh- contributions were the ﬁrst compression bolt for ter, Mrs. Lippmann Orthopedic Research Laboratory at Mount Sinai was established in 1965 in his honor. Lippmann participated in community, national, and interna- tional orthopedics. He was a Fellow of the New York Academy of Medicine, serving as secretary (1949–1950) and chairman (1950–1951) of the orthopedic section, and as a member of the advi- sory committee (1951–1956). He was a Fellow of the American College of Surgeons (1932), serving as a member of its New York and Brooklyn Regional Fracture Committee (1949). He was a Fellow of the American Academy of Orthopedic Surgeons (1932) and a member of the American Orthopedic Association (1954), the Orthopedic Research Society (1959), and the Joseph LISTER Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) (1957). Lippmann developed a spirit of cooperation and dedication on the Mount Sinai Orthopedic Joseph Lister was born at Upton House, Essex, on Service. For generations his family had agreements, and thorough exploration of clinical belonged to the Society of Friends and the early problems. These were his basic techniques in inﬂuence of this body continued to govern his resident-training. He had considerable success in back of his mind was always the idea that he business in the city and somehow managed in his would some day describe the principles of con- leisure to acquire a worldwide reputation for his servative orthopedics that he taught—a task that researches in optics, which led to the perfection must be completed by his students. He also collab- many contacts with the residents and staff, orated with Thomas Hodgkin in the publication particularly at the monthly evening journal club of papers on microscopic observations of meetings at their home in New York and at their blood and animal tissues. Lippmann’s it may be gathered that the young Lister was born service and leadership over a period of 43 years, into an environment highly favorable for the 197 Who’s Who in Orthopedics pursuit of science; and in his great quest he was less ridicule. Morton, whom destined to gaze at the amazing new world of Wells taught, succeeded in inducing anesthesia microorganisms through an apparatus perfected while J. On December 21 of the same year, Robert he showed an early taste for natural science and Liston at University College Hospital carried out which led to his choice of medicine as a career. Hospital, London, where he took his BA degree This was a memorable time—the birth of a new before proceeding to professional training.
In cases where roof osteo- phytes are absent discount lipitor uk cholesterol prescription medication, we cannot expect new growth cheap 40mg lipitor overnight delivery cholesterol medication wiki. He said that preoperative AHI must be 60% for OA Joint Reconstruction Without Replacement Surgery 173 Table 1 cheap 10mg lipitor cholesterol in large eggs. Contributing factors to radiologic results of valgus-ﬂexion osteotomy (VFO) Good Fair Poor 19 (63 buy discount lipitor on line cholesterol medication alternatives. AHI, acetabular head index; RO, roof osteophyte Data are mean ± SD Source: From Uchiyama et al. However, successful cases had preoperative AHI of 70%–73%; AHI immediately postoperative was 73%, the length of the roof osteophyte was 8. Other factors, such as age, body mass index (BMI), Sharp’s angle, or the size of the capital drop, were not directly associated with the results (Table 1). Discussion of the Biological and Biomechanical Mechanism of VFO Now I turn to a discussion of the biological and biomechanical mechanism of VFO. The basic idea is that biological effects can be introduced with the improvement of the biomechanical environment in the diseased hip joints. To ascertain the biological effect, we performed histological evaluation of 15 joints with good postoperative remodeling of the articular surface. At the time of implant removal, 1 to 3 years after osteotomy, histological specimens were taken from the patients with their consent. Under arthroscopic control, biopsy specimens were harvested, through the blade channel, from the area where there was no joint cartilage before the index surgery [15,16]. The arthrogram showed some radiolucent lines, above and below the contrast medium, which area was harvested (Fig. The tissue is very well stained by Safranin-O; the superﬁcial layer has formed a relatively smooth articu- lar surface. Unlike normal cartilage, however, the feature is that the ﬁbrous structure is relatively coarse. Looking at the superﬁcial layer, there are spindle-shaped cells within the ﬁbrous structure that run in parallel to the articular surface (Fig. The middle layer has relatively round cells with bright cytoplasm, conceivably cartilagi- nous cells, within the meshlike network of the ﬁbrous structure (Fig. In the deep layer, within the ﬁbrous structure, which runs completely perpendicular to the weight- bearing surface and stains strongly with Safranin O, bright round cartilaginous cells are observed. Another point to note is that the deepest part of the reparative tissue maintains communication with the bone marrow, and no tidemarks or subchondral bone plate are found (Fig. If S-100 protein is used to stain the tissue, most cells stain positive, substantiating the ﬁnding that they are indeed chondrocytes (Fig. Histological ﬁndings of surface repair tissue harvested from the femoral head of the patient presented on Fig. Regeneration of cartilage means cellular proliferation and matrix production. Valgus-ﬂexion osteotomy recruits undifferentiated mesenchymal cells from the bone marrow, which in turn will differ- entiate, proliferate, and produce cartilage matrix. It is believed that such a biological response is triggered by the improvement of biomechanical environment. To prove this, a number of parameters were studied, OA Joint Reconstruction Without Replacement Surgery 175 using Frankel’s free-body technique. The center of rotation of the head is plotted as the center of a circle by a digitizer, by taking 5 points on the weight-bearing surface, and its position within a coordinate was calculated by computer. I wish to call par- ticular attention to the resultant force (RF), which is the sum of force applied to the hip joint and the average pressure acting on the unit area of the femoral head (Pu). As a result of measurement and calculation, it was determined that RF was about 243 preoperatively, which decreased to about 70. As a result of the increased area of the weight-bearing surface with an extended roof osteophyte and medialization of the center of rotation, the average surface pressure (Pu) was reduced to about 44. Such an improvement in the mechanical weight-bearing environment seems to bring about the biological response. Despite the improvement, however, the levels of RF and Pu would never match those of ten cases of normal control women. To present what I mean, the force applied on the hip joint (RF) has a counterforce of RF’. RF’ is composed of P, which is perpendicular to the articular surface, and S, which is parallel to the articular surface. S is a force, directed lateral to the joint, that pushes out the femoral head laterally, in the dysplastic OA, which has an inclined acetabular weight-bearing surface. When the articular surface becomes more hori- zontal after VFO with horizontal growth of the roof osteophyte, RF’ is now composed of P, which is still perpendicular to the articular surface, and Q, which is a force that pushes in the femoral head medially, a stabilizing force, instead of S. With this, the weight-bearing environment for a stable joint is now available. Hip joint score was improved from 51 to 92; the average surface pressure was signiﬁcantly improved from 0. Coming back to the old discussion about the reparative and regenerative capacity of articular cartilage, the literature shows that there is no repair of damage and defect localized in the cartilage in situ, in other words, there is no intrinsic repair of cartilage. Damage and defect that extends to subchondral bone, however, can be repaired by tissue derived from the bone marrow or capsular or synovial tissue around the cartilage. That is to say that an extrinsic pathway for repair is believed to be present. Change in biomechanical environment by VFO Preoperative Postoperative (%)a Controlb c/b 0. RF, resultant force; S, force-S; P, force-P; Q, force-Q As we consider the mechanism of joint regeneration in our VFO, there is a remodeling process in which bone structure is reconstructed under an improved mechanical environment, and at the same time, the expanded joint gap harbors inter- posing reparative tissues. That is the biological reparative process, triggered in response to the changes in the dynamic biomechanical environment. The chondroid plug in the weight-bearing surface, which is highly capable of regeneration, continues to become worn under the very harsh weight-bearing conditions of OA and loses its regenerative ability. However, with VFO, when the environment is improved, the chondroid plug will spread on the articular surface, proliferate overall, and form the cartilage matrix [15,18]. The basic principle of OA treatment for the pre- and initial stage of OA, where the cartilage is still intact, is to enlarge the weight-bearing area and to improve congru- ency and the mechanical environment, thereby preventing the destruction of cartilage and preventing the progression of OA. In the case of advanced- and terminal-stage OA, when there is no longer cartilage in the weight-bearing surface, then the congru- ency should be destroyed ﬁrst to improve the mechanical condition and to assist the formation of repair tissue and promote the repair of the articular surface. The question is whether the cartilage would simply disappear, or whether chondroid plug-producing bone marrow would appear in the articular surface. If we wanted to treat all cases the same way, with enlarged weight-bearing area and improved congruency, as was the case in pre- and initial-stage OA, there is a limit to what we could accomplish. OA Joint Reconstruction Without Replacement Surgery 177 Significance of VFO for Advanced- and Terminal-Stage OA in Middle-Aged Patients Dr. Takatori presented the effectiveness of rotational acetabular osteotomy (RAO). For example, what happens if RAO is performed at the age of 35, as opposed to doing nothing at that age and THR at the age of 45?
In starting the child neurology program cheap lipitor american express cholesterol test at pharmacy, Freeman’s initial goal was to reverse the segregation policy that had been in place during his residency cheap lipitor 20 mg without a prescription cholesterol test variation. He established an integrated clinic that wall open to all—black buy 5mg lipitor free shipping free cholesterol test galway, white purchase discount lipitor line average cholesterol by age uk, rich or poor—and staffed it with residents and medical students under his supervision. Freeman also organized a com- bined service for pediatric neurology and neurosurgery patients. Clearly, the patients received better and more consistent care than if they had been on only a surgical ser- vice. Unfortunately, in later years because of house staff shortages, billing, and other issues, this unique concept had to be abandoned. The goal of the pediatric neurology training program was identical to that of adult neurology, i. During his tenure as Director of Child Neurology from 1969 to 1990, he trained 44 individuals in child neurology. Thirty-one of the 44 entered academic neurology and most went on to run their own training programs—wonderful legacy! His philosophy was to attract the best and the brightest and instill in than the joys of academia. As one of his pupils, I can personally attest to his strong character, teaching and motiva- tional skills, academic achievements, but most importantly to his ability to be a friend and long-term counselor. This book is a testimony to the quality and quantity of an impressive group of residents trained over the years at Johns Hopkins. Haller Professor of Pediatric Neurology Director, Child Neurology Johns Hopkins University School of Medicine Contributors Anthony M. Avellino Division of Pediatric Neurosurgery, Children’s Hospital and Regional Medical Center, University of Washington School of Medicine, Seattle, Washington, U. Bale Division of Neurology, Department of Pediatrics, The University of Utah School of Medicine, Salt Lake City, U. Shannon Barnett Department of Psychiatry, The Johns Hopkins Hospital, Baltimore, Maryland, U. Belman Department of Neurology, School of Medicine, State University of New York (SUNY) at Stony Brook, Stony Brook, New York, U. Bergin Childrens Hospital, Department of Neurology, Boston, Massachusetts, U. Bibat Neurogenetics Unit, Kennedy Krieger Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland, U. Ian Butler The University of Texas Medical School at Houston, Houston, Texas, U. Department of Neurological Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, U. Cohn Johns Hopkins Hospital, Children’s Center, McKusick-Nathans Institute of Genetic Medicine, Baltimore, Maryland, U. Conry George Washington University School of Medicine, Children’s National Medical Center, Washington, D. Courvoisie Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins Medical Institutions, Baltimore, Maryland, U. Martha Bridge Denckla Johns Hopkins University School of Medicine, Kennedy Krieger Institute, Baltimore, Maryland, U. Dure, IV Division of Pediatric Neurology, Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, Alabama, U. Paul Grahan Fisher The Beirne Family Director of Neuro-Oncology at Packard Children’s Hospital, Stanford University, Stanford, California, U. Freeman Pediatrics and Neurology, Johns Hopkins Hospital, Baltimore, Maryland, U. Natan Gadoth Department of Neurology, Meir General Hospital, Kfar Saba, Israel William Davis Gaillard Department of Neurology, Children’s National Medical Center, Washington, D. Gailloud Division of Interventional Neuroradiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, U. Gilbert Cincinnati Children’s Hospital Medical Center, Movement Disorders Clinics, Cincinnati, Ohio, U. Fiona Goodwin Department of Pediatric Neurology, Child Health, University of Southampton and Southampton University Hospitals, Southampton, U. Grados The Johns Hopkins Hospital, Department of Psychiatry, Division of Child and Adolescent Psychiatry, Baltimore, Maryland, U. Gray Kennedy Krieger Institute, Department of Neuropsychology, Baltimore, Maryland, U. Carolyn Elizabeth Hart Mecklenburg Neurological Associates, Charlotte, North Carolina, U. Hayﬂick Molecular and Medical Genetics, Pediatrics and Neurology, Oregon Health & Science University, Portland, Oregon, U. Michael Hemphill Department of Neurology, Medical College of Georgia, Savannah Neurology, Savannah, Georgia, U. Alec Hoon Johns Hopkins University School of Medicine, Kennedy Krieger Institute, Baltimore, Maryland, U. Judy Huang Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U. Ichord Department of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, U. Jinnah Department of Neurology, Johns Hopkins University, Baltimore, Maryland, U. Johnston Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, U. Edwards School of Medicine, Marshall University, Huntington, West Virginia, U. Jordan Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, U. Richard Kaplan Southern California Permanente Medical Group, San Diego, California, U. Colin Kennedy Department of Pediatric Neurology, Child Health, University of Southampton and Southampton University Hospitals, Southampton, U. Douglas Kerr Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, U. Julie Newman Kingery Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, U. Kinsman Departement of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, U. Chitra Krishnan Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, U. Lee Departments of Anesthesiology, Critical Care Medicine, and Pediatrics, The John Hopkins Hospital, Baltimore, Maryland, U.
For example 5 mg lipitor for sale cholesterol test tips, Natalie told me that she practised alternative healing independently out of her home: “I would try to heal people with my mind from a distance discount lipitor online master card cholesterol ratio ldl hdl calculator, or with my hands from a distance buy lipitor 20 mg on-line cholesterol avocado, and I was finding it was working discount lipitor 5 mg fast delivery cholesterol ranges nhs. For these people, a key encounter with an alternative practitioner reinforced their commitment to these therapies (Deierlein 1994). For example, Scott and Natalie told me about meetings with alternative practitioners that launched them on the road to becoming healers themselves. She was really inspiring, she was amazing, she was full of life and joy and she had her own health and she had her practice room and she had her own world and she travelled all over the world and did this and that and met all these amazing healers, and I had never really thought about healing up until this time. But I realized as I was getting to know this woman, it was like: ‘Oh my god! We talked about nutrition and everything else and then he said, ‘Natalie, you’re a healer. For instance, after experiencing successful acupuncture treatments, Simon made the decision to leave medical school and train to become an acupuncturist: I was on every kind of muscle relaxant, painkiller, sleep aid, everything. My chiropractor also does acupuncture so we tried acupuncture and within two weeks I was off all the medications and I said: ‘You know, I’m going into this field’ and that’s what I did. Said goodbye to formal education and mainstream medicine and went into the alternative. These key encounters and experiences are important because it is through them that alternative ideology is more deeply internalized by the individual. In other words, an individual’s “commitment to a healer/client relationship,” in particular, is instrumental in the adoption of alternative belief systems (Deierlein 1994:180). Deepening commitment to alternative ideology is, in turn, what propels people along the continuum of identity change. For example, it was the intensity of Marie’s belief in alternative therapies that inspired her to become an alternative practitioner: “I became a certified reflexologist because I believe in those things so much” (emphasis mine). CHANGES IN SELF-PERCEPTION Adopting a healer identity was one type of self-change experienced by the people who took part in this study; however, it was not the only one. For many informants, participation in alternative therapies, and adoption of alternative health and healing ideologies, led to changes in their subjective perceptions of self. In particular, it allowed them to re-define aspects of personal identity, that “unique collection of life history items that comes to be attached to the individual” (Goffman 1963:57). That participation in alternative approaches to health care can have this effect has been observed in other research on the users of alternative therapies (Csordas 1983; Easthope 1993; Glik 1988 1990; McGuire 1983, 1987; Pawluch et al. For instance, in describing the use of creative visualization among participants in a metaphysical healing group (MHG), Glik (1988:1201) reports that “In MHGs images of light emanating from and surrounding the self protected from dark forces and to some degree transformed self and others” (emphasis mine). According to Natalie, “I heard about that [course] through the healing circle; somebody mentioned to me that they were going to take it. Some told me that using alternative therapies altered their entire lives or their whole selves. Others perceived these changes to self to have occurred primarily on the level of their value systems or their personalities. For instance, some informants felt that using alternative approaches to health and healing impacted on their lives in some fundamental and per- vasive way. In Hanna’s words, The idea is that since you’re affecting the whole nervous system and hence the whole body you can have profound physical and emotional change happening. If I have a holistic perspective I know that I’m also working with someone’s emotions and their whole self.... It’s not like you’re just doing a physical thing: you change them emotionally and you change their attitude. Natalie also told me that her alternative therapies are oriented towards healing a person’s whole life: “Their life, mentally and physically and spiritually. For example, Roger told me the following: Alternative Healing and the Self | 87 I quickly saw that it had applications for the work I was doing with the handicapped people, just for working on the general organization of the nervous system, the musculature, the organization of the person in general. One of the reasons I think that the Feldenkrais work touched me so personally when I experienced the work were some of the effects on just balancing and organizing the system, the nervous system, the person. Changes in Personality Almost all of the people who spoke with me felt that their use of alternative therapies resulted in changes to one or more aspects of their personalities. For instance, Laura felt she had gained confidence and become a more assertive person through her use of alternative therapies: “At the time I wasn’t a very assertive person, I don’t believe that any more about myself.... For example, Pam believed that an alternative approach resulted in what she saw as a remarkable change in her daughter’s entire personality: I removed all the wheat that you could just see, the bread, the buns. And within three weeks there was a remarkable change, change in personality, the temper tantrums left, the disorganization left. Hanna also believed that several aspects of her personality had changed and that she had become a calmer, more tolerant, more contented, and a less worried person: I’m a lot more level. When you do yoga for several years you go through different levels of experiences and you learn not to question what’s happening to you.... It means more contentment because you’re not 88 | Using Alternative Therapies: A Qualitative Analysis worried. I feel a lot more self-sufficient, I don’t worry about the future any more. Similarly, Brenda believed she had become a more patient and tolerant person, less argumentative and judgmental, more honest with herself, and, in general, happier: I don’t judge anybody; the other thing is happiness. Also relationships, I was always angry with something, I was never satisfied, everything was wrong. Our lives were just bitching and complaining at each other and now we don’t ever. The changes Betty saw in her personality included becoming more confident and calmer, as well as less fearful and worried. She told me, “Things don’t bother me nearly as deeply or the same as they would have. I have a confidence in myself, in my ability, in my life, that I didn’t used to have. For instance, Hanna said that one of the changes she experienced in her personality was “being just a little bit more psychic. I think once you become spiritually aware or are beyond the two dimensions of body and mind I think you can,... I even said to her [alternative practitioner], ‘How will I know when I’m intuitive? Finally, Jenny pointed out that it was the changes to personality she experienced as a result of her use of alternative therapies that led to physical benefits for her. She said: “It’s given me at certain times a greater composure, ability to survive, openness to others and just a greater sense of well-being which goes through to the way I feel physically. Those who perceived their values to have changed were more likely to espouse non-mainstream religious beliefs. For example, both Hanna, who is a Buddhist, and Lorraine, who follows new age spirituality, felt they had changed in terms of the value they placed on material things. There was a point in my life that I could have never said that, they’re only things, they do not matter. Whether the changes these people perceive occur on the level of value systems, personality, or in the whole person, they are experienced as positive change. According to Lindsay, I got my orthotics and balanced my feet and started having my chiropractic done and balanced my hips.