HRI London 2023: The Homeopathy Research Community Reunites after a 4-Year Hiatus, Sparking Fresh Collaborations between Researchers 'Old and New'.

The Homeopathy Research Institute's (HRI) 5th international research conference took place in the heart of London, from 16th to 18th June 2023. With 230 attendees from 27 countries, HRI's conferences remain truly international. HRI London 2023 will be remembered for its inspiring blend of 'old and new', with a programme notable for the maturity of the evidence presented by experienced names drawing on decades of work, as well as the enthusiasm and skill of up-and-coming researchers who took the floor to present their new findings. In this report, we present scientific highlights from the event.

Technoscientific control of nature: The ultimate paradox.

The current interlinked environmental and socioeconomic global crises constitute the gravest threat to humanity's well-being, indeed survival, today. Studies of the historical roots and contemporary manifestations of the various elements of these crises-including accelerating environmental degradation, unfettered capitalist technoscientific/industrial expansion, overpopulation, and overconsumption-are plentiful. Also well-known is the influence of Francis Bacon's writings, particularly The Advancement of Learning (1605), Novum Organon (1620), and the utopian New Atlantis (1627), on the development of empiricism and the modern scientific method as well as the reform and organization of scientific research. Bacon's significance for the founding of the Royal Society of London (1660) and for the plan and structure of the Encyclopedie (1751-1772), coupled with his oft-cited aphoristic injunctions to study nature to control/dominate it, are staples in the lore and justification of technoscience. I argue that the enduring appeal of so-called Baconianism derives, in part, from a fundamental misappropriation of certain of Bacon's original ideas. Specifically, the complex ethical and religious framework within which Bacon situated his vision of scientific and technological development was discarded (or ignored) so that, by the early decades of the 18th century, Baconianism had come to be understood almost exclusively for its utilitarian role in society. This deracinated version became the familiar trope of technoscience's unlimited potential to transform nature (including human nature and behavior) in the service of an ideology of industrial/consumerist expansion since then. Linkage between the history of science/technology and addictive consumerism, apparent by the close of the 19th century, has been insufficiently examined. Such addictive consumerist behavior and continued virtually unregulated industrialization and production, were effectively removed from ethical scrutiny and a high degree of material acquisition and personal/societal rapaciousness became the norm rather than the exception in most countries. I suggest that further historical deconstruction of this denuded Baconianism will yield important insights in the search for viable solutions to the present global socioenvironmental crises.

HRI London 2019: 10 Years of Excellence in Homeopathy Research.

The Homeopathy Research Institute's (HRI's) 4th International Research Conference took place in the heart of London from 14 to 16 June 2019. With 352 attendees from 38 countries, this was HRI's largest and most international conference to date. HRI London 2019 will be remembered for the highest quality scientific programme so far, combined with a vibrant, positive atmosphere throughout, making it the perfect way to celebrate HRI's 10th Anniversary. Here we summarise the science presented during the intense 2.5-day programme.

Complementary medicine use in multi-ethnic paediatric outpatients.

OBJECTIVE: To determine the prevalence and determinants of complementary medicine (CM) use in a multi-ethnic paediatric outpatient population. METHODOLOGY: A parent-completed questionnaire survey of paediatric outpatients attending general and sub-specialist outpatient clinics at a North West London hospital during September to December 2005. RESULTS: Parents' use of CM for their children in this multi-ethnic population was higher than expected at 37%. Use was correlated with parental CM use and education but independent of ethnic group. Parental CM use and child's health status were significant predictors of child CM use. The main reason for using CM was word of mouth (45%) and the main source of information was friends and family (51%). The most popular treatments used for children were homeopathy and herbal medicine (used by 30% and 28% of CM users, respectively). 88% of CM was bought over the counter and 53% of CM use was not reported to their doctor. Parents also used traditional complementary remedies for their children. CONCLUSIONS: These results suggest that CM use in children is higher than previously estimated in the UK. This indicates the need for greater professional awareness of CM as part of clinical care. There is a need to acknowledge the beliefs that inform parents' decision-making process.

The costs of treating rheumatoid arthritis patients with complementary medicine: exploring the issue.

OBJECTIVES: To measure the marginal costs of providing complementary medicine services (mostly homoeopathy) in outpatient clinics for patients with rheumatoid arthritis (RA) and to illustrate how parameters to which the cost of complementary medicine may be sensitive can be identified. DESIGN: Retrospective, observational costing study. SETTING: The outpatient clinic of the Royal London Homoeopathic Hospital. SUBJECTS: Random sample of 89 patients from the 427 (RA) patients attending outpatient clinics from April 1995 to March 1996. MAIN OUTCOME MEASURES: The marginal costs incurred by the hospital of treating 89 patients attending outpatient clinics and the relative contribution of the different resources to the total costs. RESULTS: The total costs of treating 89 patients were 7,124 Pounds of which 543 Pounds was assumed to be fixed and the remainder variable. The marginal costs of treating additional patients, starting from zero patients treated, are presented. Consultation time (doctors and dietician) contributed to 29% of the total costs, non-conventional drugs contributed to 22% of the total costs. CONCLUSIONS: Understanding the marginal costs of providing complementary care to RA patients will inform the debate over whether these therapies are likely to be cost-effective. In addition, those who would like to explore the practicalities of establishing a service involving complementary medicine will gain an understanding of the likely provider costs. The cost of complementary medicine appears to be most sensitive to the time spent with the patient by the doctor.

Educating the reflective practitioner: graduates in practice.

This paper draws on interview research exploring how recently graduated acupuncturists and homeopaths construct their professional identities, with a goal of assessing whether the processes and values developed in the program are carried forward into practice. The interviews were designed to engage the participants in telling stories about their work and were analyzed through discourse analysis. Although the two practitioners at the focus of this paper show considerable difference in the sophistication of their client management, both can be seen to use reflection to identify problems and find solutions in their work with clients.

Evaluation of specific and non-specific effects in homeopathy: feasibility study for a randomised trial.

OBJECTIVE: To determine the feasibility, in terms of acceptability to patients, physicians and other staff; data return and statistical power of a study to elucidate the relative contributions of specific and non-specific effects in homeopathic treatment of dermatitis. DESIGN: Randomised, controlled 4-arm trial, 2 arms double-blind. SETTING: Outpatient clinic, Royal London Homoeopathic Hospital. PARTICIPANTS: Seventy-five adult patients with dermatitis. INTERVENTIONS: Patients were randomly allocated to: 'fast track' open verum homeopathy, 'fast track' double-blind verum homeopathy, 'fast track' double-blind placebo homeopathy or waiting list control. MAIN OUTCOME MEASURES: One hundred millimeter visual analogue scale of overall symptom severity; 10 point digital scores of sleep, itching, skin condition; weekly 5-point Likert scale of topical steroid use; Dermatology Life Quality Index at entry and completion. RESULTS: Recruitment was below target, but the study was acceptable to staff and feasible. Blinded patients were more likely to withdraw (P=0.021, chi2 test). After correction for baseline differences and multiple comparisons, no outcome measure showed statistically significant between group differences. Blindness appeared to have a negative effect, but this was confounded by differential withdrawal. CONCLUSIONS: A definitive trial of this design is unlikely to discriminate the relative contributions of the non-specific and specific effects to the outcome of homeopathic treatment of dermatitis, because of patient preference issues.

The feasibility of a randomised, placebo-controlled clinical trial of homeopathic treatment of depression in general practice.

UNLABELLED: Depression is common in general practice and lack of concordance is an important problem in its treatment. Homeopathy has few side effects and is generally associated with good compliance. We report a study investigating the feasibility of a trial to compare the effectiveness of homeopathy with a conventional antidepressant and placebo. OBJECTIVES: To assess the feasibility of a general practice-based clinical trial comparing the effectiveness of individualised homeopathic treatment vs Fluoxetine (Prozac) vs placebo in the treatment of major depressive episodes of moderate severity. DESIGN: Randomised, double-dummy, double-blind parallel group clinical trial. SETTING: Lower Clapton Group Practice, East London. METHOD: Patients were recruited through their general practitioners as they presented during a 9 month period. Recruitment target was 30 patients. Eligibility was confirmed by a consultant psychiatrist using standard criteria (DSM-IV) and instruments Hamilton Depression Scale (HAMD). Suicidal and psychotic patients were excluded, additional precautions against suicide were incorporated. There was a 1 week run-in period and patients showing spontaneous improvement were excluded. Homeopathic treatment was prescribed by a GP qualified in homeopathy, from a 'limited list' of 30 homeopathic medicines, with the help of decision support software. Patients were randomised to receive verum Fluoxetine and placebo homeopathy, or verum homeopathy and placebo Fluoxetine, or placebo homeopathy and placebo Fluoxetine. Treatment duration was 12 weeks. The outcomes were: adverse drug reactions, clinical global impression (CGI); HAMD; mini international psychiatric Interview; Pittsburgh sleep quality index; Side-effects checklist; Short Form 12; treatment credibility questionnaire; work and social disability scale. The primary outcome measures were HAMD and CGI. RESULTS: A recruitment calculation indicated that over 230 suitable patients would be expected to attend the practice during the recruitment phase. Thirty one patients were referred for possible inclusion in the trial by their GPs. Twenty three met the entry criteria, 11 were randomised and 6 completed the study. Of the completers, one received homeopathy, 2 placebo and 3 Fluoxetine. CONCLUSIONS: A trial of this design in general practice is not feasible, because of recruitment difficulties, many of them linked to patient preference. Different approaches are required to recruit adequate patient numbers to trials of this sort.

The perceived efficacy of complementary and orthodox medicine in complementary and general practice patients.

A total of 216 patients attending either the British School of Osteopathy, a large acupuncture centre (City Health Centre), the Royal Homeopathic Hospital or a large general practice in South London completed a questionnaire on the perceived efficacy of orthodox and complementary medicine. The questionnaire covered 1) demographic information and experience of complementary medicine; 2) the Health Locus of Control scale; (3) attitudinal variables: belief in the importance of a scientific base to medicine, the importance of psychological factors in illness and the possible side effects of modern medicine; and 4) ratings of the perceived efficacy of acupuncture, osteopathy, homeopathy, herbalism and orthodox medicine for 16 illnesses, divided into four categories: major, minor, chronic and psychological. Whilst there was no difference between the four groups, health locus of control beliefs showed the acupuncture patients believed less in the scientific basis of orthodox medicine and more in its harmful effects compared with all other groups. Again, acupuncture patients more than any other group tended to believe in the efficacy of that therapy to 'cure' major, minor, chronic and psychological problems. Beliefs in the efficacy of complementary therapies were associated with a belief in importance of psychological factors in illness and concerns about the harmful effects of orthodox medicine. Results are discussed in terms of three things: differences between lay and professional medical beliefs; the health education implications for this research, and the role of complementary therapies in general practice and health promotion.

From 19th century nursing reforms to current practice: a selective overview with special reference to The Royal London Homoeopathic Hospital (The Royal London Homoeopathic Hospital NHS trust from 1993).

Early nursing reforms in the 19th century are usually associated with Nightingale, although later emphasis has been placed on similar movements in the Poor Law sector. Extension of nursing influence over decision-making in terms of nursing practice and education is charted, using examples from 19th century Minutes of hospital committees and more recent experience based mainly on the observations made by one of the writers, who had substantial input into steering the hospital through the stages prior to achieving National Health Service (NHS) Trust status. The significance of nurse executive power following the 1990s NHS reforms is highlighted and means of extending the use of this authority are explored.