By J. Silas. American Graduate School of International Management.
X When noting details for books discount 100mg suhagra free shipping, reports or articles which may appear in the final report, include all the details which would be needed for the bibliography. By now you should have decided what type of peo- ple you need to contact. For some research projects, there will be only a small number of people within your research population, in which case it might be possible to contact everyone. However, for most pro- jects, unless you have a huge budget, limitless timescale and large team of interviewers, it will be difficult to speak to every person within your research population. SAMPLING Researchers overcome this problem by choosing a smaller, more manageable number of people to take part in their research. In quantitative research, it is believed that if this sample is chosen carefully using the correct procedure, it is then possible to generalise the re- sults to the whole of the research population. For many qualitative researchers however, the ability to generalise their work to the whole research population is not the goal. Instead, they might seek to describe or explain what is hap- pening within a smaller group of people. This, they believe, might provide insights into the behaviour of the wider re- search population, but they accept that everyone is different 47 48 / PRACTICAL RESEARCH METHODS and that if the research were to be conducted with another group of people the results might not be the same. Market research- ers use them to find out what the general population think about a new product or new advertisement. When they re- port that 87% of the population like the smell of a new brand of washing powder, they haven’t spoken to the whole population, but instead have contacted only a sam- ple of people which they believe are able to represent the whole population. When we hear that 42% of the popula- tion intend to vote Labour at the next General Election, only a sample of people have been asked about their voting intentions. If the sample has not been chosen very care- fully, the results of such surveys can be misleading. Imagine how misleading the results of a ‘national’ survey on voting habits would be if the interviews were conducted only in the leafy suburbs of an English southern city. Probability samples and purposive samples There are many different ways to choose a sample, and the method used will depend upon the area of research, re- search methodology and preference of the researcher.
X Include details about how the questionnaire is to be re- turned (making sure you enclose a pre-paid envelope if you need the respondent to return the form to you) 100 mg suhagra for sale. X Make sure you include a date by which time you would like the questionnaire returned. X Pilot the questionnaire and instructions to check that all can be understood. It is a procedure for generating under- standing about the way of life of others. However, as there are many practical ‘how to’ issues involved in the use of participant observation, I am going to discuss it as a re- search method. But as you will see, there are several meth- odological issues which are raised in the following discussion, especially concerning ethics and the personal role of the researcher. Participant observation can be carried out within any community, culture or context which is different to the usual community and/or culture of the researcher. It may be carried out within a remote African tribe or in hospitals, factories, schools, prisons and so on, within your own country. The researcher immerses herself into the community – the action is deliberate and intended to add to knowledge. The researcher participates in the community while obser- ving others within that community, and as such she must 101 102 / PRACTICAL RESEARCH METHODS be a researcher 24 hours a day. In practice most research- ers find that they play more of a role as observer, than they do as a participant. GAINING ACCESS Participant observation, as a research method, cannot work unless you’re able to gain access to the community that you wish to study. Before you spend a lot of time plan- ning your project you need to find out whether you can ob- tain this access. The level of negotiation required will depend upon the community, culture or context. If it is a culture with which you already have a certain amount of familiarity, and vice versa, you should find it easier to gain access.
Following the death of a three-year- old boy in Dublin who accidently consumed methadone kept by his parents (for measuring purposes) in a baby’s bottle order 100mg suhagra with amex, a survey revealed this to be a widespread practice (the Manchester figures included four fatalities among young children) (Harkin et al. Despite the evidence of the dangerous consequences of methadone for individual drug users and their families, the pressures on GPs to participate in methadone maintenance have intensified. In East London, we have been bombarded with methadone propaganda and invited to specially organised local seminars. The new guidelines are linked with cash incentives, offering GPs around £20 per month per patient. An editorial in the BMJ, significantly written by the main author of the Sheffield study quoted above, after asserting that the efficacy of methadone maintenance ‘is now so well established’ inquired rhetorically: ‘for how long can it be considered ethical for some GPs to refuse to prescribe it within a shared care framework? Such is the degradation of medical ethics that it is now considered virtuous for doctors to take on the role and responsibilities of the police and to subordinate the best interests of their patients to the dictates of government drug policy. Is it now to be considered ethical for GPs to take on the role of the police in relation to their patients? In his comprehensive history of modern medicine, Roy Porter comments caustically on the way in which, in the 1940s, ‘the American medical profession fell into line with the criminalisation of narcotics, accepting funds made available for setting up detoxification units and the development of anti-addiction drugs like methadone’ (Porter 1997:666). Though Porter confines his censure of the medical profession to the past, his criticism of the US physicians of the 1940s has a remarkable contemporary resonance: They could easily convince themselves that they were helping addicts and society, while doing their careers a favour’. When drug addicts ask for methadone today, I try to explain the conclusions I have drawn from my experience and my particular reluctance to play the role of a deputy constable in the drug squad in the current methadone programme. If they still want methadone, I refer them to the appropriate local agency. Otherwise, I indicate that 104 THE EXPANSION OF HEALTH I would be happy to help them with their general medical problems, while leaving their drug problem to the only person competent to sort it out, themselves. I find that this approach opens the way to a much more constructive doctor-patient relationship than I could ever achieve while haggling over doses of methadone. The devaluation of diagnosis You meet a lot of people in general practice who defy conventional psychiatric categories, but who are equally clearly some way beyond the realm of any concept of normality.
What is common in all cases order suhagra 100 mg online, however, is that they distinguish alternative therapy by differentiating it from what they see as the negative standard of Western biomedical treatment (see Figure 4. Acute All the people who spoke with me said that serious, acute, and emergency situations are the proper sphere of allopathic medicine. For example, Roger told me that while he is extremely reluctant to use allopathic therapies, he does feel that “medicine has some very powerful weapons” to mobilize in cases of acute illness. As Richard graphically put it: “If someone comes to you with their finger half cut off you don’t give them herbs to make it grow back. If I’m having a heart attack I want to go to an allopathic medical doctor. For instance, Lindsay told me, “If I had a ruptured appendix I don’t think I’d go see a naturopath, I think I’d probably be here at [the hospital]. But, you know, for long-term things alternative therapies really helped me. However, if it’s not an acute thing that requires emergency service, I will turn to my alternative health care. Dualistic Holism is perhaps most often cited as a defining criterion of alternative approaches to healing (Lowenberg1992). It’s not someone saying: ‘Here, take two aspirin, call me in the morning. In her words: A doctor can say, ‘Okay, we’ve removed the cancer, we’ve healed that patient. Similarly, for Jane, alternative healing means “treating all of the person” rather than just the symptoms of the disease. She put it this way: You can’t just say we’re going to treat your stomach without saying, ‘Well why is it the stomach? Does this person have emotional prob- lems or stresses on their shoulders that’s causing this problem?
Histology has been related in some studies to outcome generic suhagra 100 mg without a prescription, as patients with ana- plastic ependymomas do not fare as well as those with benign or cellular ependymomas. Postoperative focal radiotherapy, ranging in doses between 5500 and 6000 cGy, has been a conventional component of therapy for patients with ependymomas. Patients who undergo total resections may fare well after total resection without any other form of adjuvant therapy. However, the majority of such reports have been in patients with cortical, as opposed to posterior fossa, ependymomas. Local radiotherapy is as effective as craniospinal plus local radiotherapy. Until recently, chemotherapy has not been shown to improve survival for patients with ependymo- mas. Preliminary data suggest that the addition of chemotherapy prior to radiother- apy improves disease control in patients with partially resected lesions. Atypical teratoidrhabdoid tumors of the central nervous system have been increas- ingly recognized over the past decade. Approximately one-half to two-thirds of these tumors arise in the posterior fossa. Since they exhibit histological features consistent with other forms of primitive neu- roectodermal tumors and have a population of rhabdoid cells, diagnosis is often dif- ficult. Immunohistochemical analysis is critical, as the rhabdoid regions of the tumor can express epidermal membrane antigen, vimentin, and smooth muscle actin in the majority of cases. Molecular genetic analysis documenting a mutation on chromo- some 22 is critical in separating atypical teratoidrhabdoid tumors from other primi- tive neuroectodermal tumors of the posterior fossa. The management of atypical teratoidrhabdoid tumors is quite challenging. In the majority of patients less than two years of age, treatment with chemotherapy alone or chemotherapy plus local radiotherapy has resulted in disease control in less placement. Infants with high CSF protein and venticulomegaly (‘‘hydrocephalus ex vacuo’’) have less favorable prognoses.
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