Jeffrey A Brinker, M.D.
- Professor of Medicine
- Joint Appointment in Radiology and Radiological Science
It also calls for the development of a research agenda to 60 caps menosan free shipping zeolite herbals pvt ltd evaluate and guide improvements in confict of interest policies and procedures buy 60caps menosan with mastercard biotique herbals. Patients generic 60caps menosan mastercard just herbals, patients’ families, physicians, other researchers, and policy makers need to trust that the design, conduct, and reporting of such research are unbiased and that the time and effort that they contribute to research will be used to advance science. Participants in clinical trials need to trust that they are not exposed to unnecessary risk. Confict of interest policies should not only address concerns that fnancial relationships with industry may lead to bias or a loss of trust but should also consider the potential benefts of such relationships in specifc situations. Research partnerships among industry, academia, and government are essential to the discovery and development of new medications and medical devices that provide improved means for the prevention, diagnosis, and treatment of health problems. Historically, the federal government has taken the lead in supporting discoveries in basic science, whereas commercial frms have focused on the discovery of specifc medicines and then their development through clinical trials to the regulatory approval of marketable products. The law allowed institutions to patent discoveries resulting from federally funded research and to grant licenses for others to develop those discoveries. Since the law’s passage, patent licensing and other fnancial relationships linking medical researchers and research institutions with industry have expanded substantially (Schacht, 2008). Some scholars, however, have pointed to factors in addition to the legislation that may be associated with the historical increase in the numbers of patents, including a broadening of the criteria that allow materials to be patentable (particularly for life forms) and advances in biomedical research (see. This chapter starts with a brief overview of some dimensions of university-industry collaborations in biomedical research and then summarizes data on the extent of the relationships between pharmaceutical, device, and biotechnology companies and academic research institutions and individual researchers. The next sections review concerns about these relationships and responses to those concerns. For example, basic researchers, often at academic medical centers and other research institutions, can identify new potential targets for therapies and new strategies for treatment, suggest additional diseases that may be able to be treated by existing and newly developed compounds, and suggest both how to target therapies to the patients who are the most likely to beneft and how to avoid particular treatments for patients at high risk for adverse events from those treatments. In addition, basic scientists at biotechnology and pharmaceutical companies have made fundamental discoveries that have led to new therapies. Scientists at pharmaceutical companies can help identify or develop drugs that may be active against new biological targets that have been identifed by individuals who conduct basic research. These companies also have the critical ability to use good manufacturing practices to produce a candidate drug in suffcient quantities for clinical trials and then for largescale commercial distribution, if the product is approved for marketing. Finally, pharmaceutical companies also supply or raise the capital needed to fund the lengthy process of bringing a product to market. Medical device companies and biotechnology companies play analogous roles in translating discoveries made through basic research into products or services for medical and public health practice, although the specifc details differ from those involved with the drug approval process. When a new disease mechanism is discovered, academic and industry scientists can work together to identify promising therapeutic targets and treatment approaches. Furthermore, academic researchers can inform industry when they identify potential new targets for chemical intervention. Drug companies can then quickly scan their chemical libraries to search for compounds with potential biological activity and describe what problems they have encountered as they have tried to identify the specifc targets of those compounds. This begins the long process of applied chemistry, which is needed to identify a candidate drug. Many examples illustrate that academic collaboration with pharmaceutical and biotechnology companies can lead to dramatic therapeutic advances that save lives and improve the quality of life. Collaborations contributed to delineation of the pathophysiology of the disease and the development of successive new classes of drugs, including reverse transcriptase inhibitors, protease inhibitors, and entry inhibitors (Braunwald et al. These advances have transformed a uniformly fatal illness into a chronic disease that people are now generally able to survive for decades. Compared with the drug development process, the development of complex medical devices tends to be a more continuous process of innovation and refnement that involves frequent alterations in device design, materials, manufacturing processes, or other characteristics. Examples of medical devices that have been developed as a result of close academicindustry collaborations include implanted defbrillators (Jeffrey, 2001), prosthetic heart values (Gott et al. Advances in many technologies, such as pulse oximetry for the monitoring of anesthesia and phototherapy for the treatment of disease, highlight the results that may accrue from a combination of research collaboration and communication with senior clinicians about their experiences (Mike et al. For example, the process of device refnement (particularly when the refnements are minor or are not associated with well-designed clinical studies) is at the center of controversies over whether some consulting arrangements between orthopedic surgeons and the manufacturers of orthopedic devices represent fair payments for technical services or are inducements for the surgeons to use the device. At academic centers, this research may involve populations of individuals with rare diseases or biological agents that do not have obvious commercial potential. Such research may, nonetheless, lay the foundation for companies to develop successful products or at least for company licensing of compounds or agents for which university research has provided proof-of-concept data but for which companies must take the next steps. Between 1977 and 1989, the proportion of the total funding for clinical and nonclinical research supplied by industry grew from 29 to 45 percent (Read and Campbell, 1988; Read and Lee, 1994). Between 1995 and 2003, the yearly fgures (which are based on sources of information somewhat different from those for 1977 to 1985) ranged from 57 to 61 percent (Moses et al. This funding supports work in the laboratories of pharmaceutical, device, and biotechnology companies; contracts for research conducted by universities and other nonproft research institutions; and contracts with commercial contract research organizations that carry out clinical trials in academic and private practice settings. Extent of Academic-Industry Relationships Industry relationships with academic biomedical researchers are extensive. A 2006 national survey of department chairs in medical schools and large independent teaching hospitals found that 67 percent of academic departments (as administrative units) had relationships with industry (Campbell et al. In addition, 27 percent of nonclinical departments and 16 percent of clinical departments received income from intellectual property licensing. Among the department chairs, 60 percent had relationships with industry, including serving as a consultant (27 percent), a member of a scientifc advisory board (27 percent), a paid speaker (14 percent), an offcer (7 percent), a founder (9 percent), or a board member (11 percent) for a company. In some universities, companies fund individual departments, multidisciplinary research centers, or campuswide research programs (Bero, 2008).
Since my grandparents were unable to discount 60 caps menosan fast delivery herbals on deck leave the bank in Cuba unattended generic menosan 60 caps with amex herbs not to mix, they sent my mother out of the country alone at the age of 15 purchase 60caps menosan with visa herbals india chennai. After emigrating to the United States, my mother attended college and married my father. I spent six years on the island, moving with my family to California at the age of ten. Here I was forced to adapt to a new cultural environment which included shifting from the daily use of Spanish to English. Adjusting to a new culture was difficult, however, I feel very lucky to have experienced a bilingual and bicultural upbringing. The doctors believed it was her gallbladder which was causing her pain and scheduled her for surgery. I flew to San Francisco the night before her operation in order to take her to the hospital while my mother was at work. In the waiting room, my grandfather and I grew impatient, as the surgery took longer than expected. Finally, the surgeon emerged from the operating room and called us into his office. My grandfather, whose memory was failing, wrote furiously in his notebook while asking the doctor to repeat himself. The words, metastasized…pancreatic…no treatment…hospice…3 months at the most… stayed in my head as I sat in disbelief. During her stay at the hospital, my grandmother experienced some difficulties due to cultural differences. For example, she did not want a male nurse assigned to her to change her bedpan or bathe her. I dropped the summer school course in which I was enrolled in order to help transport my grandmother home and take care of her full time. Over the next month, I watched this horrid disease take over her body until she was unable to eat, speak, or move. After much consideration, I decided I want to contribute to the field of medicine. Finally, I started a post-baccalaureate premedical program in order to tackle all of those science and math courses I had been avoiding as an undergraduate. In addition to studying sciences, I am currently working as a volunteer at the Clinica de la Divina Providencia, a privately funded free clinic offered twice monthly in central Los Angeles which serves a primarily Latino population. I serve as an English/Spanish translator between patients and doctors at the clinic. I have also volunteered at the Pediatric Orthopedic Clinic at the Calexico/Mexicali border. This free clinic provides patients from Mexico with orthopedic medical care including casting, leg braces, and consultations for free surgery. These experiences have greatly enforced my desire to become a doctor, and I thoroughly enjoy the looks of comfort and relief I see on the faces of patients when they find out I speak fluent Spanish. I feel I can help fill a need for Spanish speaking doctors and improve the lives of others by promoting primary and preventative care. Since I can remember, I have held an intense interest in health care and the health community. I studied Psychology in order to learn more about the human mind, now I would like to learn more about the human body. I believe the knowledge of more than one culture and language has given me a greater sense of empathy for, and understanding of others. Education has been the means of survival for my family and I am a person who has overcome many obstacles to achieve success. I am aware the road to medical school will be challenging and rigorous, but I am confident I have the ability and perseverance to be successful. Sample Essay #6: There are few certainties of what one will encounter during life. Of the three, the one certainty human beings have the most control over is disease. Disease is also inevitable, however, there are methods to combat the recurrences, spread and danger of this malady. My dream is to learn the techniques required to assist my fellow human beings in their struggle against disease. Since graduating college I have given considerable thought toward finding the best path to blaze in pursuit of this quest. In doing so, I have had to face mistakes that I made during my time at Pitzer College. Being young and naïve I did both my girlfriend of the time and myself a tremendous disservice by completing her work for her. Through college I found it neigh impossible to ask for help, as the thought petrified me. From an early age, my father mistakenly led me to believe that if I did not instantly grasp a concept I would be looked down upon with the utmost disapproval and pity for someone who is so stupid. My grades faltered because I relied solely on class notes and my own abilities, to succeed.
Locoregional relapse was defined as documented ipsilateral invasive relapse occurring in the breast purchase menosan line herbs and rye, chest wall and/or in regional lymph nodes buy genuine menosan line yucatan herbals, prior to cheap generic menosan uk herbs list any distant metastatic relapse. Cumulative incidence rates and hazard ratio were obtained using both Cox and Fine-Gray models, taking into account metastatic relapse and death as competitive events. Similar results were obtained when taking locoregional relapses synchronous with distant metastatic disease into account (interaction test: p=0. Moreover, the finding that cM0(i+) status is a predictive marker for the efficacy of locoregional lymph node irradiation promises a new opportunity to better tailor adjuvant radiation therapy in early stage breast cancer patients. Lund University, Lund, Sweden; Lund University Cancer Center, Medicon Village, Lund, Sweden; 3 4 5 Skåne University Hospital, Lund, Sweden; Blekinge County Hospital, Karlskrona, Sweden; Skåne University Hospital, Malmö, 6 7 8 Sweden; Skåne University Hospital, Malmö, Sweden; Skåne University Hospital, Lund, Sweden; Lund University, Lund, 9 Sweden and Skåne University Hospital, Lund, Sweden. For 405 breast tumors in the training cohort, a comprehensive histopathological biomarker evaluation was performed by three pathology readings to estimate inter-pathologist variability on the original diagnostic slides as well as on repeat immunostains for this study, and the consensus biomarker status for all five conventional biomarkers was determined. All patients underwent upfront breast surgery; hence there are no confounding effects of neoadjuvant treatment on biomarker levels. Application of the optimal cut point from Cohort A to tumors in the validation Cohort B classified 145/316 cores (45. Results: There were 56 patients in the paclitaxel arm (A), 115 in the Paclitaxel+Neratinib arm (B), 22 patients on the Paclitaxel + Trastuzumab arm (C) and 72 on the Paclitaxel + Veliparib + Carboplatin arm (D). Lund University, Clinical Sciences Lund, Oncology and Pathology, Lund, Sweden; Skåne 3 4 University Hospital, Lund, Sweden; Lund University, Computational Biology and Biological Physics, Lund, Sweden; Uppsala 5 6 University, Uppsala, Sweden; Akademiska University Hospital, Uppsala, Sweden; Karolinska Institutet, Cancer Center 7 8 Karolinska, Stockholm, Sweden; Karolinska University Hospital, Radiumhemmet, Stockholm, Sweden; Skåne University 9 10 Hospital, Lund, Sweden; Karolinska Institutet, Stockholm, Sweden and Karolinska University Hospital, Stockholm, Sweden. Further, genes described in the literature as associated with radioresistance were included in the panel to a total of 248 genes. A custom nCounter (Nanostring Technologies) gene expression panel was designed and both the training and validation cohorts were analyzed with the custom panel. Single-sample classifiers using a k-top scoring pairs algorithm were trained in the training cohort and validated in the validation cohort. The most promising was however that it seems as the panel could be used as a predictive marker, i. Clinicopathologic variables were abstracted from pathology reports, and were available for a subset of these cases. Fudan University Shanghai Cancer Center, Shanghai, China; Cancer Institute, 3 Fudan University Shanghai Cancer Center, Shanghai, China and Shanghai Medical College, Fudan University, Shanghai, China. Training set comprised patients diagnosed between 2003 and 2009, while validation set included patients diagnosed thereafter. Ethical approval of the study was granted by the Institutional Review Board of Fudan University Shanghai Cancer Center. A logistic regression model was used to construct the nomogram in the training set and then validated in the validation set. Nomogram performance was quantified with respect to discrimination and calibration. Larger lesion, younger age at diagnosis, black ethnic and lack of hormone receptor expression were significantly related to regional nodes involvement. A calibration curve for the nomogram was plotted to evaluate the agreement between actual (observed) outcomes and expected probabilities. The slope of the calibration curve was close to 1, which indicated excellent calibration of the nomogram. The nomogram based on the clinical parameters was established, which could accurately predict regional lymph node status. This nomogram would facilitate evaluating lymph node state preoperatively and thus treatment decision-making of individual patients, especially in neoadjuvant settings. Finally, all of these features were combined, evaluated using Ranksum feature ranking, and then used to generate predictive models using four different supervised machine learning classifiers random forest, support vector machine, linear discriminant analysis, and a neural network – via a 3-fold cross validation scheme. Results: the highest performing features were consistently mitosis, epithelial architectural, and tubule features. These features were able to provide the highest level of classification utility for the most distinct cases (L-L vs. H-H) and had less classification accuracy with classification problems involving more difficult T cases. Additional independent validation of these findings is needed in a separate test set. There has been an interest in the use of image analysis of routine H&E histopathology slides to predict the course of the disease; the rationale being that the analytics are able to unearth subtle sub-visual cues regarding disease morphology that may escape visual examination. For each image, a watershed algorithm segmented the individual nuclei, which were used to generate 230 nuclei features including nuclear architecture, nuclear shape and nuclear texture features within each candidate breast duct. In addition, we captured the area of necrosis and empty lumen region inside breast ducts to generate features pertaining to tubule packing. The average feature values for each patient were calculated across all the breast ducts in each slide. Results: the top ranked features included features from three categories: nuclei architectural features (standard deviation of triangle area in Delaunay graph, skewness of edge length in Cell Cluster Graph), nuclear texture (standard deviation of Haralick matrix intensity) possibly reflecting chromatin patterns in the cell, and the Tubule Packing Ratio, a measure of the ratio of necrosis area and empty lumen area inside the breast ducts compared to the whole breast duct area. Additional independent validation of the approach is needed to confirm the preliminary findings presented here. The primary objective of this study was to explore if standard clinicopathologic variables independently correlate to the recurrence score. As a secondary objective, we explored if a model based on the clinicopathologic variables can accurately predict recurrence score. As a second step, we used these results and clinical expertise to guide a predictive model. We present an option to identify patients whose risk category can be confidently determined from the standard clinicopathologic variables alone, thereby reducing medical cost. Admittedly, this model has not undergone validation nonetheless, the data suggest the potential for a novel; low-cost; high reach diagnostic tool. Body: Background: Even after successful treatment of primary breast tumors, there is a continued risk of recurrence.
No differences were every 2 weeks for 3 doses followed by 500 mg monthly versus Version 4 cheap 60caps menosan otc herbals aarogya. In events of palbociclib and fulvestrant were mainly confined to buy menosan cheap online herbs plants postmenopausal women who have received previous antiestrogen neutropenia with the same low incidence (0 cheap menosan 60 caps overnight delivery herbs not to mix. In addition, the recently updated version includes combination with endocrine therapy. Several randomized studies have breast cancer as initial endocrine-based therapy for their metastatic investigated the use of aromatase inhibition in combination with disease. An incidences of these adverse events, but the younger patients had more improvement in median time to progression was seen when everolimus on-treatment deaths. A variety Eribulin is a non-taxane microtubule inhibitor used for the treatment of of chemotherapy regimens are felt to be appropriate, as outlined in the patients with metastatic breast cancer who have previously received at treatment algorithm. Prior therapy should have included an anthracycline and a comparison to single-agent chemotherapy. Adverse effects may require dose reduction and cessation of chemotherapy prior to disease progression. A similar trial enrolled 736 patients who were randomized to treatment with docetaxel and bevacizumab or docetaxel Ixabepilone, an epothilone B analogue, is also used for treatment of and placebo. In this context, humanized monoclonal antibody against the vascular endothelial failure to respond to a chemotherapy regimen means the absence of Version 4. The clinician typically must the guidelines include consideration of the addition of hyperthermia to assess and balance multiple different forms of information to make a irradiation for localized recurrences/metastasis (category 3). Sometimes this information may be radiation plus hyperthermia in the treatment of locally contradictory. The provides a table outlining general recommendations for the frequency addition of hyperthermia generated substantial discussion and and type of monitoring as a baseline before initiation of new therapy, for controversy among the panel and is a category 3 recommendation. Patients with persistently imaging; functional imaging; and, where appropriate, tumor biomarkers. The diagnosis is often delayed because of the rare radiation therapy with or without an associated cancer is similar to that nature of the condition and confusion with other dermatologic with breast-conserving surgery and radiation therapy with the typical conditions. In cases treated by important for risk of recurrence than does the margin of tumor-free total mastectomy, axillary staging is recommended for patients with resection achieved by surgical treatment. Diagnosis of phyllodes tumors invasive disease and should also be considered for patients with prior to excisional biopsy/lumpectomy is uncommon. This is because occur in an older age distribution than fibroadenoma, a younger age the final pathology may reveal an invasive cancer in the mastectomy distribution than the invasive ductal and lobular cancers, and with a specimen and the mastectomy precludes subsequent sentinel node mean age of 40. For clinically node-negative adjuvant cytotoxic chemotherapy provides benefit in reduction of T1-T2 tumors, a chest x-ray (with shielding), liver function and renal recurrences or death. In addition, maternal fetal Evaluation of the pregnant patient with suspected breast cancer should medicine consultation should include counseling regarding maintaining include a physical examination with particular attention to the breast and or terminating pregnancy. Mammogram of the breast with shielding can be breast cancer should include a review of the treatment options, which done safely and the accuracy is reported to be greater than 80%. The most common surgical procedure has been assess the extent of disease and also to guide biopsy. This 25 weeks of gestation or later, obstetrical and prenatal specialists must Version 4. The children are reported to be healthy and progressing well in offered to pregnant women under 30 weeks gestation. Isosulfan blue or methylene blue dye for sentinel node biopsy procedures is discouraged during pregnancy. The largest experience in pregnancy has been trastuzumab is otherwise indicated, it should be administered in the with anthracycline and alkylating agent chemotherapy. Endocrine therapy and radiation therapy, if indicated, should planned delivery in order to avoid the potential for hematologic thus not be initiated until the postpartum period. The panel also recommends completing There are no large randomized trials evaluating the optimal systemic the planned chemotherapy prior to mastectomy. To reduce the risk of local recurrence, the panel adequate, or if additional biopsy material is necessary (eg, core needle, recommends radiation therapy to the chest wall and the supraclavicular incisional, or excisional biopsy) to provide an accurate and complete region. Although treatment of women with axillary supraclavicular nodes, chest, peritoneum, retroperitoneum, liver, bone, metastases from an unknown primary tumor has typically involved or brain could also indicate primary breast cancer in women. For patients with T0, N1, M0 disease, options include mastectomy plus axillary nodal dissection or axillary nodal dissection plus whole breast irradiation with or without nodal irradiation. Systemic chemotherapy, endocrine therapy, or trastuzumab is given according to the Version 4. Laboratory assessment American Society of Clinical Oncology/College of American of the status of Her-2/neu protein and oncogene in breast cancer Pathologists clinical practice guideline update. Arch Pathol Lab Med women with metastatic breast cancer evaluated for treatment with 2014;138:241-256. Eur J Surg low risk of ductal carcinoma in situ or invasive carcinoma on Oncol 2011;37:279-289. Evolving concepts in the hyperplasia and classic lobular carcinoma in situ in core biopsy management of lobular neoplasia. Long-term survival of situ/atypical lobular hyperplasia on breast needle biopsies: does it women with basal-like ductal carcinoma in situ of the breast: a warrant surgical excisional biopsy? Available at: at core-needle biopsy: meta-analysis of underestimation and. Available at: with or without radiotherapy in ductal carcinoma-in-situ: ten-year. Available at: invasive ipsilateral breast tumor recurrences after lumpectomy in. Available at: randomized trial for good-risk ductal carcinoma in situ comparing.
You will receive medication that will make you feel sleepy and will make your mouth dry buy menosan online pills vaadi herbals review. The nurse will put up the side rails on your bed to proven menosan 60caps herbals stock photos remind you that you must stay there discount 60caps menosan amex lotus herbals 4 layer facial. If your surgery is scheduled for the afternoon, you may wait for approximately 60 to 90 minutes in the pre-anesthesia area until your operating room is ready. The purpose of the catheter is to drain urine from your bladder during surgery and for the frst day following surgery. They will receive two phone calls; one when the surgery begins and one when it is fnished. A specialized intensive care nurse will remain at your bedside until you are awake and stable. Please remember it is important for the patient, as well as the family members, to get enough rest during this time. Although we welcome your immediate family at the bedside, they may be asked to step out at frequent intervals in order to give patient care with the utmost privacy. You or your family member will also be asked to complete a spokesperson agreement, which will provide the healthcare team with contact numbers of the person to contact for information. Please also note that fresh fowers and non-patient food are not permitted in the Intensive Care Units. Cardiovascular Intensive Care Unit Nursing Unit 7-1600 (585) 275-3158 15 On Your Way to a Strong Heart the Immediate Postoperative Period Endotracheal Tube/ Mechanical Ventilator the endotracheal tube passes through your mouth or nose into your trachea (windpipe) and is attached to a mechanical ventilator (respirator). The ventilator breathes for you until you are awake and able to breathe on your own. The tube is usually removed one to six hours after surgery or when the Intensive Care Unit team feels you are ready to have the tube removed. Because the tube passes through your larynx (voice box) and into your trachea, you will be unable to talk or make any sounds while this tube is in place. Your nurse understands this and will provide a way to communicate with you during this time. While you have the endotracheal tube in place, it will be necessary for your nurse or respiratory therapist to occasionally clean the tube. This is called suctioning, and it is important because it clears the tube of mucous secretions normally produced by your lungs. A suction catheter is passed down the endotracheal tube, which will remove the mucous secretions out of your airway. After the endotracheal tube is removed, you will be asked to cough and deep breathe every hour. You will be given a small pillow to splint your chest incision while performing your deep breathing and coughing exercises. After removal of this tube you will be able to talk, but your throat may be sore for a short time afterwards. Temporary Pacing Wires Small pacing wires are placed on the surface of the heart during your surgery. The purpose of these wires is to increase your heart rate if needed after surgery. These wires are not permanent and will be removed when they are no longer needed, with little or no discomfort to you. The purpose of these tubes is to drain blood and fuid from your chest cavity following surgery. These drains will be emptied as needed by the nursing staff and will be removed when drainage is minimal. Bladder Catheter After surgery, you will have a catheter in place which will drain urine from your bladder. Heart Pressure Lines (Pulmonary Artery Catheter) After surgery, you will be attached to lines that read the pressures in your heart and measure the blood pressure in your body. Discomfort Following Surgery Following surgery, you may experience discomfort related to your incision, movement and coughing. It is very important that you tell your nurse whenever you are experiencing pain or discomfort. When you are experiencing pain, you will be asked to rate it on a scale of one to 10, with one being the least amount of pain and 10 being the worst pain you have ever experienced. Pain-relieving medicine will be ordered for you and can be given to you every few hours. Pain medications will only be given to you as needed, so it is important for you to ask your nurse for pain medication when you are experiencing pain. It is extremely important that you take your pain medication to manage your pain as it will help you move, cough and rest more effectively, which is a very important part of your recovery. You may require additional medication (a laxative) to help move your bowels the frst time after surgery. Your nurse will provide a laxative if you have not had a bowel movement by the third day after surgery. Be sure that you let the nurse and dietician know if there are any specifc foods you would like to have. Mood Changes During the postoperative recovery, you may experience mood swings, depression or even confusion at times. This is normal and results from the stress of surgery and your body’s response to the stress. Activity After the breathing tube is removed, your nurse will help you sit on the edge of the bed and dangle your legs over the side. You may experience dizziness or lightheadedness when you initially sit up on the edge of the bed.
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In addition buy menosan now herbs for weight loss, it has a unit of measurement that enables individuals or responses to order menosan 60caps on-line qarshi herbals be placed at equally spaced intervals in relation to cheap 60caps menosan with visa herbs on demand coupon the spread of the scale. This scale has a starting and a terminating point and is divided into equally spaced units/intervals. The starting and terminating points and the number of units/intervals between them are arbitrary and vary from scale to scale as it does not have a fixed zero point. In certain situations the relationship between an independent and a dependent variable does not eventuate till the intervention of another variable – the intervening variable. The cause variable will have the assumed effect only in the presence of an intervening variable. Intervention–development–evaluation process: this is a cyclical process of continuous assessment of needs, intervention and evaluation. You make an assessment of the needs of a group or community, develop intervention strategies to meet these needs, implement the interventions and then evaluate them for making informed decisions to incorporate changes to enhance their relevance, efficiency and effectiveness. Reassess the needs and follow the same process for intervention–development– evaluation. Interview guide: A list of issues, topics or discussion points that you want to cover in an in-depth interview is called an interview guide. It is basically a list to remind an interviewer of the areas to be covered in an interview. Interview schedule: An interview schedule is a written list of questions, open ended or closed, prepared for use by an interviewer in a person-to-person interaction (this may be face to face, by telephone or by other electronic media). Note that an interview schedule is a research tool/instrument for collecting data, whereas interviewing is a method of data collection. Interviewing is one of the commonly used methods of data collection in the social sciences. Any person-to-person interaction, either face to face or otherwise, between two or more individuals with a specific purpose in mind is called an interview. On the one hand, it could be highly structured and, on the other, extremely flexible, and in between it could acquire any form. Judgemental sampling: the primary consideration in this sampling design is your judgement as to who can provide the best information to achieve the objectives of your study. You as a researcher only go to those people who in your opinion are likely to have the required information and are willing to share it with you. Leading question: A leading question is one which, by its contents, structure or wording, leads a respondent to answer in a certain direction. Likert scale: the Likert scale, also known as the summated rating scale, is one of the attitudinal scales designed to measure attitudes. This scale is based upon the assumption that each statement/item on the scale has equal attitudinal ‘value’, ‘importance’ or ‘weight’ in terms of reflecting attitude towards the issue in question. Literature review: this is the process of searching the existing literature relating to your research problem to develop theoretical and conceptual frameworks for your study and to integrate your research findings with what the literature says about them. It places your study in perspective to what others have investigated about the issues. Longitudinal study: In longitudinal studies the study population is visited a number of times at regular intervals, usually over a long period, to collect the required information. Irrespective of the size of the interval, the information gathered each time is identical. Matching is a technique that is used to form two groups of patients to set up an experiment–control study to test the effectiveness of a drug. From a pool of patients, two patients with identical predetermined attributes, characteristics or conditions are matched and then randomly placed in either the experimental or control group. The two groups thus formed through the matching process are supposed to be comparable thus ensuring uniform impact of different sets of variables on the patients. Maturation effect: If the study population is very young and if there is a significant time lapse between the before-and-after sets of data collection, the study population may change simply because it is growing older. Maxmincon principle of variance: When studying causality between two variables there are three sets of variable that impact upon the dependent variable. Since your aim as a researcher is to determine the change that can be attributed to the independent variable, you need to design your study to ensure that the independent variable has the maximum opportunity to have its full impact on the dependent variable, while the effects that are attributed to extraneous and chance variables are minimised. Setting up a study to achieve the above is known as adhering to the maxmincon principle of variance. Narratives: the narrative technique of gathering information has even less structure than the focus group. Narratives have almost no predetermined contents except that the researcher seeks to hear the personal experience of a person with an incident or happening in his/her life. Essentially, the person tells his/her story about an incident or situation and you, as the researcher, listen passively, occasionally encouraging the respondent. Nominal scale: the nominal scale is one of the ways of measuring a variable in the social sciences. It enables the classification of individuals, objects or responses based on a common/shared property or characteristic. These people, objects or responses are divided into a number of subgroups in such a way that each member of the subgroup has the common characteristic. Non-experimental studies: There are times when, in studying causality, a researcher observes an outcome and wishes to investigate its causation. In a non-experimental study you neither introduce nor control/manipulate the cause variable. Non-participant observation: When you, as a researcher, do not get involved in the activities of the group but remain a passive observer, watching and listening to its activities and interactions and drawing conclusions from them, this is called non-participant observation. Non-probability sampling designs do not follow the theory of probability in the selection of elements from the sampling population.