By I. Lisk. Lyon College.
Indeed generic 500 mg chloramphenicol otc, the developers of grounded theory buy 500 mg chloramphenicol with amex, Barney Glaser and Anselm Strauss cheap 500mg chloramphenicol fast delivery, were schooled in opposing research traditions buy discount chloramphenicol 250mg on line. Glaser studied in the department of sociology at Columbia University which was renowned for a reliance on quantitative methodology whereas Strauss was schooled in the Chicago tradition, which was associated with down-to-earth, qualitative research (Glaser & Strauss, 1967). In 1967, a critical point in social science history, Glaser and Strauss co-authored the book, “The Discovery of Grounded Theory: Strategies for Qualitative Research”. At the time, there was an overwhelming preoccupation with the quantitative testing of propositions derived from a few, highly abstract “grand” theories. This lead to impoverished theory, with limited relevance to any substantive content domain and compromised the scope for the emergence of new theories (Pidgeon, 1996). Glaser and Strauss’ grounded theory, thus, served at the front of the qualitative revolution (Charmaz, 2003). In their book, Glaser and Strauss challenged the dominant view that quantitative research represents the only form of systematic social scientific inquiry. More specifically, they attempted to bridge the gap between theory and empirical research; to generate theory that is relevant to research (Glaser & Strauss, 1967). In summary, through grounded theory, Glaser and Strauss proposed a radical philosophical shift, aimed at generating more local, contextual theory that would, as a consequence, be of relevance to those studied (Pidgeon, 1996). A grounded theory approach to inquiry involves intimate engagement with the data which typically results in the generation of a theory that is 68 grounded in the data. The resultant theory is inductively developed during a study and in constant interaction with the data from that study (Ezzy, 2002; Maxwell, 2005). This theory is grounded in the actual data collected, in contrast to theory that is developed conceptually and then simply tested against empirical data. It does not rely exclusively on established views or the researcher’s own perspective, as is typical of quantitative research (Maxwell, 2005). Nonetheless, it is acknowledged that the researcher enters into the process with their own, personal preconceptions and inevitably influences the data obtained through the data gathering process (i. Grounded theory draws attention to the perspectives of research participants, including their subjective accounts of social and psychological events and of associated phenomenal and social worlds (Maxwell, 2005; Pidgeon, 1996; Rubin & Rubin, 1995). The ultimate purpose of grounded theory is to develop a theory that remains close to, and illuminates, the phenomenon under investigation by studying the experience from the standpoint of those who live it (Jones, Torres & Arminio, 2006). Grounded theory was deemed a suitable approach for the current study due to its commitment to communicating the participant perspective. I believe that the consumer perspective on medication adherence provides a valuable contribution to knowledge in the area, particularly because of the complexity of medication adherence and the failure of health services to address medication adherence effectively amongst people with schizophrenia on a large scale despite the extensive research in the area. With its openness to generating theory which has not necessarily been pre-established in research, I perceived a grounded theory approach to the topic of medication adherence as potentially groundbreaking as well as valuable both in academic and practical terms, with potential clinical implications (Rubin & Rubin, 69 1995). Although the research presented was influenced by a grounded theory approach, however, the analysis did not ultimately involve theory generation as this was beyond the scope of the thesis. Grounded theory methods have become a topic of debate from both proponents and opponents of the approach. Post-modernists and post- structuralists dispute the positivistic premises assumed by grounded theory’s major supporters and within the logic of the method itself (Charmaz, 2003). The positivistic assumptions of grounded theory stem from the reliance on a realist ontology, which posits that there is a “real”, objective reality that researchers are able to directly and, therefore, objectively and accurately capture and represent (Willig, 2001). There has also been divergence in the grounded theory methodology between Glaser and Strauss (in collaboration with his more recent co-author, Juliet Corbin), who have developed the grounded theory method into conflicting directions, leading to a split between Glaserian and Straussian grounded theory. Glaser’s position is close to traditional positivism, as it assumes an objective, external reality. Furthermore, the researcher is positioned as a neutral observer who discovers data, reduces inquiry to a set of manageable research questions and objectively renders data (Charmaz, 2003). Strauss and Corbin’s position assumes an objective external reality, aims toward unbiased data collection, proposes a set of technical procedures and supports verification (Charmaz, 2003). Strauss and Corbin’s stance is aligned more with post-positivism, however, as it additionally advocates giving voice to participants, representing them as accurately as possible, discovering and acknowledging how participants’ views of reality may conflict with researchers’ and recognizing creativity as well as science in the analytic product and process (Charmaz, 2003).
Phosphomycin has had a wide distribution as an antibacterial drug in Spain buy chloramphenicol 250mg cheap, Italy buy 250mg chloramphenicol with visa, France buy chloramphenicol 500mg with mastercard, and Japan discount chloramphenicol 500 mg fast delivery, where it has been used particularly for the treatment of patients with infections in the lower urinary tract. It is described here in some detail because particularly the transferable plasmid-borne resistance to it is very interesting from a microbiological point of view. The mechanism of action of phosphomycin is distantly sim- ilar to that of betalactams. The bacterial cell wall can be viewed as a giant molecule, murein, which has to grow continuously outside the plasma membrane by bacterial growth. For this to take place, the monomer of the polysaccharide, the glycopeptide, has to be synthesized inside the cell and then transported out through the cytoplasmic mem- brane borne on an isoprene derivative, bactoprenole, which could pass through the lipid cell membrane. One of the early steps in the glycopeptide synthesis is the condensation of the sugar com- ponent N-acetyl glucosamine with phosphoenolpyruvate to form the lactyl residue to which the pentapeptide of the glucopeptide is attached. The inhibition takes place by the very reactive epoxy group of phosphomycin binding covalently to one of the cysteine residues of the enzyme. Resistance against phosphomycin is observed by mutational changes in the transferase enzyme, diminishing its afﬁnity for the drug. Phosphomycin has been shown to be taken up in the cell by the cellular transport systems for glycerophosphate and hexosephosphate, respectively, and mutational changes in these systems could lead to phosphomycin resistance. Quite unexpectedly, transferable plasmid-borne resistance to phosphomycin has been observed. Unexpectedly, because the small molecule with its speciﬁc epoxy structure was thought of as hardly being a substrate for an acquired enzyme to degrade or modify it. As mentioned, phosphomycin has been used widely in Spain, where highly resistant clinical isolates showed up. Most of these were due to spontaneous chromosomal mutations hitting the functions of glucopeptide formation and cellular uptake. It turned out that the resistance-mediating plasmid carried a gene expressing glutathion-S-transferase with the ability to catalyze a reaction between the sulfhydryl group of the glutathione cysteine and the epoxy group of phosphomycin to form a covalent bond inactivating the antibacterial effect of phosphomycin. The glutathione transferase has been characterized biochem- ically and its corresponding gene sequenced. The nucleotide sequence of the corresponding gene was different, however; called fosB, its expressed amino acid sequence showed 50% identity with the glutathione transferase expressed from fosA. The glutathione transferase from fosBalso inactivated phosphomycin by forming a covalent bond between the sulfhydryl group of glutathione cysteine and the epoxy group of phosphomycin. It was later observed that on the chromosome of the soil bacterium Bacillus subtilis there is a gene whose nucleotide sequence is 63% identical to that of fosB. The product of this gene could be viewed as a defense against toxic products in the soil-living organism, parallel to the detoxifying function of glutathione transferase in mammalian cells. The fosB-like gene of the soil bacterium could be speculated to have developed into the fosAandfosB of pathogens under the selection pressure of a large drug distribution. Later, several homologs to fosAandfosB have been characterized in transposon-borne integron cassettes. Internationally, however, tuberculosis is a commonly occurring disease spreading at an increasing rate. Nitrofurantoin, nitroimidazoles, and phosphomycin have been treated in some detail because their mechanisms of action, and the resistance against them in bacteria, are interesting from a microbiological point of view. There is also a short description of antibiotic resistance by spontaneous mutations. We should note that the particular study of antibiotic resistance and its spread in bacterial populations has Antibiotics and Antibiotics Resistance, First Edition. The pilus of the donor bacterium establishes a cell-to-cell contact between donor and recipient. The transfer of antibiotic resis- tance between bacteria could be called contagious resistance,in that antibiotic-susceptible bacteria are infected with resistance genes. The mechanism of conjugation mentioned has the ability to transfer several resistance genes at the same time, contagious multiresistance. Those ﬁrst observations led to the discovery of the F factor (F for fertility), which turned out to be an extrachromosomal genetic element with the ability to transfer from one bacterial cell to another at cell contact.
Tese stain positive for both Sudan Black B are characteristically negative with these stains generic 500 mg chloramphenicol mastercard. C Phospholipids order chloramphenicol 500 mg free shipping, neutral fats cheap 250mg chloramphenicol mastercard, and sterols are stained by of the following disorders is most likely? The addition of ﬂuoride renders the monocytic cells (and blasts) negative cheap chloramphenicol 250mg with visa, thus allowing for diﬀerentiation from the granulocytic cells, which remain positive. Any percentage health and disease states/Leukemia/Immunochemical Hematology/Apply knowledge of special procedures/ reactions/2 Leukemias/Classiﬁcations/2 16. A patient’s peripheral blood smear and bone prognosis than other immunologic subtypes of marrow both show 70% blasts. Hematology/Apply principles of special procedures/ Leukemia/Cytochemical stains/2 17. Acute myeloid leukemias with recurrent genetic of megakaryoblasts and atypical megakaryocytes. Acute megakaryoblastic categorized leukemia is deﬁned as an acute leukemia in which D. Acute leukemias of ambiguous lineage greater than or equal to 50% of the blasts are of Hematology/Apply knowledge of special procedures/ megakaryocytic lineage. Hematology/Evaluate laboratory data to recognize Iron deﬁciency anemia is a predictable complication health and disease states/Anemia/2 of therapeutic phlebotomy because approximately 2. In essential thrombocythemia, the platelets are: 250 mg of iron is removed with each unit of blood. Decreased in number and functional function, leading to both bleeding and thrombotic D. Which of the following cells is considered It is a large, binucleated cell with a dense nucleolus pathognomonic for Hodgkin’s disease? Flame Hematology/Evaluate laboratory data to recognize cells are plasma cells with distinctive red cytoplasm. In myeloﬁbrosis, the characteristic abnormal red blood cell morphology is that of: 4. Features of secondary polycythemia include all of Answers to Questions 6–11 the following except: A. Erythropoietin is increased and oxygen saturation is decreased in secondary Hematology/Evaluate laboratory data to recognize polycythemia. Te erythrocytosis seen in relative polycythemia plasma rather than an increase in red blood cell occurs because of: volume or mass. Decreased plasma volume of circulating blood levels are high only in secondary polycythemia. Hematology/Apply knowledge of fundamental biological characteristics/Polycythemia/1 10. All of these options Hematology/Evaluate laboratory data to recognize health and disease states/Myeloproliferative neoplasms/3 28 Chapter 1 | Hematology 12. What inﬂuence does the Philadelphia (Ph1) Answers to Questions 12–17 chromosome have on the prognosis of patients with chronic myelocytic leukemia? Te prognosis is better if Ph1 is present arm deletion of chromosome 22, but is actually C. Te prognosis is worse if Ph1 is present a translocation between the long arms of D. This results in production Hematology/Evaluate laboratory data to recognize of a chimeric protein with tyrosine kinase activity health and disease states/Genetic theory and that activates the cell cycle. An increase in basophils An increase in basophils and eosinophils is a Hematology/Evaluate laboratory data to recognize common ﬁnding. Multiple myeloma and Waldenström’s macroglobulinemia have all the following in common except: A. Osteolytic lesions Hematology/Evaluate laboratory data to recognize health and disease states/Myeloma/Characteristics/2 1.