By N. Zapotek. Roger Williams University. 2018.
X You should check the national source of the data as in- formation may differ between countries proven 35mg actonel. X For some topics specific websites have been set up that contain details of questionable products cheap actonel 35 mg without prescription, services and theories order actonel 35mg without prescription. Interlibrary loans If you are a student your institutional library will prob- ably offer an interlibrary loan service which means that you can access books from other university libraries if they are not available in your library buy actonel 35mg lowest price. This is a useful service if, when referencing, you find that a small amount of infor- mation is missing (see Example 5 below). EXAMPLE 5: GILLIAN Nobody told me the importance of keeping careful re- cords of my background research. I just thought it was something you did and then that was it, you got on with 44 / PRACTICAL RESEARCH METHODS your own research and forgot about what you’d done. Of course then I had to write my report and in the ‘background’ section I wanted to include loads of things I’d read when I first started the work. Even then I still forgot to write down the name and location of the publisher, so I had to go back to them again. My advice would be to look at how bibliographies are structured and imprint that in your brain so you don’t forget anything. Keeping records When you begin your background research, keep accurate records of what data was gathered from which source as this will save you plenty of time and frustration later, especially when you come to write your research proposal, or final report. A useful way to organise your background research is to have two files – one for primary research and one for secondary research. Each file can be divided into topics with the relevant notes slotted into each. Primary research For the primary research file, notes from each contact can be separated by a contact sheet which gives the name of the person, the date and time you met and a contact num- ber or address. Secondary research In the secondary research file, each page of notes can be headed by details of the publication in the same format that will be used in the bibliography – author and initials; date of publication; title of publication; place of publica- HOW TO CONDUCT BACKGROUND RESEARCH / 45 tion and publisher. If it is a journal article, remember to include the name of the journal; the page numbers of the article and the volume and number of the journal. It is also useful to include the location of this publication so that it can be found easily if needed again (website or li- brary shelf location). TABLE 2: SOURCES OF BACKGROUND INFORMATION PRIMARY SECONDARY Relevant people Research books Researcher observation Research reports Researcher experience Journal articles Historical records/texts Articles reproduced online Company/organisation records Scientific debates Personal documents (diaries, etc) Critiques of literary works Statistical data Critiques of art Works of literature Analyses of historical events Works of art Film/video Laboratory experiments SUMMARY X There are two types of background research – primary and secondary research. X Primary research involves the study of a subject through firsthand observation and investigation. X Secondary research involves the collection of informa- tion from studies that other researchers have made of a subject. X Any information obtained from secondary sources must be carefully assessed for its relevance and accu- racy. X Notes from primary and secondary sources should be carefully filed and labelled so that the source can be found again, if required. X When noting details for books, 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.
European Journal of Neurology 2004; 11(suppl2):56 (abstract P1071) Cross References Encephalopathy; Myoclonus; Tremor Asynergia Asynergia or dyssynergia is lack or impairment of synergy of sequen- tial muscular contraction in the performance of complex movements discount 35 mg actonel free shipping, such that they seem to become broken up into their constituent parts order actonel 35 mg with amex, so called decomposition of movement purchase actonel 35 mg mastercard. Dyssynergy of speech may also occur cheap 35mg actonel visa, a phenomenon sometimes termed scanning speech (q. This is typically seen in cerebellar syndromes, most often those affecting the cerebellar hemispheres, and may coexist with other signs of cerebellar disease, such as ataxia, dysmetria, and dysdiadochokinesia. Cross References Ataxia; Cerebellar syndromes; Dysarthria; Dysdiadochokinesia; Dysmetria; Scanning speech Ataxia Ataxia or dystaxia refers to a lack of coordination of voluntary motor acts, impairing their smooth performance. The rate, range, timing, direction, and force of movement may be affected. Ataxia is used most frequently to refer to a cerebellar problem, but sensory ataxia, optic ataxia, and frontal ataxia are also described, so it is probably best to qualify ataxia rather than to use the word in isolation. Cerebellar hemisphere lesions cause ipsilateral limb ataxia (hemiataxia; ataxia on finger-nose and/or heel-shin testing) whereas midline cere- bellar lesions involving the vermis produce selective truncal and gait ataxia. These fibers run in the corticopontocerebellar tract, synapsing in the pons before passing through the middle cerebellar peduncle to the con- tralateral cerebellar hemisphere. Triple ataxia, the rare concurrence of cerebellar, sensory and optic types of ataxia, may be associated with an alien limb phenomenon (sensory type). There are many causes of cerebellar ataxia, including: ● Inherited: Autosomal recessive: Friedreich’s ataxia Autosomal dominant: clinically ADCA types I, II, and III, now reclassified genetically as spinocerebellar ataxias, types 1-25 now described Episodic ataxias: channelopathies involving potassium (type 1) and calcium (type 2) channels Mitochondrial disorders Huntington’s disease Dentatorubropallidoluysian atrophy (DRPLA) Inherited prion diseases, especially Gerstmann-Straussler- Scheinker (GSS) syndrome ● Acquired: Cerebrovascular events (infarct, hemorrhage): usually cause hemiataxia; postanoxic cerebellar ataxia Inflammatory: demyelination: multiple sclerosis, Miller Fisher variant of Guillain-Barré syndrome, central pontine myelinolysis - 42 - Ataxic Hemiparesis A Inflammatory: infection: cerebellitis with Epstein-Barr virus; encephalitis with Mycoplasma; HIV Neoplasia: tumors, paraneoplastic syndromes Neurodegeneration: one variant of multiple system atrophy (MSA-C); prion diseases (Brownell-Oppenheimer variant of sporadic Creutzfeldt-Jakob disease, kuru); idiopathic late- onset cerebellar ataxia Drugs/toxins: for example, alcohol, phenytoin Metabolic: vitamin E deficiency, thiamine deficiency (Wernicke’s encephalopathy), gluten ataxia, hypothyroidism (debatable) References Klockgether T (ed. Neurology in clinical practice: principles of diagnosis and management (3rd edition). Boston: Butterworth-Heinemann, 2000 309-317 Cross References Alien hand, Alien limb; Asynergia; Balint’s syndrome; Cerebellar syndromes; Dysarthria; Dysdiadochokinesia; Dysmetria; Head tremor; Hemiataxia; Hypotonia, Hypotonus; Macrographia; Nystagmus; Optic ataxia; Proprioception; Pseudoathetosis; Rebound phenomenon; Rombergism, Romberg’s sign; Saccadic intrusion, Saccadic pursuit; Scanning speech; Square-wave jerks; Tandem walk- ing; Tremor Ataxic Hemiparesis Ataxic hemiparesis is a syndrome of ipsilateral hemiataxia and hemi- paresis, the latter affecting the leg more severely than the arm (crural pare- sis). This syndrome is caused by lacunar (small deep) infarction in the contralateral basis pons at the junction of the upper third and lower two-thirds. It may also be seen with infarcts in the contralateral thala- mocapsular region, posterior limb of the internal capsule (anterior choroidal artery syndrome), red nucleus, and the paracentral region (anterior cerebral artery territory). Sensory loss is an indicator of cap- sular involvement; pain in the absence of other sensory features of thalamic involvement. Stroke 1998; 29: 2549-2555 Cross References Ataxia; Hemiataxia; Hemiparesis; Pseudochoreoathetosis - 43 - A Ataxic Nystagmus Ataxic Nystagmus - see INTERNUCLEAR OPHTHALMOPLEGIA; NYSTAGMUS Athetosis Athetosis is the name sometimes given to an involuntary movement dis- order characterized by slow, sinuous, purposeless, writhing movements, often more evident in the distal part of the limbs. Athetosis often coex- ists with the more flowing, dance-like movements of chorea, in which case the movement disorder may be described as choreoathetosis. Indeed the term athetosis is now little used except in the context of “athetoid cerebral palsy. Athetosis and William Alexander Hammond, a founder of American neurology. London: Imperial College Press, 2003: 413-416 Cross References Chorea, Choreoathetosis; Pseudoathetosis; Pseudochoreoathetosis Atrophy Atrophy is a wasting or thinning of tissues. The term is often applied to wasted muscles, usually in the context of lower motor neurone pathology (in which case it may be synonymous with amyotrophy), but also with disuse. Atrophy develops more quickly after lower, as opposed to upper, motor neurone lesions. It may also be applied to other tissues, such as subcutaneous tissue (as in hemifacial atrophy). Atrophy may sometimes be remote from the affected part of the neu- raxis, hence a false-localizing sign, for example wasting of intrinsic hand muscles with foramen magnum lesions. Cross References Amyotrophy; “False-localizing signs”; Hemifacial atrophy; Lower motor neurone (LMN) syndrome; Wasting Attention Attention is a distributed cognitive function, important for the opera- tion of many other cognitive domains; the terms concentration, vigi- lance, and persistence may be used synonymously with attention. It is generally accepted that attention is effortful, selective, and closely linked to intention. Impairment of attentional mechanisms may lead to distractibility (with a resulting complaint of poor memory, better termed aprosexia, - 44 - Auditory Agnosia A q. The neuroanatomical substrates of attention encompass the ascending reticular activating system of the brainstem, the thalamus, and the prefrontal (multimodal association) cerebral cortex (especially on the right). Those adapted to “bedside” use all essentially look for a defect in selective attention, also known as working memory or short term memory (although this does not necessarily equate with lay use of the term “short term memory”): Orientation in time/place Digit span forwards/backward Reciting months of the year backward, counting back from 30 to 1 Serial sevens (serial subtraction of 7 from 100, = 93, 86, 79, 72, 65).
Capener then became a chief assistant on apology for discussing so lowly a subject as shoes the Surgical Professorial Unit under Professor is amply discussed in his introduction discount actonel 35mg with mastercard. Hugh Cabot took temporary charge of the artists of his period and generic actonel 35 mg free shipping, like da Vinci best actonel 35 mg, illustrated Unit cheap 35mg actonel mastercard, he invited Capener to the University of his own publications. Michigan, Ann Arbor, as Assistant Professor of Surgery, where he served from 1926 to 1931 and 53 Who’s Who in Orthopedics was influenced by Dr. He threw new light on the anatomy, phys- Cripples Aid had been established in 1925 under iology and pathology of the lumbo-sacral region, the aegis of Dame Georgina Buller, with the but his greatest contribution was to pioneer a active collaboration of Sir Robert Jones, and the direct approach to vertebral bodies by what he Princess Elizabeth Orthopaedic Hospital had been called lateral rhachotomy, the basis of the modern opened in Exeter in 1927. To this, in 1931, operative treatment of spinal infections that has Capener was appointed orthopedic surgeon. He at saved innumerable patients from lasting once set about creating a comprehensive orthope- paraplegia. This found expression in his membership of developed its own appliance workshop and a link the medical group of the Institution of Mechani- with St. As on the selection, training and qualifications of chairman of the Dame Hannah Rogers Trust, he limb fitters was in advance of its time. A fine was instrumental in founding a residential school administrator himself, he was wont to recall that for spastic children at Ivybridge. Capener was president of the orthopedic In his adopted city of Exeter he made many section of the Royal Society of Medicine in 1951, contributions as an active member of learned of the British Orthopaedic Association in societies. He took a great interest in the valuable 1958–1959 and of the orthopedic section of the collection of medical books at the Royal Devon British Medical Association in 1960. He was a and Exeter Hospital, arranging for the return of vice president of the Anatomical Society of Great the more ancient ones to the care of the splendid Britain in 1967 and of the British Association for Cathedral Library. Northcott in setting up and endowing the Devon In 1961, he was elected to the Council of the Medical Foundation in 1961; this made possible Royal College of Surgeons of England. Here he the establishment of a pioneer postgraduate served on every important committee and rose to medical center. He took a partic- he was instrumental in securing, through the gen- ular interest in the library and scientific work of erosity of the same donor, the creation of the well- the College and also in its artistic treasures. At the known Northcott Theatre in the grounds of the College he was Hunterian Professor in 1941, University of Exeter. Arris and Gale Lecturer in 1947, Robert Jones Blessed with a fine intellect and an imaginative Lecturer in 1958, Thomas Vicary Lecturer in mind, Capener was a man of unostentatious eru- 1971 and Bradshaw Lecturer in 1972. He was also dition and taste: in music, in literature and in the Robert Jones Lecturer of the Hospital for Joint visual arts. His to the Ministry of Health from 1964 to 1971, and writing and his lecturing were clear and precise, became Chairman of the Medical Commission on and he was in much demand for both. It was his ambition to see Exeter become a in his own person and reminiscent of the versa- center for medical education. He was disap- tility of the learned in the seventeenth and eigh- pointed when his efforts to start a medical school teenth centuries. Over the portal of the old were frustrated, but he was gratified to see the first medical school at Bart’s is inscribed “Whatsoever postgraduate institute in the country without an thy hand findeth to do, do it with thy might. He dis- He exhibited a flair for the mechanical aspects played the highest standards and expected these of orthopedics and prosthetics. Suter he set up a superb splint shop and de- ing and the greatest possible interest in their vised the “lively” splints for physiological control, careers. Thus he became one of the few surgeons which he applied so effectively to the hand. His outstanding he found time to interest himself in medical qualities were honesty, steadfastness and good- history and art. Devon and Exeter Medico-Chirurgical Society, he His first wife, by whom he had one son and organized an exhibition of books, documents and three daughters, was an invalid for many years pictures from the Exeter Medical Library and the before her death in 1970.
Shortly after Pearl Harbor purchase 35mg actonel mastercard, he joined the United He lived his last few months with the dignity cheap 35 mg actonel overnight delivery, dis- States Navy and served both at sea and ashore cipline buy actonel 35mg with amex, and equanimity that were typical of him discount actonel 35 mg with mastercard. He returned to the staff of the Mayo Elizabeth “Betty” Servis Coventry, died in 1989. In 1958, he became Professor of Orthopedic Surgery, and he was Department Chairman from 1963 to 1974. He was also a member of the Board of Governors of the Mayo Clinic for 5 years. In addition to his membership in local and regional orthopedic societies, he belonged to the Inter- urban Club and the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT). His ability to see the essence of a problem, a situation, or an issue quickly and to express it suc- cinctly and often humorously made him a favorite with patients and residents alike. Always a gentleman, he was considerate and kind to even the youngest of medical students, and many young residents had their egos boosted by Andrew Hoyt CRENSHAW being asked their opinions by “The Editor of 1920–1991 Campbell’s. His last 2 years of retirement allowed Presbyterian College in Clinton, South Carolina, him to spend time with her; his children, Andrew, and his MD degree from Emory University in Tom, Sarah, and Jeannie; and his five grand- Atlanta. He finally had time for mowing the lawn service in the United States Army Medical Corps, and walking with McGregor, his Scottish terrier from July 1945 through January 1947. That he chose to spend completion of an orthopedic residency at the a large part of retirement editing the most recent Campbell Foundation, he joined the staff of the edition of “The Book” reflects his commitment to Campbell Clinic in 1951. Crenshaw’s skill as a surgeon and Throughout his 37 years as an orthopedic acumen as a diagnostician were quickly evident, surgeon, Dr. Crenshaw personified the old- his partners soon discovered another talent. After fashioned values of duty, loyalty, integrity, and contributing two chapters to the third edition of excellence. His death on October 18, 1991, left us Campbell’s Operative Orthopedics in 1956, he with one fewer of the “giants” on whose experi- became the editor of the fourth edition in 1963. He served in that capacity for five editions of this voluminous text, completing work on the eighth edition only days before his death. A colleague described his work as follows: “Hoyt reads what I’ve written, then writes what I meant to say. Crenshaw was an associate editor of The Journal of Bone and Joint Surgery from 1963 through 1972, as well as of the AAOS Bulletin and the Journal of Continuing Education in Orthopedics. He contributed numerous articles to the orthope- dic literature, many of them now classics. Crenshaw gave fully of his time and talents to orthopedic specialty societies. Among his duties, he served as librarian–historian of the 82 Who’s Who in Orthopedics On the basis of this work, he can be considered to be one of the originators of the technique of compression plating. Robert DANIS 1880–1962 Robert Danis was born in a small town in the Belgian province of Tournai. After classical studies at Anvers and Louvain, he studied medicine at the William DARRACH University of Brussels, from which he received his degree in 1904. He became associated with 1876–1948 Antoine Depage and moved up through the system, becoming professor of operative surgery Dr. William Darrach was born in Germantown, and gynecology in 1919 and succeeding his chief Pennsylvania, the son of William and Edith as professor of clinical surgery in 1925. School and was graduated from Yale University He made significant contributions to the field in 1897. Following his graduation from the of local and regional anesthesia, especially sacral College of Physicians and Surgeons in 1901, he blocks. His interest in vascular surgery led to the served an internship at the Presbyterian Hospital.