Reflective Journal Assignment Example | Topics and Well Written Essays - 1250 words - 1

Intelligent Journal - Assignment Example I can add to supportable advancement by changing my way of life in significant manners. I can screen my utilization of water with the goal that I don't squander it or use it superfluously. I can likewise discard recyclable material appropriately and discard all waste fittingly. I can diminish my utilization of vitality and non-renewable energy sources with the end goal of lessening carbon emanations. Whenever the situation allows, I can likewise give to foundation for taking care of the poor to lessen their dependence on the misuse on marine life and other characteristic food sources. Talk 2: The three primary concerns were: Sustainable improvement turned into a state commitment by means of the Rio Declaration of 1992; states’ commitment are repudiated by different UN Resolutions awards states power over their characteristic assets; and that atmosphere changes currently requires open interest through the UN Framework Convention on Climate Change 1992. Instructional exercise 2: I added to responding to the different inquiries brought up in Tutorial 2. These inquiries identified with the job of the UN in worldwide ecological law, recognizing the standards of natural insurance contained in the Rio Declaration of 1992, and different inquiries comparative with the definition and lawful nature of bargains and shows. I saw that there was a noteworthy issue with regards to universal natural law. The different instruments were just official on states and don't make arrangement for non-state entertainers. It can hence be expected that non-state actors’ impact on the earth are secured by national law. On the other hand, as a non-state on-screen character, I can decide to step up to the plate and dependably utilize just earth cordial products and guarantee that my decisions and conduct don't add to an exhaustion of regular assets. Talk 3: Three primary concerns are: As the earth’s assets are diminishing the total populace is expanding; meanwhile, the world is encountering environmental change and carbon discharges from petroleum derivatives is the

The Rights and Responsibilities of Green Card Holders

The Rights and Responsibilities of Green Card Holders A green card or legitimate changeless residency is the movement status of an outside national who goes to the United States and is approved to live and work in the United States permanently. A individual must keep up perpetual inhabitant status on the off chance that he decides to turn into a resident, or naturalized, in the future. A green card holder has lawful rights and duties as specified by the U.S. Customs and Immigration Services (USCIS) office. U.S. changeless residency is referred to casually as a green card on account of its green plan, first presented in 1946. Legitimate Rights of U.S. Changeless Residents U.S legitimate changeless occupants reserve the privilege to live for all time in the United States gave the inhabitant doesn't submit any activities that would make the individual removable under movement law U.S. perpetual occupants reserve the option to work in the United States at any lawful work of the inhabitants capability and picking. A few employments, similar to government positions, might be constrained to U.S. residents for security reasons. U.S. perpetual occupants reserve the option to be ensured by all laws of the United States, the condition of habitation and nearby wards, and can travel unreservedly all through the U.S. A lasting occupant can claim property in the U.S., go to government funded school, apply for a drivers permit, and if qualified, get Social Security, Supplemental Security Income, and Medicare benefits. Lasting inhabitants can demand visas for a companion and unmarried youngsters to live in the U.S. also, can leave and come back to the U.S. under specific conditions. Obligations of U.S. Perpetual Residents U.S. changeless inhabitants are required to comply with all laws of the United States, the states, and regions, and must document personal government forms and report pay to the U.S. Inward Revenue Service and state burdening specialists. U.S. lasting occupants are relied upon to help the law based type of government and not change the legislature through unlawful methods. U.S. perpetual inhabitants must keep up migration status after some time, convey verification of lasting occupant status consistently and tell USCIS of progress of address inside 10 days of relocation. Males age 18 up to age 26 are required to enlist with the U.S. Specific Service. Medical coverage Requirement In June 2012, the Affordable Care Act was ordered that commanded all U.S. residents and perpetual occupants must be taken on medicinal services protection by 2014. U.S. changeless occupants can acquire protection through the state social insurance trades. Legitimate settlers whose pay falls underneath administrative neediness levels are qualified to get government sponsorships to help pay for the inclusion. Most perpetual occupants are not permitted to try out Medicaid,â a social wellbeing program for people with restricted assets until they have lived in the United States for at any rate five years. Consequencesâ of Criminal Behavior A U.S. changeless inhabitant could be expelled from the nation, declined reemergence into the United States, lose lasting occupant status, and, in specific conditions, lose qualification for U.S. citizenship for participating in crime or being indicted for a wrongdoing. Different genuine infractions that could influence changeless residency status incorporate distorting data to get migration advantages or open advantages, professing to be a U.S. resident when not, casting a ballot in a government political decision, routine medication or liquor use, participating in various relationships one after another, inability to help family in the U.S., inability to document assessment forms and obstinately neglecting to enlist for Selective Service whenever required.

Bio-science Example

Bio-science Example Bio-science â€" Essay Example > Bio-science1. Drugs which act on serotonin receptors are important for managing both migraines, mood disorders (e. g. antipsychotic) and vomiting: a. For each of these conditions name one drug (using generic drug names)which is used in Australia and acts via serotinergic receptors. b. Explain the mechanism of action of each drug (i. e. how does it work? ). c. What is serotonin syndrome and why might ecstasy cause symptoms of serotonin syndrome? 1. a. The triptans act via serotinergic receptors as they are 5-HT1B/1D agonists targeting the trigeminovascular system. Sumatriptan is a triptan used in the management of migraine (Spierings del Rio, 2002). A class of drugs used in the treatment of mood disorders, which act via the serotinergic receptors are the selective serotonin reuptake inhibitors or serotonin specific reuptake inhibitors (SSRIs). Citalopram is an SSRI used in the management of mood disorders (Rollema Sprouse, 2005). The 5-HT3-receptor agonists are a class of drugs u sed in the management of vomiting, as they are capable of blocking the 5-HT-3 receptor sites efficiently. Ondansetron is a 5-HT3-receptor agonist used in the management of migraine (Husband Worsley, 2007). 1.b. Many of the triptans that are in current use for the management of migraine have selective serotonin receptor agonist activity. This action of the triptans causes constriction in the arteriovenous anastomes. Thus it is posited that the triptans ability to control migraine is based on this constriction of the arteriovenous anastomes. Sumatriptan brings about constriction in the superficial temporal artery. In addition Triptans like sumitriptan have demonstrated the capability to inhibit the release of calcitonin gene-related peptide, which is responsible for the mediation of the vasodilation element of neurogenic inflammation (Spierings del Rio, 2002). In essence the mode of action of the SSRIs can be taken as making more serotonin available in the extracellular environmen t, by inhibiting the reuptake of serotonin by the presynaptic cell. This enhanced extracellular level of serotonin makes for higher levels of serotonin to bind with the postsynaptic receptor (Rollema Sprouse, 2005). The mechanism involved in vomiting consists of the formation of local free radicals as a result of cytotoxic agents or other substances that are potentially toxic. These free radicals bring about the release of 5-HT from the enterochromaffin cells in the GI tract. 5-HT is the stimulus for the 5-HT3 receptors present on the adjacent vagal afferent neurons to cause a vigorous vomiting response. 5-HT3- receptor agonists, like ondansetron, block the 5-HT3 receptors in the GI tract, the chemoreceptor trigger zone, and the nucleus tractus solitarius efficiently, to inhibit the vomiting response triggered by the 5-HT3 receptors. (Husband Worsley, 2007). 1.c. Birmes et al 2003, p. 1439 define serotonin syndrome as “the result of over stimulation of 5-HT1A receptors by selec tive serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOI) or other serotonergic agents”. Serotonin syndrome can occur to any individual irrespective of age or sex triggered by an overdose of a serotonergic agent, and occurs within the time interval of twenty-four hours from the overdose event. The three features of mental, autonomic and neurological disorders characterize serotonin syndrome. Serotonin is life threatening, but normally serotonin syndrome is not fatal, when effectively managed (Birmes et al 2003).

Music Industry And Practice Music Production - 1726 Words

I know how much of a clichà © it is to begin this essay with the same, â€Å"I knew I wanted to be music ever since I was a little girl†, line in which you’ve probably heard over a thousand times, but I can honestly say that music has been the only passion I have continuously stuck by. I began writing songs when I was nine years old and I knew then that this was something I wanted to pursue. Therefore, when I heard there was an opportunity for me to learn about the music industry and practice music production, I couldn’t help but to apply. I think I could fit into the Tisch Summer High School Recorded Music Program, because of my experience in collaborative environments, creating music, and my overall desire to involved in this program. When†¦show more content†¦I was assigned to create the veins with two of my classmates. Our job was to form life sized models of the six main veins located in the body. Each week we would gather in or outside of class to mold, paint, and fill our body’s veins. We used clear tubing to act as the main structure and wrapped different types of yarn around the tubing to add the colors of the veins. While completing this job, I took on the leadership position within the group. Setting deadlines, organizing materials, and making sure everyone did their part wasa role I took myself. I made sure to include the creative input from all members. For example, the group, as a whole, decided on the materials and how to put the body system together. My experience with the Frankenstein project allowed me to understand the importance of group cooperation and communication. I learned in order to have a productive group you need to be willing to compromise and take others perspectives into consideration. Part of what makes group projects great are the multiple perspectives and ideas that are available, so it is necessary to take advantage of all of them. Another important aspect is communication. Whether it’s over emails or text messages, knowing what is going on and when it is going on is key. Within this experience I also learned about what I can contribute into other collaborative environments. As a person I tend to be very easy-going and

Clark Surname Meaning and Origin

The Clark surname is an occupational name for cleric, clerk, or scholar - one who can read and write, from the Old English cler(e)c, meaning priest.  Also from the Gaelic Mac a Chlerich/Cleireach; son of the cleric or, sometimes, clerk. During the Middle Ages, the common pronunciation of -er was -ar, so the man who sold items was the marchant, and the man who kept the books was the clark. At the time, the primary members of the literate class were the clergy, which in minor orders were allowed to marry and have families. The term clerk (clark) eventually came to designate any literate man. The Cleary / OClery surname, one of the oldest surnames in Ireland, is often anglicized to Clarke or Clark. Clark is the 25th most popular surname in the United States and the 34th most common in England. Clarke, with an e, is actually more common in England - coming in as the 23rd most popular surname. It is also a very common name in Scotland (14th) and Ireland. Surname Origin English, Irish Alternate Surname Spellings ï » ¿CLARKE, CLERK, CLERKE Famous People With the Surname CLARK William Clark - one half of the legendary Lewis Clark expedition to the Pacific Ocean, along with Meriwether Lewis.Guy Clark - American singer/songwriterArthur C. Clarke - British science fiction writer, best known for 2001: A Space Odyssey Genealogy Resources for the Surname CLARK 100 Most Common U.S. Surnames Their MeaningsSmith, Johnson, Williams, Jones, Brown... Are you one of the millions of Americans sporting one of these top 100 common last names from the 2000 census? Clark(e) Surname DNA ProjectThis project was started to determine if the early Clark families in Virginia were of the same family, and/or if they were connected to explorer William Clark. The project has now expanded to include a broader scope of Clark families around the world. Clark Family Genealogy ForumSearch this popular genealogy forum for the Clark surname to find others who might be researching your ancestors, or post your own Clark query. There is also a separate forum for the CLARKE variation of the Clark surname. FamilySearch - CLARK GenealogyFind records, queries, and lineage-linked family trees posted for the Clark surname and its variations. DistantCousin.com - CLARK Genealogy Family HistoryFree databases and genealogy links for the last name Clark. ----------------------- References: Surname Meanings Origins Cottle, Basil. Penguin Dictionary of Surnames. Baltimore, MD: Penguin Books, 1967. Menk, Lars. A Dictionary of German Jewish Surnames. Avotaynu, 2005. Beider, Alexander. A Dictionary of Jewish Surnames from Galicia. Avotaynu, 2004. Hanks, Patrick and Flavia Hodges. A Dictionary of Surnames. Oxford University Press, 1989. Hanks, Patrick. Dictionary of American Family Names. Oxford University Press, 2003. Smith, Elsdon C. American Surnames. Genealogical Publishing Company, 1997.

Principal methods for healthcare research Free Essays

Introduction Bulimia Nervosa (BN) is an eating disorder, which is characterised by repeated episodes of over eating and bingeing and by a set of compensatory behaviours intended to cause weight loss which includes vomiting, purging, fasting and excessive exercise. The American Psychiatric society (A.P. We will write a custom essay sample on Principal methods for healthcare research or any similar topic only for you Order Now A. DSM-IV, 2000) and the World Health Organisation ( World Health Organization. International Statistical Classification of Diseases, 10th Revision (ICD-10). Geneva, Switzerland: W.H.O., 1992), both suggest the following diagnostic criteria for the disorder 1. A persistent preoccupation with eating and irresistible craving for food. 2 .Repeated episodes of binging/overeating in which large quantities /amounts of food are consumed 3. Patients experiencing BN take excessive measures to compensate for the ‘fattening‘effects of food e.g. vomiting, purging and fasting. The Beating Eating Disorder Association (BEAT). Formerly known as the Eating Disorders Association, a voluntary sector group in the UK., as provided figures that up to 1.15 million people in the UK, experience a significant problem with BN, and up to 90.000 people are receiving treatment at any one time. It is not therefore surprising that BN is a major and widespread problem. Consequently a number of treatments have been developed and trialled, based on focused research, and developing an evidence base. The National Institute of Clinical Excellence (NICE). Published guidance in 2004, (Eating disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. London: National Institute for Health and Clinical Excellence (NICE) 2004). Which recommends Cognitive Behavioural therapy (CBT) as an efficacious treatment as well as Selective Serotonin Re-uptake Inhibitors (SSRI’s) such as Fluoxetine. Research in this area is an important on a number of counts. Firstly, on clinical intervention grounds so that the treatment offered for the disorder can be expanded and improved and secondly given that the Disorder was only recognised in 1979 ( Russell, G.1979), and with a widespread epidemiology, sufferers experiences of the disorder are important in clinical practice to deepen understanding of sufferers experiences.. The two papers presented here both focus on the condition from different perspectives and ask different questions. The first paper is a qualitative study: Binge and purge Processes in Bulimia Nervosa: A Qualitative Investigation (Jeppson et al. 2003) using a grounded theory design focusing on the two core diagnostic behaviours of BN; binging and purging. They aimed to elucidate information on these processes and their function for Bulimic’s experience. The second paper is a comparative intervention study, following a quantitative research design – a form of Randomised Control Trial (RCT) – Cognitive-Behavioural, Fluoxetine and Combined Treatment for Bulimia Nervosa: Short- and Long-term Results (Jacobi et al.2002). Both papers illustrate their design paradigms and contain a number of flaws, which will be discussed in relation to their respective research methods. Their Respective Research Design and philosophy Jeppson et al(2003), deployed a qualitative research design, which followed a grounded theory approach (Glaser Strauss,1967). Grounded theory was originally developed by these social researchers, before the approach ‘split’ into different camps, (Stebbins, R.A., 2001), the approach essentially emphasizes the ’generation of theory’ from data that is acquired in the actual process of conducting the research. So rather than beginning with an hypothesis that needs to be tested that is the hallmark of the experimental quantitative research design, grounded theory begins the research process with an aim for exploration. The quantitative paradigm illustrated by the Jacobi et al. (2002) paper, forms the basis of RCT’s and Therapy trials which are common in much of health care research, including Cognitive Behavioural Therapy (CBT) and treatment approaches/interventions to Bulimia Nervosa. At its philosophical ‘core’ is the notion of empiricism (Owen, F. Jones R, 1977), whereby quantitative properties and phenomena and their relationships are observed and studied. Thus the process of measurement is crucial to the paradigm and this affords the connection between ‘empirical’ observations i.e did X effect Y and mathematics, through the expression of quantitative relationships As measurement is crucial to the quantitative paradigm, the choice of Randomised Comparison Study is entirely appropriate for the Jacobi investigation, as it wants to compare the treatment effects of three different conditions treating the disorder. Studies of this type are a form of scientific experiment, with RCT’s often referred to as the ‘gold standard’ for intervention studies (Cartwright, A. 2007). They are often used for ‘safety’ studies in drug trials and for testing the effectiveness of clinical interventions and services The two research studies presented here, display different philosophical foundations, which shape their whole approach to research deign. The Contrasting Research Hypothesizes Jeppson et al (2003), developed an aim for their qualitative study based on previous research they had encountered on the BN binge-purge process that is seen to be central to the disorder. The study was not concerned with assessing the ‘effects’ of interventions on binge and purge behaviour, but rather to try and understand what these behaviours meant and the functions they served for the patients they studied. They considered in previous research that quantitative methods, had focused on self-monitoring of these episodes and ranking them to ‘measure’ links to mental state e.g. Stress, and had deemed that it had not sufficiently led to an understanding of their function as experienced by BN patients themselves. They had an idea that these behaviours were crucial and played a part in assisting sufferers with their ‘emotional regulation’, but were curious and wished to expand an understanding of their role. They therefore set out with an ‘aim’ for the research to find out what BN patients experiences of these two processes and the meanings /function they served for them, I believe this ‘aim’ was entirely congruent with the qualitative method, and provided a question that RCTs looking at interventions had not and could not study. The Jacobi et al., paper(2002), asked a different set of questions. They were interested in how CBT compared with the SSRI – Fluoxetine, and a combination of them both . They considered that both the psychological (Wilson, G.T., Fairburn, C.G., 1993) and pharmacological interventions (Goldstein et al.,1995) had developed an evidence base for treating BN. They designed an ambitious study to investigate the question of the relative short and long-term effectiveness of the three interventions. They questioned whether the combined approach would be more beneficial in the long-term, as previous research studies investigating a combination approach, had experienced high drop-out rates due to the side effects of the of the SSRI, which may have influenced their results. The study did not include a control or placebo condition, which would be the normal procedure for intervention type studies.The reason for this was that they considered previous research had demonstrated the effectiveness of CBT and Fluoxetine, and was not needed. The study had four aims: To compare the effectiveness of CBT, Fluoxetine and there combination, to compare the short and long-term effects of these treatments. To inquire about the possible ‘additive’ effect of combined intervention and to examine the differential effects of the treatments. These types of intervention question are suitable for a randomised study as the questions Jacobi and team are asking are essentially ones of intervention and differential effectiveness/measurement on a number of variables e.g. Binging and purging episodes, short and long term effects as ascertained by validated psychological questionnaires and clinical interview. Approaches to sampling It is generally considered that sample size is generally much smaller in qualitative studies than those recruited for quantitative studies such as RCT’s (Cresswell,J.W., 2003). As qualitative studies are generally smaller in size, criticisms have been leveled at this paradigm. Although the paradigm does not seek to study the ‘total‘ population, issues surrounding diversity and variation within a population are often cited (Jones,2007). The Jeppson study used only eight participants The approach to sampling used in the study is important as the process of selecting participants is relevant to the aims of the study. They used purposeful sampling to generate the data for their enquiry. Purposeful sampling generally refers to the selection of participants who have experience or knowledge of the area under investigation (Procter et al, 2010) As all participants were selected with a specific diagnosis of BN (APA., DSM-IV,1994) they would all currently have experiences of the processes under investigation. They were recruited from a suburban area in Utah, USA., Descriptive information, including socio economic variation, inpatient and out patient status and educational information was given.This form of sampling used in the study is not random or based on statistical probability as in quantitative studies. Sampling in quantitative research design, especially RCT’s, differs. This type of sampling is in essence the selection of of observable units, which can be measured (Maxim, P.S., 1999). As outlined in the introduction, BN is widespread in the UK (and other european countries). It is not possible in the Jacobi study to observe the effects of the treatment interventions with the whole population of people experiencing BN. Therefore quantitative studies tend to study a sample of the group or population which may represent the larger population. The study recruited its patents by a mixture of media advert and direct referral to the Department of Psychology at the University of Hamburg. All underwent telephone screening, by a clinician not involved in the study (to assess inclusion criteria) and a semi structured psychiatric interview,and physical examination As selecting people for therapy trials is open to sampling errors, in that some people selected,may be ‘exceptional’ or ‘different’ from those of the larger ‘Bulimic’ population.The method attempts minimize these possibilities, by careful inclusion/exclusion criteria and the random distribution of the participants into one of the three treatment conditions[1] The size of sample for the Jacobi study is more important than the qualitative study, to gain meaningful results. Data Collection Methods and Data analysis The Jeppson et al study (2003) study, collected its data from interviewing eight participants who agreed to take part in the study, by using a semi-structured interview format, lasting one hour. The semi-structured format differs from a more limited ‘formalized’ set of questions, by nature of its flexibility. It allows for new questions to be added in response to what the interviewee says, inviting and generating further information, which the study utilised. The study used a ‘framework’ and ‘interview guide’, which is a collection or set of topics to guide the interview process (Lindlof Taylor, 2002). The paper, makes reference to this, but does not provide specific details of what constituted the ‘guide. To enhance validity, ‘member checks’ were conducted post interview, all participants received a 20 minute phone call, where findings were ‘shared’; allowing corrective feedback on accuracy. Transcripts were also read by three mental health professionals The study reported that ‘redundancy’ or theoretical saturation occurred between interview 5-7. Grounded theory employs this framework, so sampling frame may be modified as a result of a process deemed, ‘constant comparison analysis’ i.e, that data is determined by its recurrence and re-evaluation to assist with the ‘theorizing process’ of the area under investigation. The type of process involved in the purposeful sampling used in Jeppson’s study, accepts that it is impossible to identify ahead of time, all categories of emergent data that the researcher needs to review. So its is purposely designed to pursue data collection categories to the point of concept or ‘data saturation’, which occurs when the data is stable and the pattern(s) unlikely to change (Locke,2001). They found this occurred during the interviewers 5-7, and added 1 further interview according to protocol. (Lincoln Guba, 1985) Once Jeppson collected the data, key points were assigned (or marked) to it, referred to as ‘codes’. Concepts and categories were then then worked out. The categories that emerged are seen within this methodology as the basis of theory generation for the study. This process as been referred to by Glaser and Strauss (1967) as the reverse emergence ‘hypothesis’. Thus, it was considered that to gain information on the participants binge and purging behaviours it was best to ask them about their experiences so as generate theory from their responses, rather than to come to the study with a pre-determined hypothesis or theory which needed testing. As the researcher is part of the ‘research process’ and data collection, ‘reflexivity’, is a feature of the data collection process. This can be divided into ‘personal reflexivity’ and ‘epistemological reflexivity’. ‘Personal reflexivity’ involves the researcher being aware and examining their own values, experiences etc. and how this may have shaped the research. It also involves thinking about how the research may have affected and possibly changed people and researchers. ‘Epistemological reflexivity’ as such, asks how the research question is defined and conducted and how it may of limited what was foundby asking searching questions about the data and its findings (Willig,C. 2001). Jeppson notes, that he was ‘aware’ of himself and the potential influence on the study. Jacobi, collected its data by using a battery of validated Psychological Measures to assess outcomes from the three intervention conditions.They were administered at pre and post treatment, and at 3 months and one year follow up. Descriptive statistics[2] were given using the mean[3] and standard deviation[4] of patients with regard to age, marital status, and education. Frequency of binging and vomiting, onset of these behaviours , lowest BMI etc., no table provided. Data analysis was conducted by using a number of inferential statistical tests, to ‘measure’ and quantify a host of possible influences on the outcome results obtained form the measures of each condition. Individual one-way analyses of variance ( ANOVAs) were used to compare data, i.e., demographics, clinical variables: frequency of binging etc pre and post. The ANOVA technique involves measuring the variance of the group means and comparing that to the variance predicted if all groups were randomly sampled from the same population i.e ANOVA, tests hypotheses about the mean(s) of a dependent variable(s) e.g frequency of binge eating across the different treatment groups, in relation to the independent variables i.e. group condition To analyze the differential effects of the 3 treatments is was originally proposed to use uni and multivariate analyses of covariance[5], e.g .to study the covariance of say mood state with frequency of purging across the treatment conditions, to see if the amount of change between two or more variable maps changes in another variable, an estimate of correlation.[6] Sample size, through attrition was assessed as to small to run theses tests, at one year follow up. The ANOVAs and MANOVA tests used in this study produce the F-statistic[7], which is used to calculate the P-value,[8] and significance. The choice of tests was appropriate[9], given 3 treatment conditions, and the comparative nature of the research question/hypotheses. A intention to treat analysis, conducted for drop-outs was in line with the research protocol for this study design. Quality of studies The two papers have approached the subject of BN from different research designs. It is important when considering research papers to assess their quality, in respect of their chosen methods. Jeppson’s paper, in a my opinion is a well designed study. The aim is suited to qualitative methodology. Assessing the quality of the study as proved challenging as its requires a different set of criteria, from quantitative research (table 1), And Patton (2002), outlines a series of considerations to establish rigor for qualitative research (table 2 ). The use of one interviewer, sample containing severe bulimics (Anorexia?), may have influenced the themes and results Also some ‘reporting issues‘ concerning method etc,, can all factors effecting quality. Table1 . Critical evaluation of qualitative study Table 2. Criteria to establish rigor in qualitative studies Criteria to establish rigor in qualitative methods. Patton (2002) p.552-558 Study:Jeppson et al (2003) Binge and Purge Processes in Bulimia Nervosa: A Qualitative Study My interpretation (a)Persistent observation(b) Peer debriefing (c)Progressive subjectivity (d) Member checks (e)Triangulation (f) Transferability (g) Dependability (h)Authenticity and fairness (i) confirmabilityThemes became redundant before last interview -observationStudy does not mention that this procedure occurred. Unclear in paper- could be implicit in methodology, not mentioned overtly Yes conducted Yes Makes case in conclusion for clinical enrichment and therapeutic alliance Process was of medium/high quality – audit conducted Study was conducted and reported with ‘fairness’ to process Researcher is ‘aware’ of potential influence – audit conducted The Jacobi research aims were entirely suited to the quantitative randomised trial it adopted to look at the effect of the three treatment interventions and there effects in the short and long term . It, however, suffers from a number of serious flaws, undermining its validity and effects when assessed to by RCT quality criteria (Greenhalgh T.,2006). Firstly, the study fails to provide a power calculation. For to detect differences between the three intervention groups using randomisation, it is considered that the study should be ‘powered’ i.e contain enough patients to determine statistical accuracy. Normally 80% is considered the minimum standard of accuracy for clinical trails. (Ellis, Paul D, 2010), and leaves it open to type 2 errors.[10] This was not assisted by the attrition rate, especially at follow up. It contributed to the study being significantly ‘underpowered’, so much so that the results at one year follow-up being of poor quality, the results could be dismissed[11] (Table 3 provides a critical evaluation) Table 3. Critical evaluation of quantitative study. Question Study: Jacobi et al. (2002) Cognitive-behavioural, Fluoxetine and Combined Treatment for Bulimia Nervosa: Short and long term results Does the study address the focussed question?Yes Were the patients randomly selected from a defined population?Patients were selected/recruited by advertisement and referral to the Psychology dept. Of Hamburg University. All had met the diagnostic criteria for BN. Was the assignment of patients to the intervention and control group randomised?There was no control group. Study compared effects of three different treatment conditions. Paper states they were randomised, but does not say how and by what method Were the participants and observers both blinded?Not stated though this difficult to achieve within psychotherapy trials Aside from the intervention were the groups treated equally?Yes Was a follow up completedYes- at I year Did the study have adequate power to see an effect if there was one?No, there was no power calculation provided though this is common in psychotherapy intervention trials/studies. Very high attrition rate – at follow up. Were all the patients who entered the trial properly accounted for?Full disclosure is given about the dropouts, calculations were made that suggest that the results at follow up lack validity Were the results of the trial presented in a manner that allowed for full examination?No: adequate data was presented on tests MANOVA/ANOVA. Ci’s not reported Secondly, the randomization procedure which gives the randomized controlled trial its strength. The investigators did not provide details of the randomization methods its used for the study[12], although this may be attributable to poor reporting, its is a significant emission (Jadad, 1998). The paper whilst providing a range of data, omits to report confidence intervals (CI)[13] for the three conditions and its results, and their were no proposed effect sizes included the aims/hypotheses. Discussion Both studies addressed their research using different methods. Both were appropriate for the investigation, illustrating that methodology needs to be tailored to the aim/hypotheses of the question under investigation. The Jeppson study was well designed, and managed to explore its research aim sufficiently, so some its findings had generalisability in treatment settings, and would benefit the CBT practitioner working with BN and aid ‘therapeutic alliance’ by taking into account its findings. By increasing understanding of how the processes have functions for the individual, well beyond the ‘behaviour’ itself. Jacobi’s study, although ambitious with a good design in principle, was seriously flawed. The under-powering of the study, the absence of good reporting on a number of methods and data, leave the study flawed. Its hypothesis and aims were suited to the methodology, but its sample size and attrition rate made generalizability of the results difficult. It did provide some evidence (weak), that CBT is efficacious for the treatment of BN, which continues in clinical practice. Word Count: 3489 References American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders. Washington DC., American Psychiatric Association. Cartwright, N. (2007). â€Å"Are RCTs the Gold Standard?† Biosocieties(2): 11-20. Cresswell, J. W. (2003). Research design: Qualitative, Quantitative and Mixed Methods Approaches. Thousand Oaks, CA., Sage. Daly, J., Lumley, J. (2002). â€Å"Bias in Qualiative Research.† Australian and New Zealand Journal of Public Health 26(4): 299-230. Ellis, P. D. (2010). The Essential Guide to Effect Sizes: An Introduction to Statistical Power, Meta-Analysis and the Interpretation of Research Results. Cambridge, C.U.P. Glaser, G. B., Strauss, A. L. (1967). The Discovery of Grounded Theory. Chicago, Aldine Publishing Company. Goldstein, D. J., Olmsted, M., Thompson, V.L., Potvin, j.H., Rampey, A.H. (1995). â€Å"Long term Fluoxitine treatment of bulimia nervosa.† British Journal of Psychiatry(166): 660-666. Greenhalgh, T. (2006). How to read a paper: the basics of evidence based medicine. London., BMJ Publishing Group. Jacobi, C., Dahme, B. Dittmann, R. 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I see myself as a quite liberal person on politica Essay Example For Students

I see myself as a quite liberal person on politica Essay l, social, and economic issues. I believe the public has some duties to the government such as pay taxes. In turn, the government should fund programs to help the people who need assistance. Unfortunately, much of the American public has lost its trust in the federal government because of corruption and special interest groups. However, now we are solving many of these problems, and hopefully America will again trust Washington. Once the public puts its trust with its government without criticizing each step of the way, we will see improvements in areas such as education and health care. Through federal mandates, each person will be given the opportunity to receive quality education and health coverage. Political IssuesI believe the federal government has an obligation to protect the rights of its people. America is a melting pot of various cultures from all different parts of the globe. These people all have different backgrounds, family environments, and experiences that affect their views on politics. Because of the diversity of its people, America accordingly has a diversity of political views. It is the duty of the federal government to protect the rights of each of these people whether they are black, white, Asian, conservative, liberal, socialist, or libertarian. The only time the federal government should violate someones rights is when it negatively affects the well being of others. Social IssuesThe federal government has a duty to ensure each person the opportunity to enjoy all the benefits of life. Unfortunately, the federal government has left some issues to be addressed by the states and private industry. One of the biggest issues is education. Many children are forced to attend schools that have less than adequate facilities. Most of these schools are in the inner-city neighborhoods. Their suburban counterparts have much more funding and as a result, better facilities. This has caused a gap in test scores between inner-city schools and suburban schools. If the federal government stepped in and provided equal funding to all schools, this problem would be solved. Also, the federal government has stayed out of health care and left it to industry. Millions of Americans cannot afford health care, and as a result, do not receive the treatment they require. The federal government should step in and supply health care on a federal level to all modeling the Canadian system. This would reduce costs of health care and give everyone the assistance they need. There also is too much discrimination against minorities such as blacks, homosexuals, and women. The federal government needs to help ensure that each person is given a chance to lead a life comparable to that of a member of the majority. Each has the right to live a decent life, and no one can take that away. Economic IssuesCurrently too much of the money is in the hands of the elites who control industries. Too many workers receive too little pay to afford the services they need to raise families in todays world. Big business today controls the wages and forces the workers to work its terms. The federal government should step in to ensure wages at decent levels and jobs to all people. Society should help each individual get onto his or her feet. Then each individual can return the favor and help society.