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For some research projects buy discount cialis 2.5 mg on line, there will be only a small number of people within your research population purchase 2.5mg cialis visa, in which case it might be possible to contact everyone buy cialis 10mg on line. However generic cialis 5mg without a prescription, for most pro- jects, unless you have a huge budget, limitless timescale and large team of interviewers, it will be difficult to speak to every person within your research population. SAMPLING Researchers overcome this problem by choosing a smaller, more manageable number of people to take part in their research. In quantitative research, it is believed that if this sample is chosen carefully using the correct procedure, it is then possible to generalise the re- sults to the whole of the research population. For many qualitative researchers however, the ability to generalise their work to the whole research population is not the goal. Instead, they might seek to describe or explain what is hap- pening within a smaller group of people. This, they believe, might provide insights into the behaviour of the wider re- search population, but they accept that everyone is different 47 48 / PRACTICAL RESEARCH METHODS and that if the research were to be conducted with another group of people the results might not be the same. Market research- ers use them to find out what the general population think about a new product or new advertisement. When they re- port that 87% of the population like the smell of a new brand of washing powder, they haven’t spoken to the whole population, but instead have contacted only a sam- ple of people which they believe are able to represent the whole population. When we hear that 42% of the popula- tion intend to vote Labour at the next General Election, only a sample of people have been asked about their voting intentions. If the sample has not been chosen very care- fully, the results of such surveys can be misleading. Imagine how misleading the results of a ‘national’ survey on voting habits would be if the interviews were conducted only in the leafy suburbs of an English southern city. Probability samples and purposive samples There are many different ways to choose a sample, and the method used will depend upon the area of research, re- search methodology and preference of the researcher. Ba- sically there are two main types of sample: X probability samples X purposive samples. In probability samples, all people within the research po- pulation have a specifiable chance of being selected. These types of sample are used if the researcher wishes to ex- plain, predict or generalise to the whole research popula- tion. On the other hand, purposive samples are used if HOW TO CHOOSE YOUR PARTICIPANTS / 49 description rather than generalisation is the goal. In this type of sample it is not possible to specify the possibility of one person being included in the sample. Within the probability and purposive categories there are several dif- ferent sampling methods. The best way to illustrate these sampling methods is to take one issue and show how the focus of the research and the methodology leads to the use of different sam- pling methods. The area of research is ‘school detention’ and in Table 3 you can see that the focus and sampling techniques within this topic can be very different, depend- ing on the preferences of the researcher, the purpose of the research and the available resources. SAMPLE SIZE Thefirstquestionnewresearcherstendtoaskis‘how many people should I speak to? For large scale, quantitative sur- veys you will need to contact many more people than you would for a small, qualitative piece of research. The sam- ple size will also depend on what you want to do with your results. If you intend to produce large amounts of cross tabulations, the more people you contact the better. It tends to be a general rule in quantitative research that the larger the sample the more accurate your results. However, you have to remember that you are probably re- stricted by time and money – you have to make sure that you construct a sample which will be manageable. Also, you have to account for non-response and you may need to choose a higher proportion of your research population 50 / PRACTICAL RESEARCH METHODS TABLE 3: SAMPLING TECHNIQUES PROBABILITY SAMPLES PURPOSIVE SAMPLES The researcher is interested in The researcher decides that he wants finding out about national detention to interview a sample of all pupils rates. He wants to make sure that within a school, regardless of whether every school in the country has an they have been on detention or not.

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His records were among the best the writer has Without doubt the most important was his tenure ever seen order cialis 20mg with visa. His influence was manifest in his wise of the editorship cialis 2.5mg free shipping, which covered the period from counsel in committees and conferences generic cialis 5mg. Brackett was elected Editor of The Journal His sterling qualities were duly valued and of Orthopedic Surgery in 1921 purchase 20mg cialis free shipping. With the issue of respected, as has been abundantly evidenced by the following January it again became a quarterly the confidence reposed in him by the Executive and the name was changed to The Journal of Bone Committee, and through them by the entire mem- and Joint Surgery. When he took over the editorship, the Journal The years immediately following the founda- had not progressed very far beyond the transac- tion of the Association, in 1887, were years tions stage of its evolution. It often happened that under this rule, their task to raise the specialty to a respected posi- papers were published that were not worthy of a tion among the other specialties. At that time journal having a nationwide circulation, and the neither the profession nor the public looked with new editor recognized this. Early in his adminis- much favor upon specialization, and in certain tration an advisory editorial staff was organized. The next step was the appointment of a group As more and more men became interested of foreign editors who kept Dr. Brackett informed in the problems of orthopedic surgeons, their about the development of the specialty in their distribution over the USA and Canada became countries, from time to time sending in reports more general; and, during the earlier years, the of meetings and papers by their colleagues. This policy was advocated by publication could be a real factor in the develop- 36 Who’s Who in Orthopedics ment of better understanding and closer coopera- His intimate acquaintance with the member- tion between nations. It was, therefore, a special ship of the Association for so many consecutive satisfaction to him when contributions began to years made it possible for him to be of the great- come from representative surgeons in different est assistance to younger men sending in papers countries, many of them men he had met person- for publication. From the to have the papers he thought worthy of publica- correspondence with these foreign contributors tion brought up to the standard he had set. Brackett became Editor, the total list be present at orthopedic congresses in France, of subscribers numbered 797. At the time of his Belgium, Italy, Germany, Czecho-Slovakia, and death, the number of paid subscriptions was over Switzerland. During the 20 years of his editorship, the that came from these contacts was his visit to budget of the Journal was increased eightfold. Leningrad in the summer of 1936, when he had The realization of some of his aspirations for the opportunity of meeting Prof. Henry Turner, the Journal has come through the broadening of with whom a warm friendship had developed the field of its usefulness, as shown by the fact through years of correspondence, and of seeing that there has been a steady increase in the the remarkable work for crippled children that number of foreign, as well as domestic, sub- had resulted from the labors of this pioneer, a man scribers. At the end of 1939 (the beginning of the of British parentage who had devoted his life to war), the Journal was being mailed regularly to the development of orthopedic surgery in Russia. Brackett had with the officials of the USSR Society for Cul- charge of the Journal, he provided office space in tural Relations with Foreign Countries, through his own house. He never received salary for his whose interest many of the contacts of the work, and at the time the Association made the Journal with Soviet publications had been made first attempt to show their appreciation of his possible. This sum was set up by over the standard of the papers presented at the the Association as the Elliott G. Brackett Endow- annual meetings, and the creation of a Board of ment Fund. Since the appointment of the a second attempt was made by the Association to latter, all papers have been submitted to this body, show their esteem, and a large number of letters and gradually the editor impressed upon them his were written to him, and a gift was made with the ideals and standards for a journal. No one not intimately associated with and to the Association, he found time to serve his him has any idea how much time and thought he community in its hospitals and in promoting gave to it. To him it was not merely a rostrum many movements to aid the physically handi- from which an author might exploit his ideas. He was identified with various Boston must present something that was new, or at least, hospitals, in his early years at the House of the if not wholly new, it must be presented in a better Good Samaritan, later as orthopedic surgeon at form than ever before.

In order to study these issues cheap 2.5mg cialis with visa, Berg decided to combine In addition to this unusual voluntary deferral of his own the DNA of SV40 purchase 20 mg cialis, which was known to cause cancer in some research buy cialis 5 mg otc, Berg led a group of ten of his colleagues from around animals cheap 10 mg cialis visa, into the common intestinal bacterium Escherichia the country in composing and signing a letter explaining their coli. He thought it might be possible to smuggle the SV40 collective concerns. Published in the July 26, 1974, issue of DNA into the bacterium by inserting it into the DNA of a type the journal Science, the letter became known as the “Berg let- of virus, called a bacteriophage, that naturally infects E. Two long chains of alternating sugar The Berg letter warned, “There is serious concern that and phosphate groups twist about each other, forming the sides some of these artificial recombinant DNA molecules could of the ladder. A base attaches to each sugar, and hydrogen prove biologically hazardous. The order or sequence of the bases bacteria, some of which cause disease in humans. Then, using another type of enzyme ing or other animal viruses into plasmids or other viral DNAs called terminal transferase, he added one base at a time to one that could spread the DNA to other bacteria, animals or side of the double-stranded molecule. Thus, he formed a chain humans, “and thus possibly increase the incidence of cancer or that extended out from the double-stranded portion. Such comple- California, on February 27, 1975, at Asilomar and brought mentary extended portions of DNA that bind to each other to together a hundred scientists from sixteen countries. In effect, scientists would be able to make enormous laborate on developing safeguards to prevent genetically engi- amounts of particular genes they wanted to study, or use sim- neered organisms designed only for laboratory study from ple organisms like bacteria to grow large amounts of valuable being able to survive in humans. And they drew up professional substances like human growth hormone, antibiotics, and standards to govern research in the new technology, which, insulin. Researchers also recognized that genetic engineering, though backed only by the force of moral persuasion, repre- as the technique was quickly dubbed, could be used to alter sented the convictions of many of the leading scientists in the soil bacteria to give them the ability to “fix” nitrogen from the field. These standards served as a blueprint for subsequent fed- air, thus reducing the need for artificial fertilizers. But he realized regulations have been relaxed or eliminated, except in the cases the potential danger of inserting a mammalian tumor gene into of recombinant organisms that include extensive DNA regions a bacterium that exists universally in the environment. He pathogenic characteristics that threatened humans or other is also doing research in molecular biology of HIV–1. In his own case, he The Nobel Award announcement by the Royal Swedish feared that adding the tumor-causing SV40 DNA into such a Academy of Sciences cited Berg “for his fundamental studies common bacterium would be equivalent to planting a ticking of the biochemistry of nucleic acids with particular regard to cancer time bomb in humans who might subsequently become recombinant DNA. His research man of the Department of Biochemistry there from 1969 to included tuberculosis, food preservatives, the engulfment of 1974. He was also director of the Beckman Center for particles and foreign organisms by immune cells (a phenome- Molecular and Genetic Medicine (1985), senior postdoctoral non termed phagocytosis), and the enhanced immune reaction fellow of the National Science Foundation (1961–68), and of an organism to an antigenic target (called anaphylaxis). He was was also responsible for determining the interrelations and dif- elected to the advisory board of the Jane Coffin Childs ferences that helped identify the organisms in a class called Foundation of Medical Research, serving from 1970 to 1980. Other appointments include the chair of the scientific advisory This latter research activity also formed the basis for his committee of the Whitehead Institute (1984–90) and of the most well known accomplishment. In the early years of the national advisory committee of the Human Genome Project twentieth century Bergey became chair of an organizational (1990). He was editor of Biochemistry and Biophysical committee whose mandate was to devise a classification Research Communications (1959–68), and a trustee of scheme for all known bacteria, a scheme that could be used to Rockefeller University (1990–92). He is a member of the identify unknown bacteria based on various criteria (such as international advisory board, Basel Institute of Immunology. Gram stain reaction, shape, appearance of colonies, and on a Berg received many awards in addition to the Nobel variety of biochemical reactions). In 1923, he and four other Prize, among them the American Chemical Society’s Eli Lilly bacteriologists published the first edition of Bergey’s Manual Prize in biochemistry (1959); the V. Roche Institute of Molecular Biology (1972); the Albert The first three editions of the Manual were published by Lasker Basic Medical Research Award (1980); and the the Society of American Bacteriologists (now called the National Medal of Science (1983). During the preparation American Academy of Arts and Sciences, and a foreign mem- of the fourth edition in 1934 it became apparent that the finan- ber of the Japanese Biochemistry Society and the Académie cial constraints of the Society were making publication of the des Sciences, France. Subsequently, it was agreed by the Society and Bergey that he would assume all rights, title and interest See also Asilomar conferences; Bacteriophage and bacterio- in the Manual. In turn, an educational trust was created to phage typing; Immunodeficiency disease syndromes; oversee and fund the publication of future editions of the Immunogenetics Manual. From the first edition to the present day, the Bergey’s manual has continued to be updated and new revisions pub- lished every few years.

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Nurses can be your best friend and your worst enemy buy 20 mg cialis overnight delivery,often within minutes of each other if you say the wrong thing at the wrong time buy 2.5 mg cialis with visa. Historically 2.5 mg cialis amex, doctors have always thought themselves more hard done-by than any other medical professionals and as a response to this have always seen themselves as superior to nursing staff cheap cialis 2.5 mg fast delivery,both in their educational/intellectual level or in status. Nowadays more than ever before, nurses and doctors need to work side by side as equals in the workplace although ultimately the overall responsibility and duty of care of the patient rests with the doctor. This respon- sibility can often cause problems,as some junior nursing (and occasionally older) staff do not realise this concept. When giving instructions regarding the care of patients there is often debate between doctors and nursing staff,which can look unprofessional and 41 42 What They Didn’t Teach You at Medical School not be in the best interests of the patient. They have their own role, just as you are not on the ward for their benefit. Nurses and doctors work together as a team for a common goal: the care and treatment of the patients. There are grey areas between the respon- sibilities of nursing and doctoring (for example setting up catheter/central line trol- leys, etc. Nursing staff will often do these things for you if you are busy and they are not, if you ask them nicely. However, always double-check the trolley first, as they sometimes forget small but important items. Pony trekking or horse riding can be dangerous, as can caring for patients. They also have the ability to think, assess situations and come to a decision. When a new rider gets on a horse, the horse will test the rider to see how experienced they are or how in control the rider is by trying to eat grass or wander off the track, going too slowly, etc. The horse needs to have confidence in their rider and once this relationship is established the horse and rider make a good team. Overall you are less likely to fall off and therefore the whole ride is safer. You can see the parallel with nurses: they need to be confident in your actions and judgement before they will let you do things alone without question. You need to have mutual respect and trust in each other to know that, when the nurse bleeps you, that it is for something important. Likewise when you ask a nurse to do something it is equally important that you can trust that they will do it. Once this relationship is established the ward runs more smoothly,quickly and efficiently. The time you spend on the ward will be better spent and therefore you will get more time to sip coffee in the mess. When you have this relationship with nursing staff,the patient care will improve and less clinical errors will occur. I thought this was the perfect analogy but, in retrospect, I think it is flawed in one area. In this analogy, the rider is the master and the horse does what it is told. This is absolutely not true of the relationship between doctors and nurses. Nurses are a pro- fession in their own right and, therefore, I think I should give you another example. In rowing the oarsmen can propel the boat in relative safety without the need for a coxswain. However, with a coxswain to give some direction the winning combin- ation is made.

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