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By P. Sanuyem. Columbia College. 2018.

Second silagra 50mg on line, the influence of common-causal variables is controlled, and thus eliminated, by creating initial equivalence among the participants in each of the experimental conditions before the manipulation occurs. The most common method of creating equivalence among the experimental conditions is through random assignment to conditions, a procedure in which the condition that each participant is assigned to is determined through a random process, such as drawing numbers out of an envelope or using a random number table. Anderson and Dill first randomly assigned about 100 participants to each of their two groups (Group A and Group B). Because they used random assignment to conditions, they could be confident that, before the experimental manipulation occurred, the students in Group A were, on average, equivalent to the students in Group B on every possible variable, including variables that are likely to be related to aggression, such as parental discipline style, peer relationships, hormone levels, diet—and in fact everything else. Then, after they had created initial equivalence, Anderson and Dill created the experimental manipulation—they had the participants in Group A play the violent game and the participants in Group B play the nonviolent game. Then they compared the dependent variable (the white noise blasts) between the two groups, finding that the students who had viewed the violent video game gave significantly longer noise blasts than did the students who had played the nonviolent game. Anderson and Dill had from the outset created initial equivalence between the groups. This initial equivalence allowed them to observe differences in the white noise levels between the two groups after the experimental manipulation, leading to the conclusion that it was the independent variable (and not some other variable) that caused these differences. The idea is that the only thing that was different between the students in the two groups was the video game they had played. One is that they are often conducted in laboratory situations rather than in the everyday lives of people. Therefore, we do not know whether results that we find in a laboratory setting will necessarily hold up in everyday life. Second, and more important, is that some of the most interesting and key social variables cannot be experimentally manipulated. If we want to study the influence of the size of a mob on the destructiveness of its behavior, or to compare the personality characteristics of people who join suicide cults with those of people who do not join such cults, these relationships must be assessed using correlational designs, because it is simply not possible to experimentally manipulate these variables. The goal of these designs is to get a picture of the current thoughts, feelings, or behaviors in a given group of people. The variables may be presented on a scatter plot to visually show the relationships. The Pearson Correlation Coefficient (r) is a measure of the strength of linear relationship between two variables. The possibility of common-causal variables makes it impossible to draw causal conclusions from correlational research designs. Random assignment to conditions is normally used to create initial equivalence between the groups, allowing researchers to draw causal conclusions. There is a negative correlation between the row that a student sits in in a large class (when the rows are numbered from front to back) and his or her final grade in the class. Do you think this represents a causal relationship or a spurious relationship, and why? Think of two variables (other than those mentioned in this book) that are likely to be correlated, but in which the correlation is probably spurious. Imagine a researcher wants to test the hypothesis that participating in psychotherapy will cause a decrease in reported anxiety. Describe the type of research design the investigator might use to draw this conclusion. The return of Phineas Gage: Clues about the brain from the skull of a famous patient. Video games and aggressive thoughts, feelings, and behavior in the laboratory and in life. Outline the four potential threats to the validity of research and discuss how they may make it difficult to accurately interpret research findings. Explain how generalization, replication, and meta-analyses are used to assess the external validity of research findings. For instance, if a researcher concludes that participating in psychotherapy reduces Attributed to Charles Stangor Saylor. Unfortunately, there are many threats to the validity of research, and these threats may sometimes lead to unwarranted conclusions. Often, and despite researchers’ best intentions, some of the research reported on websites as well as in newspapers, magazines, and even scientific journals is invalid. Validity is not an all-or- nothing proposition, which means that some research is more valid than other research. Only by understanding the potential threats to validity will you be able to make knowledgeable decisions about the conclusions that can or cannot be drawn from a research project. There are four major types of threats to the validity of research, and informed consumers of research are aware of each type. Although it is claimed that the measured variables measure the conceptual variables of interest, they actually may not.

For example discount silagra 50mg amex, Eiser and Cole (2002) used a quantitative method based upon the stages of change model and explored differences between individuals at different stages of attending for a cervical smear in terms of ‘cognitive closure’ and barriers to screening. The results showed that the precontemplators reported most barriers and the least need for closure and to reduce uncertainty. One qualitative study further highlighted the role of emotional factors in the form of feeling indecent. Borrayo and Jenkins (2001) interviewed 34 women of Mexican descent in five focus groups about their beliefs about breast cancer screening and their decision whether or not to take part. The analyses showed that the women reported a fundamental problem with breast screening as it violates a basic cultural standard. Breast screening requires women to touch their own breasts and to expose their breasts to health professionals. Within the cultural norms of respectable female behaviour for these women, this was seen as ‘indecent’. Contextual factors: Finally contextual factors have also been shown to predict uptake. The results showed that the women often showed complex and sometimes contradictory beliefs about their risk status for the disease which related to factors such as prevalence in the family, family size, attempts to make the numbers ‘add up’ and beliefs about transmission. The results also showed that uptake of the test related not only to the individual’s risk perception but also to contextual factors such as family discussion or a key triggering event. For example, one woman described how she had shouted at the cats for going onto the new stair carpet which had been paid for from her father’s insurance money after he had died from Huntington’s disease. Health professional factors Marteau and Johnston (1990) argued that it is important to assess health professionals’ beliefs and behaviour alongside those of the patients. In a study of general practitioners’ attitudes and screening behaviour, a belief in the effectiveness of screening was associ- ated with an organized approach to screening and time spent on screening (Havelock et al. These rates may well be related to the way in which these tests were offered by the health professional, which in turn may reflect the health professional’s own beliefs about the test. Some research has used qualitative methods to further analyse health professional factors. The analyses showed that the interviewees described the consultations in terms of four main themes which were often contradictory. These were providing information that is both objective and full and tailored to the needs of the individual; dealing with emotion by both eliciting it and containing it; communicating both directively and non direc- tively; and performing sophisticated skills whilst having only minimal training. These themes and their contradictions suggest that consultations would vary enormously between patients and between clinicians. For example, whilst a clinician may offer full information for one patient the same clinician might limit the information for another. Similarly, whilst one clinician might tend to be more directive another might be less so. Such variation in health professional beliefs about the consultation and their subsequent behaviour could influence the patient’s decision about whether or not to have a particular test (see Chapter 4 for more details on communication). This study examines the role of three social psychological models in predicting breast self-examination and cervical screening behaviour. The study illustrates how theories can be empirically tested and how research results can be used to develop interventions to promote screening behaviour. Background It is generally believed that early detection of both breast and cervical cancer may reduce mortality from these illnesses. Therefore, screening programmes aim to help the detection of these diseases at the earliest possible stages. However, even when invited to attend for cervical screening, or when encouraged to practise breast self-examination many women still do not carry out these health protective behaviours. This study examined the health belief model and health locus of control (see Chapter 2) in the context of cancer screening. In addition, the authors included a measure of emotional control (sometimes described as expressed emotion, repression and defensiveness). Individuals with high emotional control are sometimes described as having a cancer prone personality (see Chapter 13), which has been linked to cancer onset. Methodology Subjects A letter informing residents about a regional health survey was sent to 1530 randomly selected addresses in Northern Ireland. One person from each household was then randomly selected and left a questionnaire. This paper reports the results from 391 women who completed questions about breast and cervical screening behaviour. Design The study involved a cross-sectional design with subjects completing a questionnaire once. Measures The questionnaire consisted of the following measures: 1 Screening behaviour (the dependent variables).

Orient the person to the arrangement of tastes discount silagra 50 mg with amex, and smells the room and its furnishings. Difficulty with memory, problem solving, follow when dealing with patients with hear- and task performance ing impairments? Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Write any ideas that you cannot convey to Match the examples in Part B with the the person in another manner. The sense that perceives the solidity of objects and their size, shape, and texture b. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Give an example of two goals for patients may place a patient at high risk for sensory with impaired sensory functioning. Impaired ability to receive environmental healthcare patient, a 75-year-old woman with stimuli: diabetes living at home with her husband. When you arrive at their home, you notice the drapes are shut, the room is dark and c. Inability to process environmental stimuli: bleak, and there are no pictures, flowers, or the like to visually stimulate the patient. Briefly describe the following effects of sensory slightly disoriented and confused about the deprivation: date and time of day. List three examples of sensory overload you patient to avoid eye injury in the home. Describe the concept of cultural care depriva- mental stimulation and role model appropri- tion, and list an example from your own ate interactional behaviors for children in the experience of a patient who has experienced following areas. Give an example of sensory stimulation that could be provided for each of the following c. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. As an factors may influence the amount and quality item is identified, remove it from the bag. Do you believe using only one sense at a time heightens the awareness of that sense? Explain how you might assess a patient for the exercises above to the special needs of the following sensory experiences. Visually impaired patients: Chapter 44 in your textbook to answer the questions below. Hearing-impaired patients: Scenario: Dolores Pirolla, age 74, comes to the older adult clinic with her 77-year-old hus- band, who was diagnosed with macular degen- c. Pirolla also expresses concerns about her husband’s safety when moving about the 1. Have your friends take turns feel- ing the objects in the bag and guessing what Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. What would be a successful outcome for this pretty much stays in his room whenever peo- patient? Gibson if he has ever had his hearing evaluated, and he tells you no, until now, he’s been trying to 3. What intellectual, technical, interpersonal, convince himself that nothing’s wrong with and/or ethical/legal competencies are most his hearing. Identify pertinent patient data by placing a single underline beneath the objective data in the patient care study and a double underline beneath the subjective data. What resources might be helpful for page 311 to develop a three-part diagnostic Mr. Write down the patient and personal nursing strengths you hope to draw upon as you assist this patient to better health. Personal strengths: Scenario: George Gibson, an 81-year-old, married, African American man, reluctantly reports, after much prodding from his wife, that he is not hearing as well as he used to be. Pretend that you are performing a nursing “I don’t know what the trouble is,” he tells assessment of this patient after the plan of you. His wife reports that he has stopped going out and Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition.

Consequently discount 50 mg silagra with mastercard, doctors of nearly all special- How are prescribing errors to be minimized? By combining ties use drugs extensively, and need to understand the scien- a general knowledge of the pathogenesis of the disease to be tific basis on which therapeutic use is founded. Thousands of potent drugs have since been induced injury, list eight basic duties of prescribers: introduced, and pharmaceutical chemists continue to discover new and better drugs. Medical students with due regard to the likely risk/benefit ratio, available and doctors in training therefore need to learn something alternatives, and the patient’s needs, susceptibilities and of the principles of therapeutics, in order to prepare them- preferences; selves to adapt to such change. Such formularies have the questioning the patient (and sometimes family, neighbours, advantage of encouraging consistency, and once a decision other physicians, etc. What prescription tablets, medicines, has been made with input from local consultant prescribers drops, contraceptives, creams, suppositories or pessaries are they are usually well accepted. What over-the-counter remedies are being used including herbal or ‘alternative’ therapies? Has the patient experienced any problems with anaes- The scientific basis of drug action is provided by the discipline thesia? It entails the study of the interaction of The prescriber must be both meticulous and humble, espe- drugs with their receptors, the transduction (second messen- cially when dealing with an unfamiliar drug. Checking ger) systems to which these are linked and the changes that contraindications, special precautions and doses in a formu- they bring about in cells, organs and the whole organism. The use of drugs in society is encom- Great Britain 2007) is the minimum requirement. The proposed passed by pharmacoepidemiology and pharmacoeconomics – plan is discussed with the patient, including alternatives, both highly politicized disciplines! Modern methods of molecu- intended and be happy with the means proposed to achieve lar and cell biology permit expression of human genes, includ- these ends. Much of the ‘art’ of medicine lies in the ability of preclinical pharmacology and toxicology. Generic Basic pharmacologists often use isolated preparations, names should generally be used (exceptions are mentioned where the concentration of drug in the organ bath is controlled later in the book), together with dose, frequency and duration precisely. Such preparations may be stable for minutes to of treatment, and paper prescriptions signed. In therapeutics, drugs are administered to the whole print the prescriber’s name, address and telephone number to organism by a route that is as convenient and safe as possible facilitate communication from the pharmacist should a query (usually by mouth), for days if not years. The processes of absorption, distribution, metabolism and elim- Historically, formularies listed the components of mixtures ination (what the body does to the drug) determine the drug prescribed until around 1950. The perceived need for hospital concentration–time relationships in plasma and at the recep- formularies disappeared transiently when such mixtures tors. Pharmacokinetic modelling is crucial in drug development to plan a rational therapeutic A general practitioner reviews the medication of an 86-year-old woman with hypertension and multi-infarct regime, and understanding pharmacokinetics is also import- dementia, who is living in a nursing home. Her family used ant for prescribers individualizing therapy for a particular to visit daily, but she no longer recognizes them, and needs patient. Pharmacokinetic principles are described in Chapter 3 help with dressing, washing and feeding. Genetic influences on bendroflumethiazide, atenolol, atorvastatin, aspirin, haloperi- pharmacodynamics and pharmacokinetics (pharmacogenet- dol, imipramine, lactulose and senna. On examination, she smells of urine and has several bruises on her head, but ics) are discussed in Chapter 14 and effects of disease are otherwise seems well cared for. She is calm, but looks pale addressed in Chapter 7, and the use of drugs in pregnancy and bewildered, and has a pulse of 48 beats/min regular, and at extremes of age is discussed in Chapters 9–11. The only way to ensure that a drug with promising Her rectum is loaded with hard stool. Urine culture showed only a light pharmacological actions is effective in treating or preventing mixed growth. All of the medications were stopped and disease is to perform a specific kind of human experiment, manual evacuation of faeces performed. Prescribing doctors must understand the tive for occult blood and the full blood count was normal. Ignorance leaves the physician at the mercy of sources of infor- Comment mation that are biased by commercial interests. Sources of It is seldom helpful to give drugs in order to prevent some- unbiased drug information include Dollery’s encyclopaedic thing that has already happened (in this case multi-infarct Therapeutic drugs, 2nd edn (published by Churchill Livingstone dementia), and any benefit in preventing further ischaemic events has to be balanced against the harm done by the in 1999), which is an invaluable source of reference. In this case, drug-related problems probably such as the Adverse Reaction Bulletin, Prescribers Journal and include postural hypotension (due to imipramine, ben- the succinctly argued Drug and Therapeutics Bulletin provide droflumethiazide and haloperidol), reduced mobility (due to up-to-date discussions of therapeutic issues of current haloperidol), constipation (due to imipramine and haloperi- importance. Drug-induced torsades de pointes (a form of Key points ventricular tachycardia, see Chapter 32) is another issue. Despite her pallor, the patient was not bleeding into the gastro-intestinal tract, but aspirin could have caused this. Examples include inhibitors of angiotensin convert- as a result of high-affinity binding to specific receptors in ing enzyme and serotonin reuptake.