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Original statement 2: My project is to do some research into Alzheimer’s disease viagra sublingual 100mg visa, to find out what people do when their relatives have it and what support they can get and how nurses deal with it buy viagra sublingual 100 mg. Also buy generic viagra sublingual 100mg online, he found out some more information about whether his research needed to go to a Research Ethics Committee by checking out the website www discount viagra sublingual 100mg fast delivery. This site gives details about the committees 100 mg viagra sublingual overnight delivery, a list of meeting dates, guidance notes and application forms for those researchers interested in putting forward a proposal. Revised statement 2: The aim of this research is to find out how many relatives of Alzheimer’s patients use the Maple Day Centre, and to ascertain whether the ser- vice is meeting their needs. The research population is limited to relatives of Alzhei- mer’s patients who use the Maple Day Centre. One clue 22 / PRACTICAL RESEARCH METHODS to the methodology is in the words ‘how many’ which suggests a quantitative study. However, he is also inter- ested in finding out whether the service meets their needs, which requires some more in-depth inquiry. Original Statement 3: We want to find out how many of the local residents are interested in a play scheme for chil- dren during the summer holiday. The tenants’ association thought carefully about the is- sues in which they were interested, eventually coming up with the following revised statement: Revised Statement 3: This research aims to find out how many people from our estate are interested in, and would use, a children’s play scheme in the school summer holiday. The tenants’ association wanted to obtain funding for their play scheme and felt that it was important to gather sta- tistics which they could take to possible funding organi- sations. SUMMARY X The research methodology is the philosophy or general principle which guides the research. HOW TO DECIDE UPON A METHODOLOGY / 23 X Examples of qualitative methodologies include action research, ethnography, feminist research and grounded theory. X Quantitative research generates statistics through the use of large-scale survey research. X Neither qualitative nor quantitative research is better – they are just different. X Your own intuition and the words you use will give pointers to whether qualitative or quantitative research is more appropriate for your chosen project. X The term ‘triangulation’ is used when a combination of qualitative and quantitative forms of inquiry are used. FURTHER READING The theoretical and philosophical issues raised in this chapter are detailed and complex and cannot be discussed in depth in this book. However, if you wish to pursue any of these topics, some of the useful publications are listed below under the relevant topics. Qualitative research Over recent years there has been a great deal of innova- tion in the use of qualitative methodologies. Listed below are some of the more traditional texts and a selection of the newer, innovative texts. Before you de- cide which would be the most appropriate methods for your research, you need to find out a little more about these tools. This chapter gives a description of the meth- ods of interviewing, focus groups, questionnaires and par- ticipant observation. Chapters 7–10 will go on to describe in detail how to use each of these methods. The most common of these are unstructured, semi-structured and structured interviews. If you want to find out about other types of interview, relevant references are given at the end of this chapter. Unstructured interviews Unstructured or in-depth interviews are sometimes called life history interviews. This is because they are the fa- voured approach for life history research. In this type of interview, the researcher attempts to achieve a holistic un- derstanding of the interviewees’ point of view or situation. For example, if you want to find out about a Polish man’s experiences of a concentration camp during the war, 27 28 / PRACTICAL RESEARCH METHODS you’re delving into his life history. Because you are unsure of what has happened in his life, you want to enable him to talk freely and ask as few questions as possible. It is for this reason that this type of interview is called unstruc- tured – the participant is free to talk about what he or she deems important, with little directional influence from the researcher. As the researcher tries to ask as few questions as possible, people often assume that this type of interviewing is the easiest.

In Jane’s words buy 100mg viagra sublingual, “I’ve taken reiki courses and things like that so [my husband has] seen me laying on the living room carpet with my crystals and my healing stones out and doing my own thing discount viagra sublingual 100mg online. Take the case of Lorraine: Alternative Healing and the Self | 83 I have taken the reiki and now I have my first and second levels order 100 mg viagra sublingual mastercard. order 100 mg viagra sublingual. viagra sublingual 100mg lowest price.. I’m going there in August and they offer all kinds of self-awareness courses. If the individual continues along this continuum, the next stage he or she reaches is formal training in one or other alternative therapies. For example, Lucy was in training to become a reflexologist and told me she hoped to practice this therapy professionally: I’m now taking my courses for reflexology. I would like to practice the reflexology definitely and maybe shiatsu massage. I’ve never tried that but I’ve heard so many people comment on how well it made them feel. But with reflexology, if I could help somebody feel as good as it made me feel. I think what it does is it helps the individual to become in touch with themselves and allows the body to repair itself. While training in a therapy can lead to certification, not all informants who complete training in a particular therapy intend to practice it. For instance, Jenny underwent training to become a certified hypnotherapist but had no intention of practising professionally. The important point however, is that it was her belief in these therapies that brought her this far along the continuum. According to Jenny, Someone recommended hypnotherapy for something that was on my mind. I was complaining and this person started talking about it and so I decided to go and see about it and I was so completely taken with the process that I eventually ended up taking a course in certified clinical hypnotherapy and in neurolinguistics programming. Some practised therapies that were certified or regulated to some degree. For instance, Hanna explained her own experience to me: I’m a yoga therapist and a reflexologist. The brochures were offering a yoga course that was on four different levels and it took eighteen months to complete. In the course I also got taught a little 84 | Using Alternative Therapies: A Qualitative Analysis reflexology so that kind of stayed on the back burner until I got everything working with the yoga. I went for my reflexology, which was a six months course, a certified course. Similarly, after using the Feldenkrais method informally, Roger described how he sought formal training: “So I was using it also with handicapped people, just in a very informal way, and then I decided to get trained in it and did the second North American training that existed. For example, Natalie told me that she practised alternative healing independently out of her home: “I would try to heal people with my mind from a distance, or with my hands from a distance, and I was finding it was working. For these people, a key encounter with an alternative practitioner reinforced their commitment to these therapies (Deierlein 1994). For example, Scott and Natalie told me about meetings with alternative practitioners that launched them on the road to becoming healers themselves. She was really inspiring, she was amazing, she was full of life and joy and she had her own health and she had her practice room and she had her own world and she travelled all over the world and did this and that and met all these amazing healers, and I had never really thought about healing up until this time. But I realized as I was getting to know this woman, it was like: ‘Oh my god! We talked about nutrition and everything else and then he said, ‘Natalie, you’re a healer. For instance, after experiencing successful acupuncture treatments, Simon made the decision to leave medical school and train to become an acupuncturist: I was on every kind of muscle relaxant, painkiller, sleep aid, everything. My chiropractor also does acupuncture so we tried acupuncture and within two weeks I was off all the medications and I said: ‘You know, I’m going into this field’ and that’s what I did. Said goodbye to formal education and mainstream medicine and went into the alternative. These key encounters and experiences are important because it is through them that alternative ideology is more deeply internalized by the individual. In other words, an individual’s “commitment to a healer/client relationship,” in particular, is instrumental in the adoption of alternative belief systems (Deierlein 1994:180). Deepening commitment to alternative ideology is, in turn, what propels people along the continuum of identity change. For example, it was the intensity of Marie’s belief in alternative therapies that inspired her to become an alternative practitioner: “I became a certified reflexologist because I believe in those things so much” (emphasis mine).

It was only due to individual enthusiasm (by pioneers like Baskett order viagra sublingual 100mg free shipping, Chamberlain discount viagra sublingual 100mg with amex, and Ward) and private donations for equipment that any progress was made viagra sublingual 100mg free shipping. A pilot course of extended training in ambulance was launched after the Miller Report (1966-1967) and recognition by the Department of Health of the value of pre-hospital care cheap 100mg viagra sublingual mastercard. Three years later order 100mg viagra sublingual overnight delivery, after industrial action by the ambulance service, the then Minister of Health, Kenneth Clarke, pronounced that paramedics with extended training should be included in every emergency ambulance call, and he made funding available to provide each front-line ambulance with a defibrillator. In Scotland an extensive fundraising campaign enabled advisory defibrillators to be placed in each of the 500 emergency vehicles by the middle of 1990 and a A helicopter is used to speed the response 50 Resuscitation in the ambulance service sophisticated programme (“Heartstart Scotland”) was initiated to review the outcome of every ambulance resuscitation attempt. Chain of survival The ambulance service is able to make useful contributions to each of the links in the chain of survival that is described in Chapter 1. Early awareness and early access The United Kingdom has had a dedicated emergency call number (999) to access the emergency services since 1937. In Europe, a standard emergency call number (112) is available and a number of countries, including the United Kingdom, respond to this as well as to their usual national emergency number. NHS Training Manual All ambulance services in the United Kingdom now employ a system of prioritised despatch, either Advanced Medical Priority Despatch or Criteria Based Despatch, in which the call-taker follows a rigorously applied algorithm to ensure that the urgency of the problem is identified according to defined criteria and that the appropriate level of response is assigned. Three categories of call are usually recognised: ● Category A—Life threatening (including cardiopulmonary arrest). The aim is to get to most of these calls within eight minutes ● Category B—Emergency but not immediately life threatening ● Category C—Non-urgent. An appropriate response is provided; in some cases the transfer of the call is transferred to other agencies, such as NHS Direct. L Having assigned a category to the call (often with the help of a computer algorithm), the call-taker will pass it to a dispatcher who, using appropriate technology such as automated vehicle location systems, will ask the nearest ambulance or most appropriate resource to respond. In the a case of cardiorespiratory arrest this may also include a a community first responder who can be rapidly mobilised with y an automated defibrillator. The ambulance control room staff will also provide Chain of survival emergency advice to the telephone caller, including instructions on how to perform cardiopulmonary resuscitation if appropriate. The speed of response is critical because survival after cardiorespiratory arrest falls exponentially with time. The Heartstart Scotland scheme has shown that those patients who develop ventricular fibrillation after the arrival of the ambulance crew have a greater than 50% chance of long-term survival. The ambulance controller should ensure that patients with suspected myocardial infarction are also attended promptly by their general practitioner. Such a “dual response” provides the patient with effective analgesia, electrocardiographic monitoring, defibrillation, and advanced life support as soon as possible. Early cardiopulmonary resuscitation The benefits of early cardiopulmonary resuscitation have been well established, with survival from all forms of cardiac arrest at least doubled when bystander cardiopulmonary resuscitation is undertaken. All emergency service staff should be trained in effective basic life support and their skills should be regularly refreshed and updated. In most parts of the United Kingdom ambulance staff also train the general public in emergency life support techniques. Ambulance dispatch desk 51 ABC of Resuscitation Early defibrillation Equipment for front-line ambulance Every front-line ambulance in the United Kingdom now carries ● Immediate response satchel—bag, valve, mask (adult and child), hand-held suction, airways, laryngoscopy roll, a defibrillator, most often an advisory or automated external endotracheal tubes, dressing pads, scissors defibrillator (AED) that can be used by all grades of ambulance ● Portable oxygen therapy set staff. In Scotland alone, where ● Sphygmomanometer and stethoscope currently over 35 000 resuscitation attempts are logged on the ● Entonox database, 16 500 patients have been defibrillated since 1988, ● Trolley cots, stretchers, poles, pillows, blankets ● Rigid collars with almost 1800 long-term survivors—that is, 150 survivors ● Vacuum splints per year—an overall one year survival rate from out-of-hospital ● Spine immobiliser, long spine board ventricular fibrillation of about 10%. The sensitivity and specificity of these ● Waste bins, sharps box defibrillators is comparable to manual defibrillators and the ● Maternity pack ● Infectious diseases pack time taken to defibrillate is less. AEDs have high-quality data ● Hand lamp recording, retrieval, and analysis systems and, most importantly, ● Rescue tools potential users become competent in their use after considerably less training. The development of AEDs has Drugs sanctioned for use by trained ambulance staff extended the availability of defibrillation to any first responder, not only ambulance staff (see Chapter 3). It is nevertheless ● Oxygen ● Nalbuphine ● Entonox ● Syntometrine important that such first responder schemes, which often ● Aspirin ● Sodium bicarbonate include the other emergency services or the first aid societies, ● Nitroglycerine ● Glucose infusion are integrated into a system with overall medical control usually ● Adrenaline (epinephrine) ● Saline infusion coordinated by the ambulance service. It emphasises the extended skills of venous cannulation, recording and interpreting electrocardiograms Outline syllabus for paramedic training (ECGs), intubation, infusion, defibrillation, and the use of selected drugs. In 1992 the Medicines Act was amended to Theoretical knowledge Basic anatomy and physiology permit ambulance paramedics to administer approved drugs ● Respiratory system (especially mouth and larynx) from a range of prescription only medicines. Four weeks of the course is ● Presentations of ischaemic heart disease ● Differential diagnosis of chest pain provided in hospital under the supervision of clinical tutors in ● Complications and management of acute myocardial cardiology, accident and emergency medicine, anaesthesia, and infarction intensive care.

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