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Nevertheless medicine 75 yellow discount generic glucophage sr canada, there are some solely qualitative and some solely quantitative studies treatment 4 addiction discount 500mg glucophage sr free shipping. Writing the report is the last and medicine x topol 2015 500mg glucophage sr for sale, for many symptoms 4 dpo cheap 500 mg glucophage sr mastercard, the most difficult step of the research process. This report informs the world what you have done, what you have discovered and what conclusions you have drawn from your findings. If you are clear about the whole process, you will also be clear about the way you want to write your report. Your report should be written in an academic style and be divided into different chapters and/or sections based upon the main themes of your study. Summary this chapter has provided an overview of the research process, which has been broken down into eight steps, the details of which are covered in the remainder of this book. At each step the research model provides a smorgasbord of methods, models, techniques and procedures so you can select the one most appropriate for your study. It is like a buffet party with eight tables, each with different dishes made from similar ingredients. You go to all eight tables and select the dish that you like the most from each table. The main difference between the model and this example is that in the model you select what is most appropriate for your study and not what you like the most. For a beginner it is important to go through all the steps, although perhaps not in the same sequence. The eight steps cover the total spectrum of a research endeavour, from problem formulation through to writing a research report. The steps are operational in nature, following a logical sequence, and detailing the various methods and procedures in a simple stepby-step manner. Reflecting on the differences between quantitative and qualitative research (as outlined in Table 2. The place of the literature review in research One of the essential preliminary tasks when you undertake a research study is to go through the existing literature in order to acquaint yourself with the available body of knowledge in your area of interest. Reviewing the literature can be time consuming, daunting and frustrating, but it is also rewarding. The literature review is an integral part of the research process and makes a valuable contribution to almost every operational step. It has value even before the first step; that is, when you are merely thinking about a research question that you may want to find answers to through your research journey. In the initial stages of research it helps you to establish the theoretical roots of your study, clarify your ideas and develop your research methodology. Later in the process, the literature review serves to enhance and consolidate your own knowledge base and helps you to integrate your findings with the existing body of knowledge. Since an important responsibility in research is to compare your findings with those of others, it is here that the literature review plays an extremely important role. During the write-up of your report it helps you to integrate your findings with existing knowledge – that is, to either support or contradict earlier research. The higher the academic level of your research, the more important a thorough integration of your findings with existing literature becomes. In summary, a literature review has the following functions: It provides a theoretical background to your study. It helps you establish the links between what you are proposing to examine and what has already been studied. It enables you to show how your findings have contributed to the existing body of knowledge in your profession. It helps you to integrate your research findings into the existing body of knowledge. Bringing clarity and focus to your research problem the literature review involves a paradox. On the one hand, you cannot effectively undertake a literature search without some idea of the problem you wish to investigate. On the other hand, the literature review can play an extremely important role in shaping your research problem because the process of reviewing the literature helps you to understand the subject area better and thus helps you to conceptualise your research problem clearly and precisely and makes it more relevant and pertinent to your field of enquiry. When reviewing the literature you learn what aspects of your subject area have been examined by others, what they have found out about these aspects, what gaps they have identified and what suggestions they have made for further research. All these will help you gain a greater insight into your own research questions and provide you with clarity and focus which are central to a relevant and valid study. In addition, it will help you to focus your study on areas where there are gaps in the existing body of knowledge, thereby enhancing its relevance. Improving your research methodology Going through the literature acquaints you with the methodologies that have been used by others to find answers to research questions similar to the one you are investigating. A literature review tells you if others have used procedures and methods similar to the ones that you are proposing, which procedures and methods have worked well for them and what problems they have faced with them. By becoming aware of any problems and pitfalls, you will be better positioned to select a methodology that is capable of providing valid answers to your research question. This will increase your confidence in the methodology you plan to use and will equip you to defend its use. Broadening your knowledge base in your research area the most important function of the literature review is to ensure you read widely around the subject area in which you intend to conduct your research study. It is important that you know what other researchers have found in regard to the same or similar questions, what theories have been put forward and what gaps exist in the relevant body of knowledge. Another important reason for doing a literature review is that it helps you to understand how the findings of your study fit into the existing body of knowledge (Martin 1985: 30). Enabling you to contextualise your findings Obtaining answers to your research questions is comparatively easy: the difficult part is examining how your findings fit into the existing body of knowledge. Undertaking a literature review will enable you to compare your findings with those of others and answer these questions. It is important to place your findings in the context of what is already known in your field of enquiry. How to review the literature If you do not have a specific research problem, you should review the literature in your broad area of interest with the aim of gradually narrowing it down to what you want to find out about. There is a danger in reviewing the literature without having a reasonably specific idea of what you want to study. It can condition your thinking about your study and the methodology you might use, resulting in a less innovative choice of research problem and methodology than otherwise would have been the case. Hence, you should try broadly to conceptualise your research problem before undertaking your major literature review. Developing theoretical and conceptual frameworks is more difficult than the other tasks. Searching for the existing literature To search effectively for the literature in your field of enquiry, it is imperative that you have at least some idea of the broad subject area and of the problem you wish to investigate, in order to set parameters for your search. There are three sources that you can use to prepare a bibliography: (a) books; (b) journals; (c) the Internet. Books Though books are a central part of any bibliography, they have their disadvantages as well as advantages. The main advantage is that the material published in books is usually important and of good quality, and the findings are ‘integrated with other research to form a coherent body of knowledge’ (Martin 1985: 33). The main disadvantage is that the material is not completely up to date, as it can take a few years between the completion of a work and its publication in the form of a book. When librarians catalogue a book they also assign to it subject headings that are usually based on Library of Congress Subject Headings. If you are not sure, ask your librarian to help you find the best subject heading for your area. Use the subject catalogue or keywords option to search for books in your area of interest. Look through these titles carefully and identify the books you think are likely to be of interest to you. If you think the titles seem appropriate to your topic, print them out (if this facility is available), as this will save you time, or note them down on a piece of paper. Be aware that sometimes a title does not provide enough information to help you decide if a book is going to be of use so you may have to examine its contents too. When you have selected 10–15 books that you think are appropriate for your topic, examine the bibliography of each one. Go through these bibliographies carefully to identify the books common to several of them. If a book has been referenced by a number of authors, you should include it in your reading list.
The concept of reliability in relation to treatment 1st line purchase cheap glucophage sr line a research instrument has a similar meaning: if a research tool is consistent and stable treatment hyperkalemia order 500mg glucophage sr, hence predictable and accurate treatment yeast in urine buy glucophage sr paypal, it is said to treatment hyperthyroidism buy on line glucophage sr be reliable. The greater the degree of consistency and stability in an instrument, the greater its reliability. Therefore, ‘a scale or test is reliable to the extent that repeat measurements made by it under constant conditions will give the same result’ (Moser & Kalton 1989: 353). The first question focuses on the ability of an instrument to produce consistent measurements. When you collect the same set of information more than once using the same instrument and get the same or similar results under the same or similar conditions, an instrument is considered to be reliable. The second question focuses on the degree of inconsistency in the measurements made by an instrument – that is, the extent of difference in the measurements when you collect the same set of information more than once, using the same instrument under the same or similar conditions. Hence, the degree of inconsistency in the different measurements is an indication of the extent of its inaccuracy. Therefore, reliability is the degree of accuracy or precision in the measurements made by a research instrument. Suppose you develop a questionnaire to ascertain the prevalence of domestic violence in a community. You administer this questionnaire and find that domestic violence is prevalent in, say, 5 per cent of households. If you follow this with another survey using the same questionnaire on the same population under the same conditions, and discover that the prevalence of domestic violence is, say, 15 per cent, the questionnaire has not given a comparable result, which may mean it is unreliable. The less the difference between the two sets of results, the higher the reliability of the instrument. Factors affecting the reliability of a research instrument In the social sciences it is impossible to have a research tool which is 100 per cent accurate, not only because a research instrument cannot be so, but also because it is impossible to control the factors affecting reliability. Some of these factors are: the wording of questions – A slight ambiguity in the wording of questions or statements can affect the reliability of a research instrument as respondents may interpret the questions differently at different times, resulting in different responses. The physical setting – In the case of an instrument being used in an interview, any change in the physical setting at the time of the repeat interview may affect the responses given by a respondent, which may affect reliability. The respondent’s mood – A change in a respondent’s mood when responding to questions or writing answers in a questionnaire can change and may affect the reliability of that instrument. The interviewer’s mood – As the mood of a respondent could change from one interview to another so could the mood, motivation and interaction of the interviewer, which could affect the responses given by respondents thereby affecting the reliability of the research instrument. The nature of interaction – In an interview situation, the interaction between the interviewer and the interviewee can affect responses significantly. During the repeat interview the responses given may be different due to a change in interaction, which could affect reliability. The regression effect of an instrument – When a research instrument is used to measure attitudes towards an issue, some respondents, after having expressed their opinion, may feel that they have been either too negative or too positive towards the issue. The second time they may express their opinion differently, thereby affecting reliability. Methods of determining the reliability of an instrument in quantitative research There are a number of ways of determining the reliability of an instrument and these can be classified as either external or internal consistency procedures. External consistency procedures External consistency procedures compare findings from two independent processes of data collection with each other as a means of verifying the reliability of the measure. Test/retest – this is a commonly used method for establishing the reliability of a research tool. In the test/retest (repeatability test) an instrument is administered once, and then again, under the same or similar conditions. The ratio between the test and retest scores (or any other finding, for example the prevalence of domestic violence, a disease or incidence of an illness) is an indication of the reliability of the instrument – the greater the value of the ratio, the higher the reliability of the instrument. As an equation, (test score)/(retest) = 1 or (test score) – (retest) = 0 A ratio of 1 shows 100 per cent reliability (no difference between test and retest) and any deviation from it indicates less reliability – the less the value of this ratio, the less the reliability of the instrument. Expressed in another way, zero difference between the test and retest scores is an indication of 100 per cent reliability. The greater the difference between scores or findings obtained from the two tests, the greater the unreliability of the instrument. The main advantage of the test/retest procedure is that it permits the instrument to be compared with itself, thus avoiding the sort of problems that could arise with the use of another instrument. The main disadvantage of this method is that a respondent may recall the responses that s/he gave in the first round, which in turn may affect the reliability of the instrument. Where an instrument is reactive in nature (when an instrument educates the respondent with respect to what the researcher is trying to find out) this method will not provide an accurate assessment of its reliability. One of the ways of overcoming this problem is to increase the time span between the two tests, but this may affect reliability for other reasons, such as the maturation of respondents and the impossibility of achieving conditions similar to those under which the questionnaire was first administered. Parallel forms of the same test – In this procedure you construct two instruments that are intended to measure the same phenomenon. The results obtained from one test are compared with those obtained from the other. The main advantage of this procedure is that it does not suffer from the problem of recall found in the test/retest procedure. Moreover, it is extremely difficult to construct two instruments that are comparable in their measurement of a phenomenon. It is equally difficult to achieve comparability in the two population groups and in the two conditions under which the tests are administered. Internal consistency procedures the idea behind internal consistency procedures is that items or questions measuring the same phenomenon, if they are reliable indicators, should produce similar results irrespective of their number in an instrument. Even if you randomly select a few items or questions out of the total pool to test the reliability of an instrument, each segment of questions thus constructed should reflect reliability more or less to the same extent. It is based upon the logic that if each item or question is an indicator of some aspect of a phenomenon, each segment constructed will still reflect different aspects of the phenomenon even though it is based upon fewer items/questions. Hence, even if we reduce the number of items or questions, as long as they reflect some aspect of a phenomenon, a lesser number of items can provide an indication of the reliability of an instrument. The following method is commonly used for measuring the reliability of an instrument in this way: the split-half technique – this technique is designed to correlate half of the items with the other half and is appropriate for instruments that are designed to measure attitudes towards an issue or phenomenon. The questions or statements are divided in half in such a way that any two questions or statements intended to measure the same aspect fall into different halves. Reliability is calculated by using the product moment correlation (a statistical procedure) between scores obtained from the two halves. Because the product moment correlation is calculated on the basis of only half the instrument, it needs to be corrected to assess reliability for the whole. The steppedup reliability for the whole instrument is calculated by a formula called the Spearman–Brown formula (a statistical procedure). Validity and reliability in qualitative research One of the areas of difference between quantitative and qualitative research is in the use of and the importance given to the concepts of validity and reliability. The debate centres on whether or not, given the framework of qualitative research, these concepts can or even should be applied in qualitative research. As you know, validity in the broader sense refers to the ability of a research instrument to demonstrate that it is finding out what you designed it to and reliability refers to consistency in its findings when used repeatedly. In qualitative research, as answers to research questions are explored through multiple methods and procedures which are both flexible and evolving, to ensure standardisation of research tools as well as the processes becomes difficult. As a newcomer to research you may wonder how these concepts can be applied in qualitative research when it does not use standardised and structured methods and procedures which are the bases of testing validity and reliability as defined in quantitative research. You may ask how you can ascertain the ability of an instrument to measure what it is expected to and how consistent it is when the data collection questions are neither fixed nor structured. However, there are some attempts to define and establish validity and reliability in qualitative research. According to them, there are two sets of criteria ‘for judging the goodness or quality of an inquiry in constructivism paradigm’ (1994: 114). According to Guba and Lincoln, trustworthiness in a qualitative study is determined by four indicators – credibility, transferability, dependability and confirmability – and it is these four indicators that reflect validity and reliability in qualitative research. Trochim and Donnelly (2007) compare the criteria proposed by Guba and Lincoln in the following table with validity and reliability as defined in quantitative research: Traditional criteria for judging quantitative research Alternative criteria for judging qualitative research Internal Validity Credibility External Validity Transferability Reliability Dependability Objectivity Confirmability (Trochim and Donnelly 2007: 149) Credibility – According to Trochim and Donnelly (2007: 149), ‘credibility involves establishing that the results of qualitative research are credible or believable from the perspective of the participant in the research’. As qualitative research studies explore perceptions, experiences, feelings and beliefs of the people, it is believed that the respondents are the best judge to determine whether or not the research findings have been able to reflect their opinions and feelings accurately. Hence, credibility, which is synonymous to validity in quantitative research, is judged by the extent of respondent concordance whereby you take your findings to those who participated in your research for confirmation, congruence, validation and approval. Transferability – this ‘refers to the degree to which the results of qualitative research can be generalized or transferred to other contexts or settings’ (2007: 149). Though it is very difficult to establish transferability primarily because of the approach you adopt in qualitative research, to some extent this can be achieved if you extensively and thoroughly describe the process you adopted for others to follow and replicate.
This spokesperson may call the nurses’ station at 410-955-8460 for patient updates medications similar to gabapentin purchase glucophage sr us. They communicate with your surgeon every day and will manage your care throughout the day treatment goals and objectives discount glucophage sr 500 mg on line. A discharge planner medications not to take before surgery discount 500 mg glucophage sr with visa, who is a nurse symptoms of pneumonia best order glucophage sr, will also be available to help you with any discharge needs, including finding a rehabilitation facility if needed. Children who are sick or who may have been exposed to infectious diseases recently will not be allowed onto the unit. Please advise the staff of your wishes for children to visit prior to brining the children to the hospital. The hospital has many resources which can be utilized in preparation for ensuring the child’s visit will benefit all involved. Many aspects will be considered in determining if the visit is emotionally and physically safe for the patient and family. Chest X-rays show how well your lungs are expanded and note if any fluid or congestion is present. Blood samples show how your body is functioning after surgery and help in adjusting your medication doses. The wires in your chest will be covered with a small dressing (bandage) and be removed approximately two to five days after surgery. Approximately 30 percent of patients develop an irregular heart rhythm called atrial fibrillation. Most of the time, this is controlled with medication and reverts back to a regular rhythm before you go home. The nurse will remove these staples with minimal discomfort when the surgeon determines that they are ready to be removed. If these staples need to remain after you go home, a visiting nurse will remove them with orders from your surgeon. You may have small paper strips (steri-strips) applied to the chest and leg incisions for additional support. These gradually peel and should be removed one week after being discharged home. The visiting nurse will remove these sutures with minimal discomfort seven to 10 days following surgery. You may shower when you are off the bedside monitor and on telemetry as long as you are not having any problems with your blood pressure or heart rate. You may experience many different feelings that can be due to lack of sleep, decreased blood count, constant activity in your room, the hospital environment with its structured routine, physical discomforts from surgery and unfamiliar faces. You may experience a period of feeling down or blue, which usually takes place the first few weeks after surgery. It is normal to have difficulty focusing and concentrating in the first week or two after surgery. As activity increases and you return to a more normal routine, these feelings should disappear and your ability to concentrate should improve. You must ask the nurse for pain and/or sleeping medicine when you feel you need them. We will encourage you to eat as much as you can and supplement your diet with high-calorie shakes. It is important to supply your body with protein-rich foods for wound healing at this time. Dietary modifications or adjustments in your diet may include restrictions in calories, sodium, fats or cholesterol. Understanding the importance of maximizing heart-healthy foods and minimizing the restricted foods is instrumental in preventing further heart disease. Goals of Nutritional Therapy n Reduce total fat intake to 30 percent of total caloric intake and limit saturated fats as much as possible. To prevent complications such as lung congestion (pneumonia) or blood clots in your legs, it is important to begin walking around the hall as soon as possible. A physical therapist will see you and plan an exercise routine for you in the hospital as well as at home. We strongly encourage you to follow these instructions for a steady and full recovery. We will provide you with a booklet that reviews specific activity instructions for you. We will also give you instructions on sternal precautions (protection for your breastbone). Sternal precautions help you protect your chest, your sternal bone and your surgical incision. You may not lift anything heavier than 10 pounds for six to eight weeks after your surgery. You cannot raise both arms over your head at the same time, and no bending at the waist. If you have steps at home, the physical therapist will help you walk up steps before discharge. Vigorous arm activity is limited for six to eight weeks after surgery while the chest bone heals. Physical activities that require arm movement, such as golf, swimming, tennis, vacuuming, etc. We will also give you prescriptions the morning of discharge that can be filled at any pharmacy. Please speak to your primary care physician or cardiologist before resuming any previous medications. Do not have your family bring your home medications to the hospital unless your doctor tells you to bring them. Anesthesia, decreased activity and shallow breathing make your lungs susceptible to congestion and partial collapse. It is important that you cough and do deep-breathing exercises frequently to prevent lung congestion, collapse and pneumonia. If the large vein (saphenous vein) is removed from your leg for bypass grafts, it will take time for alternate (collateral) circulation to form. This will reduce swelling (edema) and therefore prevent pressure on your leg incisions. To prevent blood clots from forming in your legs, we may give you injections of heparin in your abdomen while you are in the hospital. You may begin to think about going home when you see that your activity is increasing and your suture lines are healing well. If your trip home takes several hours, you may ask them to bring a pillow and blanket so that you can rest. We ask that you stop for short rests, walk around and exercise your legs (weather-permitting) if your trip home is longer than one hour. If you are going home on public transportation such as airlines, arrange the reservation as far in advance as you can. You should not wear restrictive clothing such as girdles, garters, tight pants or socks with an elastic band. Under certain circumstances, we may ask you to stay locally after discharge, before you fly home. At first, dressing, personal hygiene, reading, writing, visiting, walking and resting should fill your day. Most people are back to their regular routines in three to four months after surgery. Do not apply moisturizers such as aloe, cocoa butter or vitamin E cream if your incision has any open areas. The incision might give you periodic discomfort because of weather changes or morning stiffness. There is usually some pinkness along the incision, which will gradually decrease, generally in six months to a year. Contact the outpatient coordinator or nurse practitioner for the following: n Continuous or increased pain at the site of the incision n Drainage from the incision n An incision that is swollen, red, warm or sore to touch n Lump near the incision Take your temperature twice a day, in the morning and evening, and record it on the chart provided for you at discharge. If your temperature is 101°F or higher, take two Tylenol and page the outpatient coordinator or nurse practitioner at 410-283-3779 and leave your call-back phone number after the beep. There may be days when your incision site will be uncomfortable and you may have a tendency to assume poor posture.
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