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Research on animals has also led to a better understanding of the physiological causes of depression buy ginette-35 cheap pregnancy 42 weeks, phobias cheap ginette-35 2 mg mastercard menstruation in dogs, and stress order ginette-35 with american express womens health ventura, among other illnesses order genuine ginette-35 online womens health 30 day ab challenge. In contrast to animal-rights activists, then, scientists believe that because there are many benefits that accrue from animal research, such research can and should continue as long as the humane treatment of the animals used in the research is guaranteed. Researchers assure that participants are given free choice to participate and that their privacy is protected. Give an example from personal experience of how you or someone you know have benefited from the results of scientific research. Science and ethics in conducting, analyzing, and reporting psychological research. Differentiate the goals of descriptive, correlational, and experimental research designs and explain the advantages and disadvantages of each. Explain the goals of descriptive research and the statistical techniques used to interpret it. Summarize the uses of correlational research and describe why correlational research cannot be used to infer causality. Review the procedures of experimental research and explain how it can be used to draw causal inferences. Psychologists agree that if their ideas and theories about human behavior are to be taken seriously, they must be backed up by data. However, the research of different psychologists is designed with different goals in mind, and the different goals require different approaches. A research design is the specific method a researcher uses to collect, analyze, and interpret data. Psychologists use three major types of research designs in their research, and each provides an essential avenue for scientific investigation. Descriptive research is research designed to provide a snapshot of the current state of affairs. Correlational research is research designed to discover relationships among variables and to allow the prediction of future events from present knowledge. Experimental research is research in which initial equivalence among research participants in more than one group is created, followed by a manipulation of a given experience for these groups and a measurement of the influence of the manipulation. May be To create a snapshot of the Allows the development of questions unethical if participants do not Descriptive current state of affairs for further study. Allows testing of expected relationships between and among Cannot be used to draw To assess the relationships variables and the making of inferences about the causal between and among two or predictions. Can assess these relationships between and among Correlational more variables relationships in everyday life events. To assess the causal impact Cannot experimentally of one or more experimental Allows drawing of conclusions about manipulate many important manipulations on a the causal relationships among variables. There are three major research designs used by psychologists, and each has its own advantages and disadvantages. Descriptive Research: Assessing the Current State of Affairs Attributed to Charles Stangor Saylor. This section reviews three types of descriptive research: case studies, surveys, and naturalistic observation. Sometimes the data in a descriptive research project are based on only a small set of individuals, often only one person or a single small group. These research designs are known as case studies—descriptive records of one or more individual’s experiences and behavior. Sometimes case studies involve ordinary individuals, as when developmental psychologist Jean Piaget used his observation of his own children to develop his stage theory of cognitive development. More frequently, case studies are conducted on individuals who have unusual or abnormal experiences or characteristics or who find themselves in particularly difficult or stressful situations. The assumption is that by carefully studying individuals who are socially marginal, who are experiencing unusual situations, or who are going through a difficult phase in their lives, we can learn something about human nature. Sigmund Freud was a master of using the psychological difficulties of individuals to draw conclusions about basic psychological processes. Freud wrote case studies of some of his most interesting patients and used these careful examinations to develop his important theories of personality. One classic example is Freud’s description of “Little Hans,‖ a child whose fear of horses the psychoanalyst interpreted in terms of repressed sexual impulses and the Oedipus  complex (Freud (1909/1964). Another well-known case study is Phineas Gage, a man whose thoughts and emotions were extensively studied by cognitive psychologists after a railroad spike was blasted through his skull in an accident. Although there is question about the interpretation of this case study (Kotowicz,  2007), it did provide early evidence that the brain’s frontal lobe is involved in emotion and  morality (Damasio et al. An interesting example of a case study in clinical psychology  is described by Rokeach (1964), who investigated in detail the beliefs and interactions among three patients with schizophrenia, all of whom were convinced they were Jesus Christ. The people chosen to participate in the research (known as the sample) are selected to be representative of all the people that the researcher wishes to know about (the population). In election polls, for instance, a sample is taken from the population of all “likely voters‖ in the upcoming elections. The results of surveys may sometimes be rather mundane, such as “Nine out of ten doctors prefer Tymenocin,‖ or “The median income in Montgomery County is $36,712. A final type of descriptive research—known as naturalistic observation—is research based on the observation of everyday events. For instance, a developmental psychologist who watches children on a playground and describes what they say to each other while they play is conducting descriptive research, as is a biopsychologist who observes animals in their natural habitats. One example of observational research involves a systematic procedure known as the strange situation, used to get a picture of how adults and young children interact. The data that are collected in the strange situation are systematically coded in a coding sheet such as that shown in Table 2. The baby resists being put down by the adult by crying or trying to climb Maintaining contact back up. Resistance The baby pushes, hits, or squirms to be put down from the adult’s arms. This table represents a sample coding sheet from an episode of the “strange situation,” in which an infant (usually about 1 year old) is observed playing in a room with two adults—the child’s mother and a stranger. Each of the four coding categories is scored by the coder from 1 (the baby makes no effort to engage in the behavior) to 7 (the baby makes a significant effort to engage in the behavior). More information about the meaning of the coding can  be found in Ainsworth, Blehar, Waters, and Wall (1978). The results of descriptive research projects are analyzed using descriptive statistics—numbers that summarize the distribution of scores on a measured variable. A distribution can be described in terms of its central tendency—that is, the point in the distribution around which the data are centered—and its dispersion, or spread. The arithmetic average, or arithmetic mean, is the most commonly used measure of central tendency.
In the latter case order 2mg ginette-35 with visa women's health clinic redwood city, an important component of traditional quality assurance is lost order ginette-35 2mg online womens health 4. The establishment of nurseries and farms supplying plant material of consistent quality would help to minimise accidental overdosage due to natural variability in potency best order ginette-35 pregnancy 5 weeks ultrasound. Another result of urbanisation in South Africa appears to be ‘the irre- sponsible quackery and reckless profiteering racket into which the erstwhile dignified practice of traditional medicine is currently degenerating in the townships and cities’ (Zondi discount ginette-35 2 mg with mastercard menstruation fatigue, personal communication in Ref. This is a phenomenon of which traditional healers are well aware and which they seek to eradicate (Kubukeli, personal communication). Registration and certification of traditional healers, as is required for their western allopathic counterparts, have been proposed as a solution and may contribute to a reduction in the incidence of poisoning. The best of drugs, in the hands of the irresponsible or ignorant, is potentially dangerous. It may be necessary to alert the public, by means of a media campaign, to the hazards of self-medication with traditional herbs known to have deleterious side effects. Although it is not possible to say if the South African experience holds true for other African states, it would be surprising if the effects on traditional medical practice of cultural disruption occasioned by urbanisation, political unrest, war or climate change would not be felt throughout the continent. These findings are a cause for concern and further toxicological studies are necessary before the species concerned can be prescribed with confidence. Quality assurance Quality assurance of medicines rests on the establishment of standards relating to their identity, purity and potency. This constitutes the first step 110 | Traditional medicine in the process of bringing traditionally used plant species from the field into the clinic, dispensary and hospital. Similar programmes have been undertaken in Mozambique, Zambia, Zimbabwe, Botswana and Malawi. Primarily a disease of the rural poor in Africa, Plas- modium falciparum malaria causes more deaths than any other infectious agent in young African children and is responsible for almost 40% of these deaths. The efficacy of such remedies has been demonstrated by the successful development of modern antimalarials from traditionally used Cinchona and Artemisia spp. Twenty years later, Africa’s fragile oral knowledge systems are threatened by war, famine, political instability and urbanisation (with concomitant loss of the ‘ecosystem generation’). Unsustainable harvesting practices, delib- erate habitat destruction and climate change threaten the survival of the plant species on which Africa’s traditional healers depend. The greatest threat to traditional medical practice, however, is the burgeoning global population, whose growth and consumption of natural resources places plant diversity at risk in most parts of the world. The quantity of wild plant material exported from Africa and destined for the international pharma- ceutical trade is enormous, but pales into insignificance compared with that required by the trade in crude drugs used in traditional medical practice, within individual states or across regional borders. This has resulted in a disregard for traditional conservation practices and ‘an opportunistic scramble for the last bag of bark, bulbs or roots’. High rates of unemployment and low levels of formal education have also given rise to an increasing number of medicinal plant vendors, plying their trade in the marketplace (Figure 5. The period 2001–10 has been declared the Decade of African Traditional Medicine and an Africa Health Strategy (2007–15) has been formulated, focusing on the strengthening of health systems for equity and development in Africa. Conclusion There is no doubt that Africa’s rich botanical biodiversity and well-estab- lished traditional medical systems can be harnessed for the provision of better healthcare throughout the continent. The neces- sary expertise and infrastructure do not exceed the capabilities of the average African university School of Pharmacy. Toen wy in Oktober omtrent den Coperbergh quamen, weird door alle man ‘tselvs op d’omliggende bergen (tot voorraad vant geheele jaar) ingesamelt ‘t welck zy gelijk d’Indianers den betel of areck gebruijcken, synde seer vroolijk van humeur, meest alle avonden in haer ‘tsamenkomst. The Traditional Medical Practitioner in Zimbabwe: His principles of practice and pharmacopoeia. Manchester: Manchester University Press in association with the International African Institute, 1986: 50–86. Riding the wave: South Africa’s contri- bution to ethnopharmacological research over the last 25 years. Policy and public health perspectives on tradi- tional, complementary and alternative medicine: an overview. In: Bodeker, G, Burford G (eds), Traditional, Complementary and Alternative Medicine: Policy and public health perspectives. Manchester: Manchester University Press in association with the International African Institute, 1986. The professionalisation of indigenous medicine: a comparative study of Ghana and Zambia. Manchester: Manchester University Press in association with the International African Institute, 1986: 117–135. Manchester: Manchester University Press in association with the International African Institute, 1986: 151–62. Report of the Inter-Regional Workshop on Intellectual Property Rights in the Context of Traditional Medicine. Proceedings of an International Workshop on Traditional Knowledge, Panama City, 21–23 September 2005. A review of the taxonomy, ethnobotany, chemistry and pharmacology of Sutherlandia frutescens (Fabaceae). Galanthamine: a randomised double-blind, dose comparison in patients with Alzheimer’s disease. Antidiabetic screening and scoring of 11 plants traditionally used in South Africa. In vitro antiplasmodial activity of medicinal plants native to or naturalised in South Africa. The distribution of mesembrine alkaloids in selected taxa of the Mesembryanthemaceae and their modification in the Sceletium derived ‘kougoed’. Antimycobacterial activity of 5 plant species used as traditional medicines in the Western Cape Province (South Africa). Uses and abuses of in vitro testing in ethnopharmacology: visualizing an elephant. A pharmacognostical study of 26 South African plant species used as traditional medicines. The African cherry (Prunus africana): can lessons be learned from an over- exploited medicinal tree? Acute toxicity associated with the use of South African traditional medicinal herbs. Clinical and analytical aspects of pyrrolizidine poisoning caused by South African traditional medicines. Screening of medicinal plants used in South African traditional medicine for genotoxic effects. Searching for a Cure: Conservation of medicinal wildlife resources in east and southern Africa. In: Bodeker G, Burford G (eds), Traditional, Complementary and Alternative Medicine: Policy and public health perspectives. In: Bodeker G, Burford G (eds), Traditional, Complementary and Alternative Medicine: Policy and public health perspectives. An Africa-wide Overview of Medicinal Plant Harvesting, Conservation and Health Care. A brief overview of other similar traditional medicine practices is also included.
Thereafter purchase genuine ginette-35 line women's health center yorba linda, during the journey buy cheap ginette-35 online menstruation age 8, the driver is required to undertake random rolling retests order ginette-35 amex menopause 44. These devices have been used in several states of the United States and also in Alberta order ginette-35 2 mg with amex womens health magazine garcinia cambogia, Canada. They are generally applied to repeat offenders, either as an alternative to disqualifica- tion or in succession to a period of disqualification. Results in the United States have shown that repeat offenses occur rapidly once the restriction is removed (28). However, in Alberta, where there is closer supervision of the Traffic Medicine 361 program, supplemented by counseling, more long-term improvements have been experienced. To regain their licenses at the end of a period of disqualification, the drivers must undergo a medical examination (including blood tests to discover biochemical evidence of excessive alcohol consumption) to demonstrate with reasonable certainty that they are not alcohol abusers (3). In the United States, penalties for drunk driving may be “enhanced” under special circumstances, such as a second conviction for drunk driving, speeding at the time of arrest, the presence of a child in the car, or the causation of property damage or injury. Procedural Issues Although the procedures involved may seem simple, numerous techni- cal defenses have been raised in most countries throughout the world. Not surprisingly, many of these challenges are similar, no matter the country in which they are offered. Unfortunately, the word “drive” is not defined, but in fact, three points need to be proved: first, that the person is in the driving seat or has control of the steering; second, that the person charged must have something to do with the propulsion of the ve- hicle; and finally, that what the individual was doing must fall within the nor- mal meaning of driving. Similar regulations are to be found throughout the European Union, and if fur- ther evidence is needed regarding just how vague the definition of “mechan- ically propelled” may be, one needs only to consider the arrest in 1997 of a paraplegic Scandinavian who was arrested (and tried) for unsafe driving of his wheelchair. In English law, a car park attached to a public house was held, during opening hours, to be a public place because it was attached to a tavern that offered its services to all members of the public, whereas the same car park would not be regarded as a public place if it were attached to a private club (30). As a general rule, the person remains in charge until he or she takes the vehicle off the road unless some intervening act occurs (e. There is a statutory defense in that a person shall be deemed not to be in charge if he or she can prove that at the time, the circumstances were such that there was no likelihood of his or her driving the vehicle while the proportion of alcohol in the blood was over the prescribed limit. That the driver was injured or that the vehicle was damaged may be disregarded by the court if it is put forward as a defense. Therefore, the court is entitled to consider what the position would have been had the defendant not been prevented from driving by damage or injury. Of course, the state must always prove that the defendant was actually driving the car. That may prove difficult if, as is the case in many accidents, there are no witnesses. The courts have already ruled against a challenge where the officer was not wearing his helmet (31). In the United Kingdom, the breath test may be taken either at or near the place where the officer makes a request for one. Normally, that would be at the roadside but not necessarily at the scene of the offense. If an accident occurs owing to the presence of a motor vehicle on a road or other public place, a police officer may require any per- son who he or she has reasonable cause to believe was driving or attempting to drive or in charge of the vehicle at the time of the accident to provide a speci- men of breath for a breath test. The test may be taken at or near the place where the requirement was made or, if the police officer thinks fit, at a police station specified by the officer. In the United States, roadside breath testing, with nonevidentiary screening devices, is permitted only in “zero tolerance” states, with drivers under the age of 21 years. In the United Kingdom, a person failing to provide a specimen of breath without reasonable excuse is guilty of an offense. A reasonable excuse would include someone who is physically or mentally unable to provide a sample, or if the act of providing the sample would, in some way entail risk to health. Additionally, if an accident occurs owing to the presence of a motor vehicle on a road or public place and a police officer reasonably sus- pects that the accident involved injury to another person, then for the purpose of requiring a breath test or arresting a person, the officer may enter (by force if need be) any place where that person is or where the officer reasonably suspects the person to be. Hospital Procedure In the United Kingdom, patients at a hospital do not have to produce a breath test or provide a specimen for a laboratory testing unless the practitio- ner in immediate charge of their case has been notified and does not object on 364 Wall and Karch the grounds that the requirement would be prejudicial to the proper care and treatment of the person. In the United States, forensic blood samples can be taken from unconscious patients who are not able to give informed con- sent. Recent legislative changes in the United Kingdom in the Police Reform Act 2002 give doctors similar powers with a few subtle differences in that blood can be taken providing the person has been involved in an accident, the doctor is satisfied that the person is not able to give valid consent (for what- ever reason, which could include mental health problems) and the person does not object to or resist the specimen being taken (34). After death, a coroner can order that the blood alcohol level be measured (remembering always that the value measured will be 14% lower than if serum or plasma had been mea- sured at a clinical laboratory). In the United States, medical examiners and coroners do not require special permission to measure ethanol (or any drug for that matter), and they do so routinely. However, no fixed relation- ship between postmortem blood and vitreous concentrations is recognized in law. Additionally, when bodily harm has resulted, or when there is evidence of criminal activity (such as leaving the scene of an accident), then it is within the power of the officer to order that blood be drawn, even if the suspect is unwilling or unconscious. Police Station Procedure Police may require a suspect to provide either two breath samples for analysis by means of an approved device or a sample of blood or urine for laboratory testing. This is usually done at a police station, because it is almost unheard of for a hospital in the United Kingdom or the United States to be equipped with an evidentiary breath testing device. This situation does not occur in the United States where, if appropriate staff are available, both blood and urine may be obtained at the police station. In the United Kingdom, if a specimen other than breath is required, police may demand either a urine or blood test. If blood cannot be obtained as, for example, might well be the case in a chronic intravenous drug abuser, then a Traffic Medicine 365 urine sample must be provided within 1 hour of the request for its provision being made and after the provision of a previous specimen of urine. In the United States, urine specimens are generally not considered admissible proof of intoxication. A large number of studies have shown that the ratio between blood alcohol and pooled urine is highly unreliable and unpredictable (35,36). Collection of ureteral urine is often attempted at autopsy, but for obvious reasons, is not an option with living patients. Only officers who are trained to use the machine are allowed to conduct the intoximeter procedure, and the lower of two readings is taken. The subject must not have smoked for 10 min- utes or have consumed alcohol or used a mouth spray or mouthwash, taken any medication, or consumed any food for 20 minutes before the breath test. If the reading is below the prescribed limit of 35 μg of alcohol per 100 mL of breath, no action is taken unless impairment through drugs is suspected. If the level is between 36 and 39, no prosecution can occur unless there is impairment. If the level is between 40 and 50, the person is given the option of having the breath sample reading replaced by a specimen of blood or urine, but it is for the police officer to decide which, in accordance with Section 7. Different rules and regulations, but with much the same intent, apply in other countries.
A 60-year-old man with schizophrenia who has been treated for 30 years with chlorpromazine develops involun- tary (choreo-athetoid) movements of the face and tongue buy cheap ginette-35 2 mg menopause the musical las vegas. Key points Question 1 Pharmacological treatment What drug-induced movement disorder has developed? Question 2 • Receptor blockade: Will an anticholinergic drug improve the symptoms? Question 3 • Although there may be a rapid behavioural benefit purchase ginette-35 with a visa menstruation for 3 weeks, a Name three other drug-induced movement disorders delay (usually of the order of weeks) in reduction of associated with antipsychotic drugs discount ginette-35 2 mg with mastercard menstrual twice in one month. Key points Adverse effects of antipsychotic drugs • Extrapyramidal motor disturbances 2 mg ginette-35 with mastercard women's health clinic dunedin, related to dopamine blockade. Haloperidol can rapidly terminate violent and psychotic • Impaired temperature homeostasis. When treating violent patients, large doses of anti- psychotics may be sometimes needed. The combination of lorazepam and haloperidol has Acute attacks are managed with antipsychotics, but lithium been successful in treating otherwise resistant delirious is a common and well-established long-term prophylactic behaviour. Drugs and in alcohol withdrawal states, in alcoholics or in those depend- Therapeutics Bulletin 2004; 42: 57–60. New England Journal of Ensure resuscitation facilities including those for mechan- Medicine 2003; 334: 1738–49. Many forms of depression are recognized clinically and most The permissive hypothesis of mania/depression suggests respond well to drugs. Such a long time- course suggests a resetting of postsynaptic or presynaptic Depression is common, but under-diagnosed. This consists of hyperthermia, restlessness, tremor, than with other antidepressants. It may have a more rapid onset of therapeutic action and medication than other antidepressants, but this has yet to be confirmed. Evaluate response Although these drugs share many properties, their to medication after profiles vary in some respects, and this may alter their use in 6–8 weeks different patients. These are more appropriate for agitated or anxious patients than for withdrawn or apa- Symptoms resolving Symptoms persist thetic patients, for whom imipramine or nortriptyline, which are less sedative, are preferred. One of the factors involved may be the wide variation in individual plasma concentrations of these drugs that is Figure 20. When symptoms persist after first-line treatment, re-evaluate the accuracy of the diagnosis, the adequacy of the dose plasma concentration and response is not well defined. A mul- and the duration of treatment before moving to the second ticentre collaborative study organized by the World Health phase of treatment. Copyright 2000 ever between plasma amitriptyline concentration and clinical Turner White Communications, Inc. Augmentation* mild symptoms, low risk involves the use of a combination symptoms, or high risk symptoms, low risk of medications to enhance the efficacy of an antidepressant. Sometimes anxiety, powerful anticholinergic and cardiac toxic effects than second- agitation and restlessness follow sudden withdrawal. Allergic and idiosyncratic reactions These include bone marrow suppression and jaundice (both rare). As discussed above, they may also induce a slow adaptive decrease in pre- and/or postsynaptic amine Contraindications receptor sensitivity. These include the following: Adverse effects • epilepsy; • recent myocardial infarction, heart block; Autonomic (anticholinergic)/cardiovascular Dry mouth, • mania; constipation (rarely paralytic ileus, gastroparesis), • porphyria. Rarely, sudden death due to a cardiac This is a mixed group which includes 1-, 2- and 4-ring struc- dysrhythmia. In overdose, a range of tachydysrhythmias tured drugs with broadly similar properties. Central nervous system Fine tremor and sedation, but also Maprotiline – sedative, with less antimuscarinic effects, but (paradoxically) sometimes insomnia, decreased rapid eye rashes are more common and fits are a significant risk. On with much fewer anticholinergic effects, but can cause withdrawal of the drug, there may be gastro-intestinal postural hypotension and blood dyscrasias, particularly in symptoms such as nausea and vomiting, headache, the elderly. This combination of actions appears to be Contraindications associated with antidepressant activity, anxiolytic and sedative effects. Reported adverse effects include increased These include the following: appetite, weight gain, drowsiness, dry mouth and (rarely) • liver failure; blood dyscrasias. A treatment • antihypertensives and diuretics increase orthostatic card for patients should be carried at all times, which describes hypotension; precautions and lists some of the foods to be avoided. The • hypertension and cardiac dysrhythmias with adrenaline, interactions are as follows: noradrenaline and ephedrine. Such serious reactions are precipitated These drugs were little used for many years because of their by amines, including indirectly acting sympathomimetic toxicity, and particularly potentially lethal food and drug inter- agents such as tyramine (in cheese), dopamine (in broad actions causing hypertensive crises. They can be effective in some forms of refractory wine), phenylephrine (including that administered as depression and anxiety states, for which they are generally nosedrops and in cold remedies), ephedrine, amfetamine reserved. These drugs will have an exaggerated attacks or multiple somatic symptoms; and prolonged effect; 4. Patients should avoid major dietary changes that alter • The choice is usually related to the side-effect profile of sodium intake and maintain an adequate water intake. Different lithium preparations have different bioavailabili- • Tricyclic antidepressants commonly cause antimuscarinic ties, so the form should not be changed. This Antidepressant contraindications probably underlies some of the adverse effects of lithium, • Tricyclic antidepressants – recent myocardial infarction, such as goitre and nephrogenic diabetes insipidus, since dysrhythmias, manic phase, severe liver disease. Although lithium is widely used in affective disorders, it has a low toxic to therapeutic ratio, and serum concentration moni- Adverse effects toring is essential. When monitored regularly lithium is reasonably safe in of possible problems due to lithium heparin, which is often the medium term. However, adverse effects occur even in used as an anticoagulant in blood sample tubes. Serum the therapeutic range – in particular, tremor, weight gain, lithium levels fluctuate between doses and serum concentra- oedema, polyuria, nausea and loose bowels. Above the therapeutic range, tremor coarsens, diarrhoea hours after the previous dose. This measurement is made fre- becomes more severe and ataxia and dysarthria appear. Goitre, hypothyroidism and exacerbation of psoriasis are to two weeks), so antipsychotic drugs, such as haloperidol, less common. Renal tubular damage has been described in association is in prophylaxis in unipolar and bipolar affective illness with prolonged use. Addison’s disease, diarrhoea, with antidepressant drugs, with which St John’s wort should vomiting); therefore not be given. The amount of active ingredient can • myasthenia gravis; vary between different preparations, thus changing the prepa- • during surgical operations; ration can alter the degree of such interactions.