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For articles: ° title ° author(s) (including first names) ° year of publication ° journal title ° journal volume/issue number ° pages containing article ° library and shelf number or topic code order 50mg avana with amex. Practical demonstrations Keep note-taking to a minimum in any sort of practical demonstration avana 200 mg generic. The emphasis will be on showing you what is happening, and in some cases on you joining in and having a go yourself. It is difficult to combine this sort of practical experience with note-taking. If you do get a chance to jot something down, then follow these rules: 1. Record any information you think you are unlikely to find in a textbook or lecture. Organising your notes Sort and file your notes immediately, otherwise they will build up into a mound of paperwork that will be frustrating and of little use to your stud­ ies. The sys­ tem you choose must be flexible, allow easy retrieval of information and be practical to use. The most common and probably the best method is to file loose-leaf sheets in A4 size ring binders. These binders allow you to insert additional 164 WRITING SKILLS IN PRACTICE notes where you want them, as well as having the capacity to hold a large amount of paper. If you lack the space or funds for a set of shelves, a cheap alternative is to use card­ board boxes from your local supermarket. Place the box on its side so that the ring binders can be filed in an upright position. The box is easily car­ ried by the precut handgrips for storage out of the way in a cupboard. Your system needs to be log­ ical, adaptable and easy to cross-reference. Avoid having to access several different files to get the required information. You may want to separate theoretical modules from clinical experience, or you may want to integrate the two. Choose a cate­ gorisation system that allows you to quickly locate the information you need to prepare for essays and revise for assessments. You will need to devise a cataloguing system as soon as you start your note-taking. Journals, newspapers cuttings and other resource materials are best stored in box files. Make a note of any cross-references between your resource materials and your filed notes. You can also use colour coding to organise files, for example so that your box file is the same colour as its related ring binder. Clearly mark each set of notes with information that will identify its source. For lectures, this will be the title, name and designation of the lec­ turer, along with the date. It might also be useful to make a note of the module under which the lecture was scheduled. Notes taken from articles, books or audiovisual material need to have sufficient information to allow you to locate the original material at a later date.

I personally use it only as an adjunctive medication in anxious patients order 200 mg avana with amex. Side effects include drowsiness buy 50 mg avana with mastercard, dizziness, fatigue, and altered behavior. If an individual fails initial therapy or presents with severe tics, medications in the Tier 2 (classical neuroleptic or atypical neurolep- tics) category should be initiated. Neuroleptics, D2 dopamine receptor antagonists, are the most effective tic-suppressing agents (about 70–80% effective), but side effects may limit their usefulness. Complications that may occur even with low doses tend to be similar with most neuroleptic medications: sedation, drowsiness, dys- phoria, movement abnormalities (acute dystonic reactions, bradykinesia, akathisia, tardive and withdrawal dyskinesias, tardive TS), depression, aggression, ‘‘fog states,’’ weight gain, EKG abnormalities, endocrine dysfunction, and poor school performance with or without school phobia. A variety of neuroleptic and atypical neuroleptic agents have been suggested as tic-suppressing therapy, although few have been adequately evaluated. My personal preferences are to use monotherapy and start with pimozide and then use fluphenazine, risperidone, olanzepine, and haloper- idol in that order. In individuals with significant behavioral issues, the use of atypical neuroleptics as the initial Tier 2 therapy should be considered. Pimozide, a diphenylbutylpiperidine derivative, is a D2 receptor antagonist that also blocks calcium channels. Two double-blind studies have 130 Singer compared the efficacy and safety of pimozide and haloperidol. In both, pimozide was either equal to or more effective than haloperidol at suppressing tics and had fewer serious side effects. Before starting pimozide, an EKG should be obtained in order to detect a prolonged Q-T interval, a contraindicating factor. Electrocardiographic changes induced by pimozide include Q-T lengthening, U waves, and alteration of T- waves (flattening, notching, or inversion). The dose is gradually increased, if necessary, in 1-mg increments on a weekly basis and used in a BID dosing schedule. The use of macrolide antibiotics (clarithromycin, erythromycin, troleandomycin, and ditromycin), azole antifungals (ketoconazole, itraconazole), and protease inhibitors should be avoided. Grapefruit juice may also inhibit the metabolism of pimozide, resulting in increased serum concentrations of this medication. Long-term treatment with pimozide is more effective in controlling the course of tics than its use solely to treat an exacerbation. Fluphenazine is an antagonist at both D1 and D2 dopaminer- gic receptors. Several studies have shown that this medication is an effective tic-suppressing agent that may have fewer side effects than other neuroleptics. Treatment is started with a dose of 1 mg at bedtime and increased in a similar fashion to pimozide, by 1 mg every 5–7 days, while the patient is monitored for a therapeutic response or side effects. Haloperidol, a butyrophenone and D2 blocking agent, was first documented to be an effective tic suppressor more than 40 years ago. Although it is probably the most widely used agent, in my experience the observed frequency of side effects is greater than with other agents in this category. Another less commonly used neuroleptic, trifluoperazine, may also have beneficial effects. Sulpiride and tiapride are substituted benzamides that are free of anticholinergic and noradrenergic effects. Both of these selective D2 antagonists have been shown to be beneficial in studies performed in Europe, but neither is available in the United States. These newer antipsychotic agents (risperidone, olanza- pine, ziprasidone, quetiapine) are characterized by a relatively greater affinity for 5HT2 receptors than for D2 receptors and the potential for fewer extrapyramidal side effects than typical neuroleptics. Substantial variations in receptor affinity profiles for subtypes of dopamine, serotonin, and adrenergic receptors exist among these agents, suggesting that there may be important differences in clinical effects.

X Remember that with postal surveys it might be difficult to control and know who has filled in a questionnaire cheap avana 50mg overnight delivery. X In some purposive samples it is difficult to specify at the beginning of the research how many people will be contacted cheap avana 200mg otc. X It is possible to use a mixture of sampling techniques within one project which may help to overcome some of the disadvantages found within different procedures. This is a document which sets out your ideas in an easily accessible way. Even if you have not been asked specifically to produce a research proposal by your boss or tutor, it is a good idea to do so, as it helps you to focus your ideas and provides a useful document for you to reference, should your research wander off track a little. Before you start work on your research proposal, find out whether you’re required to produce the document in a specific format. For college and university students, you might be given a general outline and a guide as to how many pages to produce. For those of you who are produ- cingaproposaltosendtoafundingorganisationyou might have to produce something much more specific. Some provide advice and guidance about what they would like to see in your proposal. The larger funding bodies produce their proposal forms on-line so that they can be filled in and sent electronically, which makes the process a lot quicker and easier. This rationale should be placed within the con- text of existing research or within your own experience and/or observation. You need to demonstrate that you know what you’re talking about and that you have knowl- edge of the literature surrounding this topic. If you’re un- able to find any other research which deals specifically with your proposed project, you need to say so, illustrat- ing how your proposed research will fill this gap. If there is other work which has covered this area, you need to show how your work will build on and add to the existing knowledge. Basically, you have to convince people that you know what you’re talking about and that the research is important. Aims and objectives Many research proposal formats will ask for only one or two aims and may not require objectives. However, for some research these will need to be broken down in more depth to also include the objectives (see Example 6). The aim is the overall driving force of the research and the ob- jectives are the means by which you intend to achieve the aims. HOW TO PREPARE A RESEARCH PROPOSAL / 57 EXAMPLE 6: AIMS AND OBJECTIVES Aim To identify, describe and produce an analysis of the interact- ing factors which influence the learning choices of adult re- turners, and to develop associated theory. The nature, extent and effect of psychological influences on choices, including a desire to achieve personal goals or meet individual needs. The nature, extent and effect of sociological influences on choices, including background, personal and social expecta- tions, previous educational experience and social role. The nature and influence of individual perceptions of courses, institutions and subject, and how these relate to self-perception and concept of self. The influence on choice of a number of variables such as age, gender, ethnicity and social class. The role and possible influence of significant others on choice, such as advice and guidance workers, peers, relatives and employers. The nature and extent of possible influences on choice of available provision, institutional advertising and marketing. The nature and extent of possible influences on choice of mode of study, teaching methods and type of course. How and to what extent influencing factors change as adults re-enter and progress through their chosen route.