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By K. Sibur-Narad. University of Massachusetts at Amherst. 2018.
Helps people to remember issues Other people may contaminate they might otherwise have an individual’s views buy 60 mg levitra extra dosage with visa. Helps participants to overcome Some researchers may ﬁnd it inhibitions generic levitra extra dosage 40 mg amex, especially if they diﬃcult or intimidating to know other people in the group. The group eﬀect is a useful Venues and equipment can be resource in data analysis. Participant interaction is useful Diﬃcult to extract individual to analyse. QUESTIONNAIRES There are three basic types of questionnaire – closed- ended, open-ended or a combination of both. Closed-ended questionnaires Closed-ended questionnaires are probably the type with which you are most familiar. Most people have experience of lengthy consumer surveys which ask about your shop- ping habits and promise entry into a prize draw. This type of questionnaire is used to generate statistics in quantita- tive research. As these questionnaires follow a set format, and as most can be scanned straight into a computer for ease of analysis, greater numbers can be produced. Open-ended questionnaires Open-ended questionnaires are used in qualitative re- search, although some researchers will quantify the an- swers during the analysis stage. The questionnaire does not contain boxes to tick, but instead leaves a blank sec- tion for the respondent to write in an answer. Whereas closed-ended questionnaires might be used to ﬁnd out how many people use a service, open-ended question- naires might be used to ﬁnd out what people think about a service. As there are no standard answers to these ques- tions, data analysis is more complex. Also, as it is opi- nions which are sought rather than numbers, fewer questionnaires need to be distributed. Combination of both Many researchers tend to use a combination of both open and closed questions. That way, it is possible to ﬁnd out how many people use a service and what they think about that service on the same form. Many questionnaires begin with a series of closed questions, with boxes to tick or scales to rank, and then ﬁnish with a section of open- questions for more detailed response. This suggests that soon there might be a new category of ques- tionnaire – the interactive questionnaire, which allows re- spondents to work with the researcher in both the development and completion of the questionnaire. PARTICIPANT OBSERVATION There are two main ways in which researchers observe – direct observation and participant observation. Direct ob- servation tends to be used in areas such as health and psy- chology. It involves the observation of a ‘subject’ in a certain situation and often uses technology such as video cameras or one-way mirrors. For example, the interaction of mother, father and child in a specially prepared play room may be watched by psychologists through a one- way mirror in an attempt to understand more about fa- mily relationships. In participant observation, however, the researcher becomes much more involved in the lives of the people being observed. Participant observation can be viewed as both a method and a methodology (see Chapter 10).
The cell The phases of meiosis II are similar to those of meiosis cycle is highly regulated by several enzymes purchase 40mg levitra extra dosage overnight delivery, proteins levitra extra dosage 40 mg without prescription, and I, but there are some important differences. The time between cytokines in each of its phases, in order to ensure that the the two nuclear divisions (interphase II) lacks replication of resulting daughter cells receive the appropriate amount of DNA (as in interphase I). As the two daughter cells produced genetic information originally present in the parental cell. In in meiosis I enter meiosis II, their chromosomes are in the the case of somatic cells, each of the two daughter cells must form of sister chromatids. No crossing over occurs in prophase contain an exact copy of the original genome present in the II because there are no homologues to synapse. Cell cycle controls also regulate when and to metaphase II, the spindle fibers from the opposite poles attach what extent the cells of a given tissue must proliferate, in order to the sister chromatids (instead of the homologues as before). Therefore, when one or more of the centromeres separate, the two single chromosomes are such controls are lost or inhibited, abnormal overgrowth will drawn to the opposite poles. The end result of meiosis II is that occur and may lead to impairment of function and disease. The distribution of chromatids during meio- Cell cycle (eukaryotic), genetic regulation of; Cell cycle sis is a matter of chance, which results in the concept of the (prokaryotic), genetic regulation of; Chromosomes, eukary- law of independent assortment in genetics. These enzymes interact with one another and molecular genetics 105 Cell cycle (eukaryotic), genetic regulation of WORLD OF MICROBIOLOGY AND IMMUNOLOGY CELL CYCLE (EUKARYOTIC), GENETIC molecules that promote the cell cycle) as pro-mitotic signals. For example, thy- REGULATIONCell cycle (eukaryotic), genetic regulation of OF rotrophic hormone, one of the hormones produced by the pitu- itary gland, induces the proliferation of thyroid gland’s cells. Estrogens are hormones eukaryotes, cell division may take two different paths, in that do not occupy a membrane receptor, but instead, penetrate accordance with the cell type involved. Mitosis is a cellular the cell and the nucleus, binding directly to specific sites in the division resulting in two identical nuclei is performed by DNA, thus inducing the cell cycle. The process of meiosis results in four nuclei, Anti-mitotic signals may have several different origins, each containing half of the original number of chromosomes. Both prokaryotes and eukaryotes undergo a final growth factor beta), which inhibits abnormal cell proliferation, process, known as cytoplasmatic division, which divides the proteins p53, p16, p21, APC, pRb, etc. The series of stages that a cell undergoes while pro- Oncogenes, until recently also known as proto-oncogenes, gressing to division is known as cell cycle. Cells undergoing synthesize proteins that enhance the stimuli started by growth division are also termed competent cells. When a cell is not factors, amplifying the mitotic signal to the nucleus, and/or progressing to mitosis, it remains in phase G0 (“G” zero). When each phase of the cell cycle is completed, the pro- interphase and mitosis. Interphase includes the phases (or teins involved in that phase are degraded, so that once the next stages) G1, S and G2 whereas mitosis is subdivided into phase starts, the cell is unable to go back to the previous one. Next to the end of phase G1, the cycle is paused by tumor sup- The cell cycle starts in G1, with the active synthesis of pressor gene products, to allow verification and repair of RNA and proteins, which are necessary for young cells to grow DNA damage. The time G1 lasts, varies greatly among eukary- genes stimulate other intra-cellular pathways that induce the otic cells of different species and from one tissue to another in cell into suicide or apoptosis (also known as programmed cell the same organism. To the end of phase G2, before the transition to mito- tion, such as mucosa and endometrial epithelia, have shorter sis, the cycle is paused again for a new verification and “deci- G1 periods than those tissues that do not require frequent ren- sion”: either mitosis or apoptosis. Along each pro-mitotic and anti-mitotic intra-cellular sig- The cell cycle is highly regulated by several enzymes, naling pathway, as well as along the apoptotic pathways, several proteins, and cytokines in each of its phases, in order to ensure gene products (proteins and enzymes) are involved in an that the resulting daughter cells receive the appropriate amount orderly sequence of activation and inactivation, forming com- of genetic information originally present in the parental cell. In plex webs of signal transmission and signal amplification to the the case of somatic cells, each of the two daughter cells must nucleus.
Working-Age People Who Did Not Get or Delayed Care in the Last Year Mobility Did Not Delayed Difficulty Get Care (%)a Care (%)b None 3 10 Minor 10 22 Moderate 13 28 Major 10 28 aAny time during the past 12 months generic levitra extra dosage 60 mg without prescription, when a person “needed medical care or surgery discount levitra extra dosage 40mg on line, but did not get it. Almost 98 percent of elderly people have Medicare (Medicare Payment Advisory Commission 1999, 5). Voluntary employer-based private health insurance covers roughly two-thirds of the population, although it accounts for less than one-third of national health expenditures (Reinhardt 1999, 124). Medicare and Medicaid cover people who on av- erage have greater health-care needs than workers and their families. Nonetheless, working-age persons who do not qualify for Medicare or Medicaid are often out of luck, even if they are employed. Over half of uninsured people who have any disability work (Meyer and Zeller 1999, 11). Some employers avoid hiring disabled workers, fear- ing higher health insurance premiums (Batavia 2000). The ADA does not address employment-based health insurance explicitly, although it does prohibit employers from discriminating in “terms or conditions of em- ployment” against an employee. The ADA’s legislative history suggests that em- ployers and health insurers can continue offering health plans with restricted coverage “as long as exclusions or limitations in the plan are based on sound actuarial principles” (Feldblum 1991, 102). But only 76 percent of those with minor and moderate mobility problems have health insurance, while 83 percent of younger Who Will Pay? Health Insurance Coverage among Working-Age People Mobility Health Difficulty Insurance (%) Medicare Any Medicare Medicaid and Medicaid None 80 1 4 1 Minor 76 9 20 3 Moderate 77 16 27 5 Major 83 28 35 10 persons with major mobility difficulties are insured, primarily through Medicare and Medicaid (Table 17). More unemployed than employed working-age people with major mobility problems have insurance (86 versus 79 percent), because of these public programs. Even persons with health care insurance “are rarely covered for (and have access to) adequate pre- ventive care and long-term medical care, rehabilitation, and assistive tech- nologies. These factors demonstrably contribute to the incidence, preva- lence, and severity of primary and secondary disabling conditions and, tragically, avoidable disability” (Pope and Tarlov 1991, 280). Health insur- ers typically decide what to reimburse in two stages: organizationwide de- cisions about what services are “covered” by a particular plan; and case-by- case decisions about the “medical necessity” of covered services for individual persons (Singer and Bergthold 2001). A third-order decision, potentially critical for persons with mobility problems, is the setting of care: can patients receive services at home? For mobility-related services, two major concerns generally underlie coverage decisions for private and public health insurers: • How long will the person need the service? Neither issue is especially propitious for persons with progressive chronic conditions, who, by deﬁnition, generally need services long-term and are unlikely to improve. Private health insurance appeared about seventy years ago, partly to help acute- care hospitals make their increasingly costly services affordable to “the pa- tient of moderate means” (Law 1974, 6). To ensure their ﬁnancial survival during the Great Depression, hospitals organized prepaid health insurance or Blue Cross plans, writing contracts with employers to insure their work- ers. Over ensuing decades, as new hospital-based technologies offered “medical miracles” to combat acute threats to life and limb, costly but time-limited hospital interventions became the cornerstone of most health insurance plans. Therefore, early and subsequent commercial plans primarily covered short-term, acute hospitalizations and physician services. Given today’s competitive pressures, private health insurers offer numerous plans to meet diverse demands. Private health plans typically cover acute medical and sur- gical hospitalizations and primary and specialty physician visits but differ widely in coverage for other services. Medicare and Medicaid, enacted in 1965, reﬂect decades of political ma- neuvering and compromises (Marmor 2000; Fox 1989, 1993). As with pri- vate health insurance, Medicare’s roots reach back to the Great Depression.
For example cheap levitra extra dosage 40mg with amex, some informants managed stigma by giving accounts in which they claim they are not like the stereotype they perceive others hold cheap 40mg levitra extra dosage free shipping, which assumes users of alternative therapies are cult-like fanatics out to convert non-believers. For example Roger said, “I don’t make a point of proselytizing anything particularly,” which Scott echoed with, “I don’t try and convince people of anything. I don’t push my ideas on anybody else,” and Hanna told me, “I’m not that awful about it, I don’t force my opinions. For instance, Simon’s and Hanna’s accounts of how they had been labelled deviant both made reference to the general ignorance of the other: “You know ignorance in action is frightening to behold; people aren’t knowledgeable about different things. When I first was into vitamins and herbals, they wondered” (Simon);“There’s a lot of ignorance about natural things like yoga and reflexology; they don’t realize it’s a philosophy and not an actual religion” (Hanna). Such was the imperative to distance themselves from deviant status (Goffman 1963) that Lucy was one of the few informants whose account included any “desire to... When I asked Lucy what she did when she encountered a negative reaction to her use of alternative therapies, she said, “Well, I’ll explain it to the best of my ability. If they want more answers, I’ll recommend people who’ve got better answers, who’ve got the answers. This type of account is one in which these informants reinterpret aspects of their biographies in order to show a clear, linear progression towards the use of alternative forms of health care. While they are aware that others may label their use of these therapies as deviant behaviour, they are able to see it, and themselves, as normal within the context of their reinterpreted biographies. In other words, alternative therapy use is something toward which they had always been moving. To illustrate, when discussing their use of alternative Using Alternative Therapies: A Deviant Identity | 105 health care, almost half of the people I spoke with cited their parents’ use of home remedies as foreshadowing their current use of alternative therapies. For instance, Marie told me, “Home remedies, the natural way of doing things. My mother was a smoker and if you had earaches as a kid she used to blow smoke in my ear. She would make bread poultices if you had splinters and mustard plasters when you had colds. Betty also had a story to tell about her mother’s home remedies: My mum always tried to make nutritious meals. We had our vitamins, which I believe in now within common sense, but I have in my cupboard my vitamins. Past occupational experiences were another aspect of personal biography that some informants reinterpreted to mesh with their current participation in alternative therapies. For instance, Lucy and Marie had both worked in the health care system in the past. In their accounts of their use of alternative health care, they reinterpreted these experiences to coincide with their current use of alternative therapies. Marie reinterpreted her duties as a podiatrist’s assistant as a precursor to her present-day engage- ment in training to become a reflexologist: I had worked for a podiatrist when I first got out of high school and part of his treatment was that after he finished with the patient, his digging and cutting and scraping and gouging, the last thing was that I went in for five minutes and I massaged their feet so that they left on a really positive note and I always knew the importance of that. Similarly, in her account, Lucy reinterpreted her experiences working in a hospital as seminal events that inevitably led her to become a user of alternative therapies. In her words, “Well, I had always realized that the medical field can only basically deal with disease. I’ve worked in a 106 | Using Alternative Therapies: A Qualitative Analysis number of hospitals so I was well aware of that.