By O. Topork. Barton College. 2018.

Folklore 46Folklore 46Folklore 46Folklore 46Folklore 46 123 Larisa Fialkova Stoianova generic motrin 600 mg line, Inga discount motrin 600mg on-line. Istoricheskii Vestnik: Istoriko-Literaturnyi Zhurnal [Historical Her- ald: Historical and Literary Journal] generic 400mg motrin free shipping, No. This handbook is not for sale and it is used as part of research methodology workshop. It allows for a systematc and scientfc assessment or evaluaton of the problem and ofen provides knowledge that allows for change to occur – change that can improve the quality of health and health care. No organisaton or health insttuton can grow or develop without the use of research. The major problems facing research today is the lack of applicaton of research fndings. Conductng research for “research sake” or the “publish or perish mentality”, has resulted in a food of research publicatons that have litle impact on health – the 10/90 gap in medical research (only 10% of global research funding is spent on health problems that afect 90% of the world’s populaton). What is required today is applied research – research that impacts the health of the individual and the community, resultng in meaningful improvement in health status. The style we have used is a step by step approach to preparing a research proposal. This research handbook was initated by the lead author in 1990 and revised numerous tmes since. It began as lecture notes and has gradually evolved into a brief handbook, aimed at giving the reader the “basic skeleton” or components of research methodology and provides a guide to conductng a research project. Much of the contents have been developed and revised based on numerous research training workshops conducted over many years. It has currently been extensively revised and re-writen with the view to ofer a practcal handbook to health professionals interested in conductng research. The authors would be happy to receive feedback and constructve critcism on improving this handbook. Learning points:Learning points: It is important to note that research is best learnt by actually conductng a researchIt is important to note that research is best learnt by actually conductng a research project, rather than by reading or atending lecturesproject, rather than by reading or atending lectures This handbook is aimed to be used in conjuncton with the user doing an actualThis handbook is aimed to be used in conjuncton with the user doing an actual research project. Learning points:Learning points: This handbook has two examples of research proposals in the appendices. Please refer to the relevant parts of the examples to aid your understanding asPlease refer to the relevant parts of the examples to aid your understanding as you read the various sectons of the handbook. We would like to thank the many researchers who have atended our research workshops over the past 15-20 years. They have helped to shape the contents of this handbook and given valuable feedback. They allowed us to try out many research approaches that enriched our repertoire of research methodology, data analysis and how data can be best presented. A special thanks to the authors of two research proposals who allowed us to reproduce the core summaries of the proposals here as examples. We would also like to thank, in advance, readers of this book who we hope will provide critcal feedback for its improvement. Techniques for data What techniques will best answer the collecton & pre- objectve? IntRoDuctIon Write this as one cohesive secton that includes the following components: • Identfying & prioritsing problems – write this in terms of why this study is chosen • Problem statement & analysis – Important to include problem analysis chart • Literature review – this may be incorporated into the introducton if brief, or writen as a separate secton 3. MethoDology • Overview of Research Design • Study type • ethical consideratons • Variables • Sampling • Techniques for data collecton & pre-testng • Plan for data analysis & interpretaton (include dummy tables) • Project management (including gant Chart) 5. The researcher uses this secton to crystallize the problem and justfy why it is necessary. A manager or research funding agency wants a clearly outlined argument before funding or approving it. If any of the following is true for your problem, then you don’t need to research it 1. Manager’s most urgent concern that needs research Learning points:Learning points: eliminate non-research problems before prioritzing research problems. This may not refect the most important problems in the community; in additon, difcultes arise when a group of persons try to select a research project. This method allows every member in a group or organisaton to have an equal say in decision making. Spend 10 minutes in silence thinking of important problems that you have at work or in the community. The chairman then lists all the problems on a fip-chart in round-robin fashion untl all problems are exhausted (if tme is a limitaton allow each member to list only his/her two most important problems). Duplicaton establish that the answer is not already available by some other study. Applicability Will the potental soluton be efectve for solving the problem under ideal conditons? If the scope of the study is limited to only a few areas, justfy and give reasons why (see no. Learning points:Learning points: The problem analysis chart will guide the directon of the study. Draw a centre bubble that contains the problem stated in a negatve manner (the primary bubble).

Set up a system of rinsing fingers (and fingernails) in 10% grain alcohol in the bathroom safe 400 mg motrin. A warm stomach full of food at a neutral pH is just the right culture condition for these bacteria buy motrin 600mg with visa. If your body has the right conditions (like a low acid stomach) to let them grow you dare not swallow another one! Shigellas arrive with dairy foods cheap 600mg motrin amex, too, but prefer the lower intestine as their headquarters. Besides getting digestive improvement you get mental improvement, less depression, less dizziness, less irritability after clearing these up. Other Clues Digestion problems that remain after eliminating bacteria can be diagnosed in a rational way. Ask these questions: • Is the stool orangish-yellow, or very pale, instead of greenish brown? If so, it must be lighter than water and contain fat or a great deal of undigested material. If the stool floats or is orangish in color prepare your elderly person for a liver cleanse (page 552) to clear a bile duct of ob- struction. Do a kidney cleanse (page 549) first, using half a dose instead of the regular dose, for three to six weeks. Attend your loved one in person for the liver cleanse, have a commode at bedside, protect bedding from accident: use paper underwear if necessary. Share the joy of getting gallstones out painlessly with your loved one; let them see and count them if they wish before you flush them (use a flashlight). Use starch skin soother to dispense onto the wet paper towel, besides borax solution and alcohol. The starch skin softener gives the smoothness of soap, and prevents the pain of friction. Evidently the body absorbs all the magnesium so eagerly, none is left in the intestine to absorb water and create diarrhea. It is especially important though to rehydrate your elderly person after a diarrhea. As the stones from the far corners of the liver move forward, they compact into larger stones and plug the ducts again. Try to give a cleanse once a month until the dark color of the stool returns and it no longer floats. The benefits of a liver cleanse will last longer if valerian herb is taken the day after the cleanse and from then forward. If you try bran, you should add vitamin C and boil it, first, because it is very moldy. Poop Your Troubles Away Two bowel movements a day are the minimum necessary for good health. The morning cup of water, drunk at the bedside has the magical ability to move the bowels. Walking and liver cleansing are the most health-promoting activities you can do for your loved one. To overcome resistance, find a cheerful neighborhood person will- ing to do this task for pay. The need to respond to a new stranger energizes the elderly more than your persuasion can. If your loved one is already on a pill for beginning diabetes, take this as your challenge never to let it get worse. It is a destruction of the pancreas (specifically the islets) by the pancreatic fluke which is attracted to the pancreas by wood alcohol. Zap flukes and eliminate wood alcohol as described in the section on diabetes (page 173). Use no artificial sweetener and no beverages besides milk, water and the recipes given in this book. They are well motivated to pre- vent the need for giving themselves daily shots of insulin. Fried potatoes with 2 eggs (use only butter, olive oil or lard), 1 cup hot or cold milk. Cream of rice, with homemade “half n half” or whipping cream, cinnamon and vitamin C stirred in. Fruit cup, large bowl of peeled, chopped mixed fruit with whipping cream and 1 tbs. Green beans with potatoes, meat dish, cabbage apple salad, water with lemon juice and honey, 1 cup hot milk. Fresh green beans, especially fava beans contain a sub- stance that is described in old herbal literature to be espe- cially beneficial to diabetics. Potatoes (not overcooked), peeled to make sure there are no blemishes (contain mold and pesticide) can be cooked with the beans. Add fresh chopped parsley to the sauce or butter for both green beans and potatoes. Fresh parsley has special herbal goodness (high magnesium, high potassium, diuretic. Canned meat is safe from parasites but may have smoke flavoring added (contains benzopy- rene) or nitrates. Purchase the flip-top cans to avoid eating metal grindings from the can opening process.

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Its patent protection was near expiration when the drug was voluntarily withdrawn from the antihistamine market in 1997 generic 400 mg motrin amex. It was thought that the antihistaminic effect of terfenadine was due to direct interaction with the H1 receptor order 400mg motrin overnight delivery. Subsequent studies revealed that terfenadine was completely metabolized in vivo to fexofenadine cheap 600mg motrin with amex, a metabolite entirely responsible for the antihistaminic effect (6). The unique property of fexofenadine compared to first-generation antihistamines (diphen- hydramine, chlorpheniramine) was its inability to cross the blood-brain barrier, thereby avoiding the sedation seen with the first-generation antihistamines. Terfenadine was indicated for use in allergic rhinitis (both seasonal and peren- nial), and the recommended dose was 60 mg twice daily. Clinical Pharmacology Terfenadine is at least 70% absorbed after oral administration but is rapidly metabolized by first-pass metabolism to fexofenadine (terfenadine carboxylate) and an inactive dealkylated product. Fexofenadine is about 70% protein bound and exhibits biphasic elimination with an initial plasma half-life of 3. Fexofenadine is excreted mostly unchanged (80% in feces, 12% in urine), with <10% converted to inactive metabolites (7). Adverse Experiences The first published report of a serious adverse event due to an interaction of terfenadine with another drug was that of a young woman who was taking terfenadine and subsequently began taking ketoconazole. Within a few days after beginning ketoconazole therapy, she experienced syncopal episodes and was found to have torsade de pointes (polymorphic ventricular tachycardia) (11). Torsade de pointes was also seen in patients with liver failure who took terfe- nadine and in patients who simultaneously received erythromycin and terfena- dine (12). On the basis of the initial reports of torsade with terfenadine, a ‘‘Dear Doctor’’ letter was issued by the manufacturer of Seldane in 1990. The occurrence of cardiac toxicity was closely correlated with terfenadine use, and subsequent in vitro studies confirmed that terfenadine (but not fex- ofenadine) efficiently blocks cardiac potassium channels (14). Thus, the direct inhibitory effect of terfenadine on cardiac potassium channels results in prolongation of cardiac repolarization, which is a well-known cause of ventricular arrhythmias. In one death in which terfenadine was implicated, plasma level of the drug was 55 ng/mL several hours after the last ingestion of the drug (when it normally should be undetectable). Market Dynamics Seldane held market exclusivity as a nonsedating antihistamine from its launch 1 in 1985 until 1989, when astemizole (Hismanal ) entered the market. Hismanal Drug-Drug Interactions: Marketing Perspectives 713 did not penetrate significantly into the market because of perceived inferior efficacy (longer onset of action) and cardiac toxicities similar to Seldane (7). On the basis of its nonsedating property, efficacy, and convenient dosing, Seldane maintained market leadership, with a ranking of the fifth most commonly pre- scribed drug in the United States in 1990. In 1991, 17 million prescriptions were issued, and there were more than 100 million users of Seldane worldwide. Despite the black box warning, Seldane had worldwide sales of $700 million in 1994 and held up to 29% market 1 share in the United States in 1995. With the launch of Zyrtec in 1996 (pro- moted as safer and equally effective), market share of Seldane plummeted to 2. When it was recognized that fexofenadine was the active metabolite, efforts were begun to register it as a separate entity. Mibefradil 1 Mibefradil (Posicor ) was launched in the United States in June 1997 by Roche, Switzerland. At the time of launch, it was projected to eventually provide 1–3% of Roche’s sales. Average reductions of diastolic blood pressure of as much as 15 mmHg were seen with the 100-mg dose. Thus, it was indicated for use in hypertension and stable angina at doses of 50 or 100 mg once daily (15). It was reported to be well tolerated, with the most common adverse experiences being head- ache, leg edema, dizziness, and fatigue at incidences similar to those with placebo. Clinical Pharmacology Oral bioavailability of mibefradil is dose dependent and ranges from 37% to over 90% with doses of 10 mg or 160 mg, respectively. The plasma half-life is 17 to 25 hours after multiple doses, and it is more than 99% protein bound (15). After chronic dosing, the oxidative pathway becomes less important and the plasma level of the alcohol metabolite of mibefradil increases. In animal models, the pharmacological effect of the alcohol metabolite is about 10% compared to that of the parent compound. After metabolic inactivation, mibefradil is excreted into the bile (75%) and urine (25%), with less than 3% excreted unchanged in the urine. Clinical Drug-Drug Interactions Prior to registration, several clinical drug-drug interaction studies were done. Adverse Experiences Within several weeks of its launch, numerous serious adverse events involving mibefradil were being reported on a regular basis. On the basis of these postmarketing adverse experiences, the manufacturer issued a Dear Doctor letter in which it was mentioned that mibefradil was found to interfere with the metabolism of 26 other medicines and that concomitant use of mibefradil with several of these medications was contraindicated. In a second Dear Doctor letter in June 1998, mibefradil was voluntarily withdrawn from the market by Roche due to ‘‘complexities’’ of drug inter- actions. The study reportedly found no difference between mibefradil and placebo in treating congestive heart failure, but it ‘‘provided further information on drug inter- actions’’ (19). Thus, Posicor was launched in a very competitive market, and it had virtually no impact on that market. Before its withdrawal, it had been prescribed to *200,000 patients worldwide and generated <$27 million in U. Cimetidine Cimetidine was the first histamine-2 (H2) receptor antagonist in the antiulcerant 1 market.

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Three days later She had a bronchoscopy yesterday and will get the results tomor- row order motrin 600 mg without prescription. Since her bronchoscopy showed bleeding in the lung generic 400mg motrin amex, start Ginger capsules discount motrin 400 mg with visa, 2 per day. She is craving nicotine and needs the nicorette gum; I recommended a patch plus herbs. Summary: Heidi made an excellent beginning but her craving for nicotine overwhelmed her. She took up smoking again and returned to the clinical methods for dealing with tumors; she is now unable to drive a car and is a permanent invalid. She first got lymphoma two years ago, lumps were removed from her left shoulder and left cheek. She decided to try some health routines, cutting out a lot of poor foods, starting on Echinacea, vitamin E, and various cleansing routines. Thallium, more toxic than arsenic or lead, is used as an alloy of mercury to make outdoor thermometers for use in the Arctic or Antarctica. Could the mercury being shipped to the dentist sometimes be contaminated with thallium? Is the same company that ships mercury to dentists also making the thallium/mercury alloy for thermometers? Thallium affects the legs first, climbing higher to reach the lower back and then makes it difficult to walk. She will see a dentist to remove all mercury fillings and save the drillings for me to analyze for thallium. She will drink store bought spring water and rotate brands even though they may be polluted too. Summary: We saw no more of her after this last happy visit, when she heard the cancer was gone. I had tested her husband for intestinal fluke earlier, and he was rid of it, too, by the last visit. There were no lumps anywhere, she was free of pain, and she had enough energy to bring up the idea of going back to Taiwan. Summary: The cancer news must have surprised her since she came in only for fibrocystic disease. One month later (4 months after the first visit) She still has pain over the gallbladder region. Lung cancer was diagnosed several months ago, and they first operated on the right lung, removing the top lobe. He had 34 radiation treatments and 5 chemotherapy treatments (originally scheduled to have 6). He is getting freshly made carrot juice with celery, ginger root and other vegetables, and I apple and sometimes beet or cabbage. For sweetening use: glycerin (pure vegetable); Stevia powder; honey (3 kinds), pure maple syrup, molasses, sorghum. He will have 4 cans of sardines per week, seafood and salmon for two days, and one vegetarian day per week. B6 [500 mg] from Bronson Also needs B-50 complex, 2/day; vitamin C (1000-3000 mg/day); vitamin E (100 mg/day, all before meals); beta carotene (25,000 mg, 2/day). For breakfast he should eat cooked cereal (buy salt-free variety and add own salt - aluminum-free salt) with cream and sweeteners. Pathogen test showed Clos- tridium botulinum in lungs and in 2 teeth (teeth #10 and #28). One month later (3 months and 2 weeks since first visit) Teeth numbers 10 and 28 were extracted. Summary: This was an exemplary couple; they wasted no time in carrying out every instruction. We heard from them recently; they wanted to tell all their friends and especially their clinical doctor about this treatment program. He also has a respiratory problem, pain in the upper arm, aching hands, and lower back pain. After his pains were gone and his clinical doctor said he was free of skin cancer, he lost interest in improving his health. Hopefully, his wife is keeping a watch over his shampoo and shaving products to avoid propanol. Edward is one of the rare cases where the fluke adult is already present in the liver, and yet there is no cancer marker, ortho-phospho-tyrosine, being produced. Loreen Pennell Lymphoma This 60 year old woman reported 3 main problems: 1) She had cancer (lymphoma) 3½ years ago. We can see that the cancer was not gone as she had hoped after her clinical therapy. The solvent test was not recorded, but I generally discuss propanol at the first visit. Hopefully, she has removed all propanol-containing body products from her life-style and has taken the parasite program. His clinical doctor said that within 3 months they would need to remove a testicle. I cut short his testing since he was in the office under pressure of his family, not willingly.

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