The fate of Repetition Review Essay Example

The fate of Repetition Review Paper Essay on The fate of Repetition The genius of the writer and his works of art are not determined only by subjective criteria like ponra not ponra . Genius it is always a fact of social life it is worth to be considered. Therefore, in presenting the personal considerations of this kind would be needed some deployed arguments and precisely level, and I am delighted, but time will tell, and he would you finger in your mouth not put, but this Pushkin genius. Were (dissertation Chernyshevsky), and I have met, for example, it is quite clear criteria of aesthetic perception of applying for a work of genius (and not only art, can even name the author, but I will not not yet published). It is here that: 1) breadth of coverage selected issues; 2) penetration depth of a subject; 3) Detailed images and mastery of all the details. As is known, the presence of any but a systematic look at the problem, and in this case, the problem of genius, will always be better than a complete lack of consistency and any criteria. Other wise, everything will be exactly on psevdoharmsu: Gogol goes and thinks that Pushkin a genius, but after all, Tolstoy the genius of Dostoevsky, Fyodor Mikhailovich, God rest his soul also a genius and when did it end! It seems thats not true, right? In short, Catherine rights we need clear evidence of genius, and not to get a terrible thing someone raspiarili abruptly and unleash one and you will be a genius-us, though naked. And without the use of the criteria of the whole process will soar prestigious consumer-cash payment and inspiration clamped his mouth presented by fractional collection of well we do or not ponra ponra . The fate of Repetition Review Essay Example The fate of Repetition Review Paper Essay on The fate of Repetition Actually, his Loneliness in the network I liked it. That is made quite a strong emotional impact, I do not know, maybe because I rarely book about love in general reading. This book is concocted from the same ingredients, but alas. Heroes vainly trying to overcome the effects of past trauma and tragedy, someone threw, someone died loved one and move on. Again highlights the theme of the network zadrotstva dating chat, correspondence, and of how it says Marina, you are communicating over the network for months and consider it a relationship. All this is punctuated by a lot of unnecessary information and about the structure of cells, and about some peptides, and about the search for a cure for AIDS, and even a biography of Mozart here intertwined. Moreover, one has only to be carried away by the history of the protagonist, as the story takes us to one side and begins grinding the relationship with his brothers wife, thinking about what people feel, being 11 September in the two WTC towers collapsing. History breaks down into some vague pieces, the impression that the author set out to evoke in the reader as much pity and sympathy in any way. We will write a custom essay sample on The fate of Repetition Review specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on The fate of Repetition Review specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on The fate of Repetition Review specifically for you FOR ONLY $16.38 $13.9/page Hire Writer The main character here in fact the real schizo, it still youth rejected the girl, with whom he even really nothing had happened, then his years tormented panic attacks, and then he was still a decade caring for her sick mother in a wheelchair. In short, at the time the story was ready muzhig nabrositso just any woman. In principle, he was from whom to choose, but because he was schizo, you chose a mysterious stranger from a conversation about horses, yes. Neither good nor bad rolled their virtual romancheg, chuvachok booze at the computer chatyas with his virtual lover of all these passing dramatic stories have already become nauseated and I prepared a book zasrat to complete, but no The idea of ​​the author revealed to me only on the last page and I still dragged! The main character realized that he was ready to change his life, immediately took the day off on the job, shaved, bought a new shirt and went to another city to find an Internet cafe and most fall at the feet of his sweetheart network. She always appeared in chat 8, and here at the appointed hour, he saw two young men were trafficked into the hall a very beautiful woman in a wheelchair. Of course, he escaped from there with all haste, stopped the car only 5 km from the city, and then he started again, this attack of panic, from which it seems to be long ago got rid of. The end. For some reason I was glad to let out a happy cry, and shut the book. Somehow even the mood immediately lifted. I wonder if the author of my hysterics and tears into three streams after such neschaslivogo end of this rotten stories counted?

The Oxygen Revolution - History of Life on Earth

The Oxygen Revolution - History of Life on Earth The atmosphere on early Earth was very different than what we have today. It is thought that the first atmosphere of the Earth was made up of hydrogen and helium, much like the gaseous planets and the Sun. After millions of years of volcanic eruptions and other internal Earth processes, the second atmosphere emerged. This atmosphere was full of greenhouse gases like carbon dioxide, sulfur dioxide, and also contained other types of vapors and gases like water vapor and, to a lesser extent, ammonia and methane. Oxygen-Free This combination of gases was very inhospitable to most forms of life. While there are many theories, such as the Primordial Soup Theory, Hydrothermal Vent Theory, and the Panspermia Theory of how life began on Earth, it is certain that the first organisms to inhabit the Earth did not need oxygen, as there was no free oxygen in the atmosphere. Most scientists agree that the building blocks of life would not have been able to form if there had been oxygen in the atmosphere at that time. Carbon Dioxide However, plants and other autotrophic organisms would thrive in an atmosphere filled with carbon dioxide. Carbon dioxide is one of the main reactants necessary for photosynthesis to occur. With carbon dioxide and water, an autotroph can produce a carbohydrate for energy and oxygen as waste. After many plants evolved on Earth, there was an abundance of oxygen floating freely in the atmosphere. It is hypothesized that no living thing on Earth at that time had a use for oxygen. In fact, the abundance of oxygen was toxic to some autotrophs and they became extinct. Ultraviolet Even though oxygen gas couldnt be used directly by living things, oxygen wasnt all bad for these organisms living during that time. Oxygen gas floated to the top of the atmosphere where it was exposed to ultraviolet rays of the sun. Those UV rays split the diatomic oxygen molecules and helped to create ozone, which is made up of three oxygen atoms covalently bonded to one another. The ozone layer helped block some of the UV rays from reaching Earth. This made it safer for life to colonize on land without being susceptible to those damaging rays. Before the ozone layer formed, life had to stay in the oceans where it was protected from the harsh heat and radiation. First Consumers With a protective layer of ozone to cover them and plenty of oxygen gas to breathe, heterotrophs were able to evolve. The first consumers to appear were simple herbivores that could eat the plants that survived the oxygen laden atmosphere. Since oxygen was so plentiful in these early stages of colonization of land, many of the ancestors of the species we know today grew to enormous sizes. There is evidence that some types of insects grew to be the size of some of the larger types of birds. More heterotrophs could then evolve as there were more food sources. These heterotrophs happened to release carbon dioxide as a waste product of their cellular respiration. The give and take of the autotrophs and heterotrophs were able to keep levels of oxygen and carbon dioxide in the atmosphere steady. This give and take continues today.

Does the SAT Predict Your College Success and Income

Does the SAT Predict Your College Success and Income SAT / ACT Prep Online Guides and Tips You know it’s important for you to do well on the SATs because better scores will get you into a better college - top colleges want high SAT scores because they are supposed to indicate insight that a particular student is academically strong. Ultimately, a better college education is supposed to help you be more successful in your career. But do your SAT scores really speak to how competent or prepared you are as a potential student? And does a great college really increase your chances of professional success? These are tough, but important, questions - I’ll address them all here. First, I’ll talk about what the research says about the relationships between SAT scores, college success, and income. Then, I’ll present some explanations for why these factors are (or are not) related - it might not be for the reasons you think. So what’s the real relationship between your SAT scores, college success, and income? Why do these questions even matter? Read on to find out! What Are the Relationships Between SAT Scores, College Success, and Income? In these next sections, I'll talk about the correlations between SAT scores, college success, and future income. If there's a correlation between two factors or variables, that means there's a relationship between them - a positive correlation means that if one variable increases, the other variable will also increase.Causation is something a little different: if there's a causal relationship between two factors, it means one has a direct effect on the other. Just because there's a correlation between two factors doesn't mean there's a causal relationship. Still, though, the correlational relationships I'll discuss are important because they give us clues about how important some predictive factors are - for example, can high SAT scores predict future income? You're about to find out. SAT and College Success If you have high SAT scores, are you likely to get better grades in college? Perhaps unsurprisingly, most research studies find that your SAT scores do predict college success - to an extent. The relationship isn't particularly strong, which means that if you have high SAT scores, you're only slightly more likely to have higher college grades than a student who had lower scores. Research shows a similar relationship between SAT scores and high school grades. Given this relationship, it makes sense that colleges use the SAT as part of their admissions criteria.Schools tend to prefer students with higher SAT scores because they think that, in some small part, these scores could predict how well these students do in school. If schools accept students with higher scores and then these students are successful in college (and beyond), the schools will begin building a positive reputation. Ultimately, higher SAT scores might predict college success, but they'll more likely make you a more competitive college applicant. Keep in mind, though, that highand low scores are totally relative(read more about good and bad SAT scores). SAT and Income If you have high SAT scores, are you likely to earn more money after you graduate from college?There does seem to be a positive relationship between SAT performance and future income - that is, the better a student scores on her SAT, the more likely she is to earn more money later in life. One study found that high scorers not only went on to earn higher incomes, but they were also more likely to earn PhDs, file patents, and get tenure as a professor at a top university. Again, though, this relationship doesn't seem particularly strong. There are many other factors that better predict future income; not all Bachelor degrees pay the same. College Success and Income If you're more successful in college, are you likely to earn more later in life?To answer this question, I'm going to break "college success" down into two different parts: success as attending a top school, and success as earning a high GPA. Top Schools and Income If you end up at a top college, are you likely to earn more money than other college graduates? Students who attend top colleges tend to do pretty well. Top colleges are well-rated in the first place because they have good reputations, high graduation rates, strong undergraduate programs, and strong alumni networks. It would make sense that these factors would be related to greater income post-graduation. And that's exactly what the research shows: graduates of science/math-heavy schools and Ivy League schools tend to earn more than graduates of other colleges. Again, though, these are correlative relationships - you don't necessarily need to graduate from a top college in order to earn a lot of money.Simply getting a college degree is likely to significantly increase your future earnings. GPA and Income If you get better grades in college, are you likely to earn more money than students with lower GPAs? In general, students who do well in college tend to earn more after they graduate. This might depend on your field.Research has found that the difference in income between low-GPA and high-GPA graduates can amount to tens of thousands of dollars in certain careers. You might imagine that if many recent grads are competing for the same awesome job, GPA could end up a very important factor in hiring decisions. So yes, depending on your career path, higher grades are correlated with higher income. How Do All of These Factors Fit Together? It looks like SAT scores, college success, and income are all positively correlated. We can infer that higher SAT scores tendto predict greater college success, and greater college success tends to predict higher incomes later on. These relationships seem to generally fit what we expect.It's important to keep in mind, though, that these are relationships, not rules -just because someone has a perfect SAT score, for example, doesn’t mean that she will end up a millionaire. The real question is WHY these factors are related. Why do we expect high SAT scores→ better college → higher income? I’ll address the possible explanations in the next section. What's the Reason for the Relationships Between SAT Scores, College Success, and Income? What do you think leads to successful outcomes? There’s no empirically supported response to this question. Just because we can observe a relationship (correlation) doesn’t mean we can determine what’s driving it (causation). In this section, though, I’ll present some of the most plausible explanations for the reason behind these relationships. 1. A Better SAT Score Means You'll Get Into a Better College, and Attending a Better College Means More Opportunities for a Higher Income. This explanation is perhaps the most straightforward.Top colleges consider students more competitive if they have higher SAT scores - we know this to be true (although standardized test scores aren’t the only things that admissions officers consider). The better the school you attend, the more career opportunities are available to you. Here's an example to explain what I mean.Let's say we have two very similar students who attend high school together: same GPA, same list of extracurriculars, same AP courses. Student A studies for two months for the SAT and scores a 1500, whereas student B studies for one week and scores a 20.Although both display the same degree of talent and intellectual ability, Student A gets into an Ivy League college and student B doesn't. Student A has access to more career fairs and recruiters, and can utilize a stronger alumni network before getting her first job, ultimately making more money than Student B. She isn't smarter or more ambitious than her peer - she just has more doors open to her. With student talent (and even the fundamental quality of education) being equal between two people, the opportunities that come with a top college make it easier to earn a higher income after graduation. 2. If You're Naturally Smart, You'll Have High SAT Scores and Probably High Grades. This Means You'll Get Into a Better College and Have More Opportunitiesto Earn a Higher Income. This baby was born smart and happened to score a perfect 1600. This is the College Board's general position on the SAT exam: it's designed to be a totally fair exam that tests aptitude and critical thinking, not general knowledge or even test-taking strategy. Thus, smarter students should earn higher scores without too much practice or prep. Intelligent students will go on to have success in other areas (college applications, job searches) because they're naturally skilled. Some smart people are naturally good test-takers who can earn fantastic scores without much effort. But there are many smart students who don’t necessarily do well on the SAT at first. High school students who don't have much information on the exam, or don't have a strong foundation in core SAT content areas, are at a particular disadvantage (even if they're smart). Test-taking anxiety or unfamiliarity with the exam can significantly bring down the scores intelligent students. Ultimately, while natural smarts might lead to higher scores, many other factors (unrelated to intelligence) can bring them down. 3. If You Come From a Privileged Background, You've Had More Opportunities (Like a Better High School Education), Leading to a Higher SAT Score and Greater Chances for Future Success. Having resources available to you through childhood into adulthood definitely doesn’t make things harder. Students may be fortunate enough to hire a private SAT tutor, for example. Perhaps parents help ensure future success through their own professional connections.Many critics of the SAT endorse this explanation - they feel that for this reason, the SAT puts students from underprivileged backgrounds at a disadvantage, which isn’t fair. Research tends to support this explanation: one study, sardonically naming the SAT the "Student Affluence Test," showed that students from wealthy families tend to out-score students from low-income families by about 400 points. That's a huge margin, one that can make an enormous impact on the sorts of colleges that are within students' reach.While you don't need to come from a wealthy family to do well on the SAT, attend a top college, and earn a high income, it seems that low-income students are fighting an uphill battle. So Which Explanation Is the Right One? What's the right recipe for success on the SAT, in college, and even in your career? Like I mentioned at earlier points in this points, it's really difficult to establish causality when discussing the effects of different factors on future success. It's likely that the "right" explanation is some combination of the ones listed above. High SAT scores + natural smarts + privileged background might be the easiest recipe for future success, but it isn't the only one. There are some factors you won't have any control over - like your family background, or natural test-taking aptitude - but there are things you can do to bring up your SAT scores. And like I mentioned in Explanation #1, SAT scores seem to have the clearest connection to college success and income. I'll address strategies for maxing out your chances for future success in the next section. How Do You Set Yourself Up for Future Success If You're at a Disadvantage? Even an uphill climb can be made easier with the right tools. If you don’t consider yourself a natural test-taker, or if you don’t come from a privileged background, you might be nervous about the SAT. You know it determines (to some extent) what sort of college you can get into, and it tends to predict income. So what can you do if you want to give yourself the best chance possible at being successful? Self Study Work out of a book on your own, take practice tests, and review your wrong answers to improve your scores over a set timeline. The College Board Blue Book is a great place to start if you plan on studying on your own.PrepScholar's blog is also a great free resource for comprehensive, up-to-date content on studying for the SAT. However, this self-study strategy might not be the best option for students who tend to procrastinate or who lack motivation. Take an SAT Class SAT classes are great for an intro to the test, especially if you want to focus on learning strategy. These classes can help you get motivated, but they're not customized to your particular strengths and weaknesses. Get a Private Tutor A private, one-on-one tutor can be a great resource because you get a totally customized experience. It’s also very costly, and it can be difficult to find an experienced and proven instructor. Wyzant is a good place to start looking for tutors in your area - you can see how tutees have rated them in the past. Use PrepScholar's SAT Prep PrepScholar's program isaffordable, customized, and effective. Get more info on the SAT prep program. What's Next? Ready todo your future self a favor? You can start right now by checking out our guides to the SAT. The right sidebar includes links to some of our most popular guides and a list of topics to explore further. Beginners should start here by learning about good and bad SAT scores, and what scores they should be aiming for. Already an SAT expert? Maybe you'd be interested in Ivy League SAT scores, or a guide to getting the perfect score. Disappointed with your scores? Want to improve your SAT score by 160 points?We've written a guide about the top 5 strategies you must be using to have a shot at improving your score. Download it for free now: Have friends who also need help with test prep? Share this article! Tweet Francesca Fulciniti About the Author Francesca graduated magna cum laude from Harvard and scored in the 99th percentile on the SATs. She's worked with many students on SAT prep and college counseling, and loves helping students capitalize on their strengths. Get Free Guides to Boost Your SAT/ACT Get FREE EXCLUSIVE insider tips on how to ACE THE SAT/ACT. 100% Privacy. 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Emotional Abuse in Children Annotated Bibliography

Emotional Abuse in Children - Annotated Bibliography Example He looks at the various psychological impacts the abuse can lead to in children and also some of the measures that can be put up to minimize the damage that is inflicted on children who have been victims. In addition, he states some of the ways that can be used to detect the abuse early enough so that intervention can be made to limit the permanent damage that the abuse may inflict in the children and caregivers. He states that before any action is taken, there needs to be effective confirmation of emotional abuse of the child. This will be done by a close observation of the interaction between the child and the abuser. This will be done on repeated occasions, and if abuse is suspected, action will have to be taken regardless of whether the action is committed at home, school or community setting. The caregiver will have to investigate any reports that arise of any sort of abuse as these will easily contribute to child abuse. After investigation has been conducted by Children Protection Agency, the team will provide professional opinion from say a doctor, physician or psychologist. Furthermore, other stakeholders in the legal aspect will have to be involved to ensure that all the proper actions are taken including rehabilitating the child to ensure they recover from the negative actions that they may have suffered (O’Hagan, 1993). Tomison is a renown Author and Human Rights Activist who has specialized in areas such as Child abuse and Violence prevention, relationships between different forms of violence, Indigenous child protection and child welfare as well as Child protection policy and systems development. He has worked for the Australian Centre for Criminology at different capacities over the years. Dr Joe Tucci on the other hand is a trained Sociologist and Psychologist who possesses significant experience in dealing with issues to do with children. He is also a renowned author and currently the C.E.O of the Australian

Planning and Goal Setting Essay Example | Topics and Well Written Essays - 750 words

Planning and Goal Setting - Essay Example For instance, he may ask that interviews be carried out around campus in a bid to gather certain information. For instance if the principal has heard of several complaints on numerous occasions, in order to have an idea of how many people are discontented, he may ask for data concerning this to be collected so as to enable him to act if need be. This is done mostly while analyzing data collected, mostly through questionnaires. If there was a certain question concerning this, then the campus leader will look at the responses and this will help in determining personnel needs. This article seeks to focus on a fundamental issue- the shortage of teachers and how to get more young people interested in the profession. Although this issue has been raised over a number of years, proper plans have not been put in place. This article outlines plans that have been proposed and implemented over years. For instance; CAPE. Identify the principal competencies and supporting standards involved or implicated in the reading, (e.g., Competency 5 and Competency 6, , including the following standard: Analyze the implications of various factors (e.g., staffing patterns, class scheduling formats, school organizational structures, student discipline practices) for teaching and learning, (Competency 5); Implement effective, appropriate, and legal strategies for the recruitment, screening, selection, assignment, induction, development, evaluation, promotion, discipline and dismissal of campus staff, (Competency 6). Implement old plans instead of making new plans. There are already plans on how to deal with the shortage of teachers; however these plans are usually scrapped for new ones without full implementation. Planning without implementation is an act in futility. The acute shortage of teachers is caused by the modern view of a teacher. A job deemed to be almost ‘menial’.

Critical Appraisal Role Of Physiotherapy Health And Social Care Essay

Critical Appraisal Role Of Physiotherapy Health And Social Care Essay The aim of this assignment is to critically appraise the scientific research paper The role of physiotherapy in the treatement of subacromial impingement syndrome by Dickens, Williams Bhamra (2005) while detailing the objectives of the paper, research methods used and the outcomes of the research findings. What is the scientific paper is about? The aims of the research paper according to Dickens Williams Bhamara (2005:1) was to investiagte the effectiveness of a physiotherapy programme in patients with subacromial impingement syndrome. This paper did not outline specific modalities and was reliant on convincing the reader that physiotherapy should be viewed as a first line management for subacromial impingement syndrome against the present orthepedic view which would swing towards operative intervention as the corrective action. The paper was published by Elsevier for the Chartered Society of Physiotherapy by a combined group of physiotherapists and Orthepedic surgeons and was funded by the Physiotherapy Research Foundation. When combined these groups may lead the paper to be viewed as self servicing and lead the reader to pinpoint a lack of impartiality. Patients for the research where taken from a waiting list for surgery for subacromial impingement syndrome. Each of these patients was independently reviewed by surgeon James L Williams, a coauthor of the paper, and had underwent three steroid injections into the subacromial space, given at 6-weekly intervals as part of an exisiting protocol (Dickens et al, 2005:160). The study was conducted in a randomised fashion in that the eighty five clients were selected by giving a client on a surgical waiting list an envelope that had within it either control or physiotherapy, 45 joined the physiotherapy group while 40 joined the control group. There were 100 envelopes split 50:50 between the groups which leads the reader to believe this may have been quasi-randomised. In order to assess physiotherapy without bias clients who had previous physiotherpay treatement were excluded from the study according to Dickens et al. Also clients with signs of cervical radiculopathy, adhesive capsulitis or clinically obvious rotator cuff tears or a grade III subacromial spur on their shoulder suprasinatus outlet radiograph (Dickens et al, 2005:160). The randomised fashion was administered by human administrators and not via a computerised system. A control group was used and this group had no alternative but to continue on towards surgical intervention, this created a bias for this group since the probability for having surgical intervention was P-1. Intitially the group of patients numbered eighty five patients from an initial set of 100 envelopes. 9 of the initial 40 patients in the control group refused to attend the repeat assessmemt at the end of the program, 3 of the physiotherapy group dropped out for social reasons leaving 42 partcipating in there group. Due to the substantial number of dropouts weight must be given to the emergence of unfairness to any comparsion portrayed in the paper. Follow up occurred after a 6 month period and performed by James L Williams, a coauthor of the paper, and may not have been blind since he could have easily discussed whether they felt they still needed surgery (Dickens et al, 2005:161). How the study was designed? The aims of the research paper according to Dickens Williams Bhamara (2005:1) was to investigate the effectiveness of a physiotherapy programme in patients with subacromial impingement syndrome. According to the Webster dictionary the word effectiveness means to produce a desired effect, the desired effect is not established in the aim. This ambiguity around the aim of the paper leaves any conclusion open to interpretation by the reader. When the paper is read in its entirety you could potentially interpret the aim as conveying the message that physiotherapy should be first line management for subacromial impingement therefore moving interventive surgery to second line. There is no published pilot data therefore we cannot correctly establish if the sample size for the scientific paper is justified. We do know that the randomisation process catered for 100 patients, 100 envelopes, of which only 85 were taken up, 72 patients successfully making it to the reassessement stage. The age ranges within the groups have relevance to the outcome of the scientific research. We only have a mean age of each group without an reference to outliers who could affect the statistical data. It is clear that the more junior males respond better under all conditions. This contradicts the statement the two groups were well matched for age, sex and initial constant score (Dickens et al, 2005:161). The probability values (p-values) have been averaged (p This lack of depth in the data provided does not allow the reader to establish if a null hypothesis was proved and may lead them to believe this was pure coincidence. Scientific research should always start from the null hypothesis point of view to ensure impartiality. The selection process for patients, waiting list for surgery, post steroid injection, exclusion of specific pathologies, clinical history and examination meant the group may have been skewed to fulfill the authors aims. Steriod injections can provide an improvement in subacromial impingement due to its anti-inflammatory effect. The selection process did not seem to take into account the duration nor the severity of the impingement syndrome on the individual nor if they were receiving treatment from other practitioners not listed. There is no detailed information regarding the treatment programme dispensed to the physiotherapy patients. If a specific treatment programme had been documented and applied to all patients in this group more quantative data and allowed the research to be replicated and potentially validated by other authors. This would have also allowed the treatments to be cross referenced with socio demographic data from each patient and establish sub sets within the master data. We are unsure how the null findings are interpreted since the authors do not detail this. Nor have they given any data around the chi-squared test. Probability values are give in a round format (p The constant score has a low systematic error but is not reliable for clinical follow up in patients.The constant scores taken at the start of the research were based on 85 patients not on the same 72 patients whom allowed themselves to be reassessed at the end of the programme. This lead to a lack of confidence in the method used by the authors to compare pre and post programme data, they may not have itemised which data belonged to each patient and therefore could not remove this anomoly. The involvement of James L Williams in the reassessment process ensured a lack of blinding and a bias, though the authors clearly did not see this position the follow up assessments were performed by JLW in a blinded situation (Dickens et al, 2005:162). All assessments should have been performed by a validated third party reusing the initial assessment criteria. Since we have no detailed information about the modalities utilised, treatment cycles matched with socio demographic information there is no clinical relevance to the outcomes. To have clinical relevance the process needs to be reproducable which is highly unlikely based on the information presented in the scientific paper. How was the study conducted? A quasi-randomised human administer method of 100 envelopes split evenly between the control and physiotherapy groups were handed out to 85 patients. All 85patients were told that participation on the programme would not affect there standing on a waiting list for surgery. This promise may have affected participation since they would have already been convinced of the necessity for surgery by an orthepedic surgeon. The dropping out of patients in both groups weakened the statistical data which the paper relies upon and imbalanced any findings. Interpreting clinical programmes requires greater participants reducing any potential for the play of chance. How was the study analysed and were there limitation and errors in the study? Each treatment group should have been similar based on age, sex, duration of syndrome, decrease in range of movement and similar capacities to perform the home care plan. Based on the information conveyed in the paper we must assume none of these points were established and therefore does not allowed for each group to have a comparable baseline. The quasi-randomised allocation of each patient to a group ensured that the treatment groups were not comparable. Since all participants stayed within their allocated groups we can establish that the intention was for the results to be analysed by intention to treat. Unfortunately there were patient withdrawals from the programme which would allow to construe that the comparision of treatments would no longer be fair. Also the treatment received within the physiotherapy group as a whole may have differed from individual to individual but no patient moved between groups. Not enough importance was placed on statistical information like the control group having members who improved, yet were not involved in the physiotherapy programme. Also confounding may have occured due to the pre programme steroid injection. Steroid injections are interrelated to anti inflammatory improvements in a range of impingement syndromes. The report had no reference to any confidence intervals which would have ensured the removal of the chance effect and imporved the significance of any statistics. The lack of statistical data in table format and the reliance on prose within the paper show the paper to be more a marketing document than a reliable source of data. Quantative data tables would have allowed the reader to view and validate the authors outcomes. This lack of independence in data lead the reader to wonder does the data actually support the outcome. The approach of only conveying results taken by the authors, could create suspicion in the mind of the reader, undermines the credibility of the paper. Side effects are an important factor in all scientific research papers. What if the side effect of the treatment modalities outwayed the alternative approach taken by the control group. Effectiveness of treatment and a lesser set of side effects would need to be established against the control group to ensure there is no bias. Since there is no mention of side effects for either groups we can only assume that the authors wished to purposefully withhold this information. This factor only would ensure that it clinical relevant is negated. How would you interpret the study and what if any are the implications of the study for your practice? The main finding confirms that a physiotherapy programme is of benefit (Dickens et al, 2005:163) does not confirm the objective of the scientific paper. All the paper conveys is that there are successful alternatives to surgery for a subset of the population. There are too many pervasive factors to rely on the statistical significance of the data put forward by the authors. No true finding can be extracted from the paper and it portrays a message set by the authors who went out to prove it. Therefore I cannot see any attempt by the authors to perform a null hypothesis test which should have been their approach. The only assumption to an attempt at a null hypothesis is the assumption that at the outset of the programme no difference existed between all patients in each group. Other alternatives could account for the 11 physiotherapy group patients improving, steriod injection, age, change in lifestyle etc. This overlooking of the steroid injection pre programme participation has a major impact on the validity of the results. The severity and duration of the syndrome on the patient could potentially have an impact of any positive results. The research funder being a physiotherapy organisation has may have had an effect on the interpretation of data. The length of gap between the post surgery and final step in the physiotherapy programme and final assessment may have had an effect on the results. Rehabilitation programmes may not have been adhered to during this period. Why not take periodical assessements every fortnight over the final 6 month period? We also do not know how the drop outs from the programme affect the data use to support the outcome. We can only assume if this data was removed the outcome may have not supported the objective and therefore shown the physiotherapy is not or no more effective than surgery. Alarmingly this scientific research paper references 26 papers published prior to 2000, the oldest being from 1973, while only 5 papers are based between 200 and the time of release of the paper. This points to either a lack of interest in the particular field or a selective extraction of papers to support the authors objective. Normally supporting information referencing in other reports should be relatively up to date and from journals of quality. Ideally a research paper should look to changing your clinical practice. This paper does not provide me with any rational to change nor if it had a credible case would I understand what I should be changing. Since I cannot replicate the treatment modalities used within the study I cannot change practise nor would I recommend another practioner to perform the same.

Medicine and Law Essay

On February 11, 2003, the Eighth Circuit Court of Appeals ruled that the State of Arkansas could force death row prisoner Charles Laverne Singleton to take antipsychotic drugs to make him sane enough to execute. Singleton was to be executed for felony capital murder but became insane while in prison. â€Å"Medicine is supposed to heal people, not prepare them for execution; a law that asks doctors to make people well so that the government can kill them is an absurd law,† said David Kaczynski, the executive director of New Yorkers Against the Death Penalty. There are many arguments in this passage. The first argument is this passage is â€Å"medicine is supposed to heal people, not prepare them for execution†. The premise is â€Å"medicine is supposed to heal people, not prepare them for execution† and the conclusion is â€Å"medicine shouldn’t kill people†. The second argument in this passage is â€Å"a law that asks doctors to make people well so that the government can kill them in an absurd law†. The premise is â€Å"a law that asks doctors to make people well to kill them† and the conclusion is â€Å"the law is absurd†. This passage depicts many issues occurring in America today. Although, the prisoner Charles Laverne Singleton was convicted to the death penalty, using doctors and medicine to execute him is wrong. Medicine was created to heal people from disease and prevent illness. Doctors became physicians to support people, save lives, and educate individuals to increase their quality of life. When doctors graduated from medical school they took an oath to help save lives. Participating in an execution goes against the laws medical ethics and everything a physician stands for. Arguments for this passageway may include the amount of money it takes to keep the prisoner in jail, lethal injection is a less violent way of execution, and a doctor is the most qualified person to give a lethal injection. A lthough, keeping convicts in jail costs a lot of tax payers’ dollars, there are other ways to execute the individuals on death row. The lethal injection might be less violent however; it doesn’t make it the ideal method to kill. Doctors are the most qualified to give a lethal injection yet there are not the most qualified to murder. The decision also puts prison doctors in a position that challenges ethics. Doctors have to ask themselves: Is it better to provide care for death row inmates patients, because everyone deserves competent care and protection from unnecessary suffering? Does it degrade the healing  profession to use one’s medical skills to prepare a person for execution? The government wants to kill the individuals on death row but they don’t want to do it themselves. Asking a doctor to dirty their hands results in the government keeping their hands clean. More research has to be done to find new methods to execute these death row convicts. M edicine and doctors should not be the means to kill anyone. The Code of Ethics states that a physician should never be â€Å"compelled to participate in the process of establishing a prisoner’s competence or be involved with treatment of an incompetent, condemned prisoner if such activity is contrary to the physician’s personal beliefs† [9]. On February 11, 2003, the Eighth Circuit Court of Appeals ruled that the State of Arkansas could force death row prisoner Charles Laverne Singleton to take antipsychotic drugs to make him sane enough to execute. Singleton was to be executed for felony capital murder but became insane while in prison. â€Å"Medicine is supposed to heal people, not prepare them for execution; a law that asks doctors to make people well so that the government can kill them is an absurd law,† said David Kaczynski, the executive director of New Yorkers Against the Death Penalty. There are many arguments in this passage. The first argument is this passage is â€Å"medicine is supposed to heal people, not prepare them for execution†. The premise is â€Å"medicine is supposed to heal people, not prepare them for execution† and the conclusion is â€Å"medicine shouldn’t kill people†. The second argument in this passage is â€Å"a law that asks doctors to make people well so that the government can kill them in an absurd law†. The premise is â€Å"a law that asks doctors to make people well to kill them† and the conclusion is â€Å"the law is absurd†. This passage depicts many issues occurring in America today. Although, the prisoner Charles Laverne Singleton was convicted to the death penalty, using doctors and medicine to execute him is wrong. Medicine was created to heal people from disease and prevent illness. Doctors became physicians to support people, save lives, and educate individuals to increase their quality of life. When doctors graduated from medical school they took an oath to help save lives. Participating in an execution goes against the laws medical ethics and everything a physician stands for. Arguments for this passageway may include  the amount of money it takes to keep the prisoner in jail, lethal injection is a less violent way of execution, and a doctor is the most qualified person to give a lethal injection . Although, keeping convicts in jail costs a lot of tax payers’ dollars, there are other ways to execute the individuals on death row. The lethal injection might be less violent however; it doesn’t make it the ideal method to kill. Doctors are the most qualified to give a lethal injection yet there are not the most qualified to murder. The decision also puts prison doctors in a position that challenges ethics. Doctors have to ask themselves: Is it better to provide care for death row inmates patients, because everyone deserves competent care and protection from unnecessary suffering? Does it degrade the healing profession to use one’s medical skills to prepare a person for execution? The government wants to kill the individuals on death row but they don’t want to do it themselves. Asking a doctor to dirty their hands results in the government keeping their hands clean. More research has to be done to find new methods to execute these death row convicts. M edicine and doctors should not be the means to kill anyone. The Code of Ethics states that a physician should never be â€Å"compelled to participate in the process of establishing a prisoner’s competence or be involved with treatment of an incompetent, condemned prisoner if such activity is contrary to the physician’s personal beliefs† [9].