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The informal group situaton and open-ended nature of the questons are intended to encourage partcipants to comment on behaviour and elaborate on opinions to an extent that is more difcult in more formal individual interview situatons buy 0.25mg digoxin mastercard. He/she should not show support or objectons to any opinion discussed digoxin 0.25 mg line, either verbally or non- verbally. Note-taker: a competent individual who records the discussion verbatm (in the words of the respondents). Audio-recording device: consent has to be taken from partcipants before this can be used. Moderator introduces subsequent topics as the discussion progresses, making sure each topic has been adequately explored. Additonal questons may arise that need to be asked when exploring an area to obtain in-depth informaton. Moderator summarises the topics that have been discussed, closes the session and thanks partcipants. In order to avoid confusion in the use of terms, the following table points out the distncton between techniques and tools applied in data collecton. Interview/self-administered Interview schedule/checklist; questonnaires, questonnaire audio-recording device 2. Observaton eyes, pen/paper, watch, scales, microscope, checklist, video camera etc 4. Pilot: the process of carrying out a preliminary study, or a component of the study, going through the entre procedure with a small sample. What are the limitatons, weaknesses, tme and resource requirements of the technique? Preferably limit the number of data collectors so as to reduce error in data collecton. Train immediately prior to data collecton to avoid memory lapse and loss of data collectors from the research project. This promotes team work; diferent people raise diferent issues and they can learn from each other; it standardises training for all. Duraton of training depends on the size/number of the tools and be sufcient to allow for role play and feld experience. Make sure that the data collectors and supervisors all have a clear understanding of the study and methods. Supervisors need additonal training supervision of data collectors, quality control and project management. This can be done by directon observaton or by repeat observaton/interview of same respondent and comparing with earlier data collected. Decide the sofware you want to use for data entry and for data analysis (see Pros & Cons of Database Packages). Dummy tables are blank tables that clearly show what data will be collected and how comparisons will be made. Dummy tables help to: • ensure that the data you collect will answer the queston you pose. Progress of data collecton – Both the sample required and the coverage (response rate). Tips on who to carry out the study In identfying who to collect data, make sure they are culturally and socially appropriate to respondents. Tips on when to carry out the study Take into account environmental and socio-cultural aspects when you choose the tme to implement the data collecton. Meetngs & travel – planning, implementaton (including supervision), report writng and disseminaton. However, some projects will need applicaton for funds, especially if it requires equipment and research assistants. Aside from the usual pharmacological treatment, psychoeducation has shown great promise in the management of schizophrenia. The clear aim of the treatment of such disorders is not only to control the symptoms, but it is also to prevent new symptomatic acute phases, to bring the patient to comply with the prescribed treatment plan, to restore a certain social and working functioning and to reach a better quality of life. Psychoeducational approaches have been developed to increase patients’ and their carers’ knowledge of, and insight into, their illness and treatment. A review of more than 30 randomized clinical trials have shown that family psychoeducation reduces the rate of relapses, encourages recovery of patients as well as improves family dynamics among participant (McFarlane W. Another recent study also showed signifcant reduction in patient rehospitalization rates and improved compliance over a period of 2 years after patients and their families attended a psychoeducational program consisting 8 sessions (Pitschel- WalZ G et al, Mar 2006). Participants in the psychoeducation group families’ and patients’ functioning, families’ burden of care and the number and length of patients’ rehospitalization over the 12-month follow-up period, compared with the standard care group. Family psychoeducation is a method of working in partnership with families to impart current information about the illness and to help them develop coping skills for handling problems posed by mental illness in one member of the family. The goal is that practitioner, consumer, and family work together to support recovery. It respects and incorporates their individual, family, and cultural realities and perspectives.

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No wonder then that the cell has evolved so many processes that are triggered by Ca2+ concentration generic digoxin 0.25 mg overnight delivery, rather than Na+ (or any other ion) digoxin 0.25mg without a prescription. Returning to excitation-contraction coupling in heart, regulation of the Ca2+ signal and its downstream effects is a fair amount more complicated than you may suspect. Moreover, such regulation is critical to the performance of the heart and a clear comprehension of it is key to understanding a great deal of cardiac pharmacology and pathology. The next section reviews the sources and sinks for Ca2+ and the proteins that regulate the movements of this ion across the sarcolemma and within the cell. Before proceeding to a deeper discussion of the basis of E-C coupling, it is necessary to review the fine structure of heart cells. The cells themselves are roughly cylindrical in shape, approximately 80 to m long and 10-12 m in diameter. Figure 1 depicts those cellular elements important in development and control of contractile function. The sarcolemma, sarcoplasmic reticulum and of course the Ca2+ regulated elements of the myofilaments are the essential cellular structures involved in regulating the mechanical function of the heart. The interaction of these structures controls the sequence of cardiac contraction and relaxation. The sarcolemma is an extremely complex membrane which separates the cell interior from the extracellular milieu and controls the flux of ions into and out of the cell. A large increase in sarcolemmal surface area is produced by the transverse tubules ("T" tubules). These are invaginations of the sarcolemmal membrane, which occur in register with the ends of each sarcomere. The "T" tubules are open to the interstitial space and therefore their lumens are, in effect, extracellular. The "T" tubular invaginations increase the cellular surface area over that of a smooth, non-invaginated cellular cylinder by almost 2. It is useful to think of the T-tubules as bringing information about the membrane potential into the center of the myocyte. If Ca2+ needed to diffuse from the surface into the center it would take at least 200 msec to move 6 µm. The cardiac action potential would be over and done with before the center of the fibre had a chance to hear about it. The propagation of the electrical signal along the T-tubule is, of course, much faster. T- tubules are enriched in Ca2+ channels so that they can accomplish the local increase in Ca2+ in the cell. Along with morphological entities, let’s consider the important proteins and therapeutic targets that control Ca2+ levels in the cytosol and thereby control the activation of the sarcomere. Some of the proteins have already been briefly mentioned above, while others add a further level of control, particularly during the cardiac relaxation. Ca channels - Membrane depolarization results in activation of voltage-sensitive L-type Ca2+ channels and rapid Ca2+ influx. Because of the large inwardly directed Ca gradient, Ca2+ flux will always be in the inward direction. It is the L- type Ca2+ channel which is the target of "calcium blocker" drugs such as verapamil, diltiazem, nifedipine, etc. Note that the sarcolemmal Ca pump has different properties from that present in the sarcoplasmic reticulum, although both work in parallel to restore cytosolic Ca2+ to low basal levels. Na-Ca exchange - There is a protein in the sarcolemma which catalyzes the exchange of 3 Na+ ions on either side of the membrane for one Ca2+ ion on the opposite side. The net direction of Ca transport will thus depend on the magnitude of both the Na+ and Ca2+ gradients. The contribution of the Na-Ca exchange will also be affected by the membrane potential, since the reaction involves the net movement of a charge (3 positive charges on the Na+ ions are exchanged for the 2 positive charges on one Ca ion). This will be very important for understanding the action of digitalis, which is discussed below. Some of these tubules terminate in flattened sacs or cisternae closely apposed to the sarcolemma at the periphery of the cell or at the "T" tubules. In all muscle types, it is important to remember that this membrane system is not in direct contact with the extracellular space. As discussed above, in the heart a very small increase in cytoplasmic Ca levels (e. Faster relaxation is as important as faster contraction if adrenalin is going to Excitation-contraction Coupling - Richard Tsien, Ph. This means that there is more Ca2+ stored and therefore more Ca2+ released during the next contraction. The mitochondria are much more abundant in heart muscle than in fast-twitch skeletal muscle. Thus, under normal conditions, the mitochondria have little role in fast calcium regulation, so long as they are able to supply adequate energy. The response of myocardial muscle to changes extracellular Ca is shown in the Figure.

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But if dead things had a resonant bandwidth order digoxin 0.25 mg, then maybe a prepared microscope slide of a dead creature could be used buy discount digoxin 0.25mg on line, and my trips to the garden and telephone calls to abattoirs (for meat parasites) could cease. My first slide was of the human intestinal fluke, a huge parasite, scourge of humanity. I had just found it to be present in the liver (not in- testine) of every cancer sufferer I saw. The entire catalog of biological supply companies, hundreds of specimens of viruses, bacteria, parasites, molds, and even toxins, were now available to re- search with this new technique! If a person were to hold on to the frequency generator while it was generating 434,000 Hz, what would happen to the adult fluke, if you were infected with it? I tested this plan that same week on myself, not with the fluke but with Salmonella bacteria and Giardia and Herpes that I carried chronically. Within three weeks I had reliable data re- garding the necessary level of electrical treatment. It is not as if you had to use house current which would kill you, along with the parasite. Selective Electrocution In twenty minutes (three minutes at six different frequencies) a whole family could get rid of this parasite. Cancer cases showed that in a few hours the universal cancer marker, ortho- phospho-tyrosine could be banished from their bodies by killing this same parasite. Most cases of pain got immediate relief if I could identify the correct “bug” and have its frequency found by the next office visit. This seemed to be absolute proof that living things had an essential high frequency output of some kind of energy. If I could kill something as large as an Ascaris worm or intestinal fluke, then perhaps I could kill something even larger, like an earthworm or flea, something I could see with my own eyes in- stead of having to imagine its demise inside my body. Ten minutes at a frequency chosen near the top of their broadcast range seemed to anesthetize them. There was no need to experiment, though, because the parasites we want to kill have characteristic frequencies that do not overlap the characteristic frequencies of a human. Find the resonant frequency of a bacterium, virus or parasite using a slide or dead bit. Treat the living invaders inside the human body with this frequency and in a matter of minutes they are no longer transmitting their own bandwidths—they are dead or sick and will be removed by our white blood cells. Perhaps the department of defense would use this knowledge and develop super high voltage de- vices to kill people (“enemies”) somewhere in the world. Possibly a way could be found to shield yourself from frequencies harmful to humans by wearing a choke (inductor) coil which suppresses these frequencies. Meanwhile, people must be alerted that they can safely kill their invaders and heal their chronic illnesses. Invaders that have been increasing exponentially due to lowered immunity in recent decades. Remember, though, that the true challenge is not to kill our invaders but to regain our health and immunity. The ship of “progress”, of increasingly complex, processed foods and products, must be turned around and simplicity become our goal. Or will daily parasite and pathogen electrocution become another crutch that makes us just enough better that we can continue a detri- mental lifestyle? Perhaps it is the same energy as the Asian chi; perhaps it is merely related to it. Perhaps it is the energy that runs along the meridians discovered eons ago by Asian practitioners. Perhaps it is the energy that faith healers and religious teachers know how to harness, perhaps not. Perhaps it is the energy that psychics perceive and that drives occult phenomena, perhaps not. What is truly amazing is that ordinary persons have discov- ered such energy well ahead of scientists. Persons using the “art” of kinesiology, pendulums, radionics, dousing rods and many other forms of “strange energy” have no doubt harnessed a part of this bioradiation. It is a tribute to the generally high intelligence of common people and to their open-mindedness that they discovered this energy, in spite of opposition from scientists of today. Over a century ago the scientists of Europe proposed the existence of a “life force” called “élan vitale. Young scientists, (including myself) were systematically taught to scorn this idea. Of course we were also taught that a good scientist was unemo- tional, does not scorn ideas, has a completely open mind, and does not rule something out until it is disproved to their satis- faction. The youthfulness of college years is so susceptible to prejudices of all kinds, and the desire for acceptance is so great, that special effort needs to be made to teach neutrality. I was indeed inspired with the phrase “search for truth” but then promptly led down the path of “search for acceptance. Only its frequency was noticed and caught (modulated) in such a way as to be measurable.

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It will relieve intestinal hemorrhage purchase digoxin 0.25mg with visa, when the above diarrheas are present digoxin 0.25 mg low cost, and the mucous membranes are relaxed, and out of tone. Menorrhagia and amenorrhea; hemorrhoids, with bloody discharge, atonic gastric and intestinal dyspepsia; passive hemorrhages. Therapy—While the profession has used yarrow but little, we find an individual physician occasionally who depends upon it for sonic very important conditions. He claims that it is good in all forms of passive hemorrhage, whether of the lungs or of the kidneys, or uterine hemorrhage. It is a beneficial remedy in diseases of the mucous surfaces, relieving irritation and profuse secretion. It is of benefit in improving the tone of the urinary apparatus, relieving irritation, overcoming strangury and suppression of the urine. In general relaxed conditions it is a cure for leucorrhea, where there is a profuse discharge, or thick, heavy mucus from enfeebled mucous membranes. John Fearn, of Oakland, California, claims that it has but few superiors in its influence upon the skin. He says it has a stimulating action which will be a revelation to those who have not used it. It causes the sudoriferous glands to literally pour out their secretions, and with but little depression. He claims that it will take the place of pilocarpine, with less unpleasant results, and no danger. In fevers, he says, especially of the sthenic type, when we desire to arouse the skin, nothing can surpass this remedy. The patient is covered warmly in bed and a hot infusion of Yarrow is given in frequent doses. If there are evidences of autoinfection, from retained secretion, a little capsicum can be added to the infusion. In cases of severe fever, in the first stage, intermittent or bilious fever, it will cause the secretions to be poured out so freely as to discolor the bed clothes. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 3 A syrup made from the leaves relieves chronic cough, especially if there be bloody sputum. Where there is deficient kidney action, with evidence of uremic poisoning, with or without edema, this remedy is a very active eliminant. It will take the place of a vapor bath, and that without exhaustion, the patient being very comfortable all the while. It will abort fevers, reduce high temperatures, in sthenic cases will relieve local and general congestion, will restore the secretions, will open the sluce gates of the skin, and eliminate morbific ma. Lakin quotes from an old volume, published in 1633, “The leaves of yarrow do close wounds and keep them from inflammation or fiery swelling. Cole of Seattle has confirmed in a practical manner the action of achillea on the skin. Ho has proved its action in indeterminate cases of incipient fever, where infection is the cause, but the character is not determined. In acute epididymitis the temperature of 104 degrees, the condition was controlled in twenty-four hours with achillea. When there is no abnormal temperature, he believes that it has little but a diuretic action. Where there is a temperature of 100 or above, he has never failed to get profuse diaphoresis without depression. Physiological Action—In a moderate dose of five minims of the tincture, a sense of numbness and tingling is felt in the tongue and lips, with muscular weakness and depression; by doubling the dose these symptoms are intensified and prolonged, the pulse falls and the breathing is slowed. A poisonous dose causes tingling in the skin, pain in the joints, vertigo, dimness of vision, extreme debility, pulse forty to fifty per minute and irregular, skin cool and moist, burning heat in the esophagus and stomach, nausea, vomiting and purging. There may be severe gastric and intestinal spasms, headache, complete loss of sight, hearing and speech, while consciousness remains; pupils dilated. It is a powerful depressant of the heart, and if given in sufficient quantity will paralyze that organ. Its apparent influence is upon the terminal filaments of the sensory nerves first, and afterwards, more slowly, upon the nerve trunks. It depresses the nerve centers of the cord, and destroys reflex activity and voluntary power. Larger amounts induce toxic symptoms, the principal of which are increase of tingling and numbness, excessive perspiration, rapidly lowering temperature, pupillary dilation, dimness of sight, loss of hearing and sense of touch, and diminished action of the sensory filaments supplying the skin. There may be violent burning in the stomach with great thirst and dyspagia, and vomiting and diarrhea may occur. The pulse is weak, rapid, and almost imperceptible; acute, lancinating pain Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 5 may be felt, and more or less delirium may result, though as a rule the intellect remains unimpaired.

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