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Therapists and Professionals Allied to Medicine 57 It is important to note that 30–50% of patients admitted to hospital are suffering from malnutrition and this leads to pressure sores 300 mg zyloprim mastercard, lowered immunity, decreased skeletal and cardiac muscle function and reduced cellular function to mention just a few. In surgical patients it leads to poor wound healing and increased post-operative complications. Therefore, it does not take a genius to work out that you will need to get the dietician to see half of your patients and improve their nutritional status. The bottom line is do not underestimate the importance of all the other health professionals around you. If you do not know what they do, then it is better to ask them than to ignore them. Secondly, if you are clever and have read between the lines then you will realise that, as a busy pre-registration house ofﬁcer/senior house ofﬁcer, you can ask the expertise of others, which will take less time than trying to work all these things out on your own. Your consultant will be most impressed if the post- operative infection rates suddenly decrease because you have been improving the nutritional status of your patients or getting them mobile early. Unfortunately, the way of the world is that the most junior on the team is always given the job of referring, as it can be awkward, difﬁcult and time-consuming. The practical joke of the matter is that you will always be asked to refer to a more senior doctor,but it is the junior on the team with the least experience who has to make the referral! A large proportion of doctors,but not all,do not like to receive referrals as it involves more work for already overworked people. For this reason, doctors such as this to whom you are referring will usually ﬁnd some way of refusing a referral or delaying when they need to come and see the patient. This attitude, while not necessarily in the correct ethos of medicine,is entirely understandable and should not be scoffed at without thought. For this reason referring is perhaps one of the most difﬁcult tasks for the junior doctor and this section has the following objectives: G to make it easier and less stressful to refer G to make you sound more knowledgeable G to make you more professional G to reduce the likelihood of your referral being refused or delayed Why Refer?
He during its transition from the period of tenotomy was given charge of the orthopedic department and appliances to that of open operative correc- and lectured on clinical and orthopedic surgery cheap zyloprim 300 mg with mastercard. He also served as dean of the medical school, an He derived from South Country yeoman stock ofﬁce in which his keen business instincts were and was born on May 23, 1862, the son of Alfred of value to the administration of the hospital. He Tubby, a corn merchant living in Great Titchﬁeld was also consulting surgeon to the Hospital for Street, London, and his wife Frances, née Roe. Alfred was educated at Christ’s Hospital, then in Newgate Street, London, where he had as British Orthopedic Society schoolfellow F. Smith, who was to become Tubby’s colleague on the staff of the National In 1894, Tubby was elected joint secretary of the Orthopedic Hospital and a well-known physician newly formed British Orthopedic Society, whose to the London Hospital; author of a standard avowed object was the advancement of orthope- work on medical jurisprudence. This body came into being after an years was consulting surgeon, governor and informal discussion between a group of surgeons almoner to Christ’s Hospital. On leaving the interested in the surgery of deformities, who met Bluecoat School, he proceeded to Guy’s Hospital, at Bristol during the annual meeting of the British where he distinguished himself as a prizeman, Medical Association. Meetings were held in qualifying in 1884 as a member of the Royal London or a provincial center, the program con- 3 College of Surgeons. At the ﬁnal medical exami- sisting of clinical demonstrations, papers and nations of London University in 1887, he won the discussions. Thus on May 24, 1895, the Society gold medal in medicine and the gold medal in visited the Royal Inﬁrmary and Southern Hospi- surgery, besides gaining honors in anatomy, tal, Liverpool; at the Medical Institution Robert materia medica and forensic medicine; the same Jones introduced a discussion on the treatment of year he became a fellow of the Royal College of intractable talipes equinovarus, demonstrating a Surgeons. He proceeded to the degree of Master remarkable number of patients cured of this stub- of Surgery in 1890. But the Society lasted only for at Halle and Leipzig; it was this German training about 4 years; it published three slender volumes 338 Who’s Who in Orthopedics of its transactions, which serve as a permanent 1898, was one by T. Openshaw on tendon record of an early effort to bring orthopedic sur- transplantation.
X Can your respondents see some personal beneﬁt to be 98 / PRACTICAL RESEARCH METHODS gained by completing the questionnaire? X Has a follow-up letter and duplicate questionnaire been sent in cases of none response? QUESTIONNAIRE DESIGN CHECKLIST X Make your questionnaire as short as possible cheap 100 mg zyloprim with mastercard. X Don’t assume knowledge or make it seem that you expect a certain level of knowledge by the way your questions are worded. X Decide whether you’re interested in behaviour, beliefs, attitudes or characteristics or a combination of the above. X Make sure you have made the right decisions concern- ing open-ended questions, closed-ended questions or a combination of both. X Decide whether your questionnaire is to be self-admi- nistered or interviewer administered. X Include a covering letter with information about who the research is for and what will happen to the results. X Include details about how the questionnaire is to be re- turned (making sure you enclose a pre-paid envelope if you need the respondent to return the form to you). X Make sure you include a date by which time you would like the questionnaire returned. X Pilot the questionnaire and instructions to check that all can be understood. It is a procedure for generating under- standing about the way of life of others. However, as there are many practical ‘how to’ issues involved in the use of participant observation, I am going to discuss it as a re- search method.
X Information about the personal beneﬁts to be gained by taking part in the project generic 300mg zyloprim visa. This section is optional, but I ﬁnd it helps to show that people will gain person- ally in some way by taking part in the research. You might oﬀer further informa- tion about something in which they are interested, or you might oﬀer them a copy of the ﬁnal report. Some consumer research companies oﬀer entry into a prize draw or vouchers for local shops and restaurants. CODE OF ETHICS Once you have been open and honest about what you are doing and people have agreed to take part in the research, it is useful to provide them with a Code of Ethics. The best time to do this is just before they take part in a focus HOW TO BE AN ETHICAL RESEARCHER/ 151 group or interview, or just before they ﬁll in your ques- tionnaire. The Code of Ethics supplies them with details about what you intend to do with the information they give and it shows that you intend to treat both them and the information with respect and honesty. It covers the following issues: X Anonymity: you need to show that you are taking steps to ensure that what participants have said cannot be traced back to them when the ﬁnal report is produced. How are you going to make sure it is not easily accessible to anyone with unscrupulous intentions? If not, how will you ensure that what someone says cannot be used against them in the fu- ture? However, you must be careful not to make pro- mises that you cannot keep. X Conﬁdentiality: you need to show that information sup- plied to you in conﬁdence will not be disclosed directly to third parties. If the information is supplied in a group setting, issues of conﬁdentiality should be rele- vant to the whole group who should also agree not to disclose information directly to third parties.