By X. Innostian. Indiana Wesleyan University.
Notice that buy generic fucidin 10gm on line antimicrobial peptides, although ultimately researchers discuss the population of indi- viduals discount fucidin 10 gm overnight delivery treatment for dog's broken toenail, we sometimes talk of the population of scores, as if we have already measured the behavior of everyone in the population in a particular situation. The population contains all past, present, and future members of the group, so we usually consider it to be infinitely large. A sample is a relatively small subset of a population that is intended to represent, or stand in for, the population. Thus, we might study the students in your statistics class as a sample representing the population of all college students enrolled in statistics. The individuals measured in a sample are called the participants (or sometimes, the sub- jects) and it is the scores from the sample(s) that constitute our data. As with a popula- tion, sometimes we discuss a sample of scores as if we have already measured the participants in a particular situation. Notice that the definitions of a sample and a population depend on your perspective. If these are the only individuals we are interested in, then we have measured the population of scores. Or if we are in- terested in the population of all college students studying statistics, then we have a sam- ple of scores that represent that population. But if we are interested in both the populations of college men and college women who are studying statistics, then the men in the class are one sample and the women in the class are another sample, and each represents its respective population. Finally, scores from one student can be a sample representing the population of all scores that the student might produce. Thus, a population is any complete group of scores that would be found in a particular situa- tion, and a sample is a subset of those scores that we actually measure in that situation. The logic behind samples and populations is this: We use the scores in a sample to infer—to estimate—the scores we would expect to find in the population, if we could measure them. Then, by translating the scores back into the behaviors they reflect, we can infer the behavior of the population. Thus, when the television news uses a survey to predict who will win the presidential election, they are using the scores from a sam- ple (usually containing about 1200 voters) to infer the voting behavior of the population of over 100 million voters. Likewise, if we observe that greater studying leads to better learning for a sample of statistics students, we will infer that similar scores and behav- iors would be found in the population of all statistics students. Then, because the popu- lation is the entire group to which the law of nature applies, we are describing how nature works. Thus, whenever we say a finding applies to the population, we are really describing how a law of nature applies to everyone out there in the world. Recognize that the above logic assumes that our sample is representative of the pop- ulation. We will discuss this issue in detail in Chapter 9, but put simply, a representa- tive sample accurately reflects the individuals, behaviors, and scores found in the population. Essentially, a representative sample is a good example—a miniversion—of the larger population. With such a sample, our inferences about the scores and behav- iors found in the population will also be accurate, and so we can believe what our data seem to be telling us about nature. Thus, if your class is representative of all statistics students, then the scores in the class are a good example of the scores that the popula- tion would produce, and we can believe that everyone would behave as the class does. Researchers try to create a representative sample by freely allowing the types of individuals found in the population to occur in the sample. To accomplish this, we cre- ate a random sample: the individuals in our sample are randomly selected from the population. This means that who gets chosen depends simply on the luck of the draw (like drawing names from a hat). Because we don’t influence which participants are selected, the different types of individuals are free to occur in our sample as they do in the population, so the sample’s characteristics “should” match the population. However, random sampling is not foolproof because it may not produce a representa- tive sample: Just by the luck of the draw, we may select participants whose characteris- tics do not match those of the population. Then the sample will be unrepresentative, inaccurately reflecting the behavior of the population. For example, maybe unknown to us, a large number of individuals happen to be in your statistics class who do not behave at all like typical students in the population—they are too bright, too lazy, or whatever. If so, we should not believe what such a sample indicates about our law of nature because the evidence it provides will be misleading and our conclusions will be wrong! Therefore, as you’ll see, researchers always deal with the possibility that their conclu- sions about the population might be incorrect because their sample is unrepresentative.
Graduates of Licensure by credentials order 10 gm fucidin with mastercard antibiotic quick reference guide, or licensure without these accredited Canadian dental programs face examination purchase fucidin 10 gm without prescription bacteria in urine culture, is now an acceptable pathway in more minimal additional examinations for licensure, since than 30 licensing jurisdictions. Credentialing allows licensing representatives are part of the accredita- many established dentists and dental hygienists to tion process. This system relies almost wholly on obtain a license to practice without repeating a clin- the accreditation process and faculty evaluations, ical performance examination. The goal of accreditation is to which requires practiced skill, as well as a science. The accreditation added to their didactic curriculum, often having to process evaluates the educational programs and the reduce the clinical experiences for the students to do physical facilities, not the clinical skills of the graduat- so. This can lead to poor test results on of these schools must meet individual state require- the initial competency exam. A 1995 Institute of Medicine study (Field, 1995) rec- Most states will not license a graduate of a non- ommended that reform in the accreditation process accredited school unless that individual attends an should focus on educational outcomes and on stan- accredited school for a specified period of time and is dards and methods that will identify and improve those either granted a degree or certified as equivalently edu- schools that are not educating their students effectively. Only California, Hawaii, and Ohio license a graduate of a non-accred- Continuing Competency ited dental school without these requirements. In solve medical problems with new science and technolo- addition, other organizations, such as the Academy of gy have provided additional impetus for protective reg- General Dentistry, have programs that grant fellowship ulations. The consequent cost is significant; it is esti- and mastership status to general dentists who achieve mated that the cost of federal regulation to a family of milestones in continuing professional education. Accounting procedures, the protection of rule, which was written largely with the hospital patient records, and the use of specific equipment in environment in mind, have had significant cost certain clinical procedures are the more apparent implications for dental care. In each case, laws and areas where there are efforts to regulate details of the attendant regulations were created to respond to clinical practice (Palmer, 2000a and 2000c; and problems and address perceived needs. Regulation of the dental practice case, these laws and regulations have had unfore- is so extensive today that new entrepreneurial enti- seen consequences, some of which have worked ties have emerged offering courses to teach dental counter to original intentions. Regulations become less favorable for such sweeping regula- governing the dental practice range from local zon- tions, especially when promulgating them has ing requirements regarding parking lot require- dramatic cost implications for the affected sector ments, to requirements for apparel worn in public and its consumers without identifying offsetting places that could be contaminated from the work- funding. That action was a response In the United States, government has traditionally to vigorous opposition to the rule. As health insurance became Purported benefits are difficult to estimate accurate- commonplace, the third party payer entered into the ly. The resulting complex of responsibilities, costs are more easily developed and should be avail- relationships and priorities created a mandate for regu- able for any regulation. Regulation of the dental workplace technology, education, and workforce that best is intended to protect the safety of dental practice serve the public interest. There will be Two examples that pose this possibility in the increased demand for continued development of near term are a promulgated but not yet enforced computer-based simulation as a valid method for rule on medical information privacy and a guidance testing clinical skills. Alternatives to professionals must provide translation services to traditional licensure and state-specific licensure will non-English speaking patients. The recent trend in on in-depth clinical competency for the initial com- dental office design has been toward exactly this type petency examination. These are but two examples of why the regu- late more uniform scopes of practice among the latory pendulum will likely continue to swing between state statutes and regulations. A critical under-supply of laboratory techni- cians will occur in the future unless the number of students in this field is increased. The exponential- ly expanding aspects of technology will provide new materials and procedures that will initiate expanded functions for allied personnel. The complexities and interrelations of oral and systemic diseases will continue to evolve and require more extensive examination and diagnosis by a licensed dentist for every dental patient. The liferation of ideas and assumptions, both correct expansion of the predoctoral curriculum has limited and incorrect, must not be allowed to lead to leg- the dental schools ability to teach their students the islative initiatives or regulations without scientific laboratory skills that were traditionally taught in the validation. Dentistry must proactively promote dental labo- to ensure that valid science is the basis for necessary ratory technology as an attractive career choice, as and appropriate regulation. It appears very likely well as increasing the availability of education for den- that one of the greatest issues of today––access to tal laboratory technicians. States should also assure that all regulation is based regulations and overlap of scope may render it diffi- on valid scientific evaluation and solutions. All tal professionals should serve as advocates and resources licensing jurisdictions should meet basic psychome- for developing regulatory policy development.
Yet apart from this buy 10 gm fucidin overnight delivery treatment for uti gram negative bacilli, there is an increasing in- terest being taken in medical cheap 10 gm fucidin mastercard antibiotics for sinus infection webmd, scientiﬁc and philosophical texts, not just because of their intellectual contents but also from the point of view of linguistics, literary studies, discourse analysis, narratology, ethnography of literature (orality and literacy), rhetoric and communication studies. This is related to a growing scholarly awareness of the communicative and com- petitive nature of Greek medicine and science. Greek doctors, philosophers, astronomers and mathematicians had to impress their audiences, to per- suade them of their competence and authority, to attract customers and to reassure them that they were much better off with them than with their rivals. Medical, scientiﬁc and philosophical texts functioned in a speciﬁc setting, with a particular audience and purpose, and served as vehicles not only for the transmission of ideas but also for the assertion of power and authority. These developments have given rise to a whole new ﬁeld of studies and questions regarding the ways in which knowledge was expressed and com- municated in the ancient world: the modes of verbal expression, technical idioms, stylistic registers and literary genres that were available to people who laid a claim to knowledge (healers, scientists, philosophers) in order to convey their views to their fellows, colleagues and their wider audiences; the rhetorical strategies they employed in order to make their ideas intel- ligible, acceptable, or even fashionable; the circumstances in which they Introduction 31 had to present their ideas, and the audio-visual means (writing facilities, diagrams, opportunities for live demonstration) they had at their disposal; the interests and the expectations of their audiences, and the ways in which these inﬂuenced the actual form of their writings; and the respects in which ‘scientiﬁc’, or ‘technical’, or ‘expert’ language or ‘discourse’ differed from ‘ordinary’ and ‘literary’ language and ‘discourse’. After many years of considerable neglect, the last two decades have thus seen a signiﬁcant increase in attention being given to the forms of ancient scientiﬁc writing, especially among students of the Hippocratic Corpus, but also, for example, on Latin medical literature, with some studies focusing on ‘strictly’ linguistic and textual characteristics, while others have attempted to relate such characteristics to the wider context in which the texts were produced. First, general trends in the study of rhetoric and discourse analysis, in particular the study of ‘non-literary’ texts such as advertisements, legal proceedings, minutes of meetings, political pamphlets and medical reports, the study of rhetoric and persuasive strategies in apparently ‘neutral’ scien- tiﬁc writings, and the development of genre categories based on function rather than form have led to a growing awareness among classicists that even such seemingly ‘unartistic’, non-presumptuous prose writings as the extant works of Aristotle, the Elements of Euclid and the ‘notebook-like’ Hippocratic Epidemics do have a structure which deserves to be studied in its own right, if only because they have set certain standards for the emergence and the subsequent development of the genre of the scientiﬁc treatise (‘tractatus’) in Western literature. It is clear, for example, to any student of Aristotle that, however impersonal the tone of his works may be and however careless the structure of his argument may appear, his writings nonetheless contain a hidden but undeniable rhetoric aimed at making the reader agree with his conclusions, for example in the subtle balance be- tween conﬁdent explanation and seemingly genuine uncertainty, resulting in a careful alternation of dogmatic statements and exploratory suggestions. The study of these formal characteristics has further been enriched by a growing appreciation of the role of non-literal, or even non-verbal as- pects of communication (and conversely, the non-communicative aspects of language). Aesthetics of reception, ethnography of literature and studies in orality and literacy have enhanced our awareness of the importance of 34 For more detailed discussion and bibliographical references see van der Eijk (1997), from which the following paragraphs are excerpted. Here, again, discourse studies and ethnogra- phy of literature have provided useful instruments of research, for example D. Hymes’ analysis of the ‘speech event’ into a number of components that can, not without some irony, be listed according to the initial letters of the word speaking: setting (time, place, and other circumstances), scene (e. A recent German collection of articles on ‘Wissensvermittlung’ (‘transmission of knowledge’) in the ancient world gives an impression of the kind of questions and answers envisaged from such an integrated approach. At this point, a most fortunate connection can be perceived between linguistically inspired approaches within classical philology and the recent surge of a ‘contextual’ approach in the history of science, whereby the text is seen as an instrument for scientists and practising doctors to use to deﬁne 35 Hymes (1972) 58ff. Introduction 33 and assert themselves, to establish the position of their profession and to gain authority and power. Again, the variations the Hippocratic Corpus displays with regard to the use of rhetoric (not only the well-known Gorgianic ﬁgures of speech but also argumentative techniques, analogies, metaphors, etc. Such an awareness has led to greater caution in the establish- ment of doctrinal ‘parallels’ or ‘inconsistencies’ between different works of the same author, which would have been used as evidence of a development in doctrine or even as a basis for declaring a work genuine or spurious. Such caution is inspired by a consideration of differences in genesis (single or multiple authorship), status (e. Thus it has been attempted to relate varying degrees of philosophical sophistication in some of Plato’s dialogues to differences between the au- diences for whom they were intended (as indicated by the contribution of the interlocutors),41 and something similar has been attempted with regard to differences in method – and to some extent also doctrine – between the three treatises on ethics preserved in the Aristotelian Corpus. Similar formal characteristics of medical and philosophical texts affecting the interpretation or evaluation of particular passages and their relation to other passages in the same work or in other works lie in the ﬁeld of ‘genre’, where, again, the sheer variety in forms of expression is particularly striking. When, how and for what purposes prose came to be used for the transmission of knowledge in the late sixth century bce and why some writers (such as Parmenides and Empedocles, or in later times Aratus and Nicander) preferred to write in verse when prose was available as an alternative, is not in all cases easy to say. Yet the Hippocratic Corpus provides opportunities to gain some idea of the process of text-production and genre- formation, and one can argue that medicine has played a decisive role in the formation of scientiﬁc literature. The variety of forms of writing referred to above is manifest already within the Hippocratic Corpus itself. Airs, Waters, Places; On the Sacred Disease ; On the Nature of Man), show a degree of care and elaboration on account of which they deserve a much more prominent place than they now occupy in chapters on prose in Greek literature. Here we do have a large body of texts generally agreed to be by one author (although there 41 Rowe (1992). Yet any general account of Aristotle’s philosophy is bound to begin with a discussion of the problems posed by the form and status of his writings. Do they represent the ‘lecture notes’ written by Aristotle himself on the basis of which he presented his oral teaching? Or are they to be taken as the ‘minutes’ or ‘verbatims’ of his oral teaching as written down by his pupils? Certainly, some characteristics of his works may be interpreted as evidence of oral presentation;44 and with some (parts) of his works it is not easy to imagine how they might have been understood without additional oral elucidation – although this may be a case of our underestimating the abilities of his then audience and an extrapolation of our own difﬁculties in understanding his work. However, other parts of his work are certainly far too elaborate to assume such a procedure. A further point that has attracted considerable attention is the relation between orality and literacy. Although the details and the precise signiﬁ- cance of the process are disputed, the importance of the transition from orality to literacy for Greek culture and intellectual life can hardly be over- stated.
The results from these projects will include the identiﬁcation of new combination drug targets for disease and the development of diagnostics to determine appropriate individual patient treatments cheap 10 gm fucidin amex antimicrobial keyboard covers. The parties plan to transform this coherent clinical 3D Data into computer models which link genetic alterations to changes in gene expression to progression-free patient survival times buy 10gm fucidin free shipping antibiotics for lower uti. These targets and biomarkers may be used to identify the optimal single or combination drug Universal Free E-Book Store 280 10 Personalized Therapy of Cancer therapy for a given patient’s genetic alteration proﬁle. Anderson’s clinical expertise to validate the discoveries and will work with strategic partners to make drugs and diagnostics stemming from these discoveries available to patients. Tocagen is enrolling patients for its clinical trials and will partner with Siemens on assays used for the trials. Intratumor heterogeneity of glioblastoma multiforme is likely the key to under- standing treatment failure or drug resistance. An integrated genomic analysis of spatially distinct tumor fragments has been developed to uncover extensive intratu- mor heterogeneity (Sottoriva et al. Results of the study revealed patient-speciﬁc patterns of cancer evolution, to enable more effective personalized treatment design. Several types of deletions of chromosome 1 have been identiﬁed but only the complete loss of the short arm of chromosome 1 combined with complete loss of the long arm of chromosome 19 signiﬁes a good prognosis. Partial loss of the short arm of chromosome 1, on the other hand, characterized more aggressive tumors. By using these tools, physicians can revamp and reﬁne tumor classiﬁcation to enable more individualized treatment. Inactivation of the p53 tumor suppressor is a key component of the multistep evolution of most cancers. Prognosis of Glioblastoma Multiforme Based on Its Genetic Landscape The alteration of multiple networking genes by recurrent chromosomal aberrations in gliomas deregulates critical signaling pathways through multiple, cooperative mechanisms (Bredel et al. These mutations, which are likely due to nonran- dom selection of a distinct genetic landscape during gliomagenesis, are associated with patient prognosis. A clinical study has shown that 14-3-3zeta positive expression was observed in approximately 74. This seven-gene set could retrospectively classify patients into subgroups linked to survival times. Individuals who have alterations in between zero and two of the seven genes are classiﬁed as low risk, while those with ﬁve or more affected genes are considered high risk. This type of approach could have clinical applications both for improving brain tumor classiﬁcation methods (currently based on histology and clinical factors such as age) and guiding treatment decisions. These ﬁndings will spur the develop- ment of new therapies based on key brain cancer pathways. Prospective clinical trials are planned for testing the clinical utility of the seven-gene set. A similar Universal Free E-Book Store 284 10 Personalized Therapy of Cancer genetic landscape approach may be applied to other aggressive types of cancer, such as ovarian and lung cancer. Eventually, networks may be created that account for both genetic and epigenetic changes in cancer cells. Molecular Diagnostics for Personalized Management of Brain Cancer Several molecular biomarkers have been identiﬁed in diffuse gliomas that carry diagnostic and prognostic information. In addition, some of these and other bio- markers predict the response of these gliomas to particular chemotherapeutic approaches. Molecular diagnostics is an important contribution to personalized management of glioma patients. A biomarker of tumor response would be useful for making early treatment decisions and for determining prognosis. The percentage of the tumor undergoing a signiﬁcant change in the diffusion of water is different in patients with progressive disease as compared to those with stable disease. This method has the potential to evaluate differences in efﬁcacy between patients, as well as to assess the heterogeneity of response within an individual tumor. This technique needs to be further evaluated to determine its usefulness in the individualization of treatment or evaluation of the response to treatment in clinical trials. Tumor contrast enhancement and mass effect can predict activation of speciﬁc hypoxia and proliferation gene-expression programs, respectively.
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