By J. Frillock. University of Louisiana at Lafayette.
Results of this work are normally published in scientific journals through a process called ‘peer review’ cheap 500 mg tetracycline overnight delivery, which means that the work is always subject to critical scrutiny and assessment by other scientists tetracycline 250mg sale. Through this means, new ideas or theories about MS can be thoroughly evaluated and tested. Types of research People sometimes use the term ‘research’ in a very loose way for almost any kind of information-gathering about a topic of interest – finding out information about your MS, by reading this book for example. However, ‘scientific research’ involves a very particular way of acquiring information, where a specific question – called a hypothesis – is devised and tested, to find out whether, under particular conditions, that question is answered negatively or positively. To be treated as scientifically correct (valid), the same answer must be repeated under exactly the same conditions by other researchers. There are broadly five kinds of scientific research being undertaken in relation to MS: • The systematic study of the distribution and patterns of MS in different communities and countries – usually known as epidemiological research – might involve asking questions about whether MS is more common in one geographical area than 187 188 MANAGING YOUR MULTIPLE SCLEROSIS another, or is decreasing or increasing in a particular population over time, and what factors might explain these differences. People with MS may be asked if they wish to participate in a clinical trial, for example to test a new drug. In the absence of a cure, much of this research is investigating how, for example, physiotherapy or speech therapy can reduce the impact of symptoms, or how far psychological support or counselling can help people to manage their symptoms better. Each of these approaches uses scientific methods to understand MS, and assist people with the disease. However, the most common form of scientific method you are likely to come across personally is the clinical trial. Epidemiological research As we have said, epidemiological research primarily focuses on the distribution of MS in specific populations and countries. In Chapter 1 we talked about some distribution patterns that had led to important lines of inquiry about possible causes of the disease. Thus the facts that MS is found largely in temperate regions of the world and more amongst women, and that there appear to be geographical ‘hotspots’ of the disease, all seem to explain something about MS. The problem with epidemiological research is that there are many, many reasons why such patterns could occur.
Flapan’s article presents a challenge to each one of us: to value ourselves tetracycline 250mg low cost, to pursue meaningful interests and goals discount tetracycline 500 mg mastercard, and to develop as people. Think about all we can still accomplish if we set realistic standards for ourselves. Think about undertaking a hobby, whether it is mushroom hunting, ham radio, or amateur astron- omy. Think about helping to better the world: join Amnesty Inter- national’s letter writers and write to governments on behalf of un- fairly imprisoned or tortured individuals. Lend your weight to an environmental group that is trying to curb pollutants and toxic chemicals. Tutor a youngster who needs help with reading, or just offer to let him or her read to you once or twice a week. Join a Parkinson’s support group to help (and be helped by) other people with Parkinson’s and to share activities. I want to end with an excerpt from a piece titled "Mirror, Mirror on the Wall," by Ellen Levin, the eighteen-year-old grand- daughter of someone who has Parkinson’s (it was published by Parkinson’s Educational Program [PEP-USA] in Newport Beach, California): I want you to move closer to the mirror, until all you look at are your eyes. I want all of you with Parkinson’s to look at your eyes and realize that your eyes have helped you to see life and happi- ness, and no matter how your outer body appears to others, you’ve got an inner body. An inner soul that no affliction could ever cause to tremble, a soul that can store all the happiness you want out of life. Finally, I want each and every one of you to smile, force the smile if you have to, but smile, because you’re a human being that has the God-given right to seek and secure happiness. CHAPTER 7 Doctors and Other Health Professionals Who shall decide when doctors disagree? Because there are so many health professionals, choosing the right ones can become an overwhelming task. Other patients whom one meets at Parkinson’s support group meetings, conventions, and camps can be sources of infor- mation about doctors. The neurology department at the nearest large hospital or medical center may be able to make such a recommendation. Among the best sources of information about Parkinson’s spe- cialists are the Information and Referral Centers operated by the 64 doctors and other health professionals 65 American Parkinson Disease Association (APDA).
For example discount 250 mg tetracycline with visa, ascertain pain behaviours) cheap 250mg tetracycline free shipping, but also has much greater diaries are used to help ascertain uptime/downtime. Clinical interviews can also focus such diaries on more than one occasion during the specifically on certain areas of interest. Cardiovascular events, such • Emotions, behaviour and cognition should be included as heart rate and blood pressure, are also believed in the evaluation of pain patients. Subjective measures of pain evaluation include self- to reflect changes in underlying emotional states. Interestingly, blood pressure is inversely related to • Objective measures include behavioural observation pain sensitivity, in that hypertensives and normoten- and psychophysiological methods. Other cardiovascular-related indices key information at specified times during the day. One of the most basic methods of measuring pain behaviours is to observe what people actually do. People Key points in pain will often communicate their pain experiences in a non-verbal manner, whether this is through body • Pain is a subjective multidimensional construct. Such non-verbal • Psychological processes, such as emotions, cogni- behaviours are particularly useful for the clinician tion and behaviour, influence the perception and working with groups that are unable to easily verbally experience of pain. However, observation can be a time- logical processes is critical to our understanding consuming exercise, in that some effort is needed to and ultimate management of pain. There are also important issues associated with measurement; in an ideal situa- tion patients are videotaped engaging in various behav- Further reading iours, which are then rated by trained observers. Psychological Mechanisms of Pain and of the individual can be measured via objective physi- Analgesia. Fear-avoidance and measures is skin conductance, which varies wit its consequences in chronic musculoskeletal pain: a state of changes in sweat gland activity in response to emotional the art. PART PAIN IN THE CLINICAL SETTING 3 3a CLINICAL PRESENTATIONS 97 14 EPIDEMIOLOGY OF PAIN 99 W.
