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For the next 10 years 100mg vermox mastercard, Pott was much in demand as a consultant and cheap vermox 100 mg, apart from his hos- The employment of chimney-boys was eventu- pital work, he kept up a large correspondence ally made illegal by Act of Parliament. It is almost with surgeons and practitioners who sought his incredible that even today there should exist a link opinion and advice from all over the world. He 277 Who’s Who in Orthopedics was the recipient of many distinctions: in 1764 he References was elected a Fellow of the Royal Society; the next year he was appointed Master of the Corpo- 1. Bartholomew’s Hospital Reports 30:163 first Honorary Fellow of the Royal College of 2. Lloyd, G Marner (1933) Life and Works of Perci- Surgeons of Edinburgh and the year after that an vall Pott. Bartholomew’s Hospital Reports 66:291 Honorary Member of the Royal College of Sur- 3. These last two honors were con- Percivall Pott, FRS, to which are added “A short ferred upon him at about the time of his retirement Account of the Life of the Author,” by James Earle, from St. Power, Sir D’Arcy (1923) Percivall Pott: His own boy for half a century. Power, Sir D’Arcy (1929) The Works of Percivall the hospital subscribers, he was elected a gover- Pott. British Journal of Surgery 17:1 nor and at dinner that followed there was a moving scene. The Right Honorable Thomas Harley proposed the toast of Percivall Pott, who was usually composed and eloquent, but on this occasion was overcome with such emotion that, after rising to reply, was unable to speak and resumed his seat in silence. He continued to practice, but his retirement lasted only about 18 months. On December 27, 1788, he died of pneumonia due to a chill he caught while visiting a patient in severe weather 20 miles from London. His last conscious words were: “My lamp is almost extinguished; I hope it has burnt for the benefit of others. Percivall Pott was a great leader in surgery who shone as a clinical surgeon. He flourished before the emergence of surgical pathology under John Hunter, and the deductions from his clinical observation suffered from this lack of scientific interpretation. He was, however, particularly free Kenneth Hampden PRIDIE from the shackles of tradition and was bold enough to cut a path of his own. In a sense he 1906–1963 was more acquainted with the practice of surgery than Hunter but he lacked, as they all lacked Born in Bristol, educated at Clifton College and before the coming of Pasteur and Lister, the the University of Bristol, Ken was a true son of one key that saved surgery from being a tragic that ancient city, in which he spent his whole life adventure. He took part in the an impressive personality, a character in the best formation of the Corporation of Surgeons and sense of the term, and his life and work depict the became its Master, started organized teaching of originality of his mind. Once equipped with his medical students, and by his humane attitude, Fellowship of the Royal College of Surgeons of good sense and personal integrity helped greatly England, he made comparatively brief visits to to raise the status of surgery in this country. His Böhler’s clinic in Vienna, to Watson-Jones’ frac- writings were clear and composed with scholarly ture clinic in Liverpool and to Girdlestone at grace, and his observations recorded faithfully Oxford, and by the age of 28 was appointed assis- without being tedious. Their translation into tant fracture surgeon at the Bristol Royal Infir- European languages did much to promote the mary, to become the first surgeon in Bristol to prestige of British surgery abroad. His 278 Who’s Who in Orthopedics ability, enthusiasm and boundless energy led to pulley fixtures—usually ineffectively held by the his early recognition in Bristol and in many overworked thumb screw; the grapple attach- centers throughout the country as one with an ments to enable it to be fixed readily to any type important contribution. In these early days he of bed; the wooden frame for holding the leg with worked closely with the late E. Hey Groves, knee bent, so controlling rotation and simplifying who had recently retired from the Bristol General radiography in fractures of the neck of the femur; Hospital. Hey Groves frequently visited the frac- the frequent use of the Forstner augur bit, as in ture clinic and these two personalities, with much his operation to fuse the ankle; the widespread use in common, would have long and entertaining of staples; the excellent ball-cutter for the acetab- arguments, Ken being typically uninhibited even ulum in hip arthroplasty, comprising a tool far in the presence of this doyen of orthopedic superior to any other designed for this purpose; surgery. Throughout his life he retained a great and many ingenious modifications to instruments admiration for Hey Groves, to whose inspiration that have enhanced their effectiveness. He was a he always felt he owed so much, and who had, true disciple of Hey Groves. He was a beautiful The fracture clinic grew in numbers and repu- operator and always a courageous one.

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The term vermox 100mg fast delivery, coined by Freud in 1891 cheap vermox 100 mg on line, means literally “absence of knowledge,” but its precise clinical defini- tion continues to be a subject of debate. Lissauer (1890) originally con- ceived of two kinds of agnosia: ● Apperceptive: In which there is a defect of complex (higher order) percep- tual processes. As a corollary of this last point, there should be no language disorder (aphasia) for the diagnosis of agnosia. However, others retain this category, not least because the supposition that perception is normal in associa- tive visual agnosia is probably not true. Moreover, the possibility that some agnosias are in fact higher order perceptual deficits remains: examples include some types of visual and tactile recognition of form or shape (e. Theoretically, agnosias can occur in any sensory modality, but some authorities believe that the only unequivocal examples are in the visual and auditory domains (e. Nonetheless, many other “agnosias” have been described, although their clinical definition may lie outwith some operational criteria for agnosia. With the passage of time, agnosic defects merge into anterograde amnesia (failure to learn new information). Anatomically, agnosias generally reflect dysfunction at the level of the association cortex, although they can on occasion result from thal- amic pathology. The neuropsycho- logical mechanisms underpinning these phenomena are often poorly understood. Visual agnosia: disorders of object recognition and what they tell us about normal vision. Advances in Clinical Neuroscience & Rehabilitation 2004; 4(5): 18-20 Cross References Agraphognosia; Alexia; Amnesia; Anosognosia; Aprosodia, Aprosody; Asomatognosia; Astereognosis; Auditory Agnosia; Autotopagnosia; Dysmorphopsia; Finger agnosia; Phonagnosia; Prosopagnosia; Pure word deafness; Simultanagnosia; Tactile agnosia; Visual agnosia; Visual form agnosia Agrammatism Agrammatism is a reduction in, or loss of, the production or com- prehension of the syntactic elements of language, for example articles, prepositions, conjunctions, verb endings (i. Despite this impoverishment of language, or “telegraphic speech,” meaning is often still conveyed because of the high information content of verbs and nouns. Agrammatism is encountered in Broca’s type of nonfluent aphasia, associated with lesions of the posterior inferior part of the frontal lobe of the - 9 - A Agraphesthesia dominant hemisphere (Broca’s area). Cross References Aphasia; Aprosodia, Aprosody Agraphesthesia Agraphesthesia, dysgraphesthesia, or graphanesthesia, is a loss or impairment of the ability to recognize letters or numbers traced on the skin (i. Whether this is a perceptual deficit or a tactile agnosia (“agraphognosia”) remains a subject of debate. Cross References Agnosia; Tactile agnosia Agraphia Agraphia or dysgraphia is a loss or disturbance of the ability to write or spell. Since writing depends not only on language function but also on motor, visuospatial, and kinesthetic function, many factors may lead to dysfunction. Agraphias may be classified as follows: ● Central, aphasic, or linguistic dysgraphias: These are usually associated with aphasia and alexia, and the deficits mirror those seen in the Broca/anterior and Wernicke/posterior types of aphasia; oral spelling is impaired. From the linguistic viewpoint, two types of para- graphia may be distinguished, viz. A syndrome of agraphia, alexia, acalculia, finger agnosia, right-left disorientation and difficulty spelling words (Gerstmann syndrome) may be seen with dominant parietal lobe pathologies. Oxford: OUP, 2003: 126-145 Cross References Alexia; Allographia; Aphasia; Apraxia; Broca’s aphasia; Fast micro- graphia; Gerstmann syndrome; Hypergraphia; Macrographia; Micrographia; Neglect; Wernicke’s aphasia Agraphognosia - see AGRAPHESTHESIA Agrypnia Agrypnia is severe, total insomnia of long duration. Recognized causes include trauma to the brainstem and/or thalamus, prion disease (fatal familial and sporadic fatal insomnia), Morvan’s syndrome, von Economo’s disease, trypanosomiasis, and a relapsing-remitting disor- der of possible autoimmune pathogenesis responding to plasma exchange. Annals of Neurology 2001; 50: 668-671 Akathisia Akathisia is a feeling of inner restlessness, often associated with restless movements of a continuous and often purposeless nature, such as rocking to and fro, repeatedly crossing and uncross- ing the legs, standing up and sitting down, pacing up and down. Voluntary suppression of the movements may exacerbate inner tension or anxiety. Recognized associations of akathisia include Parkinson’s disease and neuroleptic medication (acute or tardive side effect), suggesting that dopamine depletion may contribute to the pathophysiology; dopamine depleting agents (e. Treatment by reduction or cessation of neuroleptic therapy may help, but can exacerbate coexistent psychosis. Centrally acting β-blockers, such as propranolol, may also help, as may anticholinergic agents, amantadine, clonazepam, and clonidine. Cambridge: CUP, 1995 Cross References Parkinsonism; Tic - 11 - A Akinesia Akinesia Akinesia is an inability to initiate voluntary movements. More usually in clinical practice there is a difficulty (reduction, delay), rather than complete inability, in the initiation of voluntary movement, perhaps better termed bradykinesia, reduced amplitude of movement, or hypokinesia. These difficulties cannot be attributed to motor unit or pyramidal system dysfunction. Akinesia may coexist with any of the other clinical features of extrapyramidal system disease, partic- ularly rigidity, but the presence of akinesia is regarded as an absolute requirement for the diagnosis of parkinsonism.

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Of course I soon found out that he’d chosen these people for a particular rea- son vermox 100mg mastercard, and he’d actually told them that they had to attend purchase 100mg vermox amex, that there was no choice involved. When I turned up to hold the group, no one had been told who I was and what they were doing there. When I started to introduce myself some of the workers looked a bit uneasy and others just looked plain defiant. It was only after the group that I spoke to someone who said that they’d all thought I was a ‘spy’ for the company and that some had decided to give the ‘company line’ on what the scheme was all about, whereas others had decided not to say anything. She said that really they didn’t believe a lot of what had been said, but none of them dared say anything different as they thought I was going to go straight to management with the results. I felt that the information I collected wasn’t very useful in terms of my research, but it was useful in terms of getting an idea about employer-employee relations. If you are relying on someone else to find participants for you, it is important that you make sure that that person 150 / PRACTICAL RESEARCH METHODS knows who you are and what you’re doing and that this in- formation is then passed on to everyone else. A useful way to do this is to produce a leaflet which can be given to any- one who might be thinking about taking part in your re- search. This leaflet should contain the following information: X Details of who you are (student and course or employ- ee and position). X Information about who has commissioned/funded the research, if relevant. X Information about the personal benefits to be gained by taking part in the project. 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. You need to think about how you’re going to categorise and store the information so that it cannot fall into un- scrupulous hands. Again, you need to make sure that you do not make promises which you can’t keep. X Right to comment: this will depend on your personal methodological preferences and beliefs. Some re- searchers believe that willing participants should be 152 / PRACTICAL RESEARCH METHODS consulted throughout the research process and that if someone is unhappy with the emerging results and re- port, they have the right to comment and discuss al- terations. Other researchers believe that once the information has been supplied, it is up to them what they do with it. If you’re not willing to dis- cuss the final report or take on board comments from unhappy participants, you must make this clear from the outset. X The final report: it is useful for participants to know what is going to happen with the results. If the final report is very long you can produce a shorter, more succinct report which can be sent to in- terestedparticipants. X Data Protection: you need to show that you understand the Data Protection Act and that you intend to comply with its rules.

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