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Jaffe was a devoted and fiercely loyal friend to those of his colleagues with whom he collaborated and whom he respected blood pressure medication that starts with c discount avalide 162.5 mg. He was revered by his students and especially by the hun- dreds of house officers in the New York area who attended his conferences and learned pathology from the man who “wrote the book hypertension in the elderly generic 162.5 mg avalide overnight delivery. Jaffe had a life outside of the hospital heart attack 19 years old buy 162.5mg avalide free shipping, but it was Arthur Rocyn JONES indeed a rich one. The Arthur Rocyn Jones, consulting surgeon to the older, Arthur, was Professor of Mathematical Royal National Orthopedic Hospital, died peace- Physics at Harvard University in Cambridge, fully at his home on Stanmore Hill on February Massachusetts. The last 3 years, a period entertaining but liked to spend time with their of increasing frailty, had brought several alarms family and close relations even more. Jaffe about his health and once a spell of some weeks loved to garden and approached this activity with in hospital, but a strong Welsh constitution always the same passion as his scientific pursuits. He came to the rescue, keeping him on his feet with constructed a terrace on the grounds of one of a clear memory of the exciting events of his early their homes in Pelham and raised flowers, except career in orthopedics, almost to the very end. He for a brief period during World War II when he, was equally sustained by the deep but unobtrusive like many of his neighbors, converted it to a Christian belief that had governed the conduct of victory garden. He Over the years, Rocyn, as he was known affec- had an extensive record collection and often tionately, forged a strong personal link with the attended concerts. The Jaffes vacationed in early days of orthopedic surgery in Great Britain. Jaffe enjoyed In 1918, sponsored by Elmslie, the thinker, and outdoor activities with his wife and children. Bankart, the man of speedy action, he had been The worlds of pathology and radiology, and elected a founder member of the British Ortho- especially orthopedics, are deeply in the debt of pedic Association, of which in due course he this extraordinary man, who in his lifetime became the historian. To mark his 85th birthday, brought order to the chaos of bone pathology, the number of The Journal of Bone and Joint served as the final arbiter for countless puzzling Surgery for May 1968 was dedicated to him. The cases, and brought enlightenment to a vast warm appreciation it contained, from the flowing 163 Who’s Who in Orthopedics pen of Jackson Burrows, gave so many accurate Baschurch in earlier days, and to Oswestry in later and felicitous details of his life and influence. So, too, at Roehampton in the years of For many years, Rocyn was a close friend of the First World War, his enthusiastic spirit of hap- Muirhead Little, who gave him some priceless piness made wounded soldiers believe that life relics of his father W. All his apprenticeship was the safe keeping of the Institute of Orthopedics, served with his uncle Hugh Owen Thomas, the which he helped to establish in 1946. Liverpool was the first center of his activities; then it was London; then Great Britain; then the United States; and then the whole world. It is not a far cry to see that whether in surgery or in any other activity, great men do not remain parochial, or local, or national, but rather international and worldwide in their endeavors. The humble origin of Robert Jones in this small Welsh town led ulti- mately to a great British–American alliance in the world of surgery, and then to his establishment of the International Society of Orthopedics and Traumatology, of which he was the first president, this body of surgeons expressing almost inarticu- late admiration by creating for him the unprece- dented title of “Permanent President. Robert Jones qualified in medicine in 1878, and gained the Fellowship of the Royal College of Surgeons of Edinburgh in 1889. He was soon appointed general surgeon to the Liverpool Robert JONES Stanley Hospital and, while still a young man of 1857–1933 30 years, general surgeon to the Royal Southern Hospital of Liverpool. This broad surgical expe- The kindly word, the encouraging smile, the twin- rience stood him in good stead in later years, kling eye with creases all going up in the right when his abilities were applied to that part of direction, and the whole magnetic personality of general surgery concerned with disorders of the Robert Jones, seem as vivid today as they were limbs and spine—orthopedic surgery. He was of 30 years ago when he was at the peak of his course strongly influenced by his uncle Hugh endeavor in creating and establishing the princi- Owen Thomas, to whom he was apprenticed at 11 ples, science and art of orthopedic surgery. Nelson Street—the house that became a Mecca Perhaps his greatest contribution was to the art of for surgeons from all over the world. We have surgery because he taught us all to be so infec- said that Hugh Owen Thomas was descended tious in our happiness that disabled and distressed from a long line of Welsh bone-setters; but even patients also became happy. I never knew a more his father Evan Thomas, unqualified as he may joyful man with his quips, pranks, jokes and have been, treated thousands of patients not only beaming smile, so that when he went to from the industrial north of England but from 164 Who’s Who in Orthopedics every corner of the globe. Robert Jones could London, though always maintaining his free hardly have escaped this traditional influence, or Sunday clinics at Nelson Street. But before he did the powerful personality of his uncompromising so, his alliance with Agnes Hunt had been created uncle, who battled and fought continuously in and firmly established. She had first brought chil- favor of safe and conservative treatment as dren from her derelict country home at Baschurch opposed to unsafe, sometimes wild and often in Shropshire, where stables had been converted dangerous operations. So every Saturday she a wrench concealed beneath his coat-tails to would arrive in Liverpool with two or three correct a recently malunited Colles’ or Pott’s frac- perambulator-loads of crippled children for ture before the patient had time to breathe or Robert Jones to operate upon, and take back a wonder what it was all about; and here it was that similar number of loads to Baschurch.

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This observation is inconsistent with a pure ‘ground state’ tunnelling reaction hypertension nos purchase discount avalide on line, since the probability of tunnelling (and thus rate of reaction) is a function of barrier width hypertension pulmonary buy avalide 162.5mg otc, but is independent of temperature blood pressure doctor cheap 162.5 mg avalide visa. This apparent paradox is resolved by taking into account the temperature-dependent natural breathing of enzyme molecules which dis- torts the structure of the protein to produce the geometry required for nuclear tunnelling (achieved by reducing the width of the barrier between reactants and products, thus increasing the probability of tunnelling). In this dynamic view of enzyme catalysis, it is thus the width – and not the height (as with transition state theory) – of the energy barrier that controls the reaction rate. The important criterion thus becomes the ability of the enzyme to distort and thereby reduce barrier width, and not stabilisation of the tran- sition state with concomitant reduction in barrier height (activation energy). We now describe theoretical approaches to enzymatic catalysis that have led to the development of dynamic barrier (width) tunnelling the- ories for hydrogen transfer. Indeed, enzymatic hydrogen tunnelling can be treated conceptually in a similar way to the well-established quantum the- ories for electron transfer in proteins. The basic premise of transition state theory is that the reaction converting reactants (e. A B–H) is treated as a two-step reaction over a static potential energy barrier (Figure 2. B]‡ is the transi- tion state, which can interconvert reversibly with the reactants (A–H B). However, formation of the products (A B–H) from the transition state is an irreversible step. Transition state theory has been useful in providing a rationale for the so-called ‘kinetic isotope effect’. The kinetic isotope effect is used by enzy- mologists to probe various aspects of mechanism. Importantly, measured kinetic isotope effects have also been used to monitor if non-classical beha- viour is a feature of enzyme-catalysed hydrogen transfer reactions. The kinetic isotope effect arises because of the differential reactivity of, for example, a C–H (protium), a C–D (deuterium) and a C–T (tritium) bond. Enzymology takes a quantum leap forward 27 The electronic, rotational and translational properties of the H, D and T atoms are identical. However, by virtue of the larger mass of T compared with D and H, the vibrational energy of C–H C–D C–T. In the transition state, one vibrational degree of freedom is lost, which leads to differences between isotopes in activation energy. This leads in turn to an isotope- dependent difference in rate – the lower the mass of the isotope, the lower the activation energy and thus the faster the rate. The kinetic isotope effects therefore have different values depending on the isotopes being compared – (rate of H-transfer) : (rate of D-transfer) 7:1; (rate of H-trans- fer) : (rate of T-transfer) 15:1 at 25°C. For a single barrier, the classical theory places an upper limit on the observed kinetic isotope effect. However, with enzyme-catalysed reac- tions, the value of the kinetic isotope effect is often less than the upper limit. This can arise because of the complexity of enzyme-catalysed reac- tions. For example, enzymes often catalyse multi-step reactions – involv- ing transfer over multiple barriers. In the simplest case, the highest barrier will determine the overall reaction rate. However, in the case where two (or more) barriers are of similar height, each will contribute to determin- ing the overall rate – if transfer over the second barrier does not involve breakage of a C–H bond, it will not be an isotope-sensitive step, thus leading to a reduction in the observed kinetic isotope effect. An alternative rationale for reduced kinetic isotope effects has also been discussed in rela- tion to the structure of the transition state. However, when the transition state resembles much more closely the reactants (total energy change 0) or the products (total energy change 0), the presence of vibra- tional frequencies in the transition state cancel with ground state vibra- tional frequencies, and the kinetic isotope effect is reduced. This dependence of transition state structure on the kinetic isotope effect has become known as the ‘Westheimer effect’. Solvent dynamics and the natural ‘breathing’ of the enzyme molecule need to be included for a more complete picture of enzymatic reactions. Kramers put forward a theory that explicitly recognises the role of solvent dynamics in catalysis. For the reaction Reactants→Products, Kramers suggested that this proceeds by a process of diffusion over a poten- tial energy barrier.


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In nominal scales the re- spondent answers a question in one particular way arrhythmia associates fairfax va order avalide 162.5mg free shipping, choosing from a number of mutually exclusive answers blood pressure elderly cheapest avalide. Answers to questions about marital status arrhythmia knowledge a qualitative study avalide 162.5mg for sale, religious af- filiation and gender are examples of nominal scales of measurement. The categories include everyone in the sam- ple, no one should fit into more than one category and the implication is that no one category is better than another. Ordinal scales Some questions offer a choice but from the categories gi- HOW TO ANALYSE YOUR DATA/ 127 ven it is obvious that the answers form a scale. They can be placed on a continuum, with the implication being that some categories are better than others. The occupationally based social scale which runs from ‘professional’ to ‘unskilled manual’ is a good example of this type of scale. In this type of scale it is not possible to measure the difference between the specific categories. Interval scales Interval scales, on the other hand, come in the form of numbers with precisely defined intervals. Examples in- cluded in this type of scale are the answers from questions about age, number of children and household income. Arithmetic mean In mathematics, if you want to find a simple average of the data, you would add up the values and divide by the num- ber of items. This is a straightforward calculation used with interval scales where specific figures can be added together and then divided. However, it is possible to mislead with averages, especially when the range of the values may be great. Researchers, therefore, also describe the mode which is the most fre- quently occurring value, and the median which is the mid- dle value of the range. The mode is used when dealing with nominal scales, for example it can show that most respon- dents in your survey are Catholics. Quantitative data analysis can involve many complex sta- 128 / PRACTICAL RESEARCH METHODS tistical techniques which cannot be covered in this book. If you wish to follow this route you should read some of the data analysis books recommended below. SUMMARY X The methods you use to analyse your data will depend upon whether you have chosen to conduct qualitative or quantitative research. X For quantitative data analysis, issues of validity and re- liability are important. Ask two researchers to analyse a transcript and they will probably come up with very different results. X After having conducted an interview or a focus group, it is useful to complete a summary form which con- tains details about the interview. This can be attached to the transcript and can be used to help the analysis. X Qualitative data analysis methods can be viewed as forming a continuum from highly qualitative methods to almost quantitative methods, which involve an ele- ment of counting. X Examples of qualitative data analysis include thematic analysis, comparative analysis, discourse analysis and content analysis. X The analysis of large-scale surveys is best done with the use of statistical software, although simple frequency counts can be undertaken manually. X Data can be measured using nominal scales, ordinal scales or interval scales. HOW TO ANALYSE YOUR DATA/ 129 X A simple average is called an arithmetic mean; the middle value of a range is called the median; the most frequently occurring value is called the mode. WRITTEN REPORTS If you are a student your college or university may have strict rules and guidelines which you have to follow when writing up your report. You should find out what these might be before you start your research as this could influ- ence your research methodology, as Jeanne found out (see Example 13). EXAMPLE 13: JEANNE I am a mature student and had worked for many years in a women’s refuge prior to taking up my course. Naturally when it came to doing my dissertation I wanted to do some research within the refuge. I was in- terested in issues of women helping themselves to run the refuge rather than having inappropriate activities imposed upon them, sometimes by social workers who really had no experience of what the women were going through. That’s when I found out about action 131 132 / PRACTICAL RESEARCH METHODS research.