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By Q. Redge. Bowdoin College.

Strengths A number of the many models and theories used to inform and shape social marketing interventions were identified in the review [42-44 purchase celecoxib 200mg on-line getting arthritis in fingers,] and could be used to inform future development buy 200mg celecoxib overnight delivery arthritis in fingers at 30. Weaknesses • The evidence captured in the review did not demonstrate direct association between improved intervention outcomes and any specific theory or model [43]. Strengths The use of common social marketing tools, especially formative research [41, 44, 45, 46], competitive analysis [43, 44], segmentation and targeting [41, 43], and the application of the marketing mix [42- 44,] were all described in the evidence reviewed. Weaknesses • The evidence captured in the review did not demonstrate direct association between improved outcomes and the application of any specific tools [42, 43]. Strengths • Five international systematic reviews were identified, all conforming to recognised systematic review methodology [41-44, 47]. Weaknesses Some evidence of the impacts of socially marketed interventions may not have been captured because the term social marketing is not always used to describe interventions based on social marketing principles (for example, consumer orientation and a clearly stated behavioural change objective) [41]. Behavioural and other changes • Strong evidence of social marketing intervention resulting in increased compliance with hand hygiene amongst healthcare workers [43]. Weaknesses Behavioural and other changes Few interventions measured or reported impact on health status of target audiences. Application What has been applied in the practice of social marketing for the prevention and control of communicable diseases? European Social marketing has been successfully applied in hand hygiene and sexual health interventions in Europe [45, 46, 48]. Weaknesses Focus No evidence was identified that indicates that social marketing has been used for the prevention/control of other communicable diseases. European There is limited evidence of the widespread application of social marketing to the prevention and control of communicable diseases in Europe. Targeting including hard-to-reach populations Social marketing does not appear to have been applied to the prevention and control of communicable diseases among disadvantaged and hard to reach groups.

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Qualitative Trustworthiness Data trustworthiness and quality was verified through use of the following techniques: prolonged engagement cheap 100mg celecoxib otc arthritis in the knee and running, triangulation 200mg celecoxib sale arthritis pain cold weather, member checking, and reflexive journaling. Prolonged Engagement Prolonged engagement involves an understanding of the culture one plans to investigate, as well as building trust with one’s participants (Creswell, 2007; Schensul & LeCompte, 1999). Because I have been a member of The Thyroid Support Group since 2004, trust had been established with the group owner-moderator and potential participants. In addition, as a member, I have a comprehensive understanding of the context and phenomena under study. Triangulation Triangulation includes the use of different sources, theories, and investigators in an attempt to substantiate evidence (Creswell, 2007, 2008; Schensul & LeCompte, 1999). I collected data from an interview guide and had planned to collect personal electronic 105 journals or diaries. Triangulation was achieved by using more than one theoretical position (feminism and social constructionism) to interpret the data (theoretical triangulation; Denzin, 1970). I also used the services (on a voluntary basis) of a colleague for data interpretation (consensual validation; Eisner, 1991). Member Checking Member checking involves seeking and including participants’ feedback in assessing the credibility of the study’s findings (Creswell, 2007; Schensul & LeCompte, 1999). At the end of each interview, participants reviewed their individual interview transcript for accuracy. I also asked the participants to review the findings of the research for accuracy and thoroughness. Reflexive Journaling Reflexive journaling involves acknowledging and keeping a record of one’s personal thoughts and feelings while conducting research in an attempt to eliminate researcher bias (Creswell, 2007; Moustakas, 1994). I maintained a record of personal thoughts and feelings that occurred throughout the research process. Dissemination of Findings I will be the sole researcher involved in the dissemination of the findings.

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The following are also important in showing there is no impairment likely to affect driving: adequate performance in reaction times cheap celecoxib 100mg free shipping arthritis in the knee pain, memory generic celecoxib 200mg visa arthritis medication, concentration and confdence. Impairment of cognitive functioning is Impairment of cognitive functioning is not usually compatible with the driving not usually compatible with the driving of these vehicles. Mild cognitive disability may be compatible with safe disability may be compatible with safe driving – individual assessment will driving – individual assessment will be required. Licence holders wishing to drive after surgery should establish with their own doctors when it would be safe to do so. Any decision regarding returning to driving must take into account several issues, including: recovery from the effects of the procedure anaesthetic recovery from the effects of the procedure any distracting effect of pain analgesia-related impairments (sedation or cognitive impairment) other restrictions caused by the surgery, the underlying condition or any comorbidities. Drivers have the legal responsibility to remain in control of a vehicle at all times. Such a judgement may be necessary for any of a range of conditions that may temporarily affect driving, including, but not limited to: postoperative recovery (see ‘Driving after surgery’, page 112) severe migraine limb injuries expected to show normal recovery pregnancy associated with fainting or light-headedness hyperemesis gravidarum hypertension of pregnancy recovery following Caesarean section deep vein thrombosis or pulmonary embolism. Drivers taking prescribed drugs subject to the drug-driving legislation will need to be advised to carry confrmation that these were prescribed by a registered medical practitioner. Some prescription and over-the-counter medicines can affect driving skills through drowsiness, impaired judgement and other effects. Prescribers and dispensers should consider any risk of medications, single or combined, in terms of driving – and advise patients accordingly. Advice for individual driving safety should be considered carefully for all antidepressants antipsychotics – many of these drugs will have some degree of sedating side effect via action on central dopaminergic receptors. Older drugs (chlorpromazine, for example) are highly sedating due to effects on cholinergic and histamine receptors. Newer drugs (olanzapine or quetiapine, for example) may also be sedating; others less so (risperidone, ziprasidone or aripiprazole, for example) opioids – cognitive performance may be reduced with these, especially at the start of use, but neuro-adaptation is established in most cases. Driving impairment is possible because of the persistent miotic effects of these drugs on vision. Also refer to Chapter 4, psychiatric disorders (page 79), and Chapter 5, drug or alcohol misuse and dependence (page 88). According to Section 92 of the Road Traffc Act 1988: A relevant disability is any condition which is either prescribed (by Regulations) or any other disability where driving is likely to be a source of danger to the public.

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