Chinese Head Tax and the Chinese Exclusion Act in Canada

Chinese Head Tax and the Chinese Exclusion Act in Canada The primary huge flood of Chinese settlers to remain in Canada came north from San Francisco following the gold rush to the Fraser River Valley in 1858. During the 1860s many proceeded onward to prospect for gold in the Cariboo Mountains of British Columbia. At the point when laborers were required for the Canadian Pacific Railway, many were brought straightforwardly from China. From 1880 to 1885 around 17,000 Chinese workers helped manufacture the troublesome and perilous British Columbia segment of the railroad. Disregarding their commitments, there was a lot of bias against the Chinese, and they were paid just a large portion of the pay of white specialists. Chinese Immigration Act and the Chinese Head Tax At the point when the railroad was done and modest work in huge numbers was not, at this point required, there was a reaction from association laborers and a few lawmakers against the Chinese. After a Royal Commission on Chinese Immigration, the Canadian government passed the Chinese Immigration Act in 1885, putting a head duty of $50 on Chinese migrants with expectations of demoralizing them from entering Canada. In 1900 the head charge was expanded to $100. In 1903 the head charge went up to $500, which was around two years pay. The Canadian national government gathered about $23 million from the Chinese head charge. In the mid 1900s, preference against Chinese and Japanese was additionally exacerbated when they were utilized as strikebreakers at coal mineshafts in British Columbia. A financial droop in Vancouver set up for a full-scale revolt in 1907. Pioneers of the Asiatic Exclusion League mixed a procession into a free for all of 8000 men plundering and consuming Chinatown. With the episode of World War I, Chinese work was required in Canada once more. Over the most recent two years of the war, the quantity of Chinese migrants expanded to 4000 per year. At the point when the war finished and warriors came back to Canada searching for work, there was another reaction against the Chinese. It wasnt simply the expansion in numbers that caused caution, yet additionally the way that the Chinese had moved into claiming area and homesteads. The monetary downturn in the mid 1920s added to the hatred. Canadian Chinese Exclusion Act In 1923, Canada passed the Chinese Exclusion Act, which in actuality halted Chinese movement to Canada for almost a fourth of a century. July 1, 1923, the day the Canadian Chinese Exclusion Act happened, is known as embarrassment day. The Chinese populace in Canada went from 46,500 out of 1931 to around 32,500 out of 1951. The Chinese Exclusion Act was as a result until 1947. In that equivalent year, Chinese Canadians recovered the option to cast a ballot in Canadian government races. It wasnt until 1967 that the last components of the Chinese Exclusion Act were totally disposed of. Canadian Government Apologizes for Chinese Head Tax On June 22, 2006, Canadian Prime Minister Stephen Harper delivered a discourse in the House of Commons giving a proper statement of regret for the utilization of a head charge and the prohibition of Chinese settlers to Canada.

Versaces Men Without Ties :: Versace Image Advertising Essays

Versace's Men Without Ties Men Without Ties (p.25, Hannah) uncovers a male figure, physically fabricated, expansive bore, restricted waisted, solid legged, with one Versace tie close by and two tied around the midriff. The figure is caught in a powerfully running posture, arranged to flaunt his muscles, manufactured, essentialness and effortlessness. Men Without Ties is one of numerous bare postures in Versace's Men Without Ties, a portfolio collection of his works. Here, Versace assembles an assortment of portrayals, structures and magazine promotions, embedded into such avante-gard design magazines as Vogue, Elle, Bazaar, and so on for his Mens Wear assortment. Here, Versace acquaints with the overall population, to the energetic authorities of Versace garments and to those fans with an eye for style, his thought and idea of the New Man, Versace's man without ties. This man without ties alludes legitimately back to Roman artist's Diskobolos a marble duplicate of Greek's unique of c.450BCE . (Diskobolos is one of many enduring Roman duplicates of Greek figures, demonstrating Greek craftsmanship and models' unmistakable and long enduring impact on Roman human progress and society). This courageous measured sculpture delineates a bare competitor, a disk hurler right when the plate is swung farthest back, at the exceptionally definitive second only seconds before the disk will be taken off into the air (p.114, Robertson). Disk Thrower type models, workmanship and engineering is normal of Greek High Classical and Hellenistic craftsmanship and concerns. High Classical and Hellenistic craftsmanship want to depict sound and incredible competitors of perfect physical extent and magnificence, to speak to the enthusiastic, solid and dynamic Greek people and residents. Thusly, figures, alongside other workmanship mediums and design, plan to raise Greek's triumph and to observe Greek's triumph of a just and illuminated city-state over Persia's majestic powers; Greek progress over Persia's boorishness; reason over creature enthusiasm. Both Man Without Ties and Diskobolos , as referenced, depict an enthusiastic, athletic figure, moving dramatically in sensational activities and signals. Though Diskobolos is rendered in sculptural, life-size, three-dimensional structure, Man Without Ties is rendered in a two-dimensional, high contrast photo. By and by, the two mediums further express Greek High Classical and Hellenistic expressions' anxiety for an increasingly expressionistic figure, one that passes on and bids legitimately to the faculties through this shiny flickering of surfaces and feelings. The activity figures are presently ready to connect past its contained space and into the prompt general condition. The figures currently appear to force themselves commandingly upon the onlooker, inciting the watcher's reaction to the sensational circumstances.

Torture and Ethics Paper Research Example | Topics and Well Written Essays - 1250 words

Torment and Ethics - Research Paper Example The paper further analyzes if tormenting damages the essential human rights gave in the First Amendment and the Bill of Rights. Inevitably, it decides whether the demonstration of torment is reasonable under any moral hypothesis. Tormenting Enemy Combatants or High-esteem Targets and Standards of Morality in America Torturing of adversaries or hoodlums has been in opposition to the qualities and ethics of the Americans for long time. The Bill of Rights under the American Constitution disallowed unusual and brutal disciplines (Greenberg, 2006). Moreover, the United States’ government, other than Americans, has censured nations over the world that rehearses any demonstration of torment. This is exemplified by the nation giving shelter to people escaping their nations inspired by a paranoid fear of demonstrations of torment (Wijze, 2006). Throughout the entire existence of criminology and law, the demonstration of torment consistently has been particular. Torment frames some port ion of the antiquated procedures of discipline, which are extreme. Torment is viewed as the death penalty where the captors apply power and ruthlessness to get consistence from the criminal suspect (Ginbar, 2008). A segment of the general public has contended consistently that individuals who torment suspects are perverted people, getting joy from anguish and torment of different people. Any type of physical or mental intimidation is unsatisfactory for use on fear monger crooks or suspects since it adds up to cruel and undignified treatment, lessening the psychological capacities of the objectives. Denying individual people of their privileges and freedoms of which people ought to be overseers to is ethically unsuitable. Demonstrations of torment stay fiendish practices to be disdained and kept away from (Wijze, 2006). A lion's share of the acculturated social orders over the world see torment as a brutal and savage act that ought not be rehearsed on people. Thus, the utilization of torment has gotten monstrous analysis and judgment just as fights (Wendel, 2005). The development of expanded fear monger assaults after the 9/11 assaults, which prompted the American government to receive the strategy of torment, has seen blended responses from the general public over torment of suspected dread assault hoodlums or war detainees (Ginbar, 2008). The worldwide network forbids torment through the traditional lawful understandings, for example, the Geneva Conventions, of which America is gathering to. Rehearsing demonstrations of torment is an infringement of the profound quality gauges set out by the global understandings, which exemplify all around evident and indefeasible human respect esteems. Treating fear monger hoodlums and suspects in an uncaring manner is ethically immaterial. All people are equivalent and qualified for some indisputable privileges of which pride, found inside life, freedom, and quest for bliss, is among them (Greenberg, 2006). The United Stat es penetrates the rule of measures of ethical quality that it advocates for and loses its ethical position when it rehearses demonstrations of torment in any conditions (Davis, 2005). The authoritarian states discover an escape clause in opposing the progressions requested of them by the worldwide network. The utilization of pressure is ethically offensive since it opens America to charges of fraud, subverting its adequacy. Demonstration of Torture: Violation of Basic Human Rights and Global Implications The utilization of torment to get vital and basic data from criminal suspects,

Angel Island - Free Essay Example

Between 1890 and 1924, more than 20 million newcomers entered the Unified States, more than in any practically identical period in our countrys history. Escaping destitution and persecution for a superior, more liberated life, numerous settlers always remembered their first look at the Statue of Freedom. Holding up high an inviting light, she symbolized Americas guarantee. In the words later engraved at the statues base, Give me your tired, your poor, your clustered masses longing to inhale free. Emma Lazarus words mythologized the migration encounter for European settlers who entered the head portal of the East Drift: Ellis Island Movement Station in New York Harbor. On the West Drift, from 1910 to 1940, the larger part of workers landing in San Francisco got a substantially chillier gathering at the remote, Angel Island Migration Station. The dominant part of workers crossing the Pacific originated from Asia, not Europe. To comprehend their treatment, we should comprehend its foundations. The larger part of newcomers at Angel Island were from China and Japan. Their stories are very much archived. Less is thought about the relative modest bunch landed from different nations around the globe including the Punjab, Russia, the Philippines, Portugal, Australia, New Zealand, Mexico, and Latin America. Their stories stay to be assembled. In 1849, news that gold had been found in California drew hundreds, at that point a huge number of Chinese to the land they called Gold Mountain. A large number of the hopefuls hailed from Guangdong Region in southern China, which had been assailed by common and man-made calamities and by a crumbling provincial economy. More than 90% of the 250,000 Chinese who entered the U.S. in the vicinity of 1849 and 1882 originated from Guangdongs Pearl Waterway Delta. Numerous transients wanted to labor for a couple of years in the Assembled States and afterward come back to their country with a sizeable retirement fund. Fortune, in any case, was slippery, and numerous sojourners transformed into lasting pilgrims. The 1880 registration recorded more than 100,000 Chinese living in the U.S. At to start with, the Chinese were invited as a wellspring of shoddy and tractable work. They assembled railways, cleared land and worked in mining and agribusiness all through West. As they ended up noticeabl y settled, they looked for higher wages and their triumphs as free diggers and ranchers were despised. As the economy soured, sorted out work, daily papers, and government officials rushed to raise a clamor against an exceedingly unmistakable minority. Hostile to Chinese enactment was quickly passed at the neighborhood and state levels, and afterward all through the West. By the mid-1870s, lawmakers in Washington shaped a board of trustees to investigate forbidding Chinese workers from entering the nation. The times destructive bigotry gave a prepared reason. As Caleb Cushing, a U.S. official to China in the 1840s expressed, [We belong] to the brilliant white race whose power and benefit it is to Christianize and edify, to charge and to be complied, to overcome and to rule. I admit to a correspondence with me the white man my blood and race, regardless of whether he be a Saxon of Britain or the Celtic of Ireland. Be that as it may, I dont concede as my equivalents either the red man of America, the yellow man of Asia or the dark man of Africa. In 1877, Indiana Congressperson Oliver P. Morton stated, if the Chinese in California were white individuals I dont trust that the dissensions and fighting made against them would have existed. Asian workers were simple targets. It was the age of the mixture, which set extreme weight on European outsiders to forsake the dialect, dress, traditions, even the names from their country and to mix flawlessly into their embraced nation. Since Asians couldnt shed their yellow skin, they were esteemed perpetually unassimilable. Both the Popularity based and Republican gatherings bolstered the Chinese Rejection Demonstration of 1882, which restricted movement on the premise of nationality or race out of the blue. The law additionally explained what the Migration Demonstration of 1870 had just inferred, and particularly denied Chinese foreigners the privilege to wind up noticeably naturalized U.S. natives. The Chinese shaped the principal noteworthy deluge of workers from Asia. The example built up by their treatment set the tone for progressive influxes of newcomers from Japan, the Punjab, Korea, and the Philippines. These cross examinations were in no way, shape or form reasonable, nor were they in light of some other legitimate or down to earth point of reference. While absurd detainments were at that point the standard, the demonstration of questioning outsiders to the degree that the Chinese were grilled was unfathomable ever. These cross examinations were perplexing and itemized, and intended to entrap unwitting Chinese foreigners looking for entrance into the Unified States. The cross examinations not just introduced an obstacle for approaching migrants by dragging out their confinement at Angel Island and expanding the administration required to process Chinese outsiders, however would profoundly scar the Chinese arrival in the Unified States. Besides, the horrendous encounters at Angel Island combined with different works on following the confinements, for example, assaults of Chinatown amid the Red Frighten of the 1950s directed to a tireless dread of expulsion via landed Chinese. The cr oss examinations were something other than straightforward inquiries concerning ones town or guardians, rather they were, taken all in all, another strategy to reject the Chinese from America. Cross examinations of Chinese Settlers at Angel Island Like Ellis Island in New York Harbor, Angel Island in San Francisco Straight was a section point for outsiders in the mid-20th century. The Angel Island movement station prepared little quantities of workers from Japan, Italy, and different parts of the world and was the key place of cross examination and detainment for migrants from China (Angel Island Outline, Disc ROM). Angel Island in 1910 to uphold the Chinese Rejection Act go in 1882 and reestablished in 1892 and 1902. In spite of Chinese commitments to building the American West before 1880, the U. S. ordered laws restricting the relocation of Chinese workers after 1882 and tolerating just dealers, educators, understudies, and the groups of American-conceived Chinese. These were then 105, 465 Chinese in the nation, for the most part in California. Under the Naturalization Law of 1790, Chinese outsiders were considered outsiders ineligible to citizenship, however those conceived in the U. S were nationals under the 14th revision. Displayed in its techniques on Ellis Island, Angel Island was a station to filter the movement stream yet in addition a boundary to bar Chinese spare the individuals who fit the absolved classes or were identified with U. S residents (Angel Island Diagram, Compact disc Rom). Chinese movement, in the wake of being closed down for a long time by administrative enactment and an against Chinese atmosphere continued rapidly after 1906. The 1906 San Francisco quake devastated most movement records in the city, enabling numerous occupant Chinese to assert U. S citizenship and numerous others to claim to be paper children. Chinese Americans who came back from visits home and detailed births of children and girls along these lines made openings, which were regularly used to acquire migrants who took on the appearance of children or little girls. By this stratagem, a large number of Chinese evaded expected American avoidances (Male Prisoners at Angel Island, Album Rom). These paper children paper vendors expanded the quantity of Chinese settlers by an incredible rate. It was this assumed populace blast that would lead the Assembled States to explore all approaching Chinese migrants. Being careful about the difficulty of such a large number of real offspring of U. S. subjects of Chinese drop, the bureau of migration and naturalization searched out to confirm that these individuals were without a doubt the genuine children and little girls or the real representatives that they asserted to be. Accordingly, it was against this chronicled foundation and under these specific sponsorships that the cross examinations at Angel Island were completed from 1910 to 1940. The whole cross examination was approximately organized, yet in no way, shape or form were they normal or reasonable. In the wake of being held at Angel Island on a writ of habeas corpus, Chinese workers were grilled by a Leading body of Unique Request which was made out of two examiners, one of which was the Administrator of the Board, a stenographer, lastly a mediator. This board was not held to specialized guidelines of methodology orconfirm as utilized as a part of other government courts yet rather was permitted to utilize any methods it considered fit under the rejection demonstrations and migration laws to find out the candidates authenticity to enter the Assembled States (Lai, 20). Like foreigners at Ellis Island, outsiders at Angel Island were put through assessments were more troublesome, regularly stretching out more than a few days (Angel Island Sleeping quarters, Album ROM). Outsiders at Angel Island experienced stringent exams and thorough cross examinations. Any indica tions of transmittable sicknesses like trachoma or hookworm, both normal in Asia, or of undesired characteristics implied foreswearing of passageway (Therapeutic Handling, Compact disc Rom). Chinese foreigners likewise experienced nitty gritty lawful examinations. Authorities addressed them about moment parts of their lives in China, including the quantity of steps paving the way to their homes. Answers given by migrants were contrasted and those given by relatives and companions to similar inquiries. Little errors implied rejection and expelling (Cross examination, Disc ROM). To give a general thought of the structure of the cross examination, an overseer gave a concise depiction of the line of addressing he took: He began by getting the information on the candidate himself: his name, age, some other names, and physical portrayal. At that point we would request that he portray his family: his dad his childhood name, marriage name, and some other names he may have had, his age et cetera. At that point we would go down the line: what number of siblings and sisters depicted in detail names, age, sex, et cetera. At that point we would need to go into the more seasoned ages: fatherly grandparents; at that point what number of uncles and close relatives and they must be depicted. At that point the town: the area, what number of houses it was made out of, how masterminded, what number of houses in each column, which way the town confronted, what was the head and tail of the town. At that point the nearby neighbors. At that point depict the house: what number of rooms and portray them What markets they went to. Get some answers concerning the fathers excursion: when he got back home, to what extent was he home, did he go to any extraordinary places, and depict the trek from his town to Hong Kong (Lai 112). Along these lines, plainly there was a semi-inflexible structure to the line of scrutinizing that the controllers took. Notwithstanding, inside the cross-examination structure, assessors were allowed to veer off and get some information about anything that they felt may explain the genuine status of the migrant. At last, candidates were normally made a few inquiries a few hundred inquiries, yet at times were solicited upwards from a thousand (Chen 107). In the wake of investigating the witness, the board generally searched out different witnesses. These additional witnesses were generally made out of relatives or business accomplices. Customarily white witnesses would be acquired to affirm for the Chinese migrant being referred to. Normally the inquiries saved for these white witnesses were strikingly shorter than the inquiries asked of Chinese companions or relatives. In the wake of taking the announcements of relatives and colleagues, investigative specialists brought the outsider back in and started to inspect and additionally question slight inconsistencies in proclamations between relatives and the migrant. It is proposed that the looking at officer intently take after the examination as of now led, unmistakably building up any varieties which may show up (Letter from worker examiner to Magistrate of Movement). The time it took to take the declarations of all gatherings included more often than not extended from three to four days. The length of the cross examination was exacerbated if the relatives were situated in some eastern city, for example, Chicago or New York. In these cases, it was important to relate forward and backward and have relatives or other accessible witnesses give declaration to the Mig ration Administration workplaces in those urban areas and transmit the records back to San Francisco (Clauss 65-66). The aggregate declaration was somewhere in the range of twenty to eighty pages contingent upon the case yet for the most part found the middle value of forty or fifty pages of wrote declaration (Chen 107). At this point if a choice by the board could at present not be achieved the case would be suspended for ten days, in which more information would be assembled. In this period, letters from associates may be assembled from individuals from the group who knew the group of the settler. These colleagues would vouch for the way that, in reality the family was anticipating that a part should land on a specific day on a specific ship. Notwithstanding, more vitally, these letters frequently talked about the familys great remaining in the group. These letters generally composed by white businesspeople, were composed in the expectations that the board would be persuaded of the status of the settler and enable that individual to arrive. The basic tone of the message, nonetheless, was one of proposal. The white man was vouching for the Chinese family in these letters, expressing his own insight about the family. It was not adequate for the Chinese family to express that in reality they were anticipating that relatives should land in America. The board required a more dependable source which implied a white man. These letters more often than not praised the ideals of the Chinese native, for example, trustworthiness and commonly Christianity, which were held in high respect by a white America and particularly a white Uncommon Leading group of Request. After all the supplemental data, including the letters of proposal, was gotten and checked on a choice was made. In the event that the choice was induction, the prisoner was permitted to arrive without a moments delay. Nonetheless, if the choice was expulsion, the prisoner had five days to dissent this choice. His or her case would be retried and he or she would be reexamined. These investigative be that as it may, needed to remain on Angel Island while anticipating for their allure hearing. It was here that some would remain in upwards of two years, holding up to get notification from the board (Clauss, 50). What is most striking about this in any case, is that an ultimate choice of permitting Chinese into the nation was construct less in light of the expression of the Chinese family as it was on a reliable white man. The migration and naturalization benefit obviously realized that numerous Chinese outsiders were utilizing false claims to get access into the Assembled States. Assessors were at that point mindful of the way that a significant number of the Chinese contestants after 1906 were false. .. numerous Chinese started to come back to this nation and they guaranteed to return as locals. Truly, it would have been humanly unimaginable for a large portion of them to be natives on the grounds that there were relatively few Chinese ladies here (Lai 112). A moment motivation behind why the Chinese were cross examined was because of the way that the new foreigners were all charging that they were really residents or potential nationals, instead of outsiders. In this way, the migration station needed to test the legitimacy of these cases of citizenship status (Lai 111). The aim of the Leading body of Exceptional Request at Angel Island was to expel or reject however many planned Chinese foreigners as could reasonably be expected. Under the aegis of searching out reality and isolating the authentic outsiders from the spurious cases, the movement benefit tried to prohibit the Chinese. This is clear from the kind of inquiries solicited and the evading from customary guidelines of system. The sort of inquiries was regularly in view of past information concerning the town. After these examiners had worked a huge number of cases, they had picked up a reasonable learning of what a portion of the real towns resembled. With this learning of the town format, they made inquiries that were deliberately wrong to capture foreigners. The meticulousness and the questionable lines of addressing were just utilized as cause for avoidance. An auxiliary reason inspiring the migration benefit at Angel Island was execution. The more individuals they demonstrated blameworthy of false papers then the more effective that they appeared. Chinese settlers being landed would just draw feedback from people in general. Hence, they would incline toward whatever number Chinese expelled as could be expected under the circumstances since this would upgrade their picture as being exhaustive and totally committed watchmen. The activity at that point gave sufficient individual inspiration to the investigators to be particularly resolved against the passage of Chinese. This is obviously confirming by the cross-examination process, in which the fundamental goal was to not discover reality but rather to reject whatever number Chinese as could be expected under the circumstances. Investigative specialists made inquiries even after one had said no, or expressed that they didnt have the foggiest idea. Along these lines they could get inconsistencies when they at last addressed a similar inquiry expressed in an alternate frame. From here they could additionally address foreigners on why they didnt answer a similar inquiry the first run through. This sort of addressing was to a great degree regular for those guaranteeing to be children or little girls of U. S. nationals or accomplices in a business. The intention of the cross examination: to trap Chinese workers into negating themselves and in this way, give adequate motivation to have them expelled. The typical reaction to why migrants had addressed wrong was that they didnt comprehend the mediator the first run through. Other intriguing reasons were frequently given, for the most part expressing that the individual affirming was to a great degree anxious. On a few events, letters were sent to the Leading group of Unique Request by individuals who had affirmed, attempting to clarify a goof or a faltering in their declaration as being caused by a mishap while in transit to Angel Island making them be anxious or an affliction in which they were to a great degree tense and couldnt think or focus on the inquiries. The breaches in memory for the most part happened in light of the plentiful measures of data a large number of these workers needed to remember from their instructing books. The legitimacy of the reasons cant be found out , yet it was more than likely that huge numbers of the reasons and letters kept in touch with the Leading body of Extraordinary Request endeavored to compose anWe could contend this was unnecessary data however the board and the examiners could contend that anyone who knows about their own particular town should know their neighbors. Accordingly, expulsion in view of irregularities could be viewed as a to a great degree subjective action. Since all cases had errors each cases conflicting declaration must be weighed. At last it would be the subjective idea of the board in figuring out which logical inconsistencies were major and which were minor. This assurance of major or minor would fill in as a reason for which Chinese could be landed or ousted. In a last estimation, it must be said that the Leading body of Uncommon Request made endeavors to be reasonable and construct their choices with respect to what they felt was a reasonable assessment of the proof. The rate and number of Chinese that were prohibited because of the cross examinations was not really striking. What is of note, in any case, is the whole catastrophe that the Chinese needed to persist in endeavoring to enter America. The cross examinations transparently displayed consecrated American standards, for example, reasonableness and equity the Chinese at Angel Island were blameworthy until demonstrated pure. Not exclusively did the weight of evidence fall on them, choices concerning their extradition were made utilizing cross examination strategies which were unprecedented. The treatment of the Chinese was additionally in dissimilarity with that of all other foreigner gatherings. The historical backdrop of Chinese settlers at Angel Island contrasted and that of foreigners at Ellis Island demonstrates a distinct difference in conditions and treatment. The gathered Ellis Island of the West, Angel Island never replicated Ellis Island in all views as treatment of outsiders separated extraordinarily. European outsiders at Ellis Island were never associated with entering wrongfully. In particular they never experienced concentrated cross examinations like the Chinese did. A significant number of those at Ellis Island recollect the perplexity of being raced through quick therapeutic, legitimate, and mental examinations while imminent Chinese migrants at Angel Island sat tight calmly for their cross-examination dates (Yung 64). Cross examinations were never completed for other settler bunches in courtrooms or in some other movement station. There was basically no point of reference for the sort of treatment the Chinese withstood. The criticalness of these cross examinations lies not in the numbers that they dismissed but rather in the scars that they exited on the Chinese individuals. The troublesome involvement with Angel Island joined with the thorough cross examinations pervaded a steady dread of migration authorities. This dread drove numerous Chinese to stay quiet about their movement encounter. The trouble of the cross examinations and the treatment of Chinese at Angel Island was yet one of the elements which influenced the Chinese to live in tenacious dread of expulsion. Other migration strategies proceeded after Angel Island was shut, for example, assaults on private homes, eateries, and different organizations amid the 1950s which left numerous Chinese with an abused feeling of protection and authenticity as Joined States natives (Hong 75). Since numerous Chinese had a remark, and many entered unlawfully, and in view of the extraordinary level of extradition authorization coordinated at them, numerous Chinese lived in fear and stayed quiet about their encounters, doing whatever it takes not to implicate themselves (Hong 75). In this way, Angel Islands heritage did not end once the migrant was landed, but rather stayed with them for the duration of their lives. The Chinese were continually rem inded through the migration and naturalization administrations strategies even after 1940 and the conclusion of Angel Island movement station that they genuinely did not have a place here. The durable effect that the confinement and cross examinations had on Chinese settlers is endless, however it profoundly affected the lives of Chinese migrants as it drove them to adjust their lives as U. S. natives in the expectations that they would not be liable to movement official strategies or all the more critically extradition. The cross examinations can be extrapolated out to the level of American administrative arrangement. After the rejection demonstrations, America had viably removed the Chinese populace, however with the resurgence of movement following 1906, America endeavored to seal the breaks in the divider by setting up the cross examinations and the migration station at Angel Island. Taking a gander at the cross examinations from this viewpoint, plainly the foundation of Angel Island was basically another exertion in a purposeful arrangement to avoid the Chinese from America. Despite the fact that a precise measure cant be made of how fruitful Angel Island detainment focus was at ousting paper children and shippers, because of the vulnerability of who were genuine children and vendors and to the cross examiners failure to perceive reality, the insignificant nearness of such a confinement focus was an indication for the Chinese to keep out. Powerful or not, the cross examinations bring an intriguing and to a great degree assorted type of prohibition to American movement arrangement. By looking at the cross-examination process and the cross examinations, we pick up understanding into the spirit of Americas Chinese approach in the vicinity of 1910 and 1940. America would at long last end the cross examinations when it required the Chinese in World War II. It was this between time period, from 1910 to 1940, that would be the pivotal turning point for some Chinese migrants as they found direct through the lobbies of the confinement focus at Angel Island and in the hearings of the Leading group of Extraordinary Request, that America did not need them as.

Osteoarthritis - Free Essay Example

Sample details Pages: 27 Words: 8222 Downloads: 4 Date added: 2017/06/26 Category Health Essay Type Research paper Did you like this example? The relative effectiveness of full kinetic chain manipulative therapy and full kinetic chain rehabilitation in the treatment of osteoarthritis of the knee. Brief Synopsis of the Research Therefore in this study we aim to establish the effect of the KFC manipulative therapy alone, FKC rehabilitation alone and the combination of the two interventions on osteoarthritis of the knee. This will be done by means of a quantitative randomised comparative clinical trial. Don’t waste time! Our writers will create an original "Osteoarthritis" essay for you Create order 60 patients will have been diagnosed with osteoarthritis of the knee according to the inclusion and exclusion criteria, and will be randomly divided into 3 groups. The first group will receive 6 treatments using FKC manipulative therapy alone, the second will receive 6 treatments using FKC rehabilitation alone, and the third group will receive 6 treatments using FKC manipulative therapy combined with FKC rehabilitation. Subjective (Beck Depression Inventory, McMaster Overall Therapy Effectiveness Tool, Western Ontario and McMaster Universities Osteoarthritis Index and Berg Balance Scale) and objective (Inclinometer) measures will be taken at baseline, 1 week and 1 month follow up. These results will be recorded and the data analysed using SPSS statistical package at a 95% confidence interval. Section B: To be typed in Arial 12-point font in one and half line spacing (expand sections to fit contents, but keep within the specified maximum lengths) 1. Field of Research and Provisional Title The relative effectiveness of full kinetic chain manipulative therapy and rehabilitation in the treatment of osteoarthritis of the knee. 2. Context of the Research 1. Osteoarthritis is a very common condition, affects 9.6% of men and 18% of women aged 60 years worldwide (Woolf and Pfleger, 2003). 2. Although multi-factorial, falls cause nearly two-thirds of all non-intentional injury related deaths in older adults (Hawk et al., 2006). One of the causative factors is loss of hip and knee proprioception secondary to increased joint degeneration, thus by addressing these problems with the rehabilitation and/or adjustment there may be a decreased risk of fall. 3. There is research to suggest that applying manipulative therapy and rehabilitation to the full kinetic chain yields greater benefits for KOA patients than at home rehabilitation alone (Deyle et al., 2005), however this combination of treatments has never been compared against full kinetic chain manipulative therapy alone. 4. KOA stiffness, pain and dysfunction was shown by Deyle et al., (2000) and Deyle et al., (2005) to improve better when adding manipulative therapy to a rehab ilitation program as compared to placebo and exercise alone, respectively. 3. Research Problem and Aims Aim: The relative effectiveness of full kinetic chain manipulative therapy and rehabilitation in the treatment of osteoarthritis of the knee. Objectives: i) To determine whether manipulative therapy alone is effective in the short term treatment of KOA in terms of subjective and objective measurements. ii) To determine whether manipulative therapy alone is effective in the intermediate term treatment of KOA in terms of subjective and objective measurements. iii) To determine whether rehabilitation alone is effective in the short term treatment of KOA in terms of subjective and objective measurements. iv) To determine whether rehabilitation alone is effective in the intermediate term treatment of KOA in terms of subjective and objective measurements. v) To determine whether manipulative therapy combined with rehabilitation is effective in the short term treatment of KOA in terms of subjective and objective measurements. vi) To determine whether manipulative therapy combined with rehabilitation is effective in the intermediate term treatment of KOA in terms of subjective and objective measurements. vii) To compare sh ort term results and intermediate results, respectively. viii) To determine whether manipulative therapy combined with rehabilitation is effective in decreasing the risk of fall according to the Berg Balance Scale. ix) To determine whether rehabilitation alone is effective in decreasing the risk of fall according to the Berg Balance Scale. x) To determine which treatment method is more effective in decreasing the risk of fall according to the Berg Balance Scale. 4. Literature review Osteoarthritis is a chronic degenerative disorder with a complex aetiology (Felson, 2000). It is characterized by focal loss of articular cartilage within synovial joints, associated with hypertrophy of bone (osteophytes and subchondral bone sclerosis) and thickening of the capsule, resulting in alterations in biomechanical properties (Woolf and Pfleger, 2003). It is a very common joint disorder, affecting mostly those above the age of 60 and can occur in any joint but is most common in the hip; knee; and the joints of the hand, foot, and spine (Symmons, Mathers and Pfleger, 2003). As many as 40% of people over the age of 65 suffering symptoms associated with knee or hip OA (Zhang et al., 2008), resulting in OA becoming the fourth leading cause of disability in the years 2000 (Symmons, Mathers and Pfleger, 2003). Although no cure exists, a number of treatment options exist to provide symptomatic relief as well as improvement of joint function. Amongst these are non-pharmacological interventions, such as rehabilitation, manual therapies, acupuncture and electromodalities, as well as pharmacological measures such as oral medication and intra-articular injections. In severe cases, where nonsurgical interventions have failed, more invasive approaches may be needed (Scher and Pillinger, 2007). McCarthy (2004) compared the effectiveness of an at home exercise program on its own or when supplemented with a class-based exercise program. There was found to be a greater improvement in WOMAC score in the class-based exercise group (20.6%) than the at home group (8.8%). These relatively modest effects may be owed to inability of exercise to address a number of factors that prevent patients from maximising results from their exercise program. Fitzgerald (2005) identified quadriceps inhibition or activation failure, obesity, passive knee laxity, knee misalignment, fear or physical activity and self-efficacy as examples of such factors. The necessity for additional inter ventions to address these factors therefore becomes apparent. Tucker et al. (2003) compared the relative effectiveness of knee joint manipulation versus a non-steroidal anti-inflammatory drug (NSAID), and found manipulation to be just as effective as NSAIDs in the treatment on KOA. Fish et al., (2008) had similar results when comparing the effectiveness of knee joint mobilisation against Topical Capsaicin Cream. Capsaicin has been previously demonstrated superior to placebo in many painful disorders including knee and general osteoarthritis. Pollard, Ward, Hoskins and Hardy (2008) applied a manipulative therapy protocol, consisting of soft tissue mobilisation and an impulse thrust to the symptomatic knee joint complex. This was found to have a statistically significant improvement in knee pain, mobility, crepitus and function when compared to the control group (interferential current set at zero). Pollard et al. (2008) also noted that knee treatment had a significant improvement in hip movement of those in the intervention group compared to the control group. This may be owing to the effect that treatment to a single joint may have on the full kinetic chain (hereafter FKC). A number of studies have been conducted on various joints of the full kinetic chain of the lower extremity to determine their effect on the knee. Cliborne et al., (2004) aimed to determine the short-term effect of hip mobilization on pain and range of motion (ROM) measurement in patient with knee osteoarthritis (OA). It was demonstrated that the presence of hip pain and pain on squatting, restricted hip flexion and/or a positive scouring test predicts a better knee OA outcome. Currier et al., (2007) suggest that pain over the hip, groin or anterior thigh; limitations in passive knee flexion and internal rotation of the hip; as well as pain with hip distraction predicts a favourable short-term response to hip mobilizations. In fact it was found that, based on the presence of one variab le, the probability of a successful response was 92% at 48-hour follow-up, which increased to 97% if 2 variables were present. Iverson et al., (2008) suggest that the strongest predictor of whether adjusting the lumbopelvic spine will decrease knee pain (in patellofemoral pain syndrome) is if there is a side-to-side difference in hip internal rotation greater than 14 °. The presence of this variable increased the likelihood of a successful outcome from 45% to 80%. These studies collectively show that correcting the various dysfunctions within the kinetic chain will have a favourable effect on knee joint dysfunction. However, there has yet to be a study that seeks to improve knee osteoarthritis by treating all indicated joints in the full kinetic chain. Few studies have looked at what effect combining manipulation and rehabilitation would have in the treatment of KOA. Deyle et al., (2000) applied manual therapy to the knee as well as to the lumber spine, hip and ankle as require d. Additionally patients where given to knee exercise program to perform in the clinic on treatment days and at home. WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) scores are used to detect changes in the patients perception of function and quality of life, specifically related to the disease process. In this study, there was a 55.8% improvement in the treatment group as compared to a 14.6% improvement in those patients receiving placebo (subtherapeutic ultrasound), thus proving the effectiveness of combining manipulation and rehabilitation. Using similar methodologies, Deyle et al., (2005) compared an at home versus in clinic physical therapy program. Those being treated in clinic received supervised exercise, manual therapy to the FKC and a home exercise program, while a second group received at home exercise only. Significant improvements where seen in both groups, however the clinic treatment group had an improvement in WOMAC scores of 52% and only a 26% improvement was seen in the home exercise group. The author attributed this difference between groups to the application of manual therapy to the full kinetic chain. However, the clinic group performed the exercises under supervision and where corrected where necessary while the home group were largely unsupervised and may have performed the exercises incorrectly as a result, thus decreasing the benefit such exercises would have. One should therefore not consider the difference in group performance to be solely due to the addition of manual therapy. To date there is no study which compares the effect of manual therapy alone versus the above mentioned treatment combinations. Therefore there is a need for a study to determine whether FKC manual therapy combined with a standardised rehabilitation program is more effective than either intervention alone in the treatment of osteoarthritis of the knee. 5. Research Methodology Design type: Quantitative comparative clinical trial conducted at the Durban University of Technology Chiropractic Day Clinic (hereafter DUT CDC). Advertising: [Appendix A] Old age homes and retirement villages throughout the greater Durban region will be approached, as well as advertisements placed on notice boards of DUT, community halls, shopping centres and places of worship. Sampling procedure: A sample size of 60 (n=60) will be selected by means of convenience sampling (Brink, 2006). Those individuals responding to the advertisements will be screened and accepted based on the inclusion and exclusion criteria. Telephonic interview: Patients are required to contact the DUT CDC telephonically to determine whether they meet the requirements of the study. This will be determined by asking the patient the following questions; * Are you between the ages of 38 and 80? * Have you had knee pain for longer than 1 year? * Do you have a history of trauma or surgery to the lumbar spine or lower limb? * Are you able to stand and walk on your own, with minimal need and/or without significant dependence on canes and walkers? * Do you suffer from a chronic medical condition that would require you to take regular medication? * Would you be prepared to have radiographs taken of your lower limb? If the patient meets the criteria for the study, a consultation will be made, at which they will be presented with a letter of information and informed consent form [Appendix B], which they will be required to sign. The following inclusion and exclusion criteria will be assess using a case history [Appendix C]; physi cal exam [Appendix D]; lumbar and pelvis [Appendix E]; hip [Appendix F]; knee[Appendix G] and; ankle and foot [Appendix H] regional examinations. Inclusion Criteria: A. Criteria, as developed by Altman (1991), requires a minimum of one of the first three clinical criteria below (#1, 2 or 3) for diagnosis of KOA (sensitivity 89 % and specificity 88%). 1. Knee pain and crepitus with active motion and morning stiffness ? 30 min (with age 38 ? 80 years of age). 2. Knee pain and crepitus with active motion and morning stiffness 30 minutes and bony enlargement (with age 38 ? 80 years of age). 3. Knee pain and no crepitus and bony enlargement (with age 38 ? 80 years of age). B. The following 4 criteria are all required: 4. Knee pain of ? 1 year duration and able to stand and walk without severe varus/valgus deformity and/or severe instability (Kellgren and Lawrence, 1957). 5. Diagnosis of concurrent subluxation/or joint dysfunction (S/JD) complex: a. Diagnosis of S/JD will be supported throughout using the PART(S) system. 6. A patient must have a score of ?720 mm (?30%) on the WOMAC scale to be included (Tubach et al., 2005). 7. No history of meniscal or other knee surgery in the past 6 months (Pollard et al., 2008). 8. A diary will be kept to monitor whether medication consumption is increased, decreased or stays the same. Exclusion Criteria: 1. Significant visual disorders, severe vestibular disorders, neurological and peripheral sensory disorders which may be a contra-indication to exercise 2. History of knee or hip joint replacement, severe varus or valgus deformity, instability, fracture and severe osteoporosis, Rheumatoid arthritis, or frank avascular necrosis with or without moderate or severe deformity, 3. History of significant lumbar herniated disc injury with sequela, 4. Severe balance and proprioception problems (i.e. inability to stand with and/or without marked spinal or hip deformity) 5. Symptoms of moderate to severe osteoarthritis in both knees and/or hips: Note: both knees can be treated if there is KOA or joint dysfunction in the opposite knee and otherwise no other severe complications as noted above. However, only data collected from the worst knee will be used for the purpose of the study. 6. Long term chronicity combined with multiple treatment failure especially multiple failur e with previous physical treatment (? 3), with and/or long term severe pain, and/or a severely complicated or complex disorder (such as multiple co-morbidities combined with KOA such as a mix of: knee, hip and lumbosacral OA, and/or cardiovascular and/or auto-immune disease), or a severely disabled and/or a patient with severe and decreased functional ability and/or a severe clinical depression, may lead on a case by case basis, to exclusion. A basic guide for #6 to be used on a case by case basis: I. Pain: The patient gives a history that can be interpreted as having stayed constantly or chronically at a high level of an estimated verbal analogue score (VAS) of ? 7 or WOMAC score of 1680-1920mm (70-80%) (out of a maximum worst score of 2400mm) for 3 to 5 years or longer. II. Complicated or complex: 3 or more disorders at one time in the same patient (with KOA) as listed from #1-5 above. III. Severely disabled: dependent on a cane, brace or walker 75 to 100% of the time when ambulating; severe cardiovascular disease; severe instability in the knee or other joints or possibly less than, or markedly less than half the normal ROM. IV. Clinically depressed: determined by history and use the Beck Depression Inventory (BDI). The BDI has been validated for measuring depression in clinical and nonclinical settings (Beck et al., 1961). Radiological analysis: Although diagnosis of KOA will be made primarily through clinical examination, knee x-rays will be taken on patients who qualify and consent to participate in the clinical trial. The purpose is to determine the grade of osteoarthritic change (according to the Kellgren-Lawrence scale (reference)), to confirm suspicions of contra-indications to treatment, or to rule out a pathology outside of OA. Additionally, the subjects history and physical examination may indicate the need for lumbosacral/pelvic, hip, ankle and/or foot x-rays (see exclusion criteria below). Procedure: Time Baseline 2 weeks 4 weeks 6 weeks 1 week F/U 1 month F/U # Rx 2 2 2 Outcome measurement WOMAC ROM BBS BDI WOMAC OTE ROM BBS BDI WOMAC OTE ROM BBS BDI Once accepted into the study, patients will be randomly allocated into 3 (three) groups using a randomised allocation chart (reference). Interventions: Group A will be treated with only manipulative therapy of the FKC. Group B will be treated with only rehabilitation of the FKC. Group C will be treated with manipulative therapy combined with rehabilitation of the FKC. Manipulative therapy: [Appendix I] FKC manipulative therapy (manipulative therapy to the knee, and any indicated axial or appendicular joint dysfunction, such as to the spine, hip, ankle, and foot) for KOA has been hypothesized as superior to localised manipulative therapy (Deyle et al., 2005). Treatment will focus on carefully restoring knee flexion and extension by lesser grades of mobilization as recommended by Deyle et al., (2005) and Fish et al., (2008), and patellar mobilization as per Pollard et al., (2008), along with careful high velocity low amplitude axial elongation of the knee joint as per Fish et al., (2008). Additionally, manipulative therapy will be applied where needed to the full kinetic chain using other diversified techniques, such as HVLA manipulation or mobilization as outlined in Shafer and Faye (1990), and/or Peterson and Bergman (2002). Also, the hip technique, as outlined by Hoeksma et al., (2004) and the use of HVLA knee manipulation methods from Tucker et al., (2005) will also be utili zed when indicated. The particular joint dysfunction also known as the subluxation complex or manipulable lesion will be chosen based upon findings in the regional examinations. Rehabilitation: [Appendix J] Rehabilitative therapy will include exercises, focused soft tissue treatment and stretch to the knee and elsewhere along the full kinetic chain where needed based upon functional assessment (Deyle et al., 2005). Also included in rehabilitation will be patient advice, education and home exercise recommendations for managing their KOA. The rehabilitation protocol will be standardised across groups B and C, with minor case by case variations. Intervention frequency: All patient will receive: 6 treatments in the first three (3) weeks (2x treatments/week). Training in a rehabilitation program, to be completed daily. Regular telephonic communication (every 1-2 weeks) following the completion of the 6th treatment. All groups will be required to return to the clinic no more than one (1) week after the 6th treatment and at the one (1) month follow up to have readings taken. Measurement Tools: All data will be collected previsit 1, no more than 1 week after 6th treatment and at 1 month follow up, with the exception of OTE which will not be collected at previsit 1. Subjective data will b obtained by means of; Beck Depression Inventory [Appendix K] The McMaster Overall Therapy Effectiveness (OTE) Tool [Appendix L] will be used to assess patient satisfaction and general improvement. o The OTE is a valid and reliable questionnaire that allows the patient to classify the change in their health status: whether their KOA symptoms, or overall quality of life has improved, remained the same, or worsened since the last visit (Chan et al., 2006) The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [Appendix M] detects change in function and quality of life in patients suffering from KOA using multiple questions with the visual analogy scale (VAS). o The WOMAC is valid and reliable for KOA, and has a long history of being broadly and freque ntly utilized to assess knee and hip OA, thus allowing comparison to a large number of studies and trials (Bellamy et al., 1988). Berg Balance Scale (BBS) questionnaire [Appendix N] is a predictor of fall risk and will be delivered if the one legged standing test is failed (Hawk et al., 2006)). KOA patients who are +ve for the Berg Balance Scale (BBS) will be monitored as a subgroup (with a + OLST and BBS) at all clinic assessments Objective data will be obtained by means of: Inclinometer [Appendix O] readings for knee flexion and extension only to evaluate the patients range of motion (ROM) (reference). Statistics: The latest version of SPSS will be used to analyse the data. 6. Plan of Research Activities Provide a summarised work plan for each year of the project giving information for each research activity per year, under the following headings: Activity Timeframes (target dates for the duration of the project) 7. Structure of Dissertation / Thesis Chapters 1. Introduction 2. Review of the related literature 3. Subjects and methods 4. Results 5. Discussion 6. Recommendations and conclusions 7. References 8. Potential Outputs  § Provide details on envisaged measurable outputs (e.g. publications, patents, students, etc.);  § Expected national and/or international acclaim for the research and contribution of research outputs to building the knowledge base;  § Exploitability of outputs, e.g. applicability to community development, improved products, processes, services in SA, region and/or continent;  § Expected effects of research results. 9. Key References Brink, H. 2006. Fundamentals of research methodologies for health care professional. 2nd edition. Juta and co. Cape Town. Cliborne, A., Wainner, R., Rhon, D., Judd, C., Fee, T., Matekel, R., and Whiteman, J. 2004. Clinical hip tests and a functional squat test in patients with knee osteoarthritis: reliability, prevalence of positive test findings, and short-term response to hip mobilization. Journal of Orthopaedic Sports Physical Therapy, November; 34(11): 676-685. Currier, L., Froehlich, P., Carow, S., McAndrew, R., Cliborne, A, Boyles, R., Mansfield, L., and Wainner, R. 2007. Development of a clinical prediction rule to identify patients with knee pain and clinical evidence of knee osteoarthritis who demonstrate a favourable short-term response to hip mobilization. Physical Therapy, September; 87(9): 1106-1119. Deyle, G., Allison, S., Matekel, R., Ryder, M., Stang, J., Gohdes,D., Hutton, J., Henderson, N., and Garber, M. 2005. Physical Therapy Treatment Effectiveness fo r Osteoarthritis of the Knee: A Randomised Comparison of Supervised Clinical Exercise and Manual Therapy Procedures versus a Home Exercise Program. Physical Therapy, 85(12): 1301-1317. Deyle, G., Henderson, N., Matekel, R., Ryder, M., Garber, M., and Allison, S. 2000. Effectiveness of Manual Physical Therapies and Exercise in Osteoarthritis of the Knee. Annals of Internal Medicine, 132(3): 173-181. Felson, D. 2000.Osteoarthritis: New Insights Part 2: Treatment Approaches. In: National Iinstitute of Health Conference, Annals of Internal Medicine; 133: 726-737. Hawk, C., Hyland, J.K., Rupert, R., Colonvega, M. and Hall, S. 2006. Assessment of balance and risk for falls in a sample of community-dwelling adults aged 65 and older. Chiropractic and Osteopathy, 14(3). Haynes, S. and Gemmell, H. 2007. Topical treatments for osteoarthritis of the knee. Clinical Chiropractic; 10: 126-138. Iverson. C., Sutlive, T., Crowell, M., Morrell, R., Perkins, M., Garber, M., Moore, J., an d Wainner, R. 2008. Lumbopelvic manipulation for the treatment of patients with patellofemoral pain syndrome: development of a clinical prediction rule. Journal of Orthopaedic Sports Physical Therapy, June; 38(6): 297-312. McCarthy, C., Mills, P., Pullen, R., Roberts, C., Silman, A., and Oldman, J. 2004. Supplementing a home exercise programme with a class-based exercise programme is more effective than home exercise alone in the treatment of knee osteoarthritis. Rheumatology; 43: 880-886. Pollard, H., Ward, G., Hoskins, W. and Hardy, K. 2008. The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. Journal of the Canadian Chiropractic Association, December; 52(4): 229-242. Symmons D, Mathers C, Pfleger B. 2003. Global burden of osteoarthritis in the year 2000 [online]. Geneva: World Health Organization. Available at: URL: https://www3.who.int/whosis/menu.cfm?path=evidence,burden,burden_gbd2000docslanguage=english Tucker, M., Brantingham, J., Myburg, C. 2003. Relative effectiveness of a non-steroidal anti-inflammatory medication (Meloxicam) versus manipulation in the treatment of osteo-arthritis of the knee. European Journal of Chiropractic, 50: 163-183. Woolf, A.D. and Pfleger, B. 2003. Burden of major musculoskeletal conditions. Bulletin of the World Health Organization, 81 (9). Zhang, W., Moskowitz, R. W., Nuki, G., Abramson, S., Altman, R. D., Arden, N., Bierma-Zeinstra, S., Brandt, K. D., Croft, P., Doherty, M., Dougados, M., Hochberg, M., Hunter, D. J., Kwoh, K., Lohmander, L. S. and Tugwell, P. 2008. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage, 16:137-162. Appendix L The McMaster Overall Therapy Effectiveness (OTE) Tool (for general improvement and patient satisfaction) Patient No. Visit No. Page No. . Overall Treatment Evaluation KOA We would like to find out if there are any changes in the way you have been feeling since treatment started: after 6 treatments, and also at the 1st week and 1st month follow ups. Since treatment started, has there been any change in your ACTIVITY LIMITATION, SYMPTOMS AND/OR FEELINGS related to your knee osteoarthritis? Please indicate if there has been any change by checking ONE of the three boxes below (Better/About the same/Worse): Better About the Same Worse ? ? If you have checked ABOUT THE SAME, ? Please stop here. ? If you have checked the box If you have checked the box BETTER: WORSE: How much BETTER would you say How much WORSE would you say your ACTIVITY LIMITATION, your ACTIVITY LIMITATION, SYMPTOMS AND/OR FEELINGS SYMPTOMS AND/OR FEELINGS have been since treatment started? Have been since treatment started? Please choose ONE of the options Please choose ONE of the options below: below: Almost the same, hardly better at all Almost the same, hardly worse at all A little better A little worse Somewhat better Somewhat worse Moderately better Moderately worse A good deal better A good deal worse A great deal better A great deal worse A very great deal better A very great deal worse Patient No. Visit No. Page No. . Overall Treatment Effect CHF, continued Answer the following question whether or not you answered BETTER or WORSE and what your response was. Note if you have improved, the change will be important since you likely will be able to carry out your responsibilities with greater ease and comfort compared to before the study. If on the other hand you are worse, then you will have more difficulty carrying out your responsibilities; this will also be important for you as you have more difficulty with your activities. Is this change (BETTER/WORSE) important to you in carrying out your daily activities? Not important Slightly important Somewhat important Moderately important Important Very important Extremely important THANKS FOR YOUR COOPERATION! Description of scales and how they will be assessed: * Pages one and two are graded separately. * Page one is graded on a 15 point scale. Scored from +7 to -7 * If the answer to the first question is Better then you have a + integer * If the answer to the first question is About the Same the score is 0 * If the answer to the first question is Worse then you have a integer * With a + or integer, the answers below the better or worse response are numbered sequentially from top to bottom. Almost the same, hardly better is a 1 and A very great deal better is a 7. * Page two is graded on a 7 point scale. Scored from 1 to 7 * The answers are numbered sequentially from top to bottom. Not important is a 1 and Extremely important is a 7 Later we will dichotomize the scores on page one between scores 1 (improved) and 0 (not improved). Appendix M The WOMAC Western Ontario and McMaster Universities osteoarthritis index KNEE OSTEOARTHRITIS Name:_________________________________________________ Date:___/___/______DOB:___/___/_____ In Sections A, B and C questions will be asked in the following format and you should give your answers by putting a straight vertical (up-and-down) mark on the horizontal line. Note: 1. If make a straight vertical (up-and-down) mark on the line, at the left-hand end of the line, i.e. NO PAIN EXTREME PAIN Then you are indicating that you have no pain. Note: 2. If make a straight vertical (up-and-down) mark on the line, at the Right-hand end of the line, i.e. NO PAIN EXTREME PAIN Then you are indicating that you have extreme pain. 3. Please Note: a) that the further to the right-hand end you place your straight vertical (up-and-down) mark on the line, the more pain you are experiencing b) that the further to the left-hand end you place your str aight vertical (up-and-down) mark on the line, the less pain you are experiencing c) Please do not place your straight vertical (up-and-down) mark on the line outside the markers. You will be asked to indicate on this type of scale the amount of pain, stiffness, or disability you are experiencing. Please remember the further you place your straight vertical (up-and-down) mark on the line to the right, the more pain, stiffness, or disability you are indicating that you experience. Section A Instructions to Patients The following questions concern the amount of pain you are currently experiencing in your Knee. For each situation please enter the amount of pain recently experienced. (Please mark your answers with a straight vertical {up-and-down} mark on the line). 1. Walking on a flat surface NO PAIN EXTREME PAIN 2. Going up or down stairs NO PAIN EXTREME PAIN 3. At night while in bed NO PAIN EXTREME PAIN 4. Sitting or lying NO PAIN EXTREME PAIN 5. Standing upright NO PAIN EXTREME PAIN Section B Instructions to Patients The following questions concern the amount of joint stiffness (not pain) you are currently experiencing in your knee. Stiffness is a sensation of restriction or slowness in the case with which you move your joints. (Please mark your answers with a straight vertical {up-and-down} mark on the line). 1. How severe is your stiffness after first wakening in the morning? NO STIFFNESS EXTREME STIFFNESS 2. How severe is your stiffness after sitting, lying or resting later in the day? NO STIFFNESS EXTREME STIFFNESS Question: What degree of difficulty do you have with: 1. Descending stairs. NO DIFFICULTY EXTREME DIFFICULTY 2. Ascending stairs NO DIFFICULTY EXTREME DIFFICULTY 3. Rising from sitting NO DIFFICULTY EXTREME DIFFICULTY 4. Standing NO DIFFICULTY EXTREME DIFFICULTY 5. Bending to floor NO DIFFICULTY EXTREME DIFFICULTY 6. Walking on a flat surface NO DIFFICULTY EXTREME DIFFICULTY 7. G etting in/out of car NO DIFFICULTY EXTREME DIFFICULTY 8. Going shopping NO DIFFICULTY EXTREME DIFFICULTY 9. Putting on socks/stockings NO DIFFICULTY EXTREME DIFFICULTY 10. Rising from bed NO DIFFICULTY EXTREME DIFFICULTY 11. Taking off socks/stockings NO DIFFICULTY EXTREME DIFFICULTY 12. Lying in bed NO DIFFICULTY EXTREME DIFFICULTY 13. Getting in/out of bath NO DIFFICULTY EXTREME DIFFICULTY 14. Sitting NO DIFFICULTY EXTREME DIFFICULTY 15. Getting on/off toilet NO DIFFICULTY EXTREME DIFFICULTY 16. Heavy domestic duties NO DIFFICULTY EXTREME DIFFICULTY 17. Light domestic duties NO DIFFICULTY EXTREME DIFFICULTY Below is a ten-centimeter line that begins with 0 and ends with 10. On this scale 0 stands for â€Å"no pain†. 10 stands for pain â€Å"as bad as it can be.† The first scale is for your usual (daily or typical) level of knee pain. The second scale is for your knee pain level when it is at its worst. Please think about your usual knee pain. On the line below, make a straight vertical (up-and-down) mark on the line to show how you usually feel. NO PAIN WORST PAIN IMAGINABLE Please think about your knee pain when it is at its worst. On the line below, make a straight vertical (up-and-down) mark on the line to show how you feel when you knee pain is at its worst. NO PAIN WORST PAIN IMAGINABLE Appendix N Berg Balance Scale The Berg Balance Scale (BBS) was developed to measure balance among older people with impairment in balance function by assessing the performance of functional tasks. It is a valid instrument used for evaluation of the effectiveness of interventions and for quantitative descriptions of function in clinical practice and research. The BBS has been evaluated in several reliability studies. A recent study of the BBS, which was completed in Finland, indicates that a change of eight (8) BBS points is required to reveal a genuine change in function between two assessments among older people who are dependent in ADL and living in residential care facilities. Description: 14-item scale designed to measure balance of the older adult in a clinical setting. Equipment needed: Ruler, two standard chairs (one with arm rests, one without), footstool or step, stopwatch or wristwatch, 15 ft walkway Completion: Time: 15-20 minutes Scoring: A five-point scale, ranging from 0-4. â€Å"0† indicates the lowest level of function and â€Å"4† the highest level of function. Total Score = 56 Interpretation: 41-56 = low fall risk 21-40 = medium fall risk 0 -20 = high fall risk A change of 8 points is required to reveal a genuine change in function between 2 assessments. BERG BALANCE SCALE Name: __________________________________ Date: ___________________ Location: ________________________________ Rater: ___________________ ITEM DESCRIPTION SCORE (0-4) 1. Sitting to standing ________ 2. Standing unsupported ________ 3. Sitting unsupported ________ 4. Standing to sitting ________ 5. Transfers ________ 6. Standing with eyes closed ________ 7. Standing with feet together ________ 8. Reaching forward with outstretched arm ________ 9. Retrieving object from floor ________ 10. Turning to look behind ________ 11. Turning 360 degrees ________ 12. Placing alternate foot on stool ________ 13. Standing with one foot in front ________ 14. Standing on one foot ________ Total ________ GENERAL INSTRUCTIONS Please document each task and/or give instructions as written. When scoring, please record the lowest response category that applies for each item. In most items, the subject is asked to maintain a given position for a specific time. Progressively more points are deducted if: †¢ The time or distance requirements are not met †¢ The subjects performance warrants supervision †¢ The subject touches an external support or receives assistance from the examiner Subject should understand that they must maintain their balance while attempting the tasks. The choices of which leg to stand on or how far to reach are left to the subject. Poor judgment will adversely influence the performance and the scoring. Equipment required for testing is a stopwatch or watch with a second hand, and a ruler or other indicator of 2, 5, and 10 inches. Chairs used during testing should be a reasonable height. Either a step or a stool of average step height may be used for item # 12. 1. SITTING TO STANDING INSTRUCTIONS: Please stand up. Try not to use your hand for support. ( ) 4 able to stand without using hands and stabilize independently ( ) 3 able to stand independently using hands ( ) 2 able to stand using hands after several tries ( ) 1 needs minimal aid to stand or stabilize ( ) 0 needs moderate or maximal assist to stand 2. STANDING UNSUPPORTED INSTRUCTIONS: Please stand for two minutes without holding on. ( ) 4 able to stand safely for 2 minutes ( ) 3 able to stand 2 minutes with supervision ( ) 2 able to stand 30 seconds unsupported ( ) 1 needs several tries to stand 30 seconds unsupported ( ) 0 unable to stand 30 seconds unsupported If a subject is able to stand 2 minutes unsupported, score full points for sitting unsupported. Proceed to item #4. 3. SITTING WITH BACK UNSUPPORTED BUT FEET SUPPORTED ON FLOOR OR ON A STOOL INSTRUCTIONS: Please sit with arms folded for 2 minutes. ( ) 4 able to sit safely and securely for 2 minutes ( ) 3 able to sit 2 minutes under supervision ( ) 2 able to able to sit 30 seconds ( ) 1 able to sit 10 seconds ( ) 0 unable to sit without support 10 seconds 4. STANDING TO SITTING INSTRUCTIONS: Please sit down. ( ) 4 sits safely with minimal use of hands ( ) 3 controls descent by using hands ( ) 2 uses back of legs against chair to control descent ( ) 1 sits independently but has uncontrolled descent ( ) 0 needs assist to sit 5. TRANSFERS INSTRUCTIONS: Arrange chair(s) for pivot transfer. Ask subject to transfer one way toward a seat with armrests and one way toward a seat without armrests. You may use two chairs (one with and one without armrests) or a bed and a chair. ( ) 4 able to transfer safely with minor use of hands ( ) 3 able to transfer safely definite need of hands ( ) 2 able to transfer with verbal cuing and/or supervision ( ) 1 needs one person to assist ( ) 0 needs two people to assist or supervise to be safe 6. STANDING UNSUPPORTED WITH EYES CLOSED INSTRUCTIONS: Please close your eyes and stand still for 10 seconds. ( ) 4 able to stand 10 seconds safely ( ) 3 able to stand 10 seconds with supervision ( ) 2 able to stand 3 seconds ( ) 1 unable to keep eyes closed 3 seconds but stays safely ( ) 0 needs help to keep from falling 7. STANDING UNSUPPORTED WITH FEET TOGETHER INSTRUCTIONS: Place your feet together and stand without holding on. ( ) 4 able to place feet together independently and stand 1 minute safely ( ) 3 able to place feet together independently and stand 1 minute with supervision ( ) 2 able to place feet together independently but unable to hold for 30 seconds ( ) 1 needs help to attain position but able to stand 15 seconds feet together ( ) 0 needs help to attain position and unable to hold for 15 seconds 8. REACHING FORWARD WITH OUTSTRETCHED ARM WHILE STANDING INSTRUCTIONS: Lift arm to 90 degrees. Stretch out your fingers and reach forward as far as you can. (Examiner places a ruler at the end of fingertips when arm is at 90 degrees. Fingers should not touch the ruler while reaching forward. The recorded measure is the distance forward that the fingers reach while the subject is in the most forward lean position. When possible, ask subject to use both arms when reaching to avoid rotation of the trunk.) ( ) 4 can reach forward confidently 25 cm (10 inches) ( ) 3 can reach forward 12 cm (5 inches) ( ) 2 can reach forward 5 cm (2 inches) ( ) 1 reaches forward but needs supervision ( ) 0 loses balance while trying/requires external support 9. PICK UP OBJECT FROM THE FLOOR FROM A STANDING POSITION INSTRUCTIONS: Pick up the shoe/slipper, which is in front of your feet. ( ) 4 able to pick up slipper safely and easily ( ) 3 able to pick up slipper but needs supervision ( ) 2 unable to pick up but reaches 2-5 cm (1-2 inches) from slipper and keeps balance independently ( ) 1 unable to pick up and needs supervision while trying ( ) 0 unable to try/needs assist to keep from losing balance or falling 10. TURNING TO LOOK BEHIND OVER LEFT AND RIGHT SHOULDERS WHILE STANDING INSTRUCTIONS: Turn to look directly behind you over toward the left shoulder. Repeat to the right. (Examiner may pick an object to look at directly behind the subject to encourage a better twist turn.) ( ) 4 looks behind from both sides and weight shifts well ( ) 3 looks behind one side only other side shows less weight shift ( ) 2 turns sideways only but maintains balance ( ) 1 needs supervision when turning ( ) 0 needs assist to keep from losing balance or falling 11. TURN 360 DEGREES INSTRUCTIONS: Turn completely around in a full circle. Pause. Then turn a full circle in the other direction. ( ) 4 able to turn 360 degrees safely in 4 seconds or less ( ) 3 able to turn 360 degrees safely one side only 4 seconds or less ( ) 2 able to turn 360 degrees safely but slowly ( ) 1 needs close supervision or verbal cuing ( ) 0 needs assistance while turning 12. PLACE ALTERNATE FOOT ON STEP OR STOOL WHILE STANDING UNSUPPORTED INSTRUCTIONS: Place each foot alternately on the step/stool. Continue until each foot has touched the step/stool four times. ( ) 4 able to stand independently and safely and complete 8 steps in 20 seconds ( ) 3 able to stand independently and complete 8 steps in 20 seconds ( ) 2 able to complete 4 steps without aid with supervision ( ) 1 able to complete 2 steps needs minimal assist ( ) 0 needs assistance to keep from falling/unable to try 13. STANDING UNSUPPORTED ONE FOOT IN FRONT INSTRUCTIONS: (DEMONSTRATE TO SUBJECT) Place one foot directly in front of the other. If you feel that you cannot place your foot directly in front, try to step far enough ahead that the heel of your forward foot is ahead of the toes of the other foot. (To score 3 points, the length of the step should exceed the length of the other foot and the width of the stance should approximate the subjects normal stride width.) ( ) 4 able to place foot tandem independently and hold 30 seconds ( ) 3 able to place foot ahead independently and hold 30 seconds ( ) 2 able to take small step independently and hold 30 seconds ( ) 1 needs help to step but can hold 15 seconds ( ) 0 loses balance while stepping or standing 14. STANDING ON ONE LEG INSTRUCTIONS: Stand on one leg as long as you can without holding on. ( ) 4 able to lift leg independently and hold 10 seconds ( ) 3 able to lift leg independently and hold 5-10 seconds ( ) 2 able to lift leg independently and hold L 3 seconds ( ) 1 tries to lift leg unable to hold 3 seconds but remains standing independently. ( ) 0 unable to try of needs assist to prevent fall ( ) TOTAL SCORE (Maximum = 56) Section C: Ethics Note: Ethics requirements are faculty specific. Kindly ensure that you are aware of and have complied with the relevant ethics requirements. Tick as appropriate: Humans Organisations Animals Environment Yes à ¼ No Yes No Yes No Yes No Indicate Category (X) 1. Exempt from Ethics and Biosafety Research Committee Review (straightforward research without ethical problems) 2. Expedited review (minimal risk to humans, animals or environment) 3. Full Ethics and Biosafety Research Committee review recommended (possible risk to humans, animals, environment, or a sensitive research area) 4. Full Ethics and Biosafety Research Committee review required (risk to humans, animals, environment, or a sensitive research area) Attach Addendums (if any) ETHICAL ISSUES CHECKLIST FOR RESEARCH APPROVAL To be completed by all people wishing to conduct research under the auspices of Durban University of Technology. 1. Use the Durban University of Technologys Research Ethics Policy and Guidelines to ensure that ethical issues have been identified and addressed in the most appropriate manner, before finalising and submitting your research proposal. 2. Please indicate [by an X as appropriate] which of the following ethical issues could impact on your research. 3. Please type the motivations/further explanations where required in the cell headed COMMENTS. 4. The highlighted response cells indicate those responses which are of particular interest to the Ethics Committee NO. QUESTION YES NO N/A DECEPTION 1. Is deception of any kind to be used? and if so provide a motivation for acceptability. O COMMENTS: NO. QUESTION YES NO N/A 2. Will the research involve the use of no-treatment or placebo control conditions? If yes, explain h ow subjects interests will be protected. O COMMENTS CONFIDENTIALITY 3. Does the data collection process involve access to confidential personal data (including access to data for purposes other than this particular research project) without prior consent of subjects? If yes, motivate the necessity O COMMENTS 4. Will the data be collected and disseminated in a manner that will ensure confidentiality of the data and the identity of the participants? Explain your answer O COMMENTS 5. Will the materials obtained be stored and ultimately disposed of in a manner that will ensure confidentiality of the participants? If no, explain. If yes specify how long the confidential data will be retained after the study and how it will be disposed of. O COMMENTS 6. Will the research involve access to data banks that are subject to privacy legislation? If yes, specify and explain the necessity. COMMENTS RECRUITMENT 7 Does recruitment involve direct personal approach from the researchers to the potential subjects? Explain the recruitment process O COMMENTS 8 Are participants linked to the researcher in a particular relationship, for example employees, students, family? If yes, specify how. O COMMENTS 9 If yes to 8, is there any pressure from researchers or others that might influence the potential subjects to enrol? Elaborate. O COMMENTS 10 Does recruitment involve the circulation/publication of an advertisement, circular, letter etc? Specify O COMMENTS: advertisement 11 Will subjects receive any financial or other benefits as a result of participation? If yes, explain the nature of the reward, and safeguards O COMMENTS 12 Is the research targeting any particular ethnic or community group? If yes, motivate why it is necessary/acceptable. If you have not consulted a representative of this group, give a reason. In addition explain any consultative processes, identifying participants. Should consultation not take place, give a motivation. COMMENTS INFORMED CONSENT 13 Does the research fulfil the criteria for informed consent? [See guidelines]. If yes, no further answer is needed. If no, please specify how and why. O COMMENTS 14 Does consent need to be obtained from special and vulnerable groups (see guidelines). If yes, describe the nature of the group and the procedures used to obtain permission. COMMENTS 15 Will a Subject Information Letter be provided and a written consent be obtained? If no, explain. If yes, attach copies to proposal. In the case of subjects who are not familiar with English (e.g it is a second language), explain what arrangements will be made to ensure comprehension of the Subject Information Letter, Informed Consent Form and other questionnaires/documents. O COMMENTS 16 Will results of the study be made available to those interested? If no, explain why. If yes, explain how COMMENTS RISKS TO SUBJECTS 17 Will participants be asked to perform any acts or make statements which might be expected to cause discomfort, compromise them, diminish self esteem or cause them to experience embarrassment or regret? If yes, explain. O COMMENTS 18 Might any aspect of your study reasonably be expected to place the participant at risk of criminal or civil liability? If yes, explain. O COMMENTS 19 Might any aspect of your study reasonably be expected to place the participant at risk of damage to their financial standing or social standing or employability? If yes, explain. O COMMENTS 20 Does the protocol require any physically invasive, or potentially harmful procedures [e.g. drug administration, needle insertion, rectal probe, pharyngeal foreign body, electrical or electromagnetic stimulation, etc?] If yes, please outline below the procedures and what safety precautions will be used. O COMMENTS 21 Will any treatment be used with potentially unpleasant or harmful side effects? If yes, explain the nature of the side-effects and how they will be minimised. COMMENTS 22 Does the research involve any questions, stimuli, tasks, investigations or procedures which may be experienced by participants as stressful, anxiety producing, noxious, aversive or unpleasant during or after the research procedures? If yes, explain. COMMENTS 23 Will any samples of body fluid or body tissues be required specifically for the research which would not be required in the case of ordinary treatment? If yes, explain and list such procedures and techniques. COMMENTS 24 Are any drugs/devices to be administered? If yes, list any drugs/devices to be used and their approved status. O COMMENTS GENETIC CONSIDERATIONS 25 Will participants be fingerprinted or DNA fingerprinted? If yes, motivate why necessary and state how such is to be managed and controlled. O COMMENTS 26 Does the project involve genetic research e.g. somatic cell gene therapy, DNA techniques etc? If yes, list the procedures involved O COMMENTS BENEFITS 27 Is this research expected to benefit the subjects directly or indirectly? Explain any such benefits. COMMENTS 28 Does the researcher expect to obtain any direct or indirect financial or other benefits from conducting the research? If yes, explain. O COMMENTS SPONSORS: INTERESTS AND INDEMNITY 29 Will this research be undertaken on the behalf of or at the request of a pharmaceutical company, or other commercial entity or any other sponsor? If yes, identify the entity. O COMMENTS 30 If yes to 29, will that entity undertake in writing to abide by Durban University of Technologys Research Committees Research Ethics Policy and Guidelines? If yes, do not explain further. If no, explain. O COMMENTS 31 If yes to 30, will that entity undertake in writing to indemnify the institution and the researchers? If yes, do not explain further. If no, explain. O COMMENTS 32 Does permission need to be obtained in terms of the location of the study? If yes indicate how permission is to be obtained. O COMMENTS 33 Does the researcher have indemnity cover relating to research activities? If yes, specify. If no, explain why not. COMMENTS 34 Does the researcher have any affiliation with, or financial involvement in, any organisation or entity with direct or indirect interests in the subject matter or materials of this research? If yes, specify. O COMMENTS The undersigned declare that the above questions have been answered truthfully and accurately STUDENT NAME SIGNATURE- DATE SUPERVISOR NAME SIGNATURE DATE Please initial alongside if the project is to be registered as secret Guidelines for the Preparation of a Research Proposal (To be read in conjunction with the Postgraduate Student Guidelines) Please ensure that you have completed, in every respect, all of the following prior to submission of your Research Proposal. Students are advised to use the electronic version of the PG 4 form which is available from the DUT website or from the Faculty Officer. Please complete ALL SECTIONS, using Arial 12-point font, one and half line spacing in MS Word. Where sections are not applicable please adapt the form accordingly. 1. Proof-read your hard copy, ensure correct referencing, edit rigorously and then submit to your Supervisor(s). 2. Number all pages and show correct author source references both in the tex t proper and in the References at the end using the Harvard referencing method (IEEE for Engineering students). 3. Complete the Ethics Section, the Work Plan and the Budget correctly in every respect and again engage in a thorough spell check prior to submission to your Supervisor/Co- Supervisor(s)/ Promoter/Co-Promoter(s). 4. Please note carefully the closing dates, as outlined in the Academic Calendar, contained in the Rule Book for Students, the registration dates as well the expected duration for the completion of the project. 5. It is imperative that you adhere to your specified guidelines for completion of your research and institutional/faculty deadlines as published on the DUT website. Reviewer / Review Panel Chair Title Tel (W) Tel (H) Cell Fax e-Mail Yes No Un- clear Recommendations Signed: __________________________Date: _______________________ (Reviewer) Signed: __________________________Date: _______________________ (HoD) ETHICS CLEARANCE CERTIFICATE Student Name Student No Ethics Reference Number Date of FRC Approval Qualification Research Title: In terms of the ethical considerations for the conduct of research in the Faculty of Health Sciences, Durban University of Technology, this proposal meets with Institutional requirements and confirms the following ethical obligations: 1. The researcher has read and understood the research ethics policy and procedures as endorsed by the Durban University of Technology, has sufficiently answered all questions pertaining to ethics in the DUT 186 and agrees to comply with them. 2. The researcher will report any serious adverse events pertaining to the research to the Faculty of Health Sciences Research Ethics Committee. 3. The researcher will submit any major additions or changes to the research proposal after approval has been granted to the Faculty of Health Sciences Research Committee for consideration. 4. The researcher, with the supervisor and co-researchers will take full responsibility in ensuring that the protocol is adhered to. 5. The following section must be c ompleted if the research involves human participants: YES NO N/A v Provision has been made to obtain informed consent of the participants v Potential psychological and physical risks have been considered and minimised v Provision has been made to avoid undue intrusion with regard to participants and community v Rights of participants will be safe-guarded in relation to: Measures for the protection of anonymity and the maintenance of Confidentiality. Access to research information and findings. Termination of involvement without compromise Misleading promises regarding benefits of the research

Synergetic Solutions Report Essay - 1037 Words

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