By C. Peer. San Francisco Art Institute.

Each piece contains an enzyme which reacts specifically with certain urine chemicals (e order eulexin 250mg on line prostate cancer 6 and 7. According to the concentration of the chemical tested 250mg eulexin for sale prostate cancer, a certain change in colour occurs (0, 1+, 2+, 3+, 4+). Quantitative estimation of proteinuria: This is achieved through quantitation of protein in 24 hours urine collection (normally less than 150 mg/24hours) 5. Examination of urine for Bence Jones protein: Normally this could not be detected by Dip-Stix and needs immunoelectrophoresis. It is present in cases of multiple myeloma, amyloidosis and other types of macroglobulinemias. To estimate creatinine clearance, the patient should collect 24 hours urine from which V and U could be estimated then, blood is withdrawn for P estimation. In the male, glans penis should be cleaned by sterile water, and in the female the vulva is cleaned properly and during micturition labia are held away by fingers. In neonates and young children suprapubic aspiration of urine by fine needle is safe. Complement: Complement System is activated and consumed in immune- complex formation. Hypocomplementemia consequently occur in diseases such as: post infectious glomerulonephritis, shunt nephritis, nephritis associating subacute bacterial endocarditis, lupus nephritis and idiopathic mesangio-capillary (membrano-proliferative) glomerulonephritis. Immunoglobulins: Such as serum IgA concentrations could be high in IgA nephropathy and Henoch-Schönlein disease. Indications: For all adults with nephrotic syndrome, children with steroid resistant nephrotic syndrome and patients with renal impairment of unknown etiology. Peri-renal haematoma which is extremely common but of significance only in 1% of cases. We have to select the procedure which is the simplest, least invasive, most informative and which saves time for the patient. Renal ultrasonography should be the first radiologic procedure performed on patient with renal or urologic disorder; and in most instances it will be the only one that is required. Renal ultrasonography carries the advantages of being non-invasive, less costly and does not require special preparation. Pelvic ultrasonography may show bladder mass and calculate the residual urine (amount of urine remaining in the bladder after micturition). In addition, ultrasonography can help in examining surrounding organs and help in guiding needle for renal biopsy or aspiration of peri renal or peri-vesical collection. Doppler flow imaging of the renal vessels will assess the integrity of the blood supply of the kidney (Figure 2. It may help in diagnosis of renal artery occlusion or stenosis, renal vein thrombosis and kidney transplant rejection. Duplex ultrasonography shows the standard B-mode image with superimposed Doppler flow informations (Figure 2. An iodinated contrast media is injected intravenously and x-ray films are taken immediately, 1 minute and 15 minutes after injection. It shows the dye concentrated in the nephrons and the kidney appears opacified but no dye yet in the renal pelvis. In cases of renal artery stenosis, the nephrogram of the affected kidney appears delayed than the other healthy kidney. After nephrogram, dye will appear in the renal pelvis, ureter then the bladder (Fig. As the contrast media used is ionic and with high viscosity and the technique is done with dehydration, this can result in kidney damage (contrast media nephropathy) with rise in serum creatinine-even acute renal failure may occur. There is a group of patients who are more vulnerable to contrast media nephropathy. These are diabetics, elderly, hyperuricaemics, patients with multiple myeloma, presence of renal dysfunction, patients receiving other nephrotoxic drugs (e. Cystography and voiding cystourethrography: Diluted contrast is injected into the bladder through urethral or suprapubic catheter. When the bladder becomes full, the patient is asked to micturate and films are taken. Normally the dye does not appear in the ureters because of the normally present antireflux mechanism at ureterovesical junction. Urodynamic studies: Measuring the intravesical pressure (cystometry) and urine flow will give full anatomic and physiologic assessment of the lower urinary tract.

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Aristotle on sleep and dreams 199 For when the body is awake purchase eulexin 250mg online prostate biopsy video, the soul is its servant: it is divided among many parts of the body and is never on its own generic eulexin 250 mg prostate cancer psa 01, but assigns a part of itself to each part of the body: to hearing, sight, touch, walking, and to acts of the whole body; but the mind is never on its own. However, when the body is at rest, the soul, being set in motion and awake, administers its own household and of itself performs all the acts of the body. For the body when asleep has no perception; but the soul, which is awake, cognises all things: it sees what is visible, hears what is audible, walks, touches, feels pain, ponders, though being only in a small space. Whoever, therefore, knows how to interpret these acts correctly, knows a great part of wisdom. It would be impossible for Aristotle to say – as the writer of On Regimen does – that in sleep the body is at rest but that the soul works. Sleep is for Aristotle an affection of the complex of soul and body due to the heating and cooling of food and preventing the animal from perceiving actual sense movements. It is obvious, therefore, that we cannot say that Aristotle is influenced here by the medical writer’s views on dreams. It would be more appropriate to say that the non-specialised student of nature gives a theoretical explanation or even a justification of the view held by the distinguished doctors; this justification is given entirely in Aristotle’s own terminology and based on his own presuppositions (the two principles mentioned above). This procedure is completely in accordance with his general views on the relation between natural science and medicine discussed above. However, the incorporation of the medical view on the prognostic value of dreams into his own theory of sleep and dreams does confront Aristotle with a difficulty which he does not seem to address very successfully. For, as we have seen above, in On Dreams Aristotle says that dreams are based on the remnants of small sensitive movements which we receive in the waking state but do not notice at the time, because they are overruled by more powerful movements which claim all our attention. Yet during sleep, when the input of stronger competing sensitive movements has stopped, the remnants of these small movements come to the surface and present themselves to us in the form of dreams. As I have already said, it is exactly this mechanism to which Aristotle seems to refer in Div. The experiences of hearing thunder, tasting sweet flavours and going through a fire are apparently the result of movements in the body which present themselves at the time of sleep. These movements are not the remnants of movements which have occurred during the daytime but which were overruled then, but they are actual movements which take place at the moment of sleep and which are noticed at the moment that they occur. Now, as we have seen, Aristotle in On Dreams acknowledges that this kind of perception may take place in sleep; but he immediately adds the qualification that this kind of perception is not a dream (an enhupnion)in the strict sense of the word, whereas that is the word he is using here in On Divination in Sleep. Moreover, in the present passage Aristotle states that we perceive these movements ‘more clearly’ in sleep than in the waking state, whereas the examples of the borderline experiences he gives in On Dreams are said to be perceived ‘faintly and as it were from far away’. There are several ways to cope with this problem, none of which, how- ever, are free from difficulties. In this respect the transition from line 10 to 11 may be understood – and paraphrased with some exaggeration – as follows: ‘for then it even happens that small movements (no matter whether they are remnants of earlier perceptions or actual impressions) appear stronger than they really are’. The word ‘even’ (kai) may then be taken as pointing to the fact that the examples which follow demonstrate more than is really necessary for Aristotle’s purpose. What is necessary for the argument is that the small movements which escaped our notice in the waking state become manifest to us in sleep. This interpretation, however, seems unlikely: the present participles gignomenon, katarrheontos, gignomenes¯ ¯ , as well as the fact that no example from the visual domain is given, surely indicate that the occurrence of the stimulus and its experience by the sleeper are simultaneous. Aristotle on sleep and dreams 201 However, a similar problem presents itself further down in the text, when Aristotle considers yet another possible explanation for the phenomenon of divination in sleep; and again the difficulty arises while accommo- dating the view of another thinker, in this case the atomist philosopher Democritus. Just as when something sets water in motion or air, and this moves something else, and when the one has stopped exercising motion, such a movement continues until it reaches a certain point where the original moving agent is not present, likewise nothing prevents a certain movement and sense- perception from arriving at the dreaming souls, proceeding from the objects from which Democritus says the idols and the emanations proceed, and in whatever way they arrive, [nothing prevents them from being] more clearly perceptible at night because during the day they are scattered more easily – for at night the air is less turbulent because there is less wind at night – and from bringing about sense-perception in the body because of sleep, for the same reason that we also perceive small movements inside us better when we are asleep than when we are awake. These movements cause appearances, on the basis of which people foresee the future even about these things. Furthermore, Aristotle says explicitly that the explanation offered for these ‘extravagant’ cases of foresight is built on the assumption that they are not due to coincidence (e« mŸ ˆp¼ sumptÛmatov g©netai t¼ proorŽn). Thus he is offering an alternative explanation for cases of foresight which earlier on he attributed to coincidence (463 b 1–11) – and this was apparently also what Democritus was doing. The experiences mentioned here are clearly derived from sources outside the dreamer’s body, which emit ‘movements’ that, after travelling over a great distance, reach the soul in sleep; and they can do so more easily at night because, Aristotle says, there is less wind 53 See van der Eijk (1994) 310–12 for a discussion and fuller references. Aristotle does not say to which category the dreams discussed here belong, but it seems that, if the category of ‘coincidence’ (sumptoma¯ ) is eliminated, these dreams stand to the events they predict in a relationship of signs (semeia¯ ), and that both the event and the dream go back to a common cause. It is difficult, however, to see how the experiences described here can be accommodated within Aristotle’s theory of sleep and dreams.

Fruit Like vegetables generic eulexin 250 mg visa androgen hormone quotes, calories from whole fruit replace those from refined 250 mg eulexin with visa androgen hormone overdose, processed, empty-calorie foods. Just be sure to eat the whole fruit, fresh or frozen, as close to its coming off the tree, bush, or vine as you can. Eat color and make sure you throw in some ber- - 144 - the triad diet program ries daily (purple, blue, red, containing anthocyanidins) that can help protect your eyes from macular degeneration and keep them healthy, among other body benefits. Fruit is loaded with antioxi- dants and phytochemicals that protect your body and help direct your genes in the way we evolved. The whole fruit is better than the sauce or puree, which is better than the freshly made juice, which is better than the reconstituted juice, and so on. Fructose (monosaccharide), which is fruit sugar, is metabolized differently and slower than glucose or sucrose (table sugar). Sec- ondly, when you eat the whole fruit, you are diluting the calories in that fruit with water and fiber. It will be more slowly absorbed than the fresh-squeezed juice or if it was pureed into a sauce (e. Eating a whole fruit is not at all like taking a gulp of high fructose corn syrup, which is a concentrated mixture of glu- cose and fructose without any fiber or phytonutrients. A Note about Fruit and Vegetable Concentrates It is very popular now to consume one or several different fruit or vegetable extracts, juices, or concentrates (sold usually in a multilevel marketing structure) or the whole “green drinks” in powder form. In general, I don’t have a problem with patients pick- ing out one or two they like, feel better with, or seem to resonate with on some level. Eat a wide variety of whole fruit and veg- etables, and supplement a good whole-food diet with your juice/ vegetable drink du jour if you want. Beans Beans are a fabulous food because they are rich in protein, slow- release carbohydrates, fiber, and vitamins and minerals. They are - 145 - staying healthy in the fast lane great for diabetics, weight loss, and heart disease patients provid- ed they don’t come with a bunch of extra calories from fat, meats, and cheeses added to them. Aside from just eating the whole bean or putting them in soups, they can also be mashed into spreads that are much tastier and better for you than those creamy, white junk sauces that are of- ten served in the middle of an otherwise healthy vegetable platter (drives me crazy! The next time you throw a party or attend a potluck or sporting event, replace the usual high-calorie and fat- laden creamy dip with a nice bean spread (white, black, garbanzo, pinto, etc). Your friends will be so distracted by how good it tastes that they won’t even realize you’ve tricked them into eating some- thing that is great for their health! The simplest version of a healthy bean spread can be made by taking your favorite bean (organic if possible) and blending it up in a food processor, then adding garlic, herbs, and lemon or lime juice to taste. Another interesting and positive aspect of beans: not only are they a great blood sugar food, but they also help us to lose weight or maintain it. When you eat beans, a large percentage—approxi- mately 30 percent of the carbohydrates in the bean—doesn’t get absorbed into the bloodstream or broken down by the body. It goes into the colon, and the bacteria in the colon break it down and produce short-chain fatty acids. Not only are these fatty acids good for the colon cells but they act as a fuel for the liver to cause more 8 oxidation of fat by the body, which causes us to lose more weight. No matter the form in which they are served, beans are unfor- tunately underutilized because initially they tend to give people gas or some other G. Soaking the beans overnight, rinsing them, and then cooking them helps to mitigate these un- pleasant effects. Eating beans regularly over one to two months will also help get your gastrointestinal flora adjusted. If you have problems cut your daily consumption of beans in half until your distressing symptoms are gone, then gradually increase your dose of beans to a half or one cup per day. Yet both (in their whole, raw state—not roasted or salted) have non- oxidized essential fatty acids, vitamins and minerals, fiber, lignans, plant sterols, and protein. With respect to cardiovascular health, when replacing calories from the diet, especially meat calories, and not adding additional calories, nuts and seeds have been shown to reduce cholesterol and the incidence of cardiovascular disease and heart attacks. In the “Nurses’ Health Study,” women who consumed nuts greater than five times per week had about a 35 percent lower risk of coronary heart disease; 39 percent reduction of fatal coro- nary heart disease; and a 32 percent reduction in non-fatal heart attacks than those women who rarely ate nuts. They were just eating an Ameri- can diet and some of them had nuts and seeds and some of them didn’t. And because of that one change, they had a 40 percent or more reduction in sudden cardiac death.

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Anaerobic streptococcal myonecrosis clinically resembles subacute clostridial gas gangrene buy eulexin 250mg low price man health 4 all. The involved muscles are discolored order 250mg eulexin amex prostate cancer urination, in contrast to gas gangrene, early cutaneous erythema is prominent. The infection is usually mixed; anaerobic streptococci with group A Streptococcus or S. Treatment involves the use of high-dose penicillin and antistaphylococcal agent, if indicated, and surgical debridement. Cellulitis often develops within 12 to 24 hours, accompanied by excruciating pain, marked edema, and bullae. Infected vascular gangrene is a focal, usually indolent and primarily ischemic process in the small muscles of a distal lower extremity already gangrenous from arterial insufficiency. Diabetic patients are prone to develop this complication, which usually does not extend 308 Sharma and Saravolatz beyond the area of vascular gangrene to involve viable muscle. Bacterial infection of the muscle usually occurs after a penetrating wound, vascular insufficiency, or a contiguous spread. Common muscle involvement includes deltoid, psoas, biceps, gastrocnemius, gluteal, and quadriceps, though any muscle group can be involved. Patients will typically present with fever, pain, tenderness, and swelling of the involved muscle. Early modification of initial antimicrobial therapy is based on Gram stain and culture results. The most common lesion requiring hospitalization is the infected diabetic foot ulcer (Fig. Neuropathy plays a central role, with disturbances of sensory, motor, and autonomic functions leading to ulcerations due to trauma or excessive pressure on a deformed foot. This wound may progress to become actively infected, and by contiguous extension the infection can involve deeper tissues. Various immunological disturbances, especially involving the polymorphonuclear leukocytes, may affect some diabetic patients. Chronic wounds develop a more complex colonizing flora including enterococci; Enterobacteriaceae; obligate anaerobes, P. Therapy Initial therapy is empirical and should be based on severity of infection and available microbiological data, such as recent culture results or current smear findings from adequately obtained specimens. The microbiology can be identified by culture only if specimens are collected and processed properly. Deep tissue specimens, obtained aseptically at surgery, contain the true pathogens more often than do samples obtained from superficial lesions. A curettage or tissue scraping with a scalpel from the base of a debrided ulcer provides more accurate results. An antibiotic regimen should always include an agent active against staphylococci and streptococci. Previously treated or severe cases may need extended coverage that also includes commonly isolated gram-negative bacilli and Enterococcus spp. Necrotic, gangrenous, deep, or foul smelling wounds usually require antianaerobic therapy. For moderate to severe infection ampicillin/sulbactam or piperacillin/tazobactam can be used. The duration of treatment for life-threatening infection may be two weeks or longer. Many infections require surgical procedures that range from drainage and excision of infected and necrotic tissues to revascularization or amputation (for treatment refer to Table 3). Severe Skin and Soft Tissue Infections in Critical Care 309 Figure 7 (A) Limb-threatening left diabetic foot ulcer (B) Rapid progression to gas gangrene. As a result of repeated injections into a single site, skin and surrounding tissue are damaged, develop local ischemia and necrosis, and become susceptible to infection. Opiates suppress T-cell functions and also inhibit phagocytosis, chemotaxis, and killing by neutrophils and macrophages. Infection ranges from cellulitis to skin and soft tissue abscesses, and occasionally fasciitis and pyomyositis. The most common sites of involvement correspond to injection sites: the upper and lower extremities, the groin and antecubital fossa, with the microbiology being monomicrobial or polymicrobial, involving S.

It is worth in this family is a missense mutation generic 250 mg eulexin fast delivery prostate oncology 77024, resulting in substitution of briefly reviewing the progress eulexin 250mg without a prescription mens health cover, which has been made relating to asparagine by lysine (N47K). In a study of a large Mennonite Other clinically interesting phenomena associated with muta- family, many of whose members had Hirschsprung disease, tion at this locus have also been observed. This was an interesting mutation, the presence of such features in only very subtle form, does lead which showed dosage sensitivity. The in the right temporo-occipital region, and spots of retinal depig- syndrome dates from the 1963 report of Tietz of a family in mentation, in whom severe intestinal innervation defects were which deafness segregated as a dominant trait over six genera- established. These clinical findings were causally attributed tions but always in association with albinism. Nonetheless, the patients have persistent bowel symptoms suggestive of bowel obstruction. However, care- patients had been recognised as having an underlying genetic ful attention to clinical examination and investigation in these syndrome and indeed it is never addressed in any of these patient groups has contributed enormously to an enhanced publications as to whether any of the patients included in the understanding of the molecular mechanisms, the mutational various series were related. Phelps recognised that almost all spectrum, and the embryological events, which underlie the dif- cases of Pendred syndrome manifest dilatation of the vestibular fering presentations of Waardenburg syndrome. This interest in investigating deaf patients more systematically and in seeking to Phenotypic studies of syndromes with an identify the precise basis of the deafness has established that already established genetic basis enhances dilatation of the vestibular aqueduct is not confined to Pendred clinical data, patient management and syndrome. Indeed, it is not at all surprising, considering drives further research the shared pathology of ion transporter defects seen in both con- The cloning of a gene and the establishment of causative muta- ditions, that renal tubular acidosis and deafness, a distinct auto- tions at that locus for various phenotypes are sometimes seen as somal recessive condition, should share this characteristic with an end in itself. However, to clinicians, may be a genetically distinct autosomal recessive syndrome of families with the condition and those charged with delivery of dilatation of the vestibular aqueduct and deafness separate from medical services to such patients and families, the identification Pendred syndrome and for which the locus remains to be estab- of mutations does not usually change patient care other than by lished (63). Such claims, whether they will be validated in time facilitating identification of others in the kindred who them- or not, are only possible because of detailed phenotypic work, selves have inherited the mutation and might benefit from spe- which has continued following the identification of the genetic cific screening measures for covert disease. What the basis of Pendred syndrome and the incorporation of such muta- identification of mutations underlying a specific syndrome does tional studies into clinical practice. The best estimate currently allow is more detailed phenotypic studies of that condition and available is that Pendred syndrome mutation accounts for about encourage the clinical “teasing out” of clinically overlapping 86% of cases of vestibular aqueduct dilatation (29). Dilatation of the vestibular phenotypes, which are not due to mutation at this locus. Colobomatous ated with mutation at this locus, including cataract and anterior microphthalmia, heart disease, hearing loss and mental retardation: ocular defects (65), Otofaciocervical syndrome (66) and a con- a syndrome. J Pediatr Duane eye retraction syndrome, hydrocephalus, and aplasia of 1981; 99:223–227. The mutational basis of this, to date unique, family deletions: the clinical phenotype and molecular characterization remains unresolved at this time, but it is worth noting that other of a common newly delineated syndrome. Am J Hum Genet 1997; “nonsyndromic deafness” loci map to the same region on linkage 61:642–650. J Med given to another hitherto unique dominant pedigree mapping to Genet 1999; 36:657–663. Interstitial and terminal doubt that this pedigree represents another form of autosomal- deletions of the long arm of Chromosome 4: further delineation of dominant deafness associated with preauricular sinuses. Tale of A Nail; Proceedings of the Greenwood that a member of a specific gene family can cause a particular Genetics Center. Phe- notypic variability of del (2)(q22-q23): report of a case and review of the literature. Am J Med Genet 2003; 118A: exonic mutation in the HuP2 paired domain gene causes Waar- 86–89. In: Martini, and cartilage abnormalities with multiple synostoses and skeletal Read, Stephens, eds. Possible homozygous Waardenburg syndrome inheritance in some cases of Antley-Bixler syndrome? Concurrence of Pendred endothelin-B receptor gene in a family with Waardenburg- syndrome, autoimmune thyroiditis and simple goiter in one family. Am J Med obstruction and deafness: a developmental “neural-crest syndrome” Genet 1983; 14:231–239.

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That is order eulexin 250 mg online prostate cancer quizlet, the variance of one variable is stable at all levels of another variable cheap 250mg eulexin fast delivery man health guide. Homoscedasticity Homoscedasticity indicates that the residuals at each level of the explanatory variable have equal or similar variances. To test for homoscedasticity, a plot of the standardized residuals by the regression standardized predicted value can be examined. Incidence Rate of new cases with a condition occurring in a random population sample in a specified time period, for example, 1 year. Influence Influence is calculated as leverage multiplied by discrepancy and is used to assess the change in a regression coefficient when a case is deleted. Interaction An interaction occurs when the effects of an explanatory variable on the outcome variable changes depending upon the level of another explanatory variable. Inter-quartile range A measure of spread, that is, the width of the band that contains the middle half of the data that lies between the 25th and 75th percentiles. Interval scale variable A variable with values where differences in intervals or points along the scale can be made, for example, the difference between 5 and 10 is the same as the difference between 85 and 90. Intervening variable A variable that acts on the pathway between an outcome and an exposure variable. Kaplan-Meier survival method This method is a non-parametric estimator of survival function and is appropriate to use when some data are censored. The survival function is the probability of surviving to at least a certain time point and the graph of this probability is the survival curve. The Kaplan–Meier survival method can be used to compare the survival curves of two or more groups. Kappa statistic This statistic can be used to assess the concordance of responses for two or more raters or between two or more occasions after taking account of chance agreement. Kappa is an estimate of the proportion in agreement between raters in excess of the agreement that would occur by chance. Measures of kurtosis between −1 and 1 indicate that the distribution has an approximately normal bell-shaped curve and values around −2to+2 are a warning of some degree of kurtosis. Values below −3 or above +3 indicate that there is significant peakedness or flatness and therefore that the data are not normally distributed. Leverage Leverage indicates the influence of a data point on the fit of a regression. Leverage is a measure of how far a data point is from the mean of that predictor variable. Leverage values can range from 0 (no influence) to n–1∕n,wheren equals the sample size, with values close to 1 highly influential. Likelihood ratio The likelihood ratio is calculated as the probability of a test result in people with the disease divided by the probability of the same test result in people without the disease. A ratio greater than 1 indicates that the test result is associated with the presence of the disease. When the diagnostic test only has two outcomes, sensitivity and specificity can be used to calculate the likelihood ratios. Limits of agreement Assuming that the difference scores between two measurements are normally distributed it is expected that the 95% of the scores will lie within the interval calculated as the mean difference +/− 1. Linear-by-linear (or trend) test A statistic used to test for trends in crosstabulations where one variable is an ordered variable. This test is used to examine whether there is a trend for an outcome to increase or decrease across the categories of the ordered variable. This association is equivalent to testing whether the slope of a regression through the estimates is different from zero. Linear mixed model A statistical model that includes both fixed and random effects. This model is commonly used to analyse data when there are repeated or multiple measurements on participants. Log rank test This test can be used to examine whether there is a statistically significant difference between the survival curves of two or more groups.

Parametric tests are preferable to non-parametric tests because they have more statistical power cheap eulexin 250 mg without a prescription mens health online magazine. Partial correlation The correlation between two variables after the effects of a third or confounding variable has been removed buy eulexin 250 mg online prostate 44. Planned (apriori)contrasts Specific group differences can be assessed using planned contrasts, which are decided before data collection commences. The number of planned contrasts should be limited and have a theoretical and/or empirical basis. Population A collection of individuals to whom the researcher is interested in making an inference, for example, all people residing in a specific region or in an entire country, or all people with a specific disease. Positive predictive value The proportion of individuals with a positive diagnostic test result who have the disease. Glossary 377 Post-hoc tests After a statistically significant difference is found overall between groups, post-hoc tests are conducted to identify where particular group differences exist. Post-hoc testing occurs during the data analyses and typically involves all possible comparisons between groups. Statistical power can be influenced by many factors including the frequency of the outcome, the size of the effect, the sample size and the statistical tests used. Prevalence Rate of total cases with a condition in a random population sample in a specified time, for example 1 year. Proportional hazards The hazard (rate of the event) in one group should be a constant proportion of the hazard in the other study group over all time points. Quartiles Obtained by placing observations in an increasing order and then dividing into four groups so that 25% of the observations are in each group. The four groups formed by the three quartiles are called ‘fourths’ or ‘quarters’ Quintiles Obtained by placing observations in an increasing order and then dividing into five groups so that 20% of the observations are in each group. R Multiple correlation coefficient, that is, the correlation between the observed and predicted values of the outcome variable. Random factor Factors are considered to be random when only a sample of a wider range of groups or all possible levels is included. For example, factors may be classified as having random effects when only three or four ethnic groups are represented in the sample but the results will be generalized to all ethnic groups in the community. Range The difference between the lowest and the highest numerical values of a variable, that is, the maximum value subtracted from the minimum value. The term range is also often used to describe the values that are the limits of the range, that is, the minimum and the maximum values, for example, range 0–100. Rank sum tests Non-parametric tests, which are used when the data do not conform to a normal distribution, are used to compare distributions of two or more groups by ranking their measurements as scores, for example, the Mann–Whitney U test. Ratio scale variable An interval scale variable with a true zero value so that the ratio between two values on the scale can be calculated, for example, age in years is a ratio scale variable but calendar year of birth is not. Relative risk can only be used when the sample is randomly selected from the population. A relative risk of 2 indicates that the prevalence of the outcome in the exposed group is twice as high as the prevalence of the outcome in the non-exposed group. Reliability Reliability is used to measure the ratio of the variability between the same participants (for example, by different raters or at different times) to the total variabil- ity of all participants in the sample. Repeated measures An analysis of variance where multiple measurements of the same outcome variable has been obtained using the same participants. For example, the blood pressure of patients is collected at three time points – baseline, post-treatment, and follow-up or the blood pressure of participants is measured when they are off medication and measured again when they are on medication. Residual The difference between a participant’s value and the predicted value, or mean value, for the group. Risk is calculated as the number of individuals who have the disease divided by the total number of individuals in the sample or population. Risk factor An aspect of behaviour or lifestyle or an environmental exposure that is associated with a health-related condition.

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