NR 503 WEEK 3 DISCUSSION./NR 503 WEEK 3 DISCUSSION., Exams of Nursing

Download NR 503 WEEK 3 DISCUSSION./NR 503 WEEK 3 DISCUSSION. and more Exams Nursing in PDF only on Docsity! his is a graded discussion: 60 points possible due Jul 26 Week 3: Discussion- Epidemiological Methods and Measurements No unread replies.7070 replies. Purpose: This discussion board content is intended to facilitate learning for students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of discussions provides students with opportunities to contribute graduate level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the discussion generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. Discussions foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines. Due Date:  Initial prompt due by Wednesday, 11:59 PM MT of week 3  One peer and one faculty or two peer posts due by Sunday 11:59 PM MT of week 3 A 10% late penalty will be imposed for initial discussions posted after the weekly deadline regardless of the number of days late. No postings will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT. Total Points: 60 Points Assignment Requirements 1. Utilizing the list below, choose two research methods. 2. Next, find two articles, one on each of the chosen methods, from the Chamberlain College library, or you may use one that is provided within the course and one you find from the library. The articles should be related to population health and infectious disease, chronic health, occupational health, global health, genomics, or environmental health: o Randomized Control Trial o Cohort Study o Case-Control Study o Cross-Sectional o The articles you choose should be completely in English (this includes the reference list). They should be related to population health and speak to one of the following elements from the course: Infectious disease, chronic health, occupational health, global health, genomics or environmental health. 3. Read each article and answer the following questions with detail for each article, include succinct definitions/examples or rationale as fitting to the question. Organize your answers using the number of the question you are answering (1-8). Your answers should provide more than a "yes" or "no", your answers should provide examples, critical thinking, definitions, and examples. o Does the study design specify a question, goal, of the study? Why is this important? o Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study). o Describe the participant information, include recruitment. Is selection bias present? o How is data collected? o Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? o How was the data analyzed, what statistics are provided? What are potential errors related to the study design? o What are the weaknesses of the type of study design/method? o Discuss the outcomes and the implications for implementation. 2. Post your analysis of the research studies to the DB. Your analysis should have in-text citations and utilize a scholarly voice with APA formatting. You may choose to write a Word doc and upload your doc to the discussion board for this week. 3. Respond to a total of two posts; either two (2) peer posts or a peer and faculty post, with a minimum of one paragraph of 4-5 sentences for each of their articles. Your reply post should integrate in-text citation(s) and be formatted with APA and a scholarly voice. Your reply post/s should integrate course content (such as data and correctly used course terminology) related to the study method as well as an integration of in-text citations along with a scholarly voice and APA formatting. The textbook may be utilized as a resource. You may choose to write a Word Doc and upload your Doc to the discussion board for this week. Posting Directions Spelling / Grammar etc. 5 8%  Posts should utilize correct spelling and grammar (sentence structure and avoidance of slang or casual language). 17 28% Total FORMAT Points=17 pts 60 100% DISCUSSION TOTAL=60 points Search entries or author Filter replies by unread Unread Collapse replies Expand replies Subscribed  Collapse Subdiscussion Bethany Rountree Bethany Rountree Jul 20, 2020Jul 20 at 1:49pm Manage Discussion Entry Dr. Castle and Class, For this discussion, I chose two articles related to occupational health. I have labeled these as study one and study two for the following questions. Study one is a cohort study while study two is a case-control study. Does the study design specify a question, goal, of the study? Why is this important? Study 1: Yes, this study designed a specific goal. The goal of this study was to see if labeling patients as either high cost or frequent attendees in occupational health would be a good indication of future disability for those patients. Investigating the relationship between high cost patients and future disability is important patient in order to better prepare the nurse and healthcare provider to be watching for signs of future disability due to increased risk. (Reho, et al., 2020) Study 2: Yes, this study designed a specific goal as well. The goal of this study was to first determine vitamin D levels in coal miners who work underground in a tropical region, and then, second investigate the cause behind those levels. This is important because coal miners are are most likely at high risk for low vitamin D levels, however this may vary when the coal miner is working in an area that has a high concentration of sunlight. This study can investigate whether coal miners need to be labeled as high risk for low vitamin D or not. (Dash, et al., 2020) Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study). Study 1: The methodology in study one was cohort study. Cohort studies have two different ways they can be designed. First, cohort studies can be prospective which means that the researcher begins with a specific population and follows two groups of people from that population. These two groups of people are those that have been exposed and those that have not been exposed to a factor that the researcher is pursuing. The researcher then compares the data and outcomes from both groups in order to track the disease. The second type of cohort study is retrospective. In retrospective cohort studies, the researcher exams past records and outcomes to determine the incident rate of the disease. (Curley and Vitale, 2016) For study one, a retrospective cohort study was used. This was evident by the fact that the study used medical record data and joined it with data from disability and pensions. (Reho, et al., 2020) Study 2: Study two is a case-control study. Case-control studies can either exam information retrospectively while making comparisons or these studies can follow two groups while making comparisons (Curley and Vitale, 2016). This study used the second method which followed two groups: underground workers and surface workers. These groups both included 44 participants. (Dash, et al., 2020) Describe the participant information, include recruitment. Is selection bias present? Study 1: Information was collected from two different places for this cohort study. First, information was collected from a large occupational health service, Pihlajalinna. Pihlajalinna has a total of 37 working units when this study was performed. Second, Finnish Centre for Pensions provided data regarding disability and pensions. Both of these combined totaled 31,960 participants. No selection bias was present, because all workers that fit each category was included in the study. (Reho, et al., 2020) Study 2: Criteria for participants in the underground worker group included having consent and the participant working a minimum of eight hours a day for a minimum of six days a week. Surface workers were the control group and were selected and matched based on similar activity level as the underground worker. (Dash, et al., 2020) This did create a selection bias call a volunteer bias. Volunteer bias happens when people have to volunteer to be in the study which means they may different characteristics than if a random sampling had of been performed. (Curley and Vitale, 2016) How is data collected? Study 1: Data was collected from the year 2015 from all of the occupational health patients. This gave a variety of representation, because the company works nationwide as well as working in several different industries. Pension information from 2016-2017 was gathered by those that were receiving complete disability and work ability was reduced by at least 3/5. This would cause the employee to be completely withdrawn from work. (Reho, et al., 2020) Study 2: Data was collected on both groups of participants. This data included questions about age, height, weight, and the amount of calcium the participant consumed daily. In addition, blood was drawn and tested for the following levels: creatinine, blood urea nitrogen, calcium, phosphate, and total alkaline phosphatase. (Dash, et al., 2020) Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? Study 1: Variables included were in this cohort study. The independent variables were the participants who used occupational health services, because these were the groups that were being tested. The dependent group was the disability or pension group since that group remained the same throughout the study. (Reho, et al., 2020) Study 2: The independent variable was the coal miners since they were the group that was being tested. The dependent variable was the surface workers since they were in the control group. In addition, dependent variables using the case and control method were tested to obtain odd ratios and confidence intervals on variables. (Dash, et al., 2020) How was the data analyzed, what statistics are provided? What are potential errors related to the study design? Study 1: The records of the occupational health patients were divided into multiple groups. The first group was any patient that was seen by the occupational health provider more than eight times a year. These were called frequent attendees. The second group was those that had the highest cost. These patients were any patients who were in the top 10% of the company’s occupational health spending. Lastly, the control groups were any patients that did not fit into either of the other two groups, but who had been seen at least once by the occupational health provider. These results were compared to the pension results from the years 2016-2017. The data was also divided by age and compensated for older age. The data was then studied by using frequencies and probability. The only potential error that I could think of with this study is that it did not include how the data compensated for age and disability which made it so that those calculations couldn’t be followed. Odds ratios were used in this study as well as confidence intervals. (Reho, et. al., 2020) Study 2: Vitamin D levels were compared from underground workers and surface workers. These results were analyzed, and because it showed no significant difference, it was suspected that the body had compensated. Due to this, all other results were compared between the two groups. Any results that gave the probability less than 0.1 were considered significant. These results were analyzed and indicated that the level of parathormone had a significant difference between the two groups. This was considered borderline significant since the probability was less than 0.07 It was also noted that previous studies had suggested a negative relationship between vitamin D and the parathormone level. (Dash, et al., 2020) Statistical analysis was included in this study as well as standard deviation and probability. The potential error that I can think of when it comes to this study is that the value of p or probability kept changing. First it was less than 0.07, and then it was less than 0.05. Lastly, it was less than 0.1. This did make the study hard to follow as well. What are the weaknesses of the type of study design/method? Study 1: The study was not able to calculate all of the costs, because radiology costs were not able to be determined whether or not it was a preventative test or a test needed for diagnosing disability. If the study had of used prospective cohort study design, then these costs could have been followed, and different participants could have been studied or participants might have been included in different groups. However, this would have been more time consuming. (Reho, et. al, 2020) The main goal of Health Care Research is to find the most-efficient ways in financing, managing, organizing, and delivering quality care that improves patient safety while reducing medical errors in the process. o Crystal Clough Crystal Clough Jul 27, 2020Jul 27 at 12:21am Manage Discussion Entry Dr. Castle you are absolutely correct. It amazes me all of the components that have to fall perfectly together to help maintain many of the disease processes. One of my studies was on CHF, and how to decrease 30 day readmissions by utilizing many different resources. This included the patient being on the right medication regimen, this is in hopes that the patient can understand the material that is being relayed to them. Also, having a PCP follow up appt within 7 days, many patients do not have PCPs or insurance. It amazes me how well healthcare runs like a fine tuned machine however, there are so many flaws within the systems.  Karen Castle Karen Castle Jul 22, 2020Jul 22 at 5:36am Manage Discussion Entry Please see attached research study comparison chart . I thought this might be useful to some of you. Study comparison .png  Collapse Subdiscussion Kimberly Cawthon Kimberly Cawthon Jul 22, 2020Jul 22 at 5:08pm Manage Discussion Entry Professor and class, Please see my attached Word document for this week's discussion! NR503 Week 3 DB_KimberlyCawthon.docx o Collapse Subdiscussion Karen Castle Karen Castle Jul 23, 2020Jul 23 at 5:33pm Manage Discussion Entry What are some reasons for randomization?  Crystal Clough Crystal Clough Jul 27, 2020Jul 27 at 12:25am Manage Discussion Entry The main reason for utilizing randomization is to eliminate any type of biases that may come up while performing the experiment. This in return makes the outcome of the experiment more reliable and true. This decreases or eliminates all variables from the study. o Julie Yara Julie Yara Jul 24, 2020Jul 24 at 7:13pm Manage Discussion Entry Kimberley, Sample size was a concern with both articles I elected to analyzed. The sample size of the Random Controlled Trial (RCT) study was small 129 participants and the Cross-Sectional (CS) study large at 1378 participants. For the RCT study researchers attributed poor recruitment of participants as the study involved substance abusing teens. For the CS study researchers used various methods including bootstrapping which utilizes computer-based calculations to resample for accuracy. Researchers report the large sample size and the CS design could not confirm causation. Bajwa (2015) emphasizes the importance of sample size as a small sample may not be able to reveal the true difference and a large sample sizes may delay research. Both small and large samples can lead to error therefore is it critical to understand how sample size affects research outcomes. Unfortunately correcting for sample size involves very technical equations and formula which may dissuade novel researchers. Finding the sweet spot in sample size population is an ethical concern and one that the researcher must justify. Study design must support the concept, analysis methods and help define the sample size. For example, CS studies are typically descriptive and sample sizes would be estimated via a formula. Estimating sample size for RCT studies is more complicated and depend largely on design (Bolarinwa,2020). Nurse practitioners must be able to determine if studies are valid and applicable to the population they serve. Understanding research methodology, including statistical power and sample size is requisite when performing analysis of studies that can be utilized for evidenced based care. Thank you, Julie References: Bajwa,S.(2015). Basic,common errors and essentials of statistical tools and techniques in anesthesiology research. Journal of Anesthesiology Clinical Pharamcology,31(4). Bolarinwa,O.(2020). Sample size Estimation for Health and Social Science Researchers: The Principles and Considerations for Different Study Design. Nigerian Postgraduate Medical Journal, 27( 2 ). Kelly,P.,Kyngdon,F.,Ingram,I.,Deane,F.,Baker,A.,&Osborne,B.(2018). The Client Satisfaction Questionnaire- 8: Psychometric properties in a cross-sectional survey of people attending residential substance abuse treatment. Alcohol Review, 37. doi: 10.1111/dar.12522 Trudeau, K., Black ,R., Kamon,J.,& Sussman,S. (2017). A randomized control trial of an online relapse prevention program for adolescents in substance abuse treatment. Child Youth Care Forum ,46(3). doi: 10.1007/s10566-016-9387-5 o Julie Yara Julie Yara Jul 25, 2020Jul 25 at 5:56am Manage Discussion Entry Kimberley, Sample size was a concern with both articles I elected to analyzed. The sample size of the Random Controlled Trial (RCT) study was small 129 participants and the Cross-Sectional (CS) study large at 1378 participants. For the RCT study researchers attributed poor recruitment of participants as the study involved substance abusing teens. For the CS study researchers used various methods including bootstrapping which utilizes computer-based calculations to resample for accuracy. Researchers report the large sample size and the CS design could not confirm causation. Bajwa (2015) emphasizes the importance of sample size as a small sample may not be able to reveal the true difference and a large sample sizes may delay research. Both small and large samples can lead to error therefore is it critical to understand how sample size affects research outcomes. Unfortunately o The weaknesses of the cohort study design are that it can take years to perform, be costly, and data and participants can be hard to maintain and follow (Curley & Vitale, 2016) o The outcomes of this study showed that the mortality rate was nearly double for patients diagnosed with candida bloodstream infections that did not received an infectious disease consultation. This study and resulted data provided strong evidence that an infectious disease consultation and care for those patients diagnosed with a candida bloodstream infection can improve mortality rates and health outcomes by nearly 50%. This implementation would cut lengthy hospital stay costs and save lives. (Mejia-Chew et al., 2019) Article #2- Case-control Study 1. The goal of this study was to look for a correlation between exposure to arsenic, primarily in drinking water, and resulting non-melanoma skin cancer. The study design is a case-control study. This goal is important because this type of study is a comparison model between an experimental group and a control group where a measurable outcome needs to be present. (Tae-Hoon et al., 2017) 2. The methodology for this study design is the case-control study which falls under analytic epidemiology. This type of study looks at two similar groups, one exposed to a specific variable and one that is not. The outcome of this exposure is then analyzed and developed into a proportion, or “odds ratio”, that creates a look at a person’s chance of exposure to the specific variable. (Tae-Hoon et al., 2017) 3. The participants recruited for this study were identified through the Department of Dermatology at Dong-A University Hospital all having the diagnosis of non-melanoma skin cancer between March 2013 and March 2016. These participants were voluntary and provided consent for the study. They were also chosen based on gender and age to provide a good representation of the population. Age and gender selection were the only biases present in this study. (Tae-Hoon et al., 2017) 4. The data collected began with demographic information through interviews. The participants also recorded and provided diet information based on the consumption of water, rice, and seafood. In addition, samples of urine were collected and frozen for analysis of arsenic levels. 5. The variable identified were the demographics of the participants, diet, sun exposure, social habits, and location. These variables impact the outcome which non-melanoma skin cancer associated with arsenic levels found in the participants’ urine. (Tae-Hoon et al., 2017) 6. Participant urine was analyzed for the presence of arsenic. The participant characteristics were also analyzed for similarities and differences in relation to the arsenic levels in the urine. Potential errors related to this study design are interview and participant recorded data inaccuracies, discrepancies in urine storage and testing, and human error. (Tae-Hoon, 2017) 7. The weaknesses of the case-control study design/method are the ability to isolate appropriate groups with necessary characteristics for the study’s legitimacy. In addition, there can be difficulty in matching control participants to the case group closely enough. (Curley & Vitale, 2016) 8. The outcomes of this study showed evidence-based correlation between specific types of arsenic found within participants and the presence of non-melanoma skin cancer. This study only had 124 participants which did not provide strong evidence for EBP practice changes. Additional larger studies may need to be performed to justify a practice change. The implication for change would be identifying inorganic types of arsenic when testing samples, like water, for contaminants and finding a solution for removal or other safety measure. (Tae-Hoon et al., 2017) MacKenzie Richardson References Curley, L. A., & Vitale, A. P. (2016). Population-based nursing: Concepts and competencies for advanced practice (2 nd ed.). New York; NY, Springer Publishing Company. Mejia-Chew, C., O’Halloran, J., Olsen, M., Stwalley, D., Kronen, R., Lin, C., Salazar, A., Larson, L., Hsueh, K., Powderly, W., & Spec, A. (2019). Effect of infectious disease consultation on mortality and treatment of patients with candida bloodstream infections: a retrospective, cohort study. The Lancet, 19, 1336-1344. Tae-Hoon, K., Jeong-Wook, S., Young-Seoub, H., Ki-Hoon, S. (2017). Case–control study of chronic low-level exposure of inorganic arsenic species and non-melanoma skin cancer. Journal of Dermatology, 44, 1374-1379. 1. Collapse Subdiscussion Karen Castle Karen Castle Jul 23, 2020Jul 23 at 5:34pm Manage Discussion Entry What is the difference between a cohort study and a matched cohort study?  MacKenzie Richardson MacKenzie Richardson Jul 24, 2020Jul 24 at 5:10pm Manage Discussion Entry Hello Professor Castle, A cohort study involves looking at the outcome for a specific group exposed to a variable compare to the general population exposed to the same variable. A matched cohort study involves looking at the outcome of two similar, or matched, groups where one is exposed to the variable and the other is not. Cohort studies and matched cohort studies can use a prospective or retrospective approach. (Curely & Vitale, 2016) A matched cohort study is similar to a case-control study whereas outcomes of two similar, or matched, groups are analyzed in response to exposure or non-exposure to a variable. The difference between these two studies is that case-control studies only use a retrospective approach. (Curely & Vitale, 2016) MacKenzie Richardson Reference Curley, L. A., & Vitale, A. P. (2016). Population-based nursing: Concepts and competencies for advanced practice (2 nd ed.). New York; NY, Springer Publishing Company. o Collapse Subdiscussion Tracy West Tracy West Jul 22, 2020Jul 22 at 7:12pm Manage Discussion Entry Hello Dr. Castle and Class, Case-control and cohort studies are observational studies that lie near the middle of the hierarchy of evidence (Awad & Alsaleh, 2015). Case-control studies are retrospective. They clearly define two groups at the start: one with the outcome/disease and one without the outcome/disease. They look back to assess whether there is a statistically significant difference in the rates of exposure to a defined risk factor between the groups. The cohort study design identifies a people exposed to a particular factor and a comparison group that was not exposed to that factor and measures and compares the incidence of disease in the two groups. A higher incidence of disease in the exposed group suggests an association between that factor and the disease outcome. This study design is generally a good choice when dealing with an outbreak in a relatively small, well-defined source population, particularly if the disease being studied was fairly frequent (Awad & Alsaleh, 2015). Learning about these different studies are intriguing and important for our future practice. Regarding the cohort study about breast cancer and pesticides the credibility of your article seems to be of decent quality but a little suspect due to the article being biased. Is it possible to trust a source 100% when there is bias involved? How do we determine the correct numbers if all women were not used and the fact that the study was limited to data from California only? Tonisa :-) 2. Collapse Subdiscussion Karen Castle Karen Castle Jul 23, 2020Jul 23 at 5:35pm Manage Discussion Entry Is the cohort study design an effective scientific method for measuring the effects of a suspected risk factor?  Sheel Shah Sheel Shah Jul 25, 2020Jul 25 at 10:24pm Manage Discussion Entry Cohort studies are often allow researchers to ask a question and form a hypothesis about what causes various diseases. It is a great way to collect data as they can observe a group of people ( a cohort ) for a certain period of time, using this data they can come up with an analysis. In essence, it generally shows us cause and effect. This is a probably the best way to measure the effects of a suspected risk factor. For instance, a classic example would be smoking. A study was done in Denmark to assess the effects of air pollution and occupation on lung cancer, with control for smoking habits (Engholm, G., Palmgren, F., & Lynge, E, 1996). The cohort study included the national population of Denmark and concluded that smoking is the main factor behind the regional differences in lung cancer incidence and air pollution in Denmark. In this study, scientists observed people age 30-64 and over time created an analysis based on information gathered to conclude that smoking had increased risks for lung cancer and air pollution in different regions. Engholm, G., Palmgren, F., & Lynge, E. (1996). Lung cancer, smoking, and environment: a cohort study of the Danish population. BMJ (Clinical research ed.), 312(7041), 1259–1263. https://doi.org/10.1136/bmj.312.7041.1259  Tracy West Tracy West Jul 26, 2020Jul 26 at 6:22pm Manage Discussion Entry Hello Dr. Castle The cohort study design identifies the goal of individuals and investigate the association between risk factor and outcomes (Adams et al., 2016). In a retrospective study, it is likely that not all relevant risk factors have been recorded. This may affect the validity of a reported association between risk factor and outcome when adjusted for confounding. In addition, it is possible that the measurement of risk factors and outcomes would not have been as accurate as in a prospective cohort study. Many of the advantages and disadvantages of retrospective cohort studies are similar to those of prospective studies. Retrospective cohort studies are typically constructed from previously collected records, in contrast to prospective design, which involves identification of a prospectively followed group, with the objective of investigating the association between one or more risk factors and outcome. However, an advantage to both study designs is that exposure to risk factors can be recorded before the outcome occurs. This is important because it allows the sequence of risk and outcome factors to be evaluated (Adams et al., 2016). References Adams, A. S., Parker, M. M., Moffet, H. H., Jaffe, M., Schillinger, D., Callaghan, B., ... Karter, A. J. (2016). Communication barriers and the clinical recognition of diabetic peripheral neuropathy in a diverse cohort of adults: The DISTANCE study. Journal of Health Communication, 21, 544– 553. http://dx.doi.org/10.1080/10810730.2015.1103335 3. Ingrid Pradere Ingrid Pradere Jul 23, 2020Jul 23 at 6:35pm Manage Discussion Entry Hello Tracy, Thank you for sharing your post, it is very informative. It is important that we learn about the different research methods for our future as NPs. The study has a good hypothesis, definition of exposure, and eligibility criteria. One thing that could always be improved is the accuracy of exposure measurement, which I don’t feel is specified. According to the reading, cohort studies are a type of longitudinal study, meaning a method that follows research participants over a period of time (often many years) (Merrill, 2016). Cohort studies are an effective and full-bodied method of forming cause and effect. As they are usually large in size, researchers are able to make confident conclusions regarding the relationship between risk factors and disease (Merrill, 2016). Case-control studies are a type of retrospective study in that they look at the past behaviors, lifestyles, and exposures of individuals, or cases, with a pathology and compare them to the past behaviors, lifestyles and exposures of pathology-free individuals, or controls (Merrill, 2016). In other words, case-control studies collect data only after a disease has occurred to study its risk factors. While case-control studies are used to determine relative risk for a certain disease and are especially useful in the case of a rare disease, they are not as capable at showing a causal relationship, or cause of a disease as cohort studies. For example, a case-study would involve individuals already suffering from lung cancer compared to similar individuals who do not have lung cancer. Past behaviors, lifestyles, and exposures of each individual would be studied, and an association between lung cancer and smoking may be identified. A cohort study, on the other hand, would follow smokers over a long period of time to determine the outcome of smoking, whether that be lung cancer, heart disease, and stroke (Merrill, 2016). Cohort studies and case-control studies are two primary types of observational studies that help in evaluating associations between diseases and exposures (Song, J. W., & Chung, K. C. (2010). Merrill, R. M. (2016). Statistical methods in epidemiological research. Burlington, MA: Jones & Bartlett Learning. Song, J. W., & Chung, K. C. (2010). Observational studies: cohort and case-control studies. Plastic and reconstructive surgery, 126(6), 2234. o Collapse Subdiscussion Gina Sanchez Gina Sanchez Jul 22, 2020Jul 22 at 8:07pm Manage Discussion Entry Collapse Subdiscussion Karen Castle Karen Castle Jul 23, 2020Jul 23 at 5:36pm Manage Discussion Entry What are cohorts used to study?  Gina Sanchez Gina Sanchez Jul 26, 2020Jul 26 at 2:18pm Manage Discussion Entry Cohorts are used to study how a factor may or may not contribute to risk of disease development (Curley & Vitale, 2016). Cohort studies are carried out with two similar groups as baseline, then are studied when a factor is applied to one of the groups to determine how that factor affects the disease process. The two groups have a similar base risk for developing a particular disease before the factor in question is applied. Curley & Vitale (2016) state that "cohort studies are best carried out when the investigator has good evidence that links an exposure to an outcome, when the time interval between exposure and the outcome is short, and when the outcome occurs relatively often" (pg. 44). Curley, A.L. & Vitale, P.A. (2016). Population-based nursing: Concepts and competencies for advanced practice, 2nd ed. Springer Publishing Company 2. Collapse Subdiscussion Tracy West Tracy West Jul 25, 2020Jul 25 at 12:38pm Manage Discussion Entry Hello Gina, Although a family history of RA was the most significant predictor for developing RA, people with a family history of other autoimmune diseases, such as lupus, thyroid disease, inflammatory bowel disease and celiac disease also show a strong association with the risk for RA(Alleva et al., 2018). The family histories of some non-autoimmune diseases, such as pulmonary fibrosis, obstructive sleep apnea, liver disease and autism, also show a association with an increased risk for RA. A family history of type 2 diabetes and Parkinson’s disease trended toward a decreased risk for RA. Even though studies have suggested that people who have these genes could be many times more likely to develop RA than people without it, you should note that not everyone with RA has the linked HLA genes(Alleva et al., 2018). References Alleva, J. M., Diedrichs, P. C., Halliwell, E., Peters, M. L., Dures, E., Stuijfzand, B. G., & Rumsey, N. (2018). More than my RA: A randomized trial investigating body image improvement among women with rheumatoid arthritis using a functionality-focused intervention program. Journal of Consulting and Clinical Psychology, 86, 666–676. http://dx.doi.org/10.1037/ccp0000317  Gina Sanchez Gina Sanchez Jul 25, 2020Jul 25 at 2:38pm Manage Discussion Entry I'm glad you mentioned the risk of developing RA is higher among those with family history of other autoimmune diseases, Tracy. I take great interest in autoimmune diseases as I am struggling to be diagnosed. About 13 years ago, I was diagnosed with RA and Sjogren's Syndrome (an autoimmune disease characterized by dry mucous membranes) due to lack of antibodies to any of the known antibodies at the time except for the Sjogren's antibodies. I have since developed other s/s characteristic of some of the other autoimmune diseases. I continue to have systemic inflammation targeting my joints and some x-ray findings consistent with RA, however, I have yet to have symptoms of dry mucus membranes that would suggest Sjogren's. The process to test for antibodies is time consuming, many of the tests take several weeks to report. What has primarily driven me to question the RA diagnosis is the fact that my father was lupus positive and also had Raynaud's disease, which affects the extremities by essentially causing a vasospasm that leads to loss of color and heat in the fingertips or toes. There are many symptoms that could be classified among multiple autoimmune diseases further complicating diagnosis. I am glad that medicine has come a long way in narrowing down diagnosing autoimmune diseases, however, it is still disheartening that most of the autoimmune diseases have no known cause or no cure. o Collapse Subdiscussion Tonisa Hodge Tonisa Hodge Jul 22, 2020Jul 22 at 8:27pm Manage Discussion Entry Professor and class, The Randomized Control Trial Study/Population and Chronic Health 1. Does the study design specify a question, goal, of the study? Why is this important? The study does have a specific goal, the goal of the present study is to investigate the effectiveness of a multilevel intervention to increase physical activity which has demonstrated decreased risk in various cancers and other chronic diseases (Beck, 2019). This is important because the study gathers trusted information to help understand the issues and the goals that were initiated to help reduce cancers and other chronic disease. 1. Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study). This study utilized the Cluster Randomized Control Trial on rural populations in the United States. 1. Describe the participant information, include recruitment. Is selection bias present? The study took place in a 10-county region in rural southeast Missouri, participants included 1200 (at baseline) adults who are: 18–70 years of age and able to be physically active; reside in targeted communities with a walking trail intervention, control and willing to complete surveys at three time points: baseline, one-year follow-up and two-years follow-up. however, participants are not required to have a SMS capable telephone (Beck, 2019). Recruitment of participants will occur in three waves and will be facilitated by project staff and existing networks. Informed consent will be completed via a telephone script read to the participant (Beck, 2019). Intervention participants will be enrolled by active (e.g., phone calls, word of mouth, churches, businesses, and referrals) and passive (e.g., newspaper advertisements, social media, leaflet drops, and posters) strategies (Beck, 2019). 1. How is data collected? A telephone-based survey will collect demographic, behavioral, beliefs and attitudes toward PA, support for PA, and self-reported PA. Accelerometers and GPS devices will capture objective PA and location of PA (e.g., in neighborhood or at walking trails) from a subset of participants. Data collection will occur in Statistical analysis was performed using Stata version 13.0. The RAMP-DM and usual care groups. After 60 months, the RAMP-DM group showed significant reductions in all clinical parameters, indicating that the RAMP-DM group had greater improvements than the usual care group, 23.2% for RAMP DM vs 43.6% usual care group (Yuk Fai Wan et al., 2018). 1. What are the weaknesses of the type of study design/method? The weaknesses of the study design/method are, unobserved potential confounders might influence the conclusion, high attrition rates, a low number of incident events, short follow-up times, and strict subject inclusion (Yuk Fai Wan et al., 2018). 1. Discuss the outcomes and the implications for implementation The preliminary analyses found an improvement in surrogate outcomes and cardiovascular complications over 3 years, the study evaluated the long-term effectiveness of the RAMP DM regarding all DM-related complications and health service uses over 5 years to determine the characteristics of patients receiving the greatest health benefits from the program. In conclusion, the study showed that RAMP-DM, irrespective of any patient characteristics, led to significantly greater reduction in any CVD or microvascular complications and secondary or tertiary service use for patients with diabetes (Yuk Fai Wan et al., 2018). Yuk Fai Wan, E., Siu Cheung Fung, C., Jiao, F.F., Yee Tak Yu, E., Yee Chin, W., Yee Tak Fong, D., King Ho Wong, C., Ka Chun Chan, A., Hiu Yen Chan, K., Lai Ping Kwok, R. & Lo Kuen Lam, C. (2018). Five-Year Effectiveness of the Multidisciplinary Risk Assessment and Management Programme– Diabetes Mellitus (RAMP-DM) on Diabetes-Related Complications and Health Service Use A Population-Based and Propensity Matched Cohort Study. Diabetes Journal, 41, 49-59. Retrieved from: https://content.ebscohost.com/ContentServer.asp? T=P&P=AN&K=29138274&S=R&D=mdc&EbscoContent=dGJyMNXb4kSeqLA4yOvqOLCmsEiep7VSs664TK %2BWxWXS&ContentCustomer=dGJyMPGsr0%2B3rLBLuePfgeyx43zx (Links to an external site.) Tonisa :-) o Karen Castle Karen Castle Jul 23, 2020Jul 23 at 5:37pm Manage Discussion Entry Is the cohort study design an effective scientific method for measuring the effects of a suspected risk factor?  Collapse Subdiscussion Ingrid Pradere Ingrid Pradere Jul 22, 2020Jul 22 at 8:45pm Manage Discussion Entry Week 3: Discussion- Epidemiological Methods and Measurements The two selected epidemiological methods for this discussion are randomized control and a cross sectional study. Miller, A. L., Lo, S. L., Albright, D., Lee, J. M., Hunter, C. M., Bauer, K. W., Fredericks, E. M. (2020). Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): Randomized control trial study protocol. BMC Pediatrics, 20(1). doi: 10.1186/s12887-020-2012-7 o Does the study design specify a question, goal, of the study? Why is this important? In regard to the randomized control trial, the chosen article is Adolescent Interventions to Manage Self- Regulation in Type 1 Diabetes: A Systematic Review of Randomized Controlled Trails by Miller, A. L., Lo, S. L., Albright, D., Lee, J. M., Hunter, C. M., Bauer, K. W., & Katz, B. (2020). The purpose of the study is to identify if adolescents with type 1 diabetes have the capacity to control one's thoughts, emotions, and behaviors in order to achieve a desired outcomes. The study is important, because poor glycemic control places youth with T1D at a greater increased risk of acute health events including hyper and hypoglycemia and diabetic ketoacidosis, as well as serious, long-term comorbidities such as retinopathy, neuropathy, kidney disease, and cardiovascular disease. The aim is to determine whether the behavioral interventions improve Type 1 diabetes treatment regimen adherence among participating adolescents (Miller et al., 2020). o Explain the methodology (Randomized Control Trial, Cohort Study, and Case-Control Study). The methodology for this specific study is randomized control trial. Randomized Control Trials (RCTs) can provide strong and effective evidence for treatment and/or interventions because subjects are randomly assigned to either the intervention or the control group. RTCs are said to be the gold standard for effective research and provide the most reliable scientific evidence (Houser, 2018). 3. Describe the participant information, include recruitment. Is selection bias present? The study was a 24-month randomized controlled trial taking place in Ann Arbor, Michigan. The trial has been approved by the University of Michigan Institutional Review Board. A total sample of 94 participants aged 13–17 years with T1D were be selected from a pediatric diabetes clinic research registry of patients receiving diabetes care at the University of Michigan (Miller et al., 2020). 3. How is data collected? Participants were enrolled via email, phone, and text message sent to themselves or their parent(s) using contact information obtained by the Pediatrics Endocrinology clinic. The study was also advertised in newsletters sent by the clinic and via flyers available in clinic. Eligible participants were also selected face-to-face during their clinic visits (Miller et al., 2020). 3. Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? Variables in this study include biochemical assessments for blood sugar levels and demographic information. (Miller et al., 2020). 3. How the data was analyzed, what statistics are provided? What are potential errors related to the study design? Data are analyzed by use of descriptive statistics to describe and compare demographic and self-care behaviors of participants. Only 21% of adolescents meet the American Diabetes Association guidelines for Hemoglobin A1c (HbA1c) target level of 7.5% and treatment adherence and glycemic control decline across this developmental period(Miller et al., 2020). 3. What are the weaknesses of the type of study design/method? The study presented some weakness concerning methodological quality in the area of risk for biases. The results provide a large proportion of studies has “unclear” or insufficient information provided to accurately assess for biases in the study group reporting outcome. RTCs can be time-consuming, expensive, labor intensive, impractical and unethical, which can be a potential weakness in a study. Any study that time-consuming and labor intensive can be costly overtime. (Miller et al., 2020). 3. Discuss the outcomes and the implications for implementation The study does mention the self-regulation behaviors that are needed in tasks that require a high degree of self-regulation (SR), including monitoring blood sugar and carbohydrate intake, maintaining a schedule for eating as well as physical exercise, and ensuring adequate access to T1D supplies, and resources. These can help maintain optimal HbA1c levels in order to avoid long-term complications. Providing support in the areas of self-empowerment, self-management, and goal setting can be conducive to maintaining a healthy lifestyle. The support offered throughout the duration of the study was also a plus. (Miller et al., 2020). Mofrad, M., Namazi, N., Larijani, B., Bellissimo, N., & Azadbakht, L. (2019). The association of food quality score and cardiovascular diseases risk factors among women: A cross-sectional study. Journal of Cardiovascular Thoracic Research, 11(3), 237-243. https://doi.org/10.15171/jcvtr.2019.39 Merrill, R. M. (2016). Statistical methods in epidemiological research. Burlington, MA: Jones & Bartlett Learning. Fleming, S. T. (2018). Managerial epidemiology: Concepts and cases (2nd ed.). Chicago, IL: Health Administration Press.  Amber Wells Amber Wells Jul 26, 2020Jul 26 at 9:44pm Manage Discussion Entry Dr. Castle, A randomized control trial tends to come from a certain subset of people with a defined criterion in place for the selected individuals. “Randomized controlled trials (RCTs) or clinical trials are useful for evaluating treatments (including technology) and for assessing new ways of organizing and delivering health services” (Curley & Vitale. 2016.). This is a research method that is primarily used when trying out new medications on the market. Case control studies are more focused than the randomized control trials as they have a certain group of people that they must acquire for their research due to having a particular outcome in mind. “In a case-control study, the APRN must first identify a group of individuals with the outcome of interest (cases). A second group is identified without the outcome of interest (controls)” (Curley & Vitale. 2016.). This is research is more geared towards tracking disease processes and the different effects it has on the different patients. Amber Wells References Curley, L. A. & Vitale, A. P. (2016). Population-Based Nursing, Concepts and Competencies for Advanced Practice (2nd ed.). New York; NY, Springer Publishing Company. o Sheel Shah Sheel Shah Jul 26, 2020Jul 26 at 5pm Manage Discussion Entry Hi Ingrid, I found your article on food quality and cardiovascular disease particularly interesting. For years we have heard that there was a correlation between types of food we eat and cardiovascular disease. It was nice seeing a study where data was collected through questionnaires and patients’ blood pressures, biochemical markers and anthropometric measurements were record. I agree that variables such as glucose levels, cholesterol levels, height/weight and demographic are also key to this study. I decided to look further into this topic and found another study which showed that poor quality food diets that are high in “refined grains and added sugars, salt, unhealthy fats and animal-source foods; and low in whole grains, fruits, vegetables, legumes, fish and nuts” are often the most harmful (Anand, S. S., Hawkes, C., de Souza, R. J., Mente, A., Dehghan, M., Nugent, R., Zulyniak, M. A., Weis, T., Bernstein, A. M., Krauss, R. M., Kromhout, D., Jenkins, D., Malik, V., Martinez-Gonzalez, M. A., Mozaffarian, D., Yusuf, S., Willett, W. C., & Popkin, B. M. ,2015). Typically these foods are highly processed and are coined as unhealthy foods. The research article states that our global food system has implications on heart disease and related comorbidities as well. Anand, S. S., Hawkes, C., de Souza, R. J., Mente, A., Dehghan, M., Nugent, R., Zulyniak, M. A., Weis, T., Bernstein, A. M., Krauss, R. M., Kromhout, D., Jenkins, D., Malik, V., Martinez-Gonzalez, M. A., Mozaffarian, D., Yusuf, S., Willett, W. C., & Popkin, B. M. (2015). Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System: A Report From the Workshop Convened by the World Heart Federation. Journal of the American College of Cardiology, 66(14), 1590–1614. https://doi.org/10.1016/j.jacc.2015.07.050 (Links to an external site.) Sheel o Kimberly Cawthon Kimberly Cawthon Jul 26, 2020Jul 26 at 9:05pm Manage Discussion Entry Ingrid, I enjoyed reading your posts, specifically about the article regarding T1DM. In my previous class, T1DM was a topic I wrote frequently on, as the use of a PICOT topic! I also wrote about randomized control trials in this weeks discussion. Research has shown that, "Randomized controlled trials (RCTs) are the hallmark of evidence-based medicine and form the basis for translating research data into clinical practice"(Spieth, 2016). For this reason, I think that many trials needs to be randomized, even though there are some studies that do benefit from a different study design. Spieth, P. M., Kubasch, A. S., Penzlin, A. I., Illigens, B. M., Barlinn, K., & Siepmann, T. (2016). Randomized controlled trials - a matter of design. Neuropsychiatric disease and treatment, 12, 1341–1349. https://doi.org/10.2147/NDT.S101938  Collapse Subdiscussion Eboni Murphy Eboni Murphy Jul 22, 2020Jul 22 at 9:03pm Manage Discussion Entry Instructor and Class, Article 1 3. Does the study design specify a question, goal, of the study? Why is this important? The article in question for this discussion is titled, Genital herpes disclosure timing: The role of romantic and sexual relationship milestones. Herpes simplex virus (HSV) is not only a chronic health issue, it is also an infectious disease related to population health. The specified goal for this study design was to “describe genital herpes disclosure timing with respect to both sexual and romantic relationship milestones...to understand which milestones are associated with disclosure” (Myers, 2020, para. 1). Establishing a goal to this study design is important so that recognition of the connection between HSV transmission and HSV reduction of population health can occur. 3. Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study). For this study design, a cross-sectional research method using a systematic quantitative approach was applied. Also referenced as prevalence studies, cross-sectional methods concurrently gather exposure and outcome results (Curley & Vitale, 2016). Most of the time, the health of the population and characteristics of the disease in question are collected through surveys. As a result, this may leave room for bias and/or limitations. 3. Describe the participant information, include recruitment. Is selection bias present? Participants were recruited upon requirements of being at minimum 18 years of age or older, have a known diagnosis of genital herpes, and participated in sexual activity after given an HSV2 diagnosis. The population sample proved to be very much educated, majority White, and mainly female (Myers, 2020). There were no indications of bias or unfairness represented within this study. 3. How is data collected? likely inaccuracy regarding the existing stage of knee OA; presenting symptoms will not consistently concur with X-ray images. 7. What are the weaknesses of the type of study design/method? Limitations and/or weaknesses presented within this study design include the inability to blind investigators; apparently, allowing visibility of knee joint taping created an unfeasable expectation of concealed data collection. Because patients may not be able to regain full strength and functioning of their knee joint, implementation of kinesio taping as well as the results of this study are questionable. 8. Discuss the outcomes and the implications for implementation. The outcome of kinesio taping showed improvement in knee OA symptoms if worn more than 3 consecutive days. Knee OA symptoms were measured within the WOMAC subscales, which included pain, stiffness, and physical function. While advantageous outcomes are related to kinesio taping and standing balance control, differences are not found in knee-extensor strength, walking speed, or knee range of motion. It is recommended to utilize kinesio taping along with additional treatment options for knee OA. Reference Curley, L. A., & Vitale, A. P. (2016). Population-based nursing: Concepts and competencies for advanced practice (2 nd ed.). New York; NY, Springer Publishing Company. Myers, J. L. (2020). Genital herpes disclosure timing: The role of romantic and sexual relationship milestones. Sexuality & Culture, 24(3), 563–572. https://doi- org.chamberlainuniversity.idm.oclc.org/10.1007/s12119-019-09649-9 (Links to an external site.) Rahlf, A. L., Braumann, K.-M., & Zech, A. (2019). Kinesio taping improves perceptions of pain and function of patients with knee osteoarthritis: A randomized, controlled trial. Journal of Sport Rehabilitation, 28(5), 481–487. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1123/jsr.2017- 0306 (Links to an external site.) o Collapse Subdiscussion Karen Castle Karen Castle Jul 23, 2020Jul 23 at 5:41pm Manage Discussion Entry What are 2 advantages of a cross sectional study?  Eboni Murphy Eboni Murphy Jul 25, 2020Jul 25 at 9:53pm Manage Discussion Entry What are 2 advantages of a cross sectional study? Professor Cross-sectional studies are also referred to as prevalence studies, because it deals with research regarding a population and results of disease at a specific time. An advantage of conducting a cross- sectional study, aside from associating prevalence rates with distinct populations, is the ability to retrieve detailed information swiftly (Curley & Vitale, 2016). As a matter of fact, scrutiny of the candidate’s outcome and exposures are calculated simultaneously (Setia, 2016). Thus, cross-sectional studies consider study participants built on the inclusion and exclusion standards for research. Another advantage of organizing a cross-sectional study pertains to the cost. According to Curley & Vitale (2016), “they can be inexpensive” (p.26). These studies can be used for population-based surveys, prevalence estimates in clinic-based studies, and to calculate the ORs of a study (Setia, 2016). Not to mention, prevalence studies are also helpful for public health designs, observation, and assessments or contemplating the blueprint of a cohort study. Reference Curley, L. A., & Vitale, A. P. (2016). Population-based nursing: Concepts and competencies for advanced practice (2 nd ed.). New York; NY, Springer Publishing Company. Setia, M. S. (2016). Methodology series module 3: Cross-sectional studies. Indian Journal of Dermatology. 61(3): 261-264. Doi:10.4103/0019-5154.182410. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885177/ (Links to an external site.) . Accessed on July 24, 2020.  Collapse Subdiscussion Marshet Tenaw Marshet Tenaw Jul 22, 2020Jul 22 at 9:04pm Manage Discussion Entry Randomized control and cross-sectional study are the two selected epidemiological methods for this discussion. Article #1. Holly C. Felix, H., Narcisse, M., Long, C., English, E., Haggard-Duff, L., Purvis, R. and McElfish, P. (2019). The effect of family diabetes self-management education on self-care behaviors of Marshallese adults with type 2 diabetes. American Journal of Healthy Behavior, 43(3). 490 – 497. 1.Yes. The specific goal of this article is to evaluate the intervention that changes the self-care behaviors of patients with a diagnosis of type two diabetes. Interventions such as standard diabetic self- management education (DSME) is compared with family (DSME) 2. Random control trial is the methodology used in this article. 3. The participants consist of 240 Marshallese that was diagnosed with type two diabetes by a healthcare provider. The study was divided into two arms, Family DSME arms and standard DSME arms. Over 12 months the Family DSME maintained a retention rate of 81.8% whereas the standard DSME maintained 74.4%. No bias noted in this study. large population because it is free from bias and it can also be used to compare the effectiveness of the treatment (Broglio, 2018) Reference. Broglio, K. (2018). Randomization in Clinical Trials: Permuted blocks and stratification. JAMA, 319(21), 2223–2224. doi:10.1001/jama.2018.6360 o Eden Woldai Eden Woldai Jul 25, 2020Jul 25 at 5:24pm Manage Discussion Entry Marshet, Thank you for such an informative post on diabetes! Diabetes is a debilitating chronic disease that affects people physically, emotionally, and mentally. Diabetics need all the support they can get to effectively manage the disease. In your first article, I am not surprised that patients that had support from their family had better outcomes. Diabetes self-management is positively influenced by family support as it improves patient's attitudes towards the disease process (Kristianingrum, Wiarsh, Nursai, 2018). Patients that have family support have better outcomes in diabetes self-management. I also agree that educational interventions are crucial for diabetes self-management. Diabetes education is necessary to increase the knowledge of the disease and also improve the attitude and behavior of the patient. Patients that are knowledgeable about their disease will have better outcomes. Great post! Reference Kristianingrum, N. D., Wiarsih, W., & Nursai, A. Y. (2017). Perceived family support among older persons in diabetes mellitus self-management. BMC Geriatrics, 18 (1), 304-309. Retrieved from https://eds-b- ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=5&sid=2c6888a2- 371a-45d9-88de-d9b326ebb8ff%40sessionmgr101 (Links to an external site.)  Collapse Subdiscussion Sheel Shah Sheel Shah Jul 22, 2020Jul 22 at 10:11pm Manage Discussion Entry Childhood infectious disease and premature death from cancer: a prospective cohort study. 8. Does the study design specify a question, goal, of the study? Why is this important? This study has the goal of looking for links between early life infections and cancer. This is important due to the fact that childhood infectious diseases can often be related to early-life disadvantages ( Tennant, P. W. G., Parker, L., Thomas, J. E., Craft, S. A. W., & Pearce, M. S. , 2013). The question being will these early- life disadvantages influence your life as an adult, and could it increase ones risk of dying from cancer? 8. Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study). This scholarly article is a perspective cohort study of 1142 individuals born in 1947 in Newcastle-upon- Tyne, UK.. It assesses their childhood infectious diseases to their deaths from cancer. 8. Describe the participant information, include recruitment. Is selection bias present? There were 1142 participants in this study born in Newcastle-upon-Tyne in 1947. Participants in this study faced various childhood infectious diseases and also died from cancer between the age of 15-60. The selection was not biased as it included various childhood diseases such as measles, influenza, and pertussis and various different variables. “Information various factors, including birth weight, birth order, gestational age, duration breast fed, social class, and housing conditions were recorded prospectively” (Tennant, P. W. G., Parker, L., Thomas, J. E., Craft, S. A. W., & Pearce, M. S. , 2013). 8. How is data collected? Data was collected utilizing various variables and studies. Variables were compared with age using statistical analysis to determine correlations to death by cancer. 8. Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? Yes, variables are identified. Studies included variables such as birth weight, birth order, housing conditions during the time of birth, gender, social class, whether participants had influenzas, measles, mumps, pertussis, rubella, tuberculosis, varicella during the ages of 0-15, among other variables such as hormone replacement, alcohol consumption and physical activity during the age of 49-51. 8. How was the data analyzed, what statistics are provided? What are potential errors related to the study design? Data was analyzed using statistical analysis. Tables were include to portray ratios for all available early- life factors in relation to death from cancer during 15-60 years of age. 8. What are the weaknesses of the type of study design/method? This study had many limitations. It was very limited by design since it only viewed deaths by cancer, rather than all cases of cancer. The study also did not specify between types of cancer, but it did specify between types of childhood illnesses. It is due to this that there was minimal evidence to link childhood illnesses to death by cancer. 8. Discuss the outcomes and the implications for implementation. The results suggest that there may have been some “disease-specific effects of childhood infectious disease on the risk of cancer in adulthood” (Tennant, P. W. G., Parker, L., Thomas, J. E., Craft, S. A. W., & Pearce, M. S. , 2013). However, there is no circumstantial evidence to confirm that these childhood infectious diseases actually caused the cancer in adults. Tennant, P. W. G., Parker, L., Thomas, J. E., Craft, S. A. W., & Pearce, M. S. (2013). Childhood infectious disease and premature death from cancer: a prospective cohort study. European Journal of Epidemiology, 28(3), 257–265. https://doi.org/10.1007/s10654-013-9775-1 (Links to an external site.) Effect of Genetic Counseling and Testing for BRCA1 and BRCA2 Mutations in African American Women: A Randomized Trial 8. Does the study design specify a question, goal, of the study? Why is this important? This study evaluates the effects of genetic counseling and testing in African American woman for BRCA1 and BRCA2 Mutation Carriers. BRCA1 and BRCA2 Mutations can be passed from down from either parent and can increase the risk for breast cancer. This is important 8. Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study). This study is a randomized control trial evaluating the effects of genetic counseling on AA women based on three different levels of exposure “ (a) women who were randomized to culturally tailored (CTGC) and standard genetic counseling (SGC) to women who declined randomization (non-randomized group), (b) participants and nonparticipants in genetic counseling, and (c) BRCA1 and BRCA2 (BRCA1/2) test result acceptors and decliners”. 8. Describe the participant information, include recruitment. Is selection bias present? The participants in this study are all adult women who self-identify as African American or Black. Participants were recruited between February 2003 and November 2006. There was no bias in the selection, all selections had a minimum 5% prior probability of having a BRCAI/2 mutation. 8. How is data collected? #1 -Does the study design specify a question, goal, of the study? Why is this important? The article looks to identify which form of an online relapse prevention program would be more successful/motivated in preventing alcohol relapse in adolescents. Researchers present two hypotheses. The primary hypothesis was to examine difference between two groups and two online programs and the second hypothesis was to identify if the more comprehensive online program named Navigating my Journey, also identified as the control condition, would have better therapeutic relationships with counsellors. According to Polit & Beck (2017) the hypothesis identifies the key variables and the potential relationship, comparison and causality which is evident in both hypotheses. #2 Explain the methodology The authors elected for an experimental Randomized Control Trial Study (RCT) with adolescent receiving substance abuse treatment with a well-defined exclusion criterion including having completed detox. Post exclusion a total of 129 participants remained and randomized into experimental or the control group. The experimental group were given 12 online courses over 3 months and met with a counselor who were trained in the program. The control group were provided online resource material from a specific website and received nonspecific counseling. Data was collected by formatted online questionnaires based on several screening tools. Both groups met with counselor. The data assessment involved comparison of the experimental and control group with descriptive statistics. Methods are well outlined in the study, follow typical RCT research design, and demonstrate causality between the two groups. These are essential steps in should the study design be replicated (Bajwa,2015). #3 Describe the participant information, include recruitment. Is selection bias present? Juveniles receiving substance abuse counseling were recruited via their counselors and paid for their participation. This potentially could have led to bias as counselors presented the candidates to the researchers. As mentioned, the participants were selected based on 5 inclusion criteria including current counseling, age specific (13-21 years), Able to read and speak English, hx of drug/alcohol use and completed detox. #4 How is data collected? Several scales and questionnaires oriented to substance use were utilized. An example id The Drug Use and Alcohol Use scale from the Comprehensive Health Assessment for Teens. A software program was used to collect data and descriptive statistics were utilized to determine mean differences over time. Briel et al (2019) speak to the importance of sample size or poor recruitment in RCT studies affect results. #5 Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? Variables or characteristic identified were adolescents who were in counseling for substance use and then treatment modalities/technologies. The characteristics were listed according to gender, race, and substance abused. Interestingly there were more females than males, average age was 17.6 years and whites were a minority group. #6 How was the data analyzed, what statistics are provided? What are potential errors related to the study design? Descriptive statistics were used to tally data and mean differences between the two groups. Common errors in statistical analysis are found when the wrong test is chosen for a data set and small sample size (Bajwa,2015). Briel et al (2019) speak to the importance of sample size or poor recruitment in RCT studies affect results. #7 What are the weaknesses of the type of study design/method? RCT are well recognized as a gold standard in research methods however poor recruitment of participants can lead to a discontinuation of the study. The author admits that small sample size was limiting, and recruitment proved difficult. Briel et al (2019) attributes poor recruitment to narrow inclusion criteria, challenging study environments, and poor communication between the research team. Bajwa (2015) adds that RCT can prove expensive and take years to compile all necessary data. #8 Discuss the outcomes and the implications for implementation. The outcome of the study revealed that the use of structured online teaching modalities via technology can positively influence self-efficacy, motivation, and changes behavior for teen with substance abuse. Article #2 Kelly,P.,Kyngdon,F.,Ingram,I.,Deane,F.,Baker,A.,&Osborne,B.(2018). The Client Satisfaction Questionnaire-8: Psychometric properties in a cross-sectional survey of people attending residential substance abuse treatment. Alcohol Review, 37. doi: 10.1111/dar.12522 Drug and Alcohol Review (January 2018), 37, 79–86 DOI: 10.1111/dar.12522 #1 -Does the study design specify a question, goal, of the study? Why is this important? The study utilizes cross sectional data from 14 drug treatment facilities to examine and compare two client satisfaction screening tools. Researchers report that negative experiences impact patient’s engagement in treatment and an influence dropout rates and relapses. The researches hypothesize that higher levels of patient satisfaction scores would correlate with length and time in treatment. Given cross sectional design is a descriptive study focused at one point in time it is relevant to the study (Bajwa,2015). #2 Explain the methodology The study design is a cross sectional study focused on two screening tools that examine patient’s satisfaction in the mental health setting. The participants were assembled from 14 different residential treatment centers. Without established exclusion criteria a significant sample size of 1378 was recruited to participate in an anonymous survey. The study also used combined data from studies in 2009 and 2013 which classifies the research as retrospective (Polit& Beck,2016). #3 Describe the participant information, include recruitment. Is selection bias present? Given there was no inclusion/exclusion criteria for the study there is no notable bias in selection. The study had significantly more men to women participants with a mean age of 36.86 years. The primary substance used was alcohol followed by amphetamines. There was significant levels of depression at 38.5% followed by anxiety at 14.9 %. #4 How is data collected? The scores from the two questionnaires were based on a Likert scale with a numeric range. Z scores were utilized along with accelerated bootstrapping. A validating compiler programming method the researcher explains as providing standard error and confidence intervals. #5 Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? As mentioned, the descriptive characteristics are well outlined in a table and for this study demonstrate more male participants in residential treatment programs. There were approximately 318 female s and 1050 male participants. No information was collected on ethnicity nor education level. Additional variables include time in treatment, length of substance use, substance use and mental health diagnosis. Alcohol was the most widely abused substance. #6 How was the data analyzed, what statistics are provided? What are potential errors related to the study design? The researcher reports variability and the use of bootstrapping to avoid violating statistical methods. The large sample size resulted in the use of an additional statistical measure for correlation. A classification system based on satisfaction was used use to log results. #7 What are the weaknesses of the type of study design/method? Cross sectional design studies do not address causation and are often retrospective. The authors reveal that studies over time might prove more insightful. The large sample size in this study proved challenging to correlate. While the first article demonstrates problems in small sample size the second article struggle with too large a sample size. Determining sample size also includes determining the appropriate statistical test and distribution of data and reanalysis of data which was problematic for this study (Bajwa,2015). #8 Discuss the outcomes and the implications for implementation. The outcome of the study revealed that as a tool the Treatment Perceptions Questionnaire may be more useful in residential treatment centers in evaluating patient satisfaction as the tool is free of charge and was designed specifically for substance abuse. The authors caution that high satisfaction score does not equal good service and dissatisfaction scores may not be accurately measured. Julie References : Bajwa,S.(2015). Basic,common errors and essentials of statistical tools and techniques in anesthesiology research. Journal of Anesthesiology Clinical Pharamcology,31(4). Briel,M., Speich, B., von Elm, E.,& Gloy, V.(2019). Comparrison of randomized controlled trials discontinued or revised for poor recruitment and completed trials with the same research question: A matched qualitative study. BioMed Central. Retrieved from https://doi.org/10.1186/s13063-019-3957- 4 (Links to an external site.) Collapse Subdiscussion Eden Woldai Eden Woldai Jul 22, 2020Jul 22 at 10:29pm Manage Discussion Entry Randomized Control Trial 1. Does the study design specify a question, goal, of the study? Why is this important? The study by Seligman et al. (2018) aimed to determine if the glycemic control among diabetics is affected by self- management support and accessibility of diabetic appropriate food from food banks This is important because community based interventions are beneficial to help diabetic patients self-manage their disease. 2. Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study). The study used a randomized control trial where the researchers used participant-level block randomization to make sure that the enrollments across multiple pantries were distributed equally (Seligman, Smith, Rosenmoss, Marshall, & Waxman, 2018). The researchers used a 1 to 1 randomization scheme for each food bank used for the study (Seligman, Smith, Rosenmoss, Marshall, & Waxman, 2018). 3. Describe the participant information, include recruitment. Is selection bias present? The 568 participants (285 intervention group and 283 control group) selected were an average of 55 years old and were racially and ethnically diverse (Seligman, Smith, Rosenmoss, Marshall, & Waxman, 2018). They were recruited from food pantries in the community through flyers, word of mouth and in person announcements (Seligman, Smith, Rosenmoss, Marshall, & Waxman, 2018). Sixteen foodbanks from 3 states were selected through an internal Feeding America food bank and through a competitive application process (Seligman, Smith, Rosenmoss, Marshall, & Waxman, 2018). Participants had to have an HbA1c level greater than 7.5%, had to be 18 years or older, and be a member or new client of the food pantry (Seligman, Smith, Rosenmoss, Marshall, & Waxman, 2018). They also had to speak English or Spanish, have contact information such as phone number or email, and had to remain in the area for at least 12 months. Selection bias was minimized by the study’s use of randomization to select participants from many food pantries in 3 different states. 4. How is data collected? The HbA1C of the participants were measured before the study and then remeasured after the interventions to observe any improvement after interventions. 5. Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? The study measured mainly the HbA1c level of the participants but other measures included food security, food stability, intake of fruit and vegetables intake, medication adherence, depression, and intervention satisfaction (Seligman, Smith, Rosenmoss, Marshall, & Waxman, 2018). 6. How was the data analyzed, what statistics are provided? What are potential errors related to the study design? The researchers compared baseline characteristic of intervention and control groups by using the X2 test for categorial variables and t test or Wilcoxon rank sums test for interval variables (Seligman, Smith, Rosenmoss, Marshall, & Waxman, 2018). Analyses were conducted on all outcomes and adjusted for baseline value and number of days between baseline and follow up assessments by using generalized linear models with Huber-White robust standard errors (Seligman, Smith, Rosenmoss, Marshall, & Waxman, 2018). The HbA1c did not improve much after the interventions ((24% for intervention group and 29% for control group). There was no mention of potential errors in the study. 7. What are the weaknesses of the type of study design/method? Randomized control trials can be rigorous and require a lot of time, but they are more reliable, valid, and less bias. 8. Discuss the outcomes and the implications for implementation. There was significant improvement in outcomes related to food such as food security, food stability, and fruit and vegetable intake by diabetics. There were no observed improvements in outcomes related to diabetes self-management or glycemic control. While community-based organizations have showed success in helping vulnerable populations with diabetes, they will also need support from healthcare systems to improve diabetes self- management of patients. Cohort Study 1. Does the study design specify a question, goal, of the study? Why is this important? The article by Yen et al. (2017) aims to investigate how alcohol consumption affects the development of tuberculosis (TB) in Taiwanese adults. Taiwan, over the years, has had one of the highest rates of TB cases and previous studies show a relationship between TB and alcohol consumption (Yen et al., 2017). Understanding this relationship would provide information for future TB prevention programs. 2. Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study). The authors conducted a nationwide cohort study to investigate the impact of alcohol consumption on the development of TB in Taiwanese adults. 3. Describe the participant information, include recruitment. Is selection bias present? A total of 46, 196 participants, ages 18 years and over, from 3 rounds of the National Health Interview Survey (NHIS) were selected for the study (Yen et al., 2017). The NHIS is a good representative sample of the Taiwanese population and it classifies people based on geographic location, local boundaries, and urbanization (Yen et al., 2017). The NHIS gathers information such as socio-demographic and behavioral factors through in- person interviews. The participants self-reported the amount alcohol they consumed, so there may have been some bias present in the study. 4. How is data collected? The participants were selected from interviews the NHIS conducted and they were followed from the day of the interview until they were diagnosed with TB, died from the disease or the completion of the study (Yen et al., 2017). A multivariable Cox regression model was used to estimate the association between alcohol consumption and active TB (Yen et al., 2017). Participants had to rate their alcohol consumption as never, social, regular, or heavy drinker on their in-person interviews. 5. Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? The main variable identified in the study was alcohol consumption. Other variables mentioned include the socio-demographic characteristics of the participants and any comorbidities that they may have. 6. How was the data analyzed, what statistics are provided? What are potential errors related to the study design? The researchers gathered the baseline data of the amount of alcohol consumed by the participants. 61.8% of participants said they never drink, 24.2 % said they were social drinkers, 13.5% said they were regular drinkers and 0.5 % said they were heavy drinkers (Yen et al., 2017). The Cochran Armitage trend test was used to determine the trend of the amount of alcohol the participants drank in relation to the incidents of TB (Yen et al., 2017). The univariable Cox regression and the multivariable Cox regression were also used to determine the correlations of alcohol consumption, TB incidents and the other variables identified in the study (Yen et al., 2017). There may have been some bias in the study since the data was collected from self-reports and interviews. The study only focused on people living in Taiwan so the sample cannot be generalized to other ethnicities or races. 7. What are the weaknesses of the type of study design/method? The weakness of this study design is that there is no control group and instead the study is based on the self-reports and in-person interviews. 8. Discuss the outcomes and the implications for implementation. The study showed that regular and heavy drinkers have an increased risk of developing TB compared to individuals who never drink (Yen et al., 2017). There was a positive trend between the increasing alcohol consumption and TB incidents. Future implementations on developing programs that help people reduce the amount of alcohol individuals consume in order to reduce the incidents of TB in Taiwan should be considered. References Seligman, H. K., Smith, M., Rosenmoss, S., Marshall, M. B., & Waxman E. (2018). Comprehensive diabetes self-management support from food banks: A randomized controlled trial. American Journal of Public Health, 108 (9), 1227-1234. Retrieved from https://eds-a-ebscohost- com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=2&sid=e35db8a1-97ce-4b86- b41c-759cf1314d57%40sessionmgr4006 Yen, Yung-Feng, Hu, Hsiao-Yun, Lee, Ya-Ling, Ku, Po-Wen, Chuang, Pei-Hung, Lai, Yun-Ju, and Chu, D. (2017). Heavy alcohol consumption increases the risk of active tuberculosis in Taiwanese adults: A nation-wide population-based cohort study. Addiction, 112 (12), 2124-2131. Retrieved from https://eds-b-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/detail/detail? vid=1&sid=4d42cb25-eec4-4c1d-968e-65bf4f0e772f%40pdc-v- sessmgr02&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d o Collapse Subdiscussion Karen Castle Karen Castle Jul 23, 2020Jul 23 at 5:46pm Manage Discussion Entry What are some reasons for randomization?  disappearance or end of the follow-up period (31 December 2013), whichever came first” (Tolstrup,2017). 6. The data collected was analyzed confirming that persons with alcohol dependence have a higher rate of developing somatic conditions as first known disease and cause of death compared to that of the general population for that area. This data enhances my current knowledge about alcohol dependence and its risk factors. 7. A weakness of this type of study is that is what not able to identify the impact of the socio economy on alcohol dependence for this study area. 8. The outcome of this study verifies the risk factors associated with alcohol dependence and it is imperative for dependent persons to rid of their dependence in order to achieve a healthier lifestyle. Randomized Controlled Trial 9. Does the study design specify a question, goal, of the study? Why is this important? The study specifies whether or not patients with uncontrolled hypertension can be controlled with a renal denervation (RDN). The goal of the study is to compare patients that are using pharmaceuticals versus the RDN and what is more effective. This study is important because for the patients that are noncompliant or have resistant hypertension this could be an effective route for these patients to get their hypertension under control. 1. Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study). For this research topic they did a randomized control trial. “The experiment is prospective multicentered single-blinded randomized sham-controlled trial” (Chen et al., 2019). They used 13 medical centers nation wide and conducted two tests before they decided if a patient was eligible for the RDN. 1. Describe the participant information, include recruitment. Is selection bias present? There were 200 participants that were chosen from the 13 medical centers. There were two sets of questionnaires that the patients had to fill out to see if they would be eligible for the experiment. In addition, all of the patients were given four weeks’ worth of medication, so the team could evaluate whether or not the medication was working on their hypertension. Then the clients had a second questionnaire they would fill out while coming in for a check up after the initial four weeks to see how the medication was doing. The team also had a selection of exclusions that would disqualify a patient from the experiment. There was no bias in the selection process. 1. How is data collected? The data was collected during a series of four doctors visits that were set at the initial appointment, 1 month, month 3, and month 6 after discharge. Then a final appointment six months after that. They conducted blood pressure measurements at each appointment, a 24-hour ambulatory blood pressure. All the information was collected at the follow up appointments. 1. Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? The variables are the individuals that received the RDN. The patient’s that took the medication and were able to be managed were consistent throughout the experiment and did not variate in blood pressure. The patient’s that received the RDN were showing different reactions to the RDN, but the mean rate of dropped blood pressure was 11.8. 1. How was the data analyzed, what statistics are provided? What are potential errors related to the study design? The data that was analyzed were the blood pressures from the appointment and 24 hour ambulatory blood pressure that they monitored. The data was taken from each appointment and analyzed through a series of graphs and charts. The potential errors with the study is that the patient could have a serious side effect within the timeframe of when they are supposed to go back and be checked up on. In addition, the lack of oversight with diet and exercise could also be a factor that was not calculated. 1. What are the weaknesses of the type of study design/method? The weakness of this type of study is that once you have your select group chosen if something happens to any of your variables or controls it skews the results and the experiment. Having a set number of people with no variance or ability for error creates a tight line with no room for error. 1. Discuss the outcomes and the implications for implementation. So the individuals that did not receive the RDN continued to have uncontrolled hypertension and their hypertension did not end up being controlled. Some of the individuals that received the RDN ended up having adverse reactions where renal artery necrosis and perineurial fibrosis. This is an extreme reaction and was not the common result. Most of the individuals that received the RDN ended up dropping 11.8 points with their blood pressure. However due to the risks that take place doing the surgery only a select clientele are eligible for this surgery. There needs to be more research done to prove that this is an effective alternative for patients with resistant hypertension. Once more research has been done proving to be safer and a better fit for patients, it would be great to implement into practice. Thanks, Amber Wells Resources Chen, H., Ji, M., Zhang, Y., Xu, Y., Qiao, L., Shen, L., &amp; Ge, J. (2019). Efficiency and safety of renal denervation via cryoablation (Cryo-RDN) in Chinese patients with uncontrolled hypertension: Study protocol for a randomized controlled trial. Trials, 20(1). doi:10.1186/s13063-019-3693-9 Holst, C., Tolstrup, S. J., Sorensen, J. & Becker, U. (2017). Alcohol dependence and risk of somatic diseases and mortality: a cohort study in 19002 men and women attending alcohol treatment. Society for the Study of Addiction 112, 1358-1366. https://doi.org/10.1111/add.13799  Collapse Subdiscussion Candace Polk Candace Polk Jul 23, 2020Jul 23 at 10:18pm Manage Discussion Entry “Dental Problems and Chronic Disease in Mentally Ill Homeless Adults” o In this study, researchers questioned the incidence of chronic health problems in persons with both dental disease and mental illness. The goal of this study is to show how the dental health problems of mentally ill homeless patients are associate with higher incidences of other chronic diseases. o This is a cross-sectional study. A Cross-sectional study is a form of observational research that takes place at a particular time frame, observing a specific population. There is no manipulation of test variables (Munnangi, & Boktor, 2020). o The study takes place over a six-month time period in which 575 participants voluntarily took part in this study. The study took place at a Canadian homeless intervention housing center. Subjects were randomly selected. Patients had to have been homeless and also had a mental illness disorder. o Patients self-reported their history of chronic disorders. Patients also answered questions from a questionnaire that inquired about their mental, physical health, and any history of substance abuse. Researcher’s also asked participants about their housing and community involvement. o There was one variable identified in this study. Participants either had dental problems or did not have dental issues. All participants were homeless and had a mental illness. This allows the study to be utterly random without influence or manipulation from researchers. Having no variables helps establish the accuracy of the final results. o The data was then collected and categorized by chronic disorder type. Each type of associated chronic disorder information is provided about the number of patients that suffer from each disorder. The information is also broken down into various characteristics such as race, sex, lifestyle, length of homelessness, education, and smoking history. o This study was completed in Canada, where private care clinics provide the majority of dental care; this is not the case in other countries like the USA. Here in the US, health care and dental care are accessible to those that are socioeconomically disadvantaged. o The outcome of this study demonstrates an urgent need for better dental health care and overall health care for those that are socioeconomically disadvantaged. Health care, as well as dental care, needs to be more accessible. Marshet Tenaw Marshet Tenaw Jul 26, 2020Jul 26 at 3:30pm Manage Discussion Entry Candace, Thank you for your discussion, you choose the most important topic with lots of information that is essential to know as a health care provider. Poor dental care health may not result in immediate death, but it can lead to a lot of physical and psychological problems. The cross-sectional study addresses the homeless patients that are vulnerable to poor dental health was informative. The fact that it is a voluntary approach it makes the outcome reliable with no bias. A cross-sectional study is essential because it allows the entire population group to study and evaluate at once this makes the study of homeless patients convenient. Reference. Nguyen, A. B., Grimes, B., Neuhaus, J., & Pomerantz, J. H. (2019). A Cross-sectional Study of the Association between Homelessness and Facial Fractures. Plastic and reconstructive surgery. Global open, 7(6), e2254. https://doi.org/10.1097/GOX.0000000000002254 o Collapse Subdiscussion Theodora Isikala Theodora Isikala Jul 23, 2020Jul 23 at 11:59pm Manage Discussion Entry Article 1: Randomized Control Trial Randomized control trial is deemed the most accurate scientific approach of research method and theory analysis. The randomized control group trial assigns experimental and control groups, unlike cohort study that does not assign control groups. The experimental group receives the prophylactic treatment, curative procedure, or intervention depending on the study whereas the control group will be given a placebo or no treatment. The results will be assessed by comparison of the assigned groups. (Zeni, 2021). Does the study design specify a question, goal, of the study? Why is this important? The study by Adamson, Abraham, Stevenson, et al. (2016) wanted to examine the effect of pulmonary artery pressure–guided heart failure (HF) care on 30-day readmissions in Medicare-eligible patients. The study has formulated a specific question and goal of the study. The rationale for this is that it facilitates the subjects to appraise the significance of the study. Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study. The study entitled “Pulmonary artery pressure-guided heart failure management reduces 30-day readmissions circulation” published in 2016, utilizes a randomized control trial method. The study assigned participants at random to test group to receive the intervention while the control group will not receive the intervention Describe the participant information, including recruitment. Is the selection bias present? How is data collected? The study chose 550 patients with New York Heart Association class III symptoms and hospitalization for HF within the prior 12 months. The selection of participants was free from bias as patients were randomly allocated in 1:1 fashion to either a treatment group or the control group. Potential inaccuracies in randomized control trial design include control error. Data was collected through the hemodynamic monitoring system and transmitted to the physicians electronically. Are the variables identified? If yes, discuss it. If no, how does this impact your interpretation of the study? The variables are identified, the independent variable is the pulmonary artery pressure whereas the dependent variable is the readmission rates. How was the data analyzed, what statistics are provided? What are the potential errors related to the study design? The data were analyzed utilizing the correlation data analysis. This analysis focuses on the 245 Medicare-eligible participants who are compliant with transmissions was 93% compared with 88% for the overall population. Patient demographics, baseline hemodynamics, and medical histories were analyzed and compared between the test and control groups. The potential error is that the test exclusively focused on patients with New York Heart Association class III symptoms who were hospitalized in the previous year for heart failure related condition. The patients enrolled in the trial may not be a true representative of the average patients.” For all statistical analyses, significance levels were 2-sided with a P-value <0.05” (Adamson, et al., 2016). What are the weaknesses of the type of study design/method? Discuss the outcomes and the implications for implementation. A weakness of randomized control trial is that long trial time required may lead to loss of relevance as the practice may have changed by the time trial is published. The selected groups sometimes may not truly represent the average population. The study observed that in-home monitoring with the use of pulmonary artery pressure identifies patients who need a change in treatment, thereby reduces congestive heart failure hospitalizations by 49% and 30-day re-hospitalizations by 58%. (0.07 events/patient-year) compared with 0.18 events/patient-year in the control group. (Adamson, et al., 2016). Article 2: Cohort Study The Cohort Study is identified as a follow-up of occurrences in a group of participants of a potential study. This cohort-study approach can also portray as a part of the study group. In a cohort study, the investigators choose a group of people who are subjected to an event and a group who are not and then compare the effect of the incidence between the two groups. (Zeni, 2021). Does the study design specify a question, goal, of the study? Why is this important? The study by Delicio, Lajos, Amaral, et al. (2018) indicated the goal of the study which was to evaluate the neonatal effects to maternal Antiretroviral therapy (ART). This informs the reader of the general purpose of the study. The methodology The study entitled “Adverse effects in children exposed to maternal HIV and antiretroviral therapy during pregnancy in Brazil” published in 2018, adopted a cohort-study of newborns from HIV pregnant women. Describe the participant information, including recruitment. Is the selection bias present? How is data collected? The participants of the study were neonates born of mothers who are HIV positive. Data were collected from the patients' file in the obstetric clinic from 2000 to 2015 Are the variables identified? If yes, discuss it. If no, how does this impact your interpretation of the study? The independent variables were mothers with HIV and Antiretroviral therapy, while dependent variables were adverse effects of the therapy on the neonates. How was the data analyzed, what statistics are provided? What are the potential errors related to the study design? The data were analyzed using descriptive, statistical analysis of SAS 9.4 version What are the weaknesses of the type of study design/method? Discuss the outcomes and the implications for implementation The weakness of the cohort study is costly and time-consuming. The study discovered that Antiretroviral use in pregnant mothers is correlated with a high-ranking incidence with low severity adverse effects on Sara Morra Sara Morra Jul 26, 2020Jul 26 at 10:04pm Manage Discussion Entry Hi Theodora, Thanks for sharing. Your post was very informative and thorough. A cohort study identifies as two groups. One of which receives exposure of interest and one that does not. Use of cohort studies has become increasingly popular in epidemiology due to the impractility of obtaining measures of all variables of interest (Newcombe, Connolly, Seaman, Richardson, & Sharp, 2018). Sara References Morrow, B. (2010). An overview of cohort study designs and their advantages and disadvantages. International Journal of Therapy and Rehabilitation, 17(10), 518-523. doi:10.12968/ijtr.2010.17.10.78810 Newcombe, P. J., Connolly, S., Seaman, S., Richardson, S., & Sharp, S. J. (2017). A two-step method for variable selection in the analysis of a case-cohort study. International Journal of Epidemiology, 47(2), 597-604. doi:10.1093/ije/dyx224 o Collapse Subdiscussion Sara Morra Sara Morra Jul 24, 2020Jul 24 at 1:02pm Manage Discussion Entry Dr. Castle and class, For this discussion I chose the articles Outcomes of a nurse-led model of care for hepatitis C assessment and treatment with direct-acting antivirals in the custodial setting as well as the article Alcohol dependence and risk of somatic diseases and mortality: a cohort study in 19002 men and women attending alcohol treatment. Both articles are cohort studies. Alcohol dependence and risk of somatic diseases and mortality: a cohort study in 19002 men and women attending alcohol treatment. Both articles are cohort studies. o Does the study design specify a question, goal, of the study? Why is this important? The goal of the study is to estimate sex specific risks in a population of individuals with alcohol dependence versus a control population from the general population as well as estimate sex-specific risks of dying from somatic diseases related to alcohol dependence. This is important because the results may give important information as well as add information onto what is already known about the risks of alcohol dependence and the somatic diseases related to alcohol dependence. o Explain the methodology. The methodology of conducting this study includes the use of general population controls and a long follow up time (Holst, Tolstrup, Sorensen, & Becker, 2017). This is important to develop chronic diseases and cancer. 3. Describe the participant information, include recruitment. Is selection bias present? Somatic disease information was obtained from the Danish National Patient Registry. This covers all admissions to non-psychiatric hospitals from 1977 and forward. Controls were selected randomly using the Danish Civil Registration system. They chose a total of 19,002 alcohol dependent individuals and 186,767 controls. The selection was randomized and non-bias. 3. How is data collected? Data was collected by identifying people through their personal identification number. The data came from the Copenhagen Alcohol Cohort and from the national registries. 3. Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? Yes, the variables are identified as 11 disease groups and 29 subgroups, defined according to the International Classification of Disease. The main variable was to be diagnosed of alcohol dependence according to the International Classification of Disease. 3. How was the data analyzed, what statistics are provided? What are the potential errors related to the study group? The data was analyzed using age and sex. The statistics found were that women have a much higher chance of alcohol dependence than men due to differences in alcohol metabolism. Women were also found to have faster onset and worse progression of the diseases caused by alcohol dependence. Potential errors related to the study group are very low due to the study using a large population. 3. What are the weaknesses of the type of study design/method? One weakness is risk of confounding due to not having socio-economic information. 3. Discuss the outcomes and the implications for implementation. The outcomes and the implications of this study are that alcohol dependence is associated with a higher risk of somatic diseases as well as high mortality from the diseases. Outcomes of a nurse-led model of care for hepatitis C assessment and treatment with direct-acting antivirals in the custodial setting 1. Does the study design specify a question, goal, of the study? Why is this important? The goal of the study is to evaluate the efficiency of the New South Wales Justice Health and Forensic Mental Health Network Hepatitis Nurse Led Model of Care throughout the 12 months after the widespread availability of HCV direct acting antivirals in Australia (Overton, Clegg, Pekin, Wood, McGrath, Lloyd, & Post, 2019). 3. Explain the methodology. The initial clinical assessment as well as confirmatory testing was conducted by population health nurses. Then patients were referred to a Hepatitis Clinical Nurse Consultant (CNC) for further assessment. The case was then discussed with an infectious disease physician and therapies were prescribes to patients. 3. Describe the participant information, include recruitment. Is selection bias present? The cohort study was conducted on 36 correctional centers across New South Wales. It included 13,000 inmates. Selection bias is not present. 3. Does the study design specify a question, goal, of the study? Why is this important? The goal of the study is to find the sex-specific risks of a comprehensive spectrum of somatic diseases in alcohol-dependent men and women. Also, the sex-specific risks of these men and women dying from such diseases. It is important because the goal of a research study is the issue the research intends to investigate to shed more light and provide evidence for the problem. 3. Explain the methodology (Randomized Control Trial, Cohort Study). The study utilized a retrospective cohort study methodology. This is a study where the researcher looks back over the records of a selected sample after exposure to determine differences in the risk of diseases between the exposed and unexposed. It ascertains the presence of any outcome at the time the study begins, (Curley and Vitale, 2016). The study investigated the health outcome of a control group (unexposed) compared to that of alcohol-dependent individuals (exposed). Register-based research was used where information was obtained from past data of the participants. 3. Describe the participant information, include recruitment. Is selection bias present? A total of 19002 alcohol-dependent individuals were sampled from the Copenhagen Alcohol Cohort, (14091 men and 4911 women). Control group obtained from the Danish Civil Registration System by random selection. 10 control individuals were matched with one alcohol-dependent individual making a final control population of 186767 individuals, (Holst et al, 2017). Individuals with alcohol dependence diagnosis were included. Those individuals born before 1927 and those who died before 1977 were excluded. This ensured that only individuals not older than 50-year-old were included. Selection bias occurs when the key characteristics of the individuals selected differ from the population it represents, (Holst et al, 2017). The study was well conducted, and the participating individuals followed up to ascertain the outcome resulting from exposure to alcohol. The control sample was randomly selected and represent the Denmark population. 3. How is data collected? Data collection was register-based. The researchers obtained records from the Danish National Patient Registry which provided information on somatic diseases. This registry also provided information on all non-psychiatric hospital admissions with the diagnoses coded through ICD revision 8. The cause of death information was obtained from the Cause of Death Registry, (Holst et al, 2017). 3. Are the variables identified? If yes, discuss it. If no, how does this impact your interpretation of the study? A variable is a research item that can change. An independent variable is the cause of the dependent variable. The variable identified in the article is the diagnosis of alcohol dependence, (Holst et al, 2017). This is the independent variable because it is the cause of the dependent variable which is the disease outcome that the researcher is interested in. 3. How was the data analyzed, what statistics are provided? What are the potential errors related to the study design? The Cox proportional hazards model was used to analyze the hazard ratios and had 95% confidence intervals. The results for both men and women were presented separately along with their relative risks. The information for the cause of death was obtained and investigated. the Charlson Comorbidity Score was calculated for the alcohol dependent individual who started treatment, and the controls. The statistics showed that alcohol-dependent men and women had a higher risk of developing somatic disease compared to their controls, (Holst et al, 2017). They also had a higher risk of dying from these alcohol-related diseases. The information was obtained retrospectively so there exist potential errors from inaccurate recall by the participants. Also, the control group may have consumed alcohol but were not officially diagnosed. 3. What are the weaknesses of the type of study design/method? In a cohort study, the researchers may have to follow a large sample population for a long time and participants may be lost to follow up. It might also be very time consuming and expensive, (Curley and Vitale, 2016). In a retrospective cohort study such as this, the researchers cannot control exposures and outcome which have already occurred. They must rely on the participants who may provide inaccurate accounts either deliberately or from poor memory. 3. Discuss the outcomes and the implications for implementation. The study establishes that alcoholism can cause several somatic diseases and early death. There is a higher risk of developing or dying from alcohol-related somatic disease when one is alcohol-dependent irrespective of gender than the general population, (Holst et al, 2017). Alcohol-dependence is therefore a risk factor for developing a wider spectrum of somatic diseases that were not previously thought of, (Holst et al, 2017). Article 2: Are people living with HIV less productive at work? 3. Does the study design specify a question, goal, of the study? Why is this important? The goal of the study is to determine if having HIV will hinder productivity at work. The quality of work of people who have HIV was compared to those of the general working population to see if there is a difference between them. 3. Explain the methodology (Randomized Control Trial, Cohort Study) This is a cross-sectional study. In a cross-sectional study, the researcher evaluates and measure the exposures and outcome at the same time. It produces a fast result and is therefore inexpensive, unlike cohort study. 3. Describe the participant information, include recruitment. Is selection bias present? An initial 600 HIV patients attending the outpatient clinic of the Erasmus Medical Center in Rotterdam, Netherlands were eligible, and their data collected. They were at least 18-year-old. Patients who were above 65years or those with complications of HIV were excluded. A total of 298 were finally sampled. Their data was compared to that of 986 individuals from the general working population aged 18 to 65, (Verbooy et al, 2018). The possible selection bias could be from the fact that only about half of the eligible patients were recruited. 4. How is data collected? The data was collected through survey questionnaires. The patient’s data were obtained from the TREVI project, a 2-year study of their cognitive functions between December 2012 to December 2013. The one for the control group was collected during online research in 2010 investigating the effect of their health on productivity, (Verbooy et al, 2018). 3. Are the variables identified? If yes, discuss it. If no, how does this impact your interpretation of the study? The purpose was to study the effect of HIV on the patients’ work productivity. Some variables given were the ages, gender, educational level, income level, absenteeism, and the quality of work, (Verbooy et al, 2018). 6. How was the data analyzed, what statistics are provided? What are the potential errors related to the study design? The study utilized a descriptive analysis to study the baseline characteristics of the participants. A statistically significant relationship between the variables was determined by using the Pearson correlations and Fisher exact tests. Logit models (Appendix A) was used to compare their variables. Their productivity was explored using the logit models and analyzed with the two-part models. The mean income for the patients was higher making their productivity costs higher than that of the general population. A cross-sectional study only reveals the prevalence of a disease. It does not show the incidence or the risks of the disease, (Curley and Vitale, 2016). The timing of the study may not be representative of the population. 3. What are the weaknesses of the type of study design/method? Cross-sectional study obtains data for the outcome and exposures at the same time, it is difficult to assess the relationship between the exposures and causality cannot be established. Also, the study only addressed Dutch-speaking patients. Non-Dutch speakers who were not assessed may have issues that can affect their productivity, (Verbooy et al, 2018). 8. Discuss the outcomes and the implications for implementation. The study showed that health issues were associated with absenteeism in both groups. A higher level of health issues accounted for higher productivity losses in both groups. The overall total productivity losses were not significantly different between the two groups, (40.1 and 38.6h). HIV infection was not necessarily a hindrance to productivity at work. This fact can help with future counseling to encourage patients. It also provides reasons for not working such as social discrimination and stigmatization. References Curley, L. A. & Vitale, A. P. (2016). Population-Based Nursing, Concepts, and Competencies for Advanced Practice (2nd ed.). New York; NY, Springer Publishing Company. Holst, C., Tolstrup, S. J., Sorensen, J. & Becker, U. (2017). Alcohol dependence and Karen Castle Karen Castle Jul 25, 2020Jul 25 at 3:20pm Manage Discussion Entry Research is essential to find out which treatments work better for patients. It plays an important role in discovering new treatments, and making sure that we use existing treatments in the best possible ways. Research can find answers to things that are unknown, filling gaps in knowledge and changing the way that healthcare professionals work. Some of the common aims for conducting research studies are to: o Diagnose diseases and health problems o Prevent the development or recurrence of disease and reduce the number of people who become ill o Treat illness to improve survival rates or increase the number of people who are cured o Improve the quality of life for people living with illness (n.d.). Retrieved July 25, 2020, from https://www.pat.nhs.uk/education-and-research/why-is-research- important.htm o Crystal Clough Crystal Clough Jul 27, 2020Jul 27 at 12:14am Manage Discussion Entry 1. Does the study design specify a question, goal, of the study? Why is this important? Yes, the study shown was to investigate and delineate the risk factors, which may be implicated in putting a patient at greater risk of readmission due to heart failure. This is important to have a specific goal or outcome to know what type of research method to use. 2. Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study). A cohort study-Is a study where one or more samples are followed, to help associate which risk factors are associated with it. 3. Describe the participant information, include recruitment. Is selection bias present? This was a cohort study conducted at a tertiary hospital in Al A in city in UAE. They selected a total of 170 patients diagnosed with HF, who were admitted sequentially to the tertiary hospital for the management of their CHF during the study period. There were no exclusion criteria. 4. How is data collected? Through patient data through their charts. They looked at ER readmissions that had a diagnoses of HF. 5. Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? The variables discussed are occupational status, daily dosing regimen, DM, number of prescriptions provided, Prescribed ACE, ASA, and diuretics, along with ejection fraction. 6. How was the data analyzed, what statistics are provided? What are potential errors related to the study design? Statistics that were provided were that if someone is admitted for HF the likelihood of them getting readmitted within 30 days for the same diagnoses is substantially higher of those that are not managing their HF. Related errors could be that the study is not taking into consideration the comorbidities this patient may have such as CRF. This could lead to misdiagnosing and this could scew the results. 7. What are the weaknesses of the type of study design/method? The weaknesses are the same that comorbidities were not taken into consideration along with the variables that may cause an exacerbation. Therefore, some of this data could be an exacerbation of another diagnosis. 8. Discuss the outcomes and the implications for implementation. The outcomes shown that if a patient is not on a particular regimen ACE/ARB, evidence based beta blocker, and they do not have a follow up within 7 days of their prior hospitalization discharge date, that they are at a substantially higher risk to be re-hospitalized for the same diagnosis. Sadeq, A., Sadeq, A., Sadeq, A., Alkhidir, I. Y., Aburuz, S., Mellal, A. A., Al Najjar, M. S., & Elnour, A. A. (2020). Risk Factors for Hospital Readmission of Patients With Heart Failure: A Cohort Study. Journal of Pharmacy & Bioallied Sciences, 12(3), 335-343. https://doi- org.chamberlainuniveristy.idm.oclc.org/10.4103/jpbs.JPBS_323_20 9. Does the study design specify a question, goal, of the study? Why is this important? This was a randomized control trial that incorporated a educational package that included a self-care guidebook, educational DVDs, a logbook for blood glucose levels, and daily meal plan for patients that had been diagnosed with gestational diabetes, hoping to help patients manage their disease process. 10. Explain the methodology (Randomized Control Trial, Cohort Study, Case-Control Study). Randomized control trial-this type of trial aims to decrease a certain type of bias. 11. Describe the participant information, include recruitment. Is selection bias present? 151 women were included in the trial study that had been diagnosed with gestational diabetes. Selected bias is not included.. 12. How is data collected? The target population was at Kermanshah city, West Iran, the study was performed at the Diabetes Research Center, through patient charts, and information. The study participants were pregnant and referred to the university clinic from all healthcare centers. 13. Are the variables identified? If yes, discuss. If no, how does this impact your interpretation of the study? The variables that were identified included patients that were between 20 and 30 weeks pregnant and had been diagnosed with GDM by the glucose study in hopes to improve mothers self-care efficiency and improve apgar scores at birth. 14. How was the data analyzed, what statistics are provided? What are potential errors related to the study design? I did not see any potential errors when using this type of research. The research was provided to analyze if using this self-care package in fact decreased complications in pregnancy. 15. What are the weaknesses of the type of study design/method? There were no weaknesses using this type of trial study. 16. Discuss the outcomes and the implications for implementation. That patients that received the self-care package were able to maintain and manage their gestational diabetes and were able to have no complications after birth. This package had positive effects on the primary and secondary outcomes of GDM. Kolivand, M., Rahimi, M. A., Keramat, A., Shariati, M., & Emamian, M. H. (2019). Effect of a new self-care guide package on maternal and neonatal outcomes in gestational diabetes: A randomized control trial. Journal of Diabetes, 11(2), 139-147, https://doi-org.chamberlainuniversity.idm.oclc.org/10,1111/1753- 0407.12827 Previous Next