Journal Club Presentation Public Health

1. Journal Club Presentation
Presented By:
Name: Seema B.K.
Roll No: 24
BPH, VIII Semester, SHAS, PU.
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2. Presented for the partial fulfillment of requirement
of
PHA 451 Journal Club/Health Seminar
of
Bachelor of Public Health, VIII Semester,
School of Health and Allied Sciences, Pokhara University
under the cardinal supervision of
Assistant Professor Dr. Hari Prasad Kaphle
By
Seema B.K.,
17370201,
2016-1-37-0125.
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3. Selected Article for Presentation
• Authors: RK Chandyo , TA Strand , RJ Ulvik , RK Adhikari1 , M Ulak
, H Dixit and H Sommerfelt
• Tittle of article journal: Prevalence of iron deficiency and anemia
among healthy women of reproductive age in Bhaktapur, Nepal
• Journal name: European Journal of Clinical Nutrition
• Volume 61 Issue 2, February 2007
• DOI: https://doi.org/10.1038/sj.ejcn.1602508
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4. Journal Information
• The European Journal of Clinical Nutrition (EJCN) is an
international, peer-reviewed journal covering all aspects of human and
clinical nutrition
• History: 1947-present
• Publisher: Springer Nature
• Frequency: Monthly
• Impact factor of 2019: SNIP: 1.252
SJR: 1.165
• ISSN number: 0954-3007
• eISSN number: 1476-5640
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5. About the editors
• Co-editors-in-chief
• Manfred James Müller, Germany: expertise: Body composition,
energy expenditure, hormonal regulation of metabolism, integrative
physiology, obesity, malnutrition, prevention of overweight, public
health nutrition
• Current Director of the Institute of Human Nutrition and Food Science
at Christian Albrechts University, Kiel, Germany
Mario J Soares, Australia: Expertise: Obesity, T2DM, energy and
protein metabolism, weight loss
• There are 11 associate editors, 4 statistical editors and 1 social media
editor.
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6. Abstracted/indexed in
• Some of them are:
• BOISIS
• Google Scholar
• Medline
• SCOPUS
• OCLC
• Current Contents Clinical Medicine
• Current Contents Life Sciences
• Science Citation Index
• EBSCO
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7. Critical Appraisal of Journal
• The European journal of Clinical nutrition(EJCN) is a good journal for
publishing this article as the article is related with nutrition-related
health problem and uses clinical method to fulfill its objectives
• EJCN is monthly peer-reviewed, international journal of nutrition
science.
• EJCN is a member of Committee on Publication Ethics (COPE)
• Reporting guidelines like PRISMA, CONSORT are followed.
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8. Critical Appraisal of Journal
• The journal gives detail information on editorial process and policies, peer-
review process, submission fee, conflict of interest, ethics , editors
information etc.
• Average time from submission to acceptance - 160 days
Average time from acceptance to publication - 15 days
• Average time for peer review-3 to 6 weeks
• The cost for open access publication in the EJCN is £2,560/ $3,860/ €3,060
(VAT or local taxes will be added where applicable)
• High levels of author satisfaction, with 94% of published authors reporting
that they would definitely or probably publish with the journal again.
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9. Tittle of Article
Prevalence of iron deficiency and anemia among healthy
women of reproductive age in Bhaktapur, Nepal
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10. Critical Appraisal of Tittle
• The title of the article is quite simple, clear and understandable.
• The title gives the idea of study subject, study population and study
area.
• The title is not too lengthy or too short.
• The title reflects the aim and objective of the study.
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11. Authors
R K Chandyo, R K Adhikari & M Ulak
Department of Child Health, Institute of Medicine, Tribhuvan University,
Kathmandu, Nepal
T A Strand & H Sommerfelt
Centre for International Health, University of Bergen, Norway
R J Ulvik
 Institute of Medicine, Haukeland University Hospital, University of Bergen and
Laboratory of Clinical Biochemistry, Norway
H Dixit
Department of Pediatrics, Kathmandu Medical College, Kathmandu University,
Kathmandu, Nepal
T A Strand
 Corresponding author
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12. Author’s information
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S.N. Author Publications Reads Citations
1 R K Chandyo 64 7554 1106
2 R K Adhikari 68 11256 3243
3 H Dixit 5 313 51
4 H Sommerfelt 195 12523 7457
Source: ResearchGate

13. Critical Appraisal of Authors
• Total 7 authors.
• Authors names, correspondence authors were mentioned with their
respective study area and subject.
• Every authors had access to their credentials.
• Every author’s post, work and contribution to the study was clearly
mentioned.
• Every author’s contact, email were provided.
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14. Abstract
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15. Critical Appraisal of Abstract
• Abstract is within the recommended word limit by the journal, i.e.250
words.
• Abstract is structured. It has specific sections which are self-
explanatory.
• Abstract gives the accurate summary of the article.
• The body of abstract is double-spaced throughout.
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16. Introduction
• Iron deficiencies(ID) is one of leading nutritional deficiencies
particularly in developing countries. When ID is sufficiently severe,
the hemoglobin (Hb) concentration in the blood decreases, leading to
iron deficiency anemia (IDA),A substantial proportion of women,
enter pregnancy with inadequate iron stores and are at increased risk
of developing IDA during pregnancy..
• The aim of this cross-sectional study, in a random sample of non-
pregnant women from an agriculture-based urban community in
Nepal, was to determine the prevalence of anemia and ID.
Furthermore, we also estimated the intake of iron and identified the
main dietary sources of iron.
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17. Critical Appraisal of Introduction
• It provides the background of the study
• It explains why the study is needed
• It has relevant literature regarding the topic
• All the citations are followed with correct references
• The final paragraph states the aim/objective of the study
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18. Materials and methods
• Study area: Bhaktapur, urban area
• Study population: Non-pregnant women aged 13-35 years.
• Study design: Cross-sectional study
• Sample size: 500 women
• Sampling method: Cluster random sampling
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19. Materials and methods
• Blood sampling and storage: The blood samples are analyzed at
theLaboratory of Clinical Biochemistry, Norway. Behring
Nephelometer Analyzer II , immunoassay in a Roche/Hitachi Modular
Analyzer, Micronutrient-free heparinized polypropylene tubes.
• Techniques: 24 hr dietary recall, Indian food tables from the Wfood2
program version 1.0 (WorldFood, 1996)
• Tools: Weighing machine, UNICEF electronic scale (SECA,
Hamburg, Germany) with an accuracy of 100 g and A locally made
height board measured height to the nearest 0.1 cm.
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20. Materials and methods
• Software used: Stata, version 8 and statistical software R version
1.9.0
• Inclusion criteria: Women aged 13–35 years ,non-pregnant, without
any ongoing disease, who lived in Bhaktapur municipality, and who
gave informed consent.
• Exclusion criteria: Women with acute or chronic illness and those
taking vitamins, minerals or drugs (with the exception of contraceptive
pills or injections)
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21. 12/10/2020 Seema B.K. 21

22. Critical Appraisal of Materials and Methods
• Study population was defined as reproductive aged women in the title
but only 13-35 aged women were taken.
• The time period of the study is not mentioned.
• The temperature of blood samples were maintained until transferring
to next country.
• Every materials and method used were properly explained.
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23. Critical Appraisal of Materials and Methods
• The NHRC and the Human Research Ethical Committee of the
Medical Faculty at the University of Bergen, Norway approved the
study and International Ethical Guidelines for research involving
human subjects, as stated in the latest version of the Helsinki
Declaration was implemented.
• Exclusion and inclusion criteria are defined.
• All the study variables are operationally defined, logical and
measurable.
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24. Results
The prevalence of anemia was 12%
The prevalence of depleted iron stores was 20%
The prevalence of iron deficiency anemia was 6%
54% of the women ate less than the recommended average intake of iron.
Out of 379 women, 76% of the had energy intakes less than the
recommended dietary allowances of 2200 Kcal
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25. Results
• Women who were 18-35 years of age using Depo-Provera
contraceptives was associated with a substantially higher Hb
concentration.
• Women with parity of ≥ 2 also had higher mean Hb concentration than
the nulliparous women.
• Women working in CF had a substantially lower mean Hb
concentration than the local resident women
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26. Results
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27. Critical Appraisal of Results
Results are presented in an easy way via. Tables, figures and graphs
All of the results are not shown.
Tables, figure and graphs are clear, understandable, numbered and titled.
The tables shows descriptive as well as inferential data.
Not all sample population was taken for 2 hr dietary recall
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28. Discussion
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29. Critical Appraisal of Discussion
• The authors had discussed other studies that both support and
contradicts their findings
• Discussions was made according to analyzed data
• New research questions had arise
• Author’s had discussed about the limitations of the study.
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30. Conclusion
Conclusion: The prevalence of anemia in our study was substantially
lower than the national figure for non-pregnant women. Only about half
of the women with anemia were also having depleted iron stores,
suggesting that other causes of anemia may be prevalent in this
population.
• What are the recommendations?
Authors suggest that other causes of anemia may be prevalent in this
population.
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31. Critical Appraisal of Conclusion
• Conclusions are based on data and analysis
• It reflects the objective of the study
• It suggests about other factors may had prevalent which influence the
result.
• Conclusion can be believed as far methods are concerned.
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32. References
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33. Critical Appraisal of References
• References are cited as per the recommended guidelines by the journal
• References are relevant and easily accessible through internet.
• References are in the Vancouver style recommended by the journal.
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34. Strengths
• Article was published and cited by various authors.
• Ethical guidelines were maintained for involving human subjects.Informed
consent were taken from participants.
• Field workers were trained before taking interview.
• Sponsorship and acknowledgement are discussed.
• Author’s had suggested about other factors which may alter the results.
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35. Weaknesses
• 13-35 yrs. of women were participants but the title says reproductive
age women
• Migration of study population during 24 hour dietary recall.
• Excluded women with acute or chronic illness, those taking vitamins,
minerals or drugs
• Article did not had new findings different from previous ones.
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36. Overall significance of the article
• Findings believable?
Findings were lower to the national estimate as the study population
was apparently healthy women, living in an urban area.
• New finding
Findings shows that IDA accounted only about half of the total
anemia; therefore, other causes are likely to be important in the
development of anemia in this population.
• Contribution to the scientific society
The use of Hb measurement as a proxy for ID and IDA clearly
underestimates other causes of anemia
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37. Overall significance of the article
• Evidence generated
Evidence generated about prevalence of iron deficiency , iron
deficiency anemia and association between iron markers and iron
status.
• Generalizability of article
This result of the article can be applied to other studies. Since,the
sample size is 500 women, it may be applicable to larger population.
• New research question generated
Yes, for example: what are factors contributing to anemia?
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38. Contribution to my research
• My research title - ‘Assessment of household food security and dietary
diversity among undergraduates of Pokhara,Nepal’
• The article will help in better understanding of the methods and
materials used.
• The article can be helpful in my literature review.
• The references used in this article helps in my research.
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39. Questions?
Quarries?
Suggestions?
Feedbacks?
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40. Thank You!
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