Dr. Obumneke Amadi-Onuoha Scripts- 10_comparative effectiveness
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The document discusses issues that a principal investigator leading a clinical trial may encounter, even without experience in clinical trials. Some potential issues include recruitment failure if the target patient population is too rare or not properly surveyed initially. Another issue is costs exceeding the study budget. Poor patient compliance or prognosis can also impact the study if many patients need to be excluded. Maintaining patient retention and follow-up is also important to avoid biased results from patients dropping out.
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184 Deutsches Ärzteblatt International⏐⏐Dtsch Arztebl Int 2009.docx
184 Deutsches Ärzteblatt International⏐⏐Dtsch Arztebl Int 2009; 106(11): 184–9
M E D I C I N E
M edical research studies can be split into fivephases—planning, performance, documenta-
tion, analysis, and publication (1, 2). Aside from finan-
cial, organizational, logistical and personnel questions,
scientific study design is the most important aspect of
study planning. The significance of study design for
subsequent quality, the relability of the conclusions,
and the ability to publish a study are often underestimated
(1). Long before the volunteers are recruited, the study
design has set the points for fulfilling the study objec-
tives. In contrast to errors in the statistical evaluation,
errors in design cannot be corrected after the study has
been completed. This is why the study design must be
laid down carefully before starting and specified in the
study protocol.
The term "study design" is not used consistently in
the scientific literature. The term is often restricted to
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the question to be answered, the study population, the
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nique, and the calculation of sample size—, on the
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ture and our own expertise. This is intended to help
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cations. Those who plan to perform their own studies
must occupy themselves intensively with the issue of
study design.
Question to be answered
The question to be answered by the research is of
decisive importance for study planning. The research
worker must be clear about the objectives. He must
think very carefully about the question(s) to be
answered by the study. This question must be opera-
tionalized, meaning that it must be converted into a
measurable and evaluable form. This demands an
adequate design and suitable measurement parameters.
A distinction must be made between the main questions
to be answered and secondary questions. The result of
the study should be that open questions are answered
R E V I E W A RT I C L E
Study Design in Medical Research
Part 2 of a Series on the Evaluation of Scientific Publications
Bernd Röhrig, Jean-Baptist du Prel, Maria Blettner
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a medical study are determined to a major extent by the
study design. Errors in study design cannot be corrected
afterwards. Various aspects of study design are discussed
in this article.
Methods: Six essential considerations in the planning and
evaluation of medical research studies are presented and
discussed in the light.
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184 Deutsches Ärzteblatt International⏐⏐Dtsch Arztebl Int 2009.docx
184 Deutsches Ärzteblatt International⏐⏐Dtsch Arztebl Int 2009; 106(11): 184–9
M E D I C I N E
M edical research studies can be split into fivephases—planning, performance, documenta-
tion, analysis, and publication (1, 2). Aside from finan-
cial, organizational, logistical and personnel questions,
scientific study design is the most important aspect of
study planning. The significance of study design for
subsequent quality, the relability of the conclusions,
and the ability to publish a study are often underestimated
(1). Long before the volunteers are recruited, the study
design has set the points for fulfilling the study objec-
tives. In contrast to errors in the statistical evaluation,
errors in design cannot be corrected after the study has
been completed. This is why the study design must be
laid down carefully before starting and specified in the
study protocol.
The term "study design" is not used consistently in
the scientific literature. The term is often restricted to
the use of a suitable type of study. However, the term
can also mean the overall plan for all procedures in-
volved in the study. If a study is properly planned, the
factors which distort or bias the result of a test procedure
can be minimized (3, 4). We will use the term in a
comprehensive sense in the present article. This will
deal with the following six aspects of study design:
the question to be answered, the study population, the
type of study, the unit of analysis, the measuring tech-
nique, and the calculation of sample size—, on the
basis of selected articles from the international litera-
ture and our own expertise. This is intended to help
the reader to classify and evaluate the results in publi-
cations. Those who plan to perform their own studies
must occupy themselves intensively with the issue of
study design.
Question to be answered
The question to be answered by the research is of
decisive importance for study planning. The research
worker must be clear about the objectives. He must
think very carefully about the question(s) to be
answered by the study. This question must be opera-
tionalized, meaning that it must be converted into a
measurable and evaluable form. This demands an
adequate design and suitable measurement parameters.
A distinction must be made between the main questions
to be answered and secondary questions. The result of
the study should be that open questions are answered
R E V I E W A RT I C L E
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Part 2 of a Series on the Evaluation of Scientific Publications
Bernd Röhrig, Jean-Baptist du Prel, Maria Blettner
SUMMARY
Background: The scientific value and informativeness of
a medical study are determined to a major extent by the
study design. Errors in study design cannot be corrected
afterwards. Various aspects of study design are discussed
in this article.
Methods: Six essential considerations in the planning and
evaluation of medical research studies are presented and
discussed in the light.
Overview of Diffrent types of studies in clinical research.pptx
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Research studies show thatevidence-based practice(EBP) leads t.docx
Research studies show thatevidence-based practice(EBP) leads to higher qual-
ity care, improved patient out-
comes, reduced costs, and greater
nurse satisfaction than traditional
approaches to care.1-5 Despite
these favorable findings, many
nurses remain inconsistent in their
implementation of evidence-based
care. Moreover, some nurses,
whose education predates the in-
clusion of EBP in the nursing cur-
riculum, still lack the computer
and Internet search skills neces-
sary to implement these practices.
As a result, misconceptions about
EBP—that it’s too difficult or too
time-consuming—continue to
flourish.
In the first article in this series
(“Igniting a Spirit of Inquiry: An
Essential Foundation for Evidence-
Based Practice,” November 2009),
we described EBP as a problem-
solving approach to the delivery
of health care that integrates the
best evidence from well-designed
studies and patient care data,
and combines it with patient
preferences and values and nurse
expertise. We also addressed the
contribution of EBP to improved
care and patient outcomes, de-
scribed barriers to EBP as well as
factors facilitating its implementa-
tion, and discussed strategies for
igniting a spirit of inquiry in clin-
ical practice, which is the founda-
tion of EBP, referred to as Step
Zero. (Editor’s note: although
EBP has seven steps, they are
numbered zero to six.) In this
article, we offer a brief overview
of the multistep EBP process.
Future articles will elaborate on
each of the EBP steps, using
the context provided by the
Case Scenario for EBP: Rapid
Response Teams.
Step Zero: Cultivate a spirit of
inquiry. If you’ve been following
this series, you may have already
started asking the kinds of ques-
tions that lay the groundwork
for EBP, for example: in patients
with head injuries, how does
supine positioning compared
with elevating the head of the
bed 30 degrees affect intracranial
pressure? Or, in patients with
supraventricular tachycardia,
how does administering the
!-blocker metoprolol (Lopressor,
Toprol-XL) compared with ad-
ministering no medicine affect
By Bernadette Mazurek Melnyk, PhD,
RN, CPNP/PMHNP, FNAP, FAAN,
Ellen Fineout-Overholt, PhD, RN,
FNAP, FAAN, Susan B. Stillwell, DNP,
RN, CNE, and Kathleen M.
Williamson, PhD, RN
The Seven Steps of Evidence-Based Practice
Following this progressive, sequential approach will lead
to improved health care and patient outcomes.
This is the second article in a new series from the Arizona State University College of Nursing and Health Innova-
tion’s Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving
approach to the delivery of health care that integrates the best evidence from studies and patient care data with clini-
cian expertise and patient preferences and values. When delivered in a context of caring and in a supportive organi-
zational culture, the highest quality of care and best patient outcomes can be achieved.
The purpose of this s ...
18Falls in The Long-Term Care SettingsNayaris Reye
1
8
Falls in The Long-Term Care Settings
Nayaris Reyes
Florida National University
June 12, 2021
Brief Literature Review
The elderly in the long-term care facilities are typically predisposed to falling and might fall for various reasons. Some predisposing factors might be related to unsteady balance and gait, poor vision, weak muscles, dementia, and medications. In addition, various medical conditions, including stroke, low blood pressure, brain disorders, and poorly managed epilepsy, might increase older people's risk for falls (Golmakani et al., 2014). Therefore, several studies have been conducted to evaluate the efficacy of multi-factorial interventions on the occurrence of falls in long-term care settings, including psycho-geriatric nursing home patients. Based on the clinical study, it was concluded that various multi-factorial interventions used in preventing falls such as a general medical assessment emphasizing falls, specific fall risk evaluation devices, assessing medication intake, fall history, and mobility, using protective and assistive aids play a significant role in reducing the incidence of falls among the elderly (Ungar et al., 2013). Accordingly, it was evident that fall prevention, usually geared towards psycho-geriatric patients in a long-term care facility, is possible and efficient in minimizing falls among older people.
Other researchers carried out a study in developing a fall prevention program for the aged patients in long-term care entities, especially those at risk of falling, by increasing caregiving expertise or skills and motivating staff members. From the analysis, exercise programs encompassing warm-up, muscle reinforcement, especially in the lower extremities, and proprioceptive neuromuscular expedition are used in increasing motivation and caregiving skills (Donath et al., 2016). Another research conducted to evaluate the statistics of falls among the elderly found out that falls are the leading cause of injury-interrelated visits to emergency facilities in the U.S. They are also the primary etiology of accidental deaths in persons aged 60 and above. From the analysis, falls might be markers of diminishing function and poor health and are significantly attributable to morbidity.
To assess the risk factors related with falls among the older people in the long-term care facilities, it was realized that more than 25% of facility-dwelling older individuals and 60% of nursing home residents fall yearly (Pfortmueller et al., 2014). Various risk factors linked to their falls are medication use, increasing age, sensory deficits, and cognitive impairment. Studies depict that older persons who have fallen must undergo a thorough clinical evaluation (within the facilities) to analyze the preventive strategies further. This will aid in determining and treating the underlying cause of their falls, return them to baseline function, and minimize the likelihood of recurrent falls (Karlsson et al., 20 ...
Running head CRITIQUE QUANTITATIVE, QUALITATIVE, OR MIXED METHODS.docx
Running head: CRITIQUE QUANTITATIVE, QUALITATIVE, OR MIXED METHODS DESIGN
5
CRITIQUE OF QUANTITATIVE, QUALITATIVE, OR MIXED METHODS DESIGN
Critiquing Quantitative, Qualitative, or Mixed Methods Studies
Adenike George
Walden University
NURS 6052: Essentials of Evidence-Based Practice
April 11, 2019
Critique of Quantitative, Qualitative, or Mixed Method Design
Both quantitative and qualitative methods play a pivotal role in nursing research. Qualitative research helps nurses and other healthcare workers to understand the experiences of the patients on health and illness. Quantitative data allows researchers to use an accurate approach in data collection and analysis. When using quantitative techniques, data can be analyzed using either descriptive statistics or inferential statistics which allows the researchers to derive important facts like demographics, preference trends, and differences between the groups. The paper comprehensively critiques quantitative and quantitative techniques of research. Furthermore, the author will also give reasons as to why qualitative methods should be regarded as scientific.
The overall value of quantitative and Qualitative Research
Quantitative studies allow the researchers to present data in terms of numbers. Since data is in numeric form, researchers can apply statistical techniques in analyzing it. These include descriptive statistics like mean, mode, median, standard deviation and inferential statistics such as ANOVA, t-tests, correlation and regression analysis. Statistical analysis allows us to derive important facts from data such as preference trends, demographics, and differences between groups. For instance, by conducting a mixed methods study to determine the feeding experiences of infants among teen mothers in North Carolina, Tucker and colleagues were able to compare breastfeeding trends among various population groups. The multiple groups compared were likely to initiate breastfeeding as follows: Hispanic teens 89%, Black American teens 41%, and White teens 52% (Tucker et al., 2011).
The high strength of quantitative analysis lies in providing data that is descriptive. The descriptive statistics helps us to capture a snapshot of the population. When analyzed appropriate, the descriptive data enables us to make general conclusions concerning the population. For instance, through detailed data analysis, Tucker and co-researchers were able to observe that there were a large number of adolescents who ceased breastfeeding within the first month drawing the need for nurses to conduct individualized follow-ups the early days after hospital discharge. These follow-ups would significantly assist in addressing the conventional technical problems and offer support in managing back to school transition (Tucker et al., 2011).
Qualitative research allows researchers to determine the client’s perspective on healthcare. It enables researchers to observe certain behaviors and experiences amo.
Family Practice© Oxford University Press 1996Vol. 13, No.docx
Family Practice
© Oxford University Press 1996
Vol. 13, No. 6
Printed in Great Britain
Sampling for qualitative research
Martin N Marshall
Marshall, MN. Sampling for qualitative research. Family Practice 1996; 13: 522-525.
The probability sampling techniques used for quantitative studies are rarely appropriate
when conducting qualitative research. This article considers and explains the differences
between the two approaches and describes three broad categories of naturalistic sampling:
convenience, judgement and theoretical models. The principles are illustrated with practical
examples from the author's own research.
Keyword. Qualitative sampling.
Introduction
The benefits of a qualitative approach to health care
research are becoming increasingly recognized by both
academics and clinicians, but misunderstandings about
the philosophical basis and the methodological approach
remain. The impression is sometimes given that
qualitative research differs from the hypothetico-
deductive model simply in terms of the way that data
is collected. The process of sampling is one of the prin-
cipal areas of confusion, a problem not helped by the
inadequate way that it is covered in the literature, where
there is little agreement on definitions and authors fre-
quently invent new and complex terms which cloud
simple fundamental issues. In this article I will describe
both quantitative and qualitative methods of sampling
and consider the basic differences between the two
approaches in order to explain why the sampling tech-
niques used are not transferable. I will consider issues
relating to sample size and selection in qualitative
research and illustrate the principles with practical
examples.
Quantitative sampling
Choosing a study sample is an important step in any
research project since it is rarely practical, efficient or
ethical to study whole populations. The aim of all quan-
titative sampling approaches is to draw a representative
sample from the population, so that the results of
studying the sample can then be generalized back to
the population. The selection of an appropriate method
depends upon the aim of the study. Sometimes less
rigorous methods may be acceptable, such as incidental
or quota samples, but these methods do not guarantee
Received 30 May 1996; Accepted 15 July 1996.
Institute of General Practice, University of Exeter, Postgraduate
Medical School, Barrack Road, Exeter EX2 5DW, UK.
a representative sample. The most common approach
is to use random, or probability samples. In a random
sample the nature of the population is defined and all
members have an equal chance of selection. Stratified
random sampling and area sampling are variants of
random sampling, which allow subgroups to be studied
in greater detail.
The size of the sample is determined by the optimum
number necessary to enable valid inferences to be made
about the population. The larger the sample size, the
smaller the chance of a random sampling error, but since
t ...
Statistical methods for cardiovascular researchers
Statistical Methods for Cardiovascular Researchers
An overview of clinical research the lay of the land
kbtt ugvubni unnuguy uyvnuin btvuyb uhbnku jhnniun
Running head PLANNING STAGE 2-(DESIGN PHASE) OF A RESEARCH PROJEC.docx
Running head: PLANNING STAGE 2-(DESIGN PHASE) OF A RESEARCH PROJECT 1
PLANNING STAGE 2- (DESIGN PHASE) OF A RESEARCH PROJECT 8
Planning Stage 2- (Design Phase) of a Research Project
Student name
Florida National University
Planning Stage 2- (Design Phase) of a Research Project
Heart failure is one of the most common types of chronic conditions among the elderly, which results into increased readmissions globally. This statistic is attributable to poor coordination and communication in the transition care settings. The various care settings include skilled nursing facilities, acute-care hospitals, long-standing care facilities and ambulatory stay (Naylor et al., 2017). This research paper is aimed at investigating the reason for poor continuity of care in transition care facilities. A detailed literature review was performed regarding the standard of care in such settings for patients with heart failure. The research methodologies used include case study methods, interviews, and administration of questionnaires. Probability and non-probability methods including stratified sampling and convenience sampling were used as the sampling methodologies. The necessary tools for data collection include questionnaires, interviews, schedules and observation techniques. In addition, an algorithm was created during this design phase. Thus, an insight into the design phase is sought and discussed herein.
Literature Review
Heart failure is a prolonged condition that has been highlighted as one of the top causes of public health complications in the world. The American Journal of Accountable care provides detailed information on heart failure as a public health problem. According to this journal, there are numerous causes of readmission of patients undergoing the transition care model (A Literature Review of Heart Failure Transitional Care Interventions, 2019). The journal highlights various issues, such as early discharge, poor management of underlying problems, poor coordination among key stakeholders and early discharge of patients as the major causes of readmission. All such issues can, however, be prevented and thus this research will discuss some of the coping methods. In addition, the US medical beneficiaries discuss the quality and safety in the transition care model (Teno et al. , 2018). Some of the beneficiaries state their experiences following being admitted into the transition care model. This article complements the previous article by adding real life case study analysis of patients who have been previously admitted to the transition care. Further, interviews of clinicians working in the transition care model are highlighted with an explanation of failure to conduct follow up visits of particular patients.
The American Journal of Public Health explores the affordability of the transition care and the quality of care that some patients can be able to afford. The article has explored the ...
Reply DB5 w9 researchReply discussion boards 1-jauregui.docx
Reply DB5 w9 research
Reply discussion boards
1-jauregui
Discuss how the quantitative and qualitative data would complement one another and add strength to the study.
Evidently, the use of EBP in healthcare mostly relies on the available qualitative and quantitative data which is supported by scientific or clinical research. In studying the EBP, quantitative data is used to enhance qualitative information and vice versa, because one method complements the other one (Tappen, 2015, p.88). For example, in the selected article the EBP about beliefs and behaviors of nurses showed that the number of the nurses who were certified vs. nurses who were not certified explained why some of the nurses have higher perceived EBP implementation than others (Eaton, Meins, Mitchell, Voss, & Doorenbos, 2015, “Evidence-Based Practice Beliefs and Behaviors”). Quantitative data would improve the study by providing evidence in the form of numbers or amounts such as the scores which show the proficiency of nurses in different areas (Eaton, Meins, Mitchell, Voss, & Doorenbos, 2015, “Evidence-Based Practice Beliefs and Behaviors”). Quantitative data could strengthen the study by providing more detailed information about EBP implementation which will explain certain trends and occurrences as found in the research.
2- rosquete
The qualitative research is exploratory/ descriptive and emphasizes the importance of subjects frame to be referenced and the context of the study. The research will be more concerned with the truth perceived by informants and less concerned with the truth of the objectives. The information from this research will be important in understanding the informants’ behaviors in details. The description of this approach will be used to get the picture and the opinion of nursing caregivers on the use of CNS depressants by the elderly (Susan, Nancy, & Jennifer, 2013).
The method that is used is explorative/descriptive. The strengths of the descriptive method are: effective to analyze non-quantified subjects and issues, the possibility to observe the phenomenon in a natural environment, the opportunity to use qualitative and quantitative method together, and less time consuming than quantitative studies. In the case of exploratory studies, the principal advantage is the flexibility and adaptability to change and it is effective in laying the groundwork that guides to future research. We can find disadvantages in this kind of studies. For example, descriptive studies cannot test or verify the research problem statically, the majority of descriptive studies are not repeatable due to their observational nature, and they are not helpful in identifying cause behind the described phenomenon. Another weak point, that includes exploratory research, is the interpretation of information is subject to bias. These type of studies make use a modest number of samples that may not represent the target population and they are not usually helpful in decision ma.
Evidence based medicine
This topic is very essential for Pharm.D students. It includes application, benefits, limitations of EBM. It also includes EBM history and background which helps you for examinations. EBM is very important topic in Pharmacotherapeutics-III so you may find this needful.
All the best!!!
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Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
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Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
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Describe the primary categories of smells and the concept of odor blindness.
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Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
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Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
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Olfactory Genes:
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400 genes for odorant receptors.
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- 1. Dr. Obumneke Amadi-Onuoha_Scripts_ 10 Clinical Investigation_CRA Study Monitoring Clinical trial as is known is a research investigation that involves people(human subjects). I have no experience with clinical trail investigations, I believe there are diverse issues that principal investigators(PI) will encounter leading a clinical trial, moreover, most clinical trails with knowledge are lead by a doctor as the PI that prepares a protocol for the trail. Thou, am not a doctor, I can also be a PI leading a clinical trial based on my academic credentials but work in collaborations with, and supervised by a doctor, therefore the issues that I can foresee taking on this lead for a clinical trail may include: recruitment failure, either because of inadequate organization from poor survey of problem studied, the patients of interest and trail site. If target patients are so rare it will make it impracticable to recruit the required sample for the study, thus, the need for appropriate sample size for any research study is inevitable as it is the base to answer the study primary questions. Also, incurring cost may super exceed the budgeted cost thereby not matching the available funding received for the project. Consequent issues in poor compliance or overall prognosis from enrolled patients will lead to subjective exclusion that will impact the study on-going process ( Umscheid, Margolis, & Grossman,2011). In addition, as a PI, I foresee the issue of patient retention, from discontinuing participation in the trail, and loss of patient follow up therefore, it is important to analyze properly and account for subjects dropping out of the study to avoid biased result conclusions. Reference Umscheid, C. A., Margolis, D. J., & Grossman, C. E. (2011). Key concepts of clinical trials: a narrative review. Postgraduate medicine, 123(5), 194-204